Once Again No, Vaccines Did Not Harm Children in Mexico

A couple of weeks ago the autism-hating, anti-vaccine blog Age of Autism ran a story of vaccines killing and hospitalising several infants in Chiapas, Mexico during a routine immunisation programme.  As of this writing only one commenter linked to a news story of possible bacterial contamination and the author of the blog post hasn't even bothered to issue a correction.

However, Orac in his usual Respectful Insolence style correctly urged patience for the investigation to conclude and that bacterial contamination was a more likely explanation.  Well that investigation has concluded and it was a bacterial source but not from the vaccines themselves but rather externally during handling and administration:

• Although no hypothesis is not rejected, the only vaccine given in common to all children affected was that of Hepatitis B, so the research focused on the biological.
• The batch of the vaccine was properly certified.
• No adverse events were recorded after 100,000 doses were administered in various parts of the country since Oct. 2014.
• Results of blood cultures at that time showed the presence of the local external contamination, outside the biological vaccine, in particular bacteria, which was consistent with the clinical pictures of hospitalized children. Microbiology studies conducted on children reported the finding of Staphylococcus hominis, a type of bacterium commonly found in the skin of people. These findings rule out other bacteria, such as those found in the gastrointestinal tract and airways. Molecular studies demonstrated that isolated Staphylococcus hominis in different patients was the same, namely that the bacteria came from a single source of contamination.
• In conclusion, the Federal Commission for Protection Against Health Risks (COFEPRIS) analysis found that the vaccine was not defective and remained in temperature. Therefore, bacterial contamination occurred during the procedure of handling and application of the vaccine.  

While the conclusion that the vaccines were manufactured and stored properly can help establish confidence in vaccine programmes, two infants are dead and dozens were hospitalised due to improper handling of the vaccines.  This tragic result emphasises the need for more rigorous training of personnel administering any medications.  This was an avoidable error and the focus should be on that, not vaccinesdidit.

Disneyland Measles Outbreak is Due to Measles

The current measles outbreak primarily emanating from Disneyland in California is up to 100 cases but not all are epidemiologically-linked to the Disneyland outbreak.  As is usual with measles outbreaks, most were completely unvaccinated, some were too young to be vaccinated.  There are numerous articles highlighting this well-known fact and that has anti-vaxxers on the defensive.  In fact, this screed by Laura Hayes appeared on the anti-vaxx, autism-hating blog Age of Autism:

1.  Has there been any laboratory confirmation of even one case of the supposed measles related to Disneyland?  If yes, was the confirmed case tested to determine whether it was wild-type measles or vaccine-strain measles?  If not, why not?  These are important questions to ask. Is it measles or not? If yes, what kind, because if it's vaccine-strain measles, then that means it is the vaccinated who are contagious and spreading measles resulting in what the media likes to label "outbreaks" to create panic (strange how they've completely missed the Autism outbreak going on for the past 25 years). It would be what one might call vaccine fallout.  People who receive live-virus vaccines, such as the MMR, can then shed that live virus, for up to many weeks...and can infect others.  Multiply that in your head by all of the people who receive not only the MMR live-virus vaccine, but many others. Other live-virus vaccines include the nasal flu vaccine, shingles vaccine rotavirus vaccine, chicken pox vaccine, and yellow fever vaccine.

That's right, apparently Laura Hayes is really good at asking the really dumb questions but not too adept at finding the answer before postulating what measles strain is circulating amongst those infected.  Hint: it isn't the vaccine strain.  This wasn't hard to find and is very specific about the genotypes:

Measles genotype information was available from 9 measles cases; all were genotype B3 and all sequences linked to this outbreak are identical. The sequences are also identical to the genotype B3 virus that caused a large outbreak in the Philippines in 2014. During the last 6 months, identical genotype B3 viruses were also detected in at least 14 countries and at least 6 U.S. states, not including those linked to the current outbreak.

And even more information regarding the differences in wild-type strains and vaccine-strains can be found here:

Genetic Characterization and Sequencing

Wild-type measles viruses have been divided into distinct genetic groups, referred to as genotypes, based on the nucleotide sequences of their hemagglutinin (H) and nucleoprotein (N) genes, which are the most variable genes on the viral genome.

The 450 nucleotides encoding the carboxy-terminal 150 amino acids of the nucleoprotein has up to 12% nucleotide variation between genotypes. The 450 nucleotides that encode the carboxy-terminal region of the nucleoprotein (N–450) are required for determination of the genotype. The measles genotyping protocol is available from CDC.

For each genotype, a reference strain is designated for use in genetic analysis (phylogenetic analysis), usually the earliest known virus isolation of that group. The means of referring to the genotypes has been standardized using alphabetical designations for the main groupings (clades). Within the main clades, numerals are added to identify the individual genotypes.
The following 19 genotypes have been detected since 1990:

A*, B2, B3, C1, C2, D2, D3, D4, D5, D6, D7, D8, D9, D10, D11, G2, G3, H1, H2

*Vaccine strains Moraten, Edmonston, Zagreb are all genotype A.

 There were 2 putative wild-type cases of measles identified as genotype A in 2008.

During 2011, 8 genotypes were identified by global surveillance:
B2, B3, D4, D8, D9, D11, G3, H1

Gosh that was simple.  Laura Hayes asks a lot more dumb questions and fills in the answers with her own fact-free assertions but there is too much stupid and not enough time to take them apart.  The important point here is that measles outbreaks are caused by measles viruses (not vaccine-strain) and a critical mass of anti-vaxxers clustering and causing large gaps in herd immunity. 

Wakefraud: A New Internet Meme is Born

Last week, Andrew Jeremy Wakefield did not like a blogpost on Forbes by Emily Willingham and penned a whiny threat of legal action against her.  His threat appeared on the autism crank blog Age of Autism whose readership consists mainly of rabid anti-vaxx parents of autistic children who hate Emily Willingham with a white-hot passion.  It was a most calculated move by Wakefield as Penumbrage opines:

So why is he doing it? My best guess is that he has issued this threat and published it on Age of Autism to rally the troops and revitalize his flagging support. And why is he doing it to Ms Willingham? Perhaps he thinks she is more vulnerable than CNN or Time Magazine. Maybe he hoped that Forbes would take the corporate view and silence her to fend off a potential troublesome lawsuit. Not for the first time he has been proven wrong. Ms Willingham is an eminent scientist, an educator and an accomplished journalist. Forbes recognize her talent and show no signs of surrendering to Wakefield’s bluster.

Today, Harpocrates Speaks published a hilarious post describing the "Wakefraud".

The sun set long ago, and outside, the world sleeps. Only the occasional passing car breaks the tranquility of the night. Inside, a lone figure sits before a laptop. The lamp on the desk sheds a soft, if weak, light, nearly drowned out itself by the cold illumination of the monitor. The figure's fingers tap out a few final strokes, then move to the mouse. She drags the cursor across the screen and clicks "Publish". A sudden flash of lightning and thunder, then the room goes dark.

A low, quiet chuckle filters out of the laptop as the screen fitfully flickers back to life. On the screen, four words shed an ominous, baleful glow:

The Wakefraud had struck.

Read both Penumbrage and Harpocrates Speaks for more excellent commentary about the Wakefraud.  Wakefield wanted some publicity and attention, well he's got it.

Jake Crosby Throws Fellow Anti-Vaxxers Under the Bus

Anyone following anti-vaccine groups like Age of Autism (AoA), Generation Rescue and SafeMinds (they are really comprised of the same group of core members who have set up multiple fronts in order to appear more numerous than they actually are) will know Jake Crosby, wonder boy "cub reporter" for AoA.

Last November (2012) there was a congressional hearing lead up by California Republican representative Darrell Issa.  Autism parent Brian Hooker revealed a series of meetings he had with rep. Issa and other congress critters.  Mr. Hooker was accompanied by Andrew Wakefield who wined and dined members of the oversight committee that would ultimately hear testimonies from anti-vaccine groups on the topic of autism.  The testimonies and speakers at this hearing has made Jake Crosby very angry and has posted his diatribe on none other than the Bolen Report.

The Cliff Notes version is that Jake has decided to slam his comrades-in-arms, particularly SafeMinds, because they chose to try and appear sane and rational (as sane and rational as one can be given that they believe vaccines cause autism) in front of the congressional committee by refusing to let Jake present his contorted conspiracy theories and instead letting Mark Blaxill speak and trimming Brian Hooker's screed down.  Jake's little hissy fit is a thing of beauty to read as it illustrates the mindset of anti-vaxxers and their slimy tactics to weasel their way onto a platform of legitimacy.

ETA: Since Liz Ditz was so kind to take screen shots of Jake's exposition, I'm including the link to her page here.   Jake recently "spoke" at the IACC public comment session (for a limited value of "spoke" since he launched into a predictably atrocious tirade) so to see him in action, the video is available here (138 minute mark).

Olmsted Can't Find SSPE Either

This past weekend, Age of Autism had their "Weekly Wrap" by Dan "The Amish don't have autism" Olmstead entitled, "Do MMR + Hg + SSPE = ASD?"  Dan Olmsted opines via Kathy Blanco that:

"I wonder whether autistic enterocolitis isn’t a kind of SSPE with a weakened (vaccine) virus," Kathy Blanco wrote in an e-mail this week, with a link to a blog post HERE  that reports: "Hidden government documents have revealed that leading professionals have had serious concerns about the safety of the single measles vaccines for many years. Secret government documents that have been under lock and key for thirty years have revealed that the UK government has known for many years that the single measles vaccine can cause the debilitating neurological disorder SSPE or Subacute Sclerosing Panencephalitis."

Whether "autism" is in effect a variant form of SSPE is well worth wondering.

Not worth wondering at all.  There is no variant of SSPE.  SSPE is subacute sclerosis panencephalitis and is a distinct diagnosis even though there are atypical cases.  SSPE is almost always fatal within about 3-7 years after a measles infection although cases that have occurred in adolescents and adults with aggressive treatment administered can remain alive for several more years although severely debilitated.

Olmsted and Blanco are relying upon the frantic hand-waving of Dr. Rebecca Carly, a bat-guano insane physician who lost her medical license for well, being bat-guano insane.  The symptoms and clinical course of SSPE are:

Subacute sclerosis panencephalitis (SSPE) is a persistent and chronic encephalitis secondary to measles virus infection that causes widespread demyelination of the central nervous system (CNS). (1) SSPE was described first by Dawson (2) in 1934, in an individual with rapidly progressive encephalitis. Later, in 1945, van Bogaert (3) described another individual with the same clinical presentation but in whom the disease exhibited a more
gradual course. The disease is so called because it typically develops over a period of less than 9 months (subacute), (4) because of the nature of the pathological lesions (sclerosis), and from the fact that the whole brain is affected (i.e. panencephalitis). (5–7)

The age at presentation is usually 8 to 11 years, (19,37,38) with onset usually occurring 6 years after measles infection. (6,19) Affected individuals present with poor school performance and progressive intellectual deterioration, personality changes, and behaviour abnormalities; this is followed by steady motor decline, myoclonus, focal paralysis, seizures, autonomic failure, and rigidity, finally leading to death with akinetic mutism. (5,16,19,38,39) These changes are characterized in four stages (see Table I). Motor regression is eventually seen in 100% of individuals with SSPE, cognitive decline in 86%, myoclonus in 74%, generalized seizures in 16%, and focal seizures in 10%. (16)

Does this sound like an ASD in any way?  Well of course not providing you are a rational and sane person.  In fact the differential diagnoses are: multiple sclerosis, acute demyelinating encephalomyelitis, Hashimoto’s encephalopathy, paraneoplastic limbic encephalitis, lafora disease, mitochondrial diseases and other rare neurodegenerative disorders. Olmsted and Blanco account for this disparity in symptoms between SSPE and ASDs with their usual torture of anything resembling a logical train of thought:

“At the level of the immune response, the newborn tends towards a TH2 response to pathogens and gradually shifts towards a TH1 response with age. If this transition does not take place appropriately, the infant is likely to be at greater risk of mounting aberrant immune responses in later life, as seen in patients with allergies. Given that, under normal circumstances the age of this transition will be different for different children, it seems inevitable that a ubiquitous viral exposure of all 15-month-old children could induce an immune response that is consistent with the individual dynamics of this TH2-TH1 transition.” (Wakefield AJ, and Montgomery SM. Autism, viral infection, measles-mumps-rubella vaccination. Israeli Med Ass J 1999;1:183-187 ).

Using their tortured "logic", wouldn't this create a clinical course worse than what is observed with SSPE?  But then again, these are people who believe that autism is a fate worse than death.  Furthermore, the epidemiology of SSPE is:

Overall, 4 to 11 cases of SSPE are expected for every 100 000 cases of measles, but the incidence is higher among children aged less than 5 years (18 ⁄ 100 000, compared with 1.1 ⁄ 100 000 after 5 years of age). (9) The highest incidence of SSPE relative to the rate of measles is reported in the Middle East, where the rate is 360 ⁄ 100 000 in individuals infected before 1 year of age. (11) The incidence varies dramatically depending on the age at which the measles infection is acquired and vaccination status. (8,11–13)

How does this explain their "autism epidemic"?  I can't help but wonder (for only a second though) why they chose to co-opt SSPE  when there are so many other disease presentations that they could more easily contrive to fit with their mental convolutions.  For instance, West Nile Virus or Herpes Simplex Virus-1 and 2 have more in common with features of some ASDs and have clinical courses they could more easily manipulate to fit with their paradigm but alas, there are no vaccines to blame so that wouldn't work.  Their basis for their "hypothesis" is hilariously inept:

The official concerns about the measles vaccine and SSPE Blanco cites go back to the early 1970s. But from the very earliest autism reports, there's been evidence that some kids were neurologically vulnerable to live virus vaccines -- perhaps because, as Blanco notes, they've been immunologically "set up" by early or simultaneous exposures to such toxins as mercury.

Actually the "official" concerns pre-date the 1970s but it isn't as though the AoA braintrusts are ever interested in facts.  Going back to Dr. Carly's "expose" she writes:

‘There has been some concern recently about the suggestion that measles vaccines might occasionally give rise to Subacute Sclerosing Panencephalitis. Professor Sir Charles Stuart-Harris, as chairman of the Joint Committee on Vaccination and Immunisation, has asked whether members of the Association would be prepared to notify cases we see.’

Note the words ‘might occasionally' which in my opinion, were specifically chosen to cover the fact that this was a growing problem.

This document, along with many others uncovered, means that the measles vaccination was proving problematic to the neurological well being of young children as far back as 1972. If this were the end of the matter, then it would be easy to assume that the problems had been overcome. However, the problem of vaccine-induced SSPE continued to persist even when the measles vaccination was combined with the mumps and the rubella vaccination to form the MMR triple vaccine.

No Dr. Carly, that's not what your not-so-secret document means.  There are several publications in the literature such as Schneck et al. 1968 and Payne et al. 1969 that implicated measles vaccine as the causative agent because there were no measles infection reported but measles vaccination was in temporal relationship to SSPE.  Public health officials, at that time, made a rational assumption that SSPE could be caused by measles vaccine virus since it is a live viral vaccine and cases of SSPE were being reported in the absence of a measles infection but in measles-vaccinated children.

Olmsted adds:

But is there anything that might suggest SSPE, like polio, could be a product of a co-factor interacting with the measles virus (or vaccine)? Well, here's something Mark and I came across: "Further Epidemiological Studies of Subacute Sclerosing Panencephalitis," by Detels et al., from The Lancet of July 7, 1973 (right around the same time the Brits were noticing SSPE could be an outcome of measles vaccination, as it happens).

This case-control study in various areas of the United States found that among 43 SSPE patients who had clinical measles, the median age at original infection was 15 months, whereas among controls who didn't have SSPE, the median age was 43 months. That matches exactly what Wakefield et al. were saying in that study Blanco sites -- "it seems inevitable that a ubiquitous viral exposure of all 15-month-old children could induce" an aberrant immune response. He was talking about the MMR, of course, which was originally given at 15 months but has since been moved forward to 12 months. But clearly, the risk of neurological problems from measles increases when the infection occurs earlier.

Here is the 1973 Lancet study he neglects to link to and what they really state:

Our data indicate that events accompanying measles infection differ between S.S.P.E. patients and controls. Measles occurred at a much younger age among patients, although their controls were selected as having been lifelong friends. Clinical measles did not occur in 11 patients, 6 of whom also did not receive measles vaccine. High measles-antibody titre was present in these patients and several had known intra-family exposure to measles at an early age. Presumably these patients had inapparent measles infection. It is probable that some of the cases with no clinical history of measles and in some with measles under age one, the infection occurred while there was partial immunity to this virus as a result of passively acquired maternal antibody. When the infection occurred the host response may have been incomplete, permitting the virus to persist in tissues.

Even then, investigators were beginning to understand that subclinical measles infections were occurring prior to onset of SSPE and that is why wild-type measles was suspected because some subjects weren't vaccinated and did have exposure to measles.   That doesn't stop Olmsted from abusing more information from this 40 year old study to suit his agenda.  Again from Detels et al:

Our data and those of others, however, indicate that unusual measles, while perhaps a necessary component, is not a sufficient explanation for the pathogenesis of S.S.P.E. S.S.P.E. is more common among males than females (though this was not striking in our series) and at a higher rate in non-urban settings. In urban inner-city areas where crowding is intense, the proportion of patients who are infected with measles below age one or concomitantly with chickenpox, might be expected to exceed the proportion in rural areas, so the rarity of S.S.P.E. patients in cities suggests that additional determinants play a key role.

This is what Olmsted somehow extracted from this excerpt:

They automatically turn toward other viral co-factors as a possibility, because these guys are virus hunters. But their observation -- SSPE as a largely rural phenomenon, strikingly absent in central urban areas -- also could point to toxic co-factors, such as pesticides. That's what we believe the rural character of the early poliomyelitis epidemics is pointing to. (The father of another of Kanner's early cases was a plant pathologist who spent most of his career in Puerto Rico, which shows the degree to which commercial agriculture, including chemically intensive coffee growing, occurs on that island.)

There is one viral co-factor in SSPE that seems quite clear: "Additional evidence that unusual circumstances accompany the measles infection was the significant excess of chickenpox associated with measles in SSPE patients. While this occurred in only 6 instances it is of note because of the relatively early age of clinical measles in patients versus controls, decreasing the likelihood of this sequence."

So atypically catching measles and chickenpox about the same time at 15 months is a big fat risk factor for setting up a persistent measles infection that results in a neurological catastrophe. If I were in charge of the U.S. vaccination schedule, I would have a bit of a breakdown over that fact.

However, they are all using information from over 40 years ago prior to the advent of molecular techniques that could distinguish viruses and better epidemiological surveillance to rule out confounding information.  And who in their right mind would be using decades old information that has been monumentally revised to dictate vaccine policy?  Right, an anti-vaxx wingnut. Why would they rely upon such dated information when there are so many more contemporary studies that employ molecular testing?  Simple.  They intentionally ignore these studies because they find the information inconvenient to their preposterous conjecture.

Let's take a look at some work that has been done in the last 40 years heck within the last seven years that completely refutes what Olmstead, Blanco and Carly prattle on about.  First, there appears to be an increased risk of SSPE among certain ethnicities although it hasn't been determined if there is a genetic pre-disposition associated with certain ethnic groups or whether the increased incidence of SSPE is due to socio-economic disparities. 

Ethnicity and genetic factors

There is evidence of ethnic differences, including increased risk associated with Hispanic and Asian ethnicity in the USA⁵⁹ and UK,²² respectively. A relatively low SSPE incidence was observed in black Americans.⁵⁵ One South African study reported distribution of cases by race roughly proportionate to the racial distribution in the population, but a measles incidence in black babies markedly higher than that for white infants.¹² Other South African studies calculated higher risks of SSPE in the ‘coloured’ (mixed race or of Indian/Sri Lankan origin) compared with the white population with lowest incidence in the black population.⁴⁷,^,66 In Israel, SSPE was reported almost exclusively in Sephardi Jews (of Afro-Asian origin) and Arabs, and not Ashkenazi Jews (of Euro-American origin).³¹ A later Israeli study found differences between Arabic and Jewish populations, but Sephardi and Ashkenazi Jews were not distinguished.¹⁰ Real ethnic differences may exist but this could reflect socio-economic circumstances that affect the likelihood of early measles exposure.

There is no strong evidence of a genetic factor associated with SSPE risk. Where cases have been reported in a twin, the condition has been discordant even in identical twins.⁶⁷ Familial aggregation has rarely been reported.⁶⁸,^,69 Two cases in two families have been observed in England and Wales. The probability of two families having more than one case by chance was calculated as under 1 in 10 000, suggesting some genetic tendency.⁸

There is also inconsistency among studies with regards to a male preponderance and in studies that do observe a male bias, may be due to differing latency between measles infection and onset of SSPE.  Olmsted tries to use this male preponderance as "proof" because of the male preponderance observed with ASD prevalence.  Of course he fails.

Age at onset and sex ratios

Worldwide average onset ages for SSPE ranged between 6 and 13 years, except Papua New Guinea at 4.9 years¹¹ (Table 1) and individual ages at onset ranged from 0 to 56 years in the papers reviewed. The average period from initial measles infection to SSPE symptom onset (latency) ranged between 4 and 10 years. A higher incidence has mainly been reported in boys (Table 1); the reason for this is not clear. However, data from South Africa (1984–90),¹² Japan (1999)¹³ and Papua New Guinea (1997–2000)¹⁴ indicated more equal distribution between the sexes.

An increase in age at onset once measles transmission has been greatly reduced or interrupted has been observed²²,^,49,58 together with an apparent lowering of male predominance in some countries.¹⁴,^,53,59 SSPE cases in Romania exceptionally moved to a slight female predominance.⁴² This suggestion of later onset in females is upheld by data from the SSPE Registry in England and Wales, based on 345 cases with onset between 1962 and 2005. The latency using only cases in whom age or date of measles infection was known n = 274, (and age at onset), in male cases had a different distribution to female cases (Figure 1), which was apparent before puberty. Females had a later age at SSPE onset (10.14 vs 12.21, P = 0.005 Kruskal–Wallis test) and a longer latency (8.32 vs 9.73, P = 0.03 Kruskal–Wallis test). Brazilian, US and South African data also supported the suggestion of later female onset.¹⁷,^,55,60 In two of three published adult onset case series, there were similar numbers of men and women (gender m/f 4/4⁶¹ and 7/6⁶²), in the third case series there was a male predominance (25/14).⁶³

And this section addresses Olmstead's wankery about co-infections and rural dwelling predominance:

Other factors

Rural dwelling has been reported as having a higher associated risk than urban dwelling,¹⁶,^{,36,49,53,64,52,65,70} but some studies have found no difference²³,^{,24,32,34,37,38,40,43,55,57} or, unusually, an urban excess.⁸ Animal or sick animal contact (more common in rural settings) has been a suggested risk,¹⁶,^{,18,20,54,64,70} but was not substantiated by other studies.⁴⁰,^,70 Close temporal association with another infection, either near the time of SSPE onset or initial measles infection, has also been reported¹⁶,^,31,64 as has an increased incidence of serious head injury in cases; though this may be due to early undiagnosed disease.⁸,^,42,39,54

Other suggested risk factors have included larger number of siblings and a later birth order (consistent with increased risk of early disease), lower socio-economic status and more crowded homes.⁸,^{,26,31,50,52,54} Uneven geographical distribution has been reported within countries, with a small number of very local clusters,⁴⁶,^,49,70 but no overall geographical pattern has emerged.

I saved the best for last though and could have actually just trotted this out in the beginning to completely demolish Olmstead's and Blanco's twaddle to save myself a lot of trouble but where's the fun in that?

Every SSPE biopsy sample submitted for molecular sequencing has always been wild-type virus and never vaccine strain measles virus.

6.4. Only wild-type virus sequences have been found in SSPE

The description of specific clades and genotypes of MV has allowed the evaluation of mutations found in the MV RNA sequences from SSPE brain material against wild-type (clades B–G) viruses. All the vaccine viruses are derived from the Edmonston strain (clade A) but no clade A virus has been found in SSPE brain material. The sequences found in SSPE brain are related to the wild-type viruses circulating at the time of initial infection of the child and not to those circulating at the time of onset of symptoms. Hence, the virus which initially infected the child, appears to persist and SSPE is not due to a super-infection by viruses circulating during the onset of symptoms (Jin et al., 2002) (Rima et al., 1995); Rota, personal communication). To the best of the authors’ knowledge no vaccine virus, genotype A, sequences have been obtained from SSPE cases. SSPE has been vastly reduced in incidence after successful control of measles by vaccination (Dyken et al., 1989). In contrast, vaccine strains have been identified in MV infections in immuno-compromised patients who died from MIBE (Bitnun et al., 1999) and giant cell pneumonia (Mawhinney et al., 1971).

Even in SSPE cases who did not have any reported measles disease but had measles vaccination, only wild-type measles strains were identified:

Although measles is a monotypic virus, 22 genotypes of wild-type virus are recognized; many genotypes have been associated with endemic circulation of measles virus in certain geographic regions or have been documented in connection with an outbreak or epidemic in an area [4, 5]. The measles vaccine virus strains belong to genotype A and can be distinguished from wild-type virus of the same genotype by means of sequence analysis [6 –8]. Analyses of measles virus sequences in brain tissue samples obtained from patients with SSPE have identified only wild-type measles virus, and the virus genotypes identified have been consistent with the genotype of measles virus that circulated in the area where the patients lived and to which the patients had been exposed ⩾10 years before the onset of symptoms of SSPE [6, 9 –13]. Genetic studies have supported epidemiologic evidence that measles vaccine virus does not cause SSPE [6, 14, 15]. In cases of SSPE that developed in children or adults who had no history of measles but who did have a history of vaccination against measles virus, analysis of measles virus sequences derived from the patients confirmed the presence of the wild-type genome, indicating that the individuals had an undiagnosed measles virus infection [6, 7, 9] 

To sum it up, the barmy trifecta of Olmsted, Blanco and Carly state that the measles vaccines are causing some kind of abhorrent SSPE masquerading as autism because some forty year old studies and super, (not so) secret meeting notes by public health officials who postulated that measles vaccines could cause SSPE.  That, in spite of hundreds of studies since that cannot find any association between measles vaccines and SSPE these dunderheads are doubling down on their deception to frighten people even more about vaccination in order to perpetuate their own delusion and to pay homage to their Saint Andy Wakefield.

Not only has MMR and measles vaccination reduced the incidence of SSPE and other measles encephalopathy, MMR vaccination also contains protection for congenital rubella syndrome which is well-documented to cause autism spectrum disorders.  We have a vaccine that prevents autism and other neuropathy and these dunderheads continue to try and find a way to discourage uptake.  Only in anti-vaxx land could this possibly make sense.

H1N1 Influenza Deaths in Children with Neurological Disorders and Anti-Vaxx Autism Groups Don't Care

This past Wednesday, 29 August 2012 a CDC press release, Children with Neurological Disorders at High Risk of Death from Flu was issued.  LeftBrain/RightBrain was the first I could see who relayed this information on 29 August 2012.  In the past couple of days, Disability Scoop, History of Vaccines,  Autism Science Foundation and a plethora of news outlets have reported this.  The original study can be found in the most recent edition of Pediatrics.

Of the 336 children (defined as people younger than 18 years) with information available on underlying medical conditions who were reported to have died from 2009 H1N1 flu-associated causes, 227 had one or more underlying health conditions. One hundred forty-six children (64 percent) had a neurologic disorder such as cerebral palsy, intellectual disability, or epilepsy. Of the children with neurologic disorders for whom information on vaccination status was available, only 21 (23 percent) had received the seasonal influenza vaccine and 2 (3 percent) were fully vaccinated for 2009 H1N1.

“We’ve known for some time that certain neurologic conditions can put children at high risk for serious complications from influenza,” said Dr. Lyn Finelli, chief of the surveillance and outbreak response team in CDC’s Influenza Division. “However, the high percentage of pediatric deaths associated with neurologic disorders that occurred during the 2009 H1N1 pandemic was a somber reminder of the harm that flu can cause to children with neurologic and neurodevelopmental disorders.”

Remarkably absent from reporting this are the "usual suspects" of anti-vaccine and autism crankery.  The National Vaccine Information Center (NVIC) has absolutely nothing mentioned about this finding.  This is an organisation that prides itself on "informed consent":

The National Vaccine Information Center (NVIC) is dedicated to the prevention of vaccine injuries and deaths through public education and to defending the informed consent ethic in medicine.

As an independent clearinghouse for information on diseases and vaccines, NVIC does not advocate for or against the use of vaccines. We support the availability of all preventive health care options, including vaccines, and the right of consumers to make educated, voluntary health care choices.

Emphasis added.  Yet not a single word about this study for parents of high risk children, in particular to make an informed choice.

Let's take a look at Dr. Joseph Mercola's website, the "alternative practitioner" who actively railed against the potential dangers of H1N1 influenza vaccination and vocally dissuaded his readers from getting the vaccine for themselves and their children no matter what.  Nope, not a word there either about this study.

Surely Dr. Bob Sears another proponent of "informed consent" for vaccines has something about this study.  He is after all a paediatrician and DAN! doctor who takes care of medically-fragile children.  One would think that this is very important information to share with his readers and patients.  Sixty-four percent of the H1N1-related deaths in 2009 were among children with cerebral palsy, intellectual disability, or epilepsy and only 3% were fully vaccinated for H1N1.  No, complete silence there too.  Except of course to register his outrage over California's AB2109 bill which requires informed consent before opting out of vaccines.  At least he is consistently against informed consent by not providing his own patients with any.  Dr. Sears also shares his extraordinary knowledge of H1N1 vaccines, vaccine testing and his ability to sling conspiracy theories around with the best of them. 

Another obvious place to look would be Dr. Jay Gordon's website since he is so terribly concerned with vaccines and vaccine-preventable diseases.   I would imagine that Dr. Jay also has medically-fragile children in his practice and would want their parents to know about how such underlying conditions can be risk factors for things like complications from flu.  No, nothing there either but he is certainly not shy about promoting his interview with Anderson Cooper and letting us know what a particular colour of poop means. Dr. Jay is also against AB2109.  Dr. Jay also had some truly brilliant insights regarding H1N1 pathology, vaccination and epidemiology.

This CDC press release was embargoed which essentially means that their media contact will pre-release it to certain parties in order for them to prepare a story for when the story is released.  It is considered really bad manners to break an embargo.  Needless to say, many anti-vaccine/autism groups have really bad manners and think nothing of breaking embargoes when it suits them.  One of the most egregious anti-vaccine/autism sites, Age of Autism not only minded the embargo but seems to have extended it by not mentioning a word of it.  The only "stories" there were the usual wailing and gnashing of teeth over genetics studies, conspiracy theories and how the IACC won't recommend study directives for vaccinesdidit.

This is clearly inconvenient information for those who take every opportunity to denigrate vaccines, lie about the true risks of vaccine-preventable diseases and vaccines or are just too dumb to disseminate factual information regarding vaccines and the diseases they can prevent.  The true believers will never be swayed and completely miss the point that there are medically-fragile children who are at a greater risk for disease complications and intentionally withholding this information by so-called autism and vaccine-safety organisations and healthcare practitioners is tantamount to lying.

Addendum 9.1.12:  Commenter lilady linked to Dr. Jay Gordon's views on H1N1 vaccines and disease shortly after H1N1 began circulating.  I added that and Dr. Bob Sears' views as well.  Thank you lilady; I now feel stupid for reading those.

An Open Letter to the Biomeddlers

I'm not going to couch this in the platitude, "I think you love your children but..." because I don't think you do.  That's right, I said it...

You don't love your children.

Sure you say you do, you go on about your sacrifices, how much money you spend "recovering" your children but you love you more and you may love the idea of the child you think is "trapped" inside but you don't love the child there in front of you.  You also lie about "us neurodiversity folks" who you say are just about accepting our children and having no hope.  False and you know it because it's been explained many times over.  Neurodiversity is about accepting your child as challenged or differently-abled but also providing the tools and treatments necessary to allow them to fulfil their potential and help them negotiate a neurotypical world.  It is the opposite of hopeless; we just don't treat our children as "stolen, souless shells who'll suck the life's marrow out of family members". And even though you'll try to defend this paraphrase as referring to autism, you can't because that's precisely what you see when you look at your children.

And neurodiversity folks aren't jealous of your "aspirations" and your "hope" and "recovery".  On the contrary, some pity your lack of empathy, your denial and your desperation but others, like me don't have it within to pity you any longer and see you for the inhumane, ignorant child abusers you are.  I don't think love is complicated at all, sure there are different kinds of love or different ways to love but reducing a child to a gruesome science experiment in the name of "recovery" isn't love, determination perhaps but your warped rationalisation for what you do to your children will never be love.  This ain't love:

Thank you for writing this article! We have been using MMS now for 3 weeks and have only seen positive results. I have to say the amount of worms and junk coming out of my son now is really what has convinced me to stay the course. Who knew our kids were harboring such horrific parasites inside their little bodies. I am one of the Moms who for the past seven years has seen multiple DAN docs, attended conferences, had $1000's of dollars of tests done and spent 10 times that on supplements and treatments. I cannot count the hours spent reading books and researching. I am please to say that almost every single thing we tried has been helpful in some way. Things that worked, like Chelations, TMG and vitamin support help my son to speak in 2 word utterances when he was 5, before that it was guteral sounds, finally be toilet trained at the age of 6, and to go on to make continual and significant recovery. Yasko and Enhansa helped hhim take the next step and today he is in 3rd grade, reading at grade level and talking in full sentences all the time. Just learned to ride a bike, is swimming, and even has a few friends. Cured? Recovered? No, not fully, not yet, there is still a ways to go, but he went from very severe Autism to a moderately high level of functionality. The immense amount of progress made so far gives me hope and I will NEVER quit trying to help my child.

"Worms and junk"?  Bullshit!  Your child didn't have parasites or heavy metal toxicity or any other imagined diagnosis you came up with.  You're bleaching your child you ditchpig and any developmental advancement is coincidental and in spite of you, not because of you.  It's all about you isn't it?  And where the hell are the spouses in all of this?  I'm going to say husbands because this is primarily perpetrated by women.  Do you blithely join in holding your child down for numerous blood draws for bogus tests, the infamous one two punch of chemical castration and chelation and enemas? Or have capitulated to your wife the care abuse of your special needs children because she spends so much time "researching" and shuffling them off to DAN! quacks?  Whether you are actively participating or enabling, you're still responsible for the abuse of your children.

And if it's not bad enough you are abusing and exploiting your own children, Teresa Conrick another Age of Autism luminary exploits a teenage autist for her own gain.

As fate would have it, I was to meet another inspiring and heroic man, this one was only seventeen-years-old, yet his mission and message equaled the two I have just described.  While I was waiting to talk to a presenter, I watched this young man make his way over to a space near me, talking to a nearby mother, I heard his words - "I am recovering myself from Autism."  I looked quickly as he smiled at me and I reached out to shake his hand, while I tried to hide my tears.  "How", I asked him, "are you doing this on your own?" He began to tell me his name, "Nicholas Glenski", and that he and his Dad were up from Springfield, MO.  (That's he in the photo with AofA's Jake Crosby.) I was so impressed that I asked if we could talk together, maybe I could ask him some questions for a blog about Autism?  He smiled again and was very happy to oblige.  Saying he was freezing in the air conditioning, with his dad's permission, we sat outside on a strip of warm, narrow grass, with the sun blazing above.

Congratulations, now you have indoctrinated a young man into believing he is "vaccine-damaged" and needs "recovery".   I'll bet it just thrilled you to hear this young man's beliefs because it validates your own.  You are positively shameful, gathering at that quackfest AutismOne for what passes as camaraderie with your fellow biomeddlers to share your bullshit recovery stories (even though you've been "recovering" your kid for years now) and swap "diagnoses' and "treatments" like baking tips you foist upon your children.

I have certainly faltered as a parent; I'll even go so far as to admit that I've spanked my children a couple of times.  I didn't do it out of love; I was angry and where this has a parallel with what you are doing, you are angry with autism; you hate it. Deny as you might, you can't separate the autism from the child, it is part of them.  Your hatred for autism has obscured your humanity and consequently, true love for your children.  Another parallel I can draw from my own meagre experience is the self-loathing I felt afterward.  Oh you haven't gotten to this part yet because you think you are helping your children.  I felt awful for intentionally inflicting physical and emotional harm upon my children; I still feel awful even writing this. I would imagine that actually having the realisation of the harm, physically and emotionally, you are inflicting upon your children would send you to the darkest depths of despair.  If that's where you need to go to stop this insanity, then so be it.  Get the help you desperately need and learn to love your children.

You Spin Me Right Round, Blaxill Right Round

On 12 February of this year Neurotoxicology withdrew the article Delayed acquisition of neonatal reflexes in newborn primates receiving a thimerosal-containing Hepatitis B vaccine: Influence of gestational age and birth weight co-authored by none other than Andrew Wakefield. KWombles of Countering Age of Autism was the first to break this news and Just the Vax also blogged about it along with Respectful Insolence, A Photon in the Darkness and several others that day.

AoA's Mark Blaxill only just issued a predictably petulant diatribe regarding the withdrawn paper by Hewitson et al. It starts off with the bewildered meanderings of one that is clearly not familiar with scientific publications and editorial accountability.

How can a scientific study simply vanish? This paper had cleared every hurdle for entry into the public scientific record: it had passed peer review at a prestigious journal, received the editor’s approval for publication, been disseminated in electronic publication format (a common practice to ensure timely dissemination of new scientific information), and received the designation “in press” as it stood in line awaiting future publication in a print version of the journal. Now, and inexplicably, it has been erased from the official record. For practical scientific purposes it no longer exists.

The answer, of course, is that this is no ordinary scientific study. Age of Autism reported previously on its importance HERE , where we noted that “one likely tactic of critics of the study will include attempts to nullify the evidence based on the alleged bias of those involved.” The obvious risk, of course, was that a co-investigator on the paper, Dr. Andrew Wakefield, might make the study a target, especially in light of the hearings then underway at the U.K.’s General Medical Council (GMC).

First, let me point out that Neurotoxicology isn't a prestigious journal; it's an okay journal with an impact factor of 2.4. It may be nitpicking but it is disingenuous to attach exaggerated attributes such as 'prestigious' and 'world-renowned', especially when referring to cranks and their science. But Blaxill is right about two things; that was no ordinary scientific study and Wakefield's self-inflicted predicament was undoubtedly targeted, after the fact however. The monkey HepB study was not good, in fact, the study design, methods and results were quite poor. It never should have passed peer-review but somehow did; perhaps the editorial staff at Neurotoxicology were hedging their bets on a bombshell study and had enough reputable authors to withstand the blowback. That is evidenced by this response to Lynn Redwood's request for information by Elizabeth Perill:

Elizabeth Perill (Elsevier is a division of Reed Elsevier PLC, a large scientific publishing corporation and owner of Neurotoxicology). Perill wrote the following note to Ms. Redwood on February 4th.

Dear Dr. Redwood [sic],
Aside from any authorship concerns, on reflection the paper is not suitable for publication in this journal. The decision was based on the fact that the paper should not have been accepted in Neurotoxicology and the paper is not suitable for the audience of Neurotoxicology.
Kind regards,
Liz
Elizabeth Perill
Publisher, Toxicology,
Elsevier
360 Park Av. South, New York, NY 10010

So when more scrutiny was applied to the study itself, it didn't pass muster.

When Joan Cranmer accepted the primate paper in Neurotoxicology, her decision could not have been an easy one. The study subject and one of the study authors, Andrew Wakefield, were known to be highly controversial. All of the information about the GMC proceedings and the accusations against Wakefield were well known to the editors and peer reviewers. Despite that knowledge and the risks involved, Cranmer and her editorial team judged the science to be sound and decided to go ahead. We complimented them at the time, noting that “the journal editors at Neurotoxicology have taken a courageous stand in publishing what is sure to be unwelcome evidence in some circles.” It appears, however, that Cranmer’s superiors within Elsevier did not share those views.

Emphasis mine. That's bollocks Blaxill; let's review what the Conflict of interest statement in the study stated:

Prior to 2005, CS and AJW acted as paid experts in MMR-related litigation on behalf of the plaintiff. LH has a child who is a petitioner in the National Vaccine Injury Compensation Program. For this reason, LH was not involved in any data collection or statistical analyses to preclude the possibility of a perceived conflict of interest.

And let's review what the known conflicts of interest really are. Andrew Wakefield was well in the midst of GMC misconduct proceedings against him regarding the 1998 Lancet paper and the Neurotoxicology study was not submitted until 16 June 2009. Thoughtful House routinely treats autism as vaccine injury and promotes the use of chelation and Wakefield was firmly in place as the director then. Laura Hewitson is registered as a DAN! and also is employed at Thoughtful House as is her husband, Dan Hollenbeck. He is on the board of directors for SafeMinds, one of the funding sources for the monkey studies and a vitriolic supporter of the mercury-autism 'hypothesis'. Additionally, both openly support chelation. David Atwood from the University of Kentucky is the patent holder for N,N’-bis (2-mercaptoethyl)isophthalamide an industrial chelator designed for cleaning up mining sludge, or better known as OSR which is being marketed by Boyd Haley, also of the University of Kentucky as an autism cure for children.

As Orac pointed out, those of us involved in the topic of vaccines and the claims of 'damage' are an oddball bunch; it's a niche interest and it is audacious to assume that journal editors would have all of this information at their fingertips about any authors that makes submissions to their publications. That is what COI statements are for and probably a substantial reason why this study was withdrawn. Think about it; a group of authors don't declare their full COIs and then one is later shown in a formal proceeding to have acted with callous disregard for children that he was supposed to care for, unethically and dishonestly, not to mention the other glaring omissions. That cannot be simply ignored, at least in the real world. As Dr. Perill stipulated, "Aside from any authorship concerns, on reflection the paper is not suitable for publication in this journal.", can certainly be taken as the science was more closely scrutinised after the appalling COIs came to light. An update to AoA's post on this confirms this:

UPDATE: After publishing the article, Age of Autism received this statement from Joan Cranmer.

“Scientific integrity and good science are fundamental principles for publication of research articles in Neurotoxicology. Although rare, the journal withdraws papers whenever these essential principles are cast into doubt. The January 28, 2010 UK General Medical Council ruling of research dishonesty by Dr. Andrew Wakefield cast into doubt the scientific integrity of a new related paper co-authored by Wakefield*. However, it would be inappropriate for either me or the other editors to discuss the specific factors publicly.

Professor Joan M. Cranmer, Editor, Neurotoxicology

This shouldn't be so difficult for Blaxill and Co. to parse, but somehow it is. Scientific integrity and good science; principles that seem to allude the vaccine-autism pseudo-scientists. Blaxill also predictably pulls out the Galileo gambit and compares Wakefield to Herbert Needleman a physician who made the discovery that lead poisoning is responsible for developmental disorders and took on a powerful industry that tried to railroad him.

One of the reasons that Needleman is revered in the neurotoxicology community is because he had to surmount formidable obstacles and fight powerful opponents in order to protect children from dangerous exposures to heavy metals. Like Wakefield, Needleman once served as an expert witness in a legal proceeding, in this case on behalf of a child from Utah who had been injured by lead pollution. Also like Wakefield, Needleman found himself facing off against powerful industry forces, in this case the oil and gas industry and their suppliers of lead, companies such as Ethyl Corp and E.I. DuPont de Nemours. Most notably, in order to defend their profits, the lead industry mounted an aggressive effort to discredit Needleman. In 1991, he was called before the Office of Scientific Integrity at the National Institutes of Health (NIH) on charges of scientific misconduct.

The chasmic differences between Dr. Needleman and Wakefield are scientific integrity and unassailable science that prevailed even under intense scrutiny. It really is a grotesque affront to someone of Dr. Needleman's credentials and righteousness. Wakefield is no Galileo, no Needleman and no Marshall and Warren. Just because Wakefield is viewed by his supporters as David taking on the big bad Goliath of Pharma, that doesn't make him right. If he had the science to support his assertions, it would have been replicated and it would have withstood scrutiny.

Seen from this perspective, what if the next-generation incarnation of Herbert Needleman is Andrew Wakefield, but in today’s version of the story, the balance of power has shifted in critical ways? In Wakefield’s case the product is neither gasoline nor paint, but vaccines, one of the most privileged product categories ever invented, products that are produced and promoted by the medical industry with missionary zeal. In contrast to the limited scientific influence of the oil and gas industry, the medical industry Wakefield faces is far more powerful, pursues its interests with greater skill, controls the flow of scientific information and effectively dictates media coverage. It appears now that the medical industry is so powerful that it can rewrite scientific history when it wants and even erase important scientific publications in a reputable journal.

The oil and gas industry have limited influence? Are you kidding me? Sadly, that was a rhetorical question that I well know the answer to. If Pharma is so competent and omnipotent, how did they allow Wakefield to not only publish the 1998 Lancet case series, but leave it published for almost 12 years, not to mention all of his subsequent publications and the most recent Neurotoxicology study? And only just got around to getting the GMC to instigate proceedings against him? Scientific publications get retracted all the time, it's part of the process when scientific fraud is discovered, and Wakefield fits that bill.

Wakefield is in a league with the likes of Victor Ninov, Jan Hendrik Schön, Robert P. Liburdy and Hwang Woo-Suk, the latter also feigning ignorance of bioethics in his defence. But Wakefield is a rank amateur compared to the Piltdown Man hoax. Whoever that was, kept that going for more than 4 decades and the true identity of the perpetrator(s) remains unknown. Wakefield's fraud was discovered a mere 5 years after the 1998 (now retracted) Lancet paper by a journalist, no less. Even if one wishes to (erroneously) argue that Mr. Deer was aimed at Wakefield, if there was nothing there, then Wakefield wouldn't have been so thoroughly discredited and looking for his next gig right now.

AoA's call for Neurotoxicology's editor Joan Cranmer to resign in the name of 'think of the children' is preposterous and just isn't going to be considered, let alone done. It is a vapid attempt to rally the troops in the face of yet another failed attempt to get their pseudo-scientific tripe into a real peer-reviewed journal and game over for Wakefield. I think that even they can see the disgrace of having to publish in bottom-dwelling vanity press journals such as JAPandS, Medical Veritas (ooo, they say it's a 'pre-eminent' journal) and of course, Medical Hypotheses and even though that is an Elsevier journal, I think they would give the monkey study a go, given their standards.

If you are interested in reading more on this topic, please visit Countering Age of Autism and of course, Respectful Insolence.