Pro-disease Nutters...

There are people out there that think vaccines cause autism. They have some "celebrities" in their ranks. Never mind that these people are just plain WRONG in their assertions, but they are a public health risk in their stances. Dr. Phil Plait (The Bad Astronomer and President of JREF) takes on these nutters on a regular basis. Not because it's particularly astronomy related, but because these nutters are lying to make their case, are endangering children (not only their own, but others as well), and are trying to drag public health back 70 years. (P.S. That body count is out of date, I think the numbers are closer to 18,000 and 160 as of 23 April 09.)

Invariably, every time he makes a post on his blog, the nutters come to try to spread their lies and falsified claims. A fellow that posts on Dr. Plait's blog by the name of Todd W. has made a preemptive compilation of why these nutters are wrong. So, for your enjoyment, here is that list (with some added material at the end for even MORE actual evidence and citations):

The Truth About The "Evils" Of Vaccination

by Todd W

Before making any comments on how evil vaccines are and how they cause autism, please read the following. I apologize for the length, but the mouthpieces of the pro-disease anti-vax movement spout so much nonsense and misinformation.

MMR

(info available from FDA, CDC, investigative reports by Brian Deer)

• Some in the pro-disease anti-vax movement claim that the MMR has/had mercury in it. However, the MMR vaccine does not and never has had any mercury in it.


• The basis of the “MMR vaccine causes autism” argument is a flawed study by Andrew Wakefield, who had several ethics breaches, including failure to disclose financial compensation from a lawyer representing families claiming MMR cause their children’s autism, failure to disclose financial interests in patents for MMR alternatives, failure to include data which contradicted his conclusions, use of contaminated samples to support his conclusions.


• Independent studies trying to replicate Wakefield’s results have come up negative. To date, no properly controlled study has shown a causal link between vaccines and autism.

Thimerosal

(info available from both FDA and CDC)

• Thimerosal is a preservative that is used in the manufacturing process of some vaccines and other medicines to prevent the growth of bacteria and fungi, which could otherwise cause illness or injury.


• It metabolizes into ethylmercury, not methylmercury, a mistake commonly made by pro-disease anti-vaxers who claim that the amount of mercury that used to be in vaccine exceeded EPA exposure guidelines. Those guidelines were for methylmercury, a compound that has a half-life in the body of several weeks to months and is often found in fish or other environmental exposures. Ethylmercury, on the other hand, has a half-life of a few days to about a week, meaning that it is not in the body long enough for it to build up to toxic levels from vaccination to vaccination.


• It was removed from the final product of nearly all vaccines around 2001/2002. This was a political move, due in large part to public pressure, rather than based on sound science. This was a recommendation rather than a regulatory requirement. A handful of studies that suggested problems with thimerosal, but which were inconclusive, prompted a “better safe than sorry” approach from the FDA while the issue was investigated by FDA, CDC and others. No follow-up studies have found any health risks beyond local hypersensitivity.


• Some vaccines still use it during the manufacturing process, but remove it from the final product, leaving, at most, trace amounts. The influenza vaccine still uses thimerosal, though thimerosal-free versions are available.


• Despite the removal of thimerosal from vaccines, resulting in exposure levels lower than anytime in the past, autism rates have not declined, suggesting that there is no connection between thimerosal and autism.


• To date, no properly controlled study has shown a causal link between thimerosal and autism.

Other Vaccine Additives

• Some pro-disease anti-vaxers claim there is antifreeze in vaccines. This is false. Antifreeze is ethylene glycol. Vaccines use polyethylenes glycol. These are different substances, the latter of which is not toxic. More info can be found at Inside Vaccines.


• Vaccines contain formaldehyde. However, the chemical structure of the formaldehyde in vaccines is the same as that produced by our own bodies. It is used during the manufacturing process, but is diluted to remove it from the finished product, leaving only small or trace amounts. The total amount of formaldehyde in a finished product is far less than what is naturally found in the human body.


• As an aside; the total amount of Formaldehyde in vaccines from the vaccine schedule for a 6 year old child is 1.2016mg, BUT 1 (one) banana contains 16.3mg!


• Vaccines contain aluminum in a salt form. Pro-disease anti-vaxers claim this is toxic, and some will cite that 4ppm will cause blood to coagulate. However, individuals are not exposed to such amounts of aluminum in a single vaccination visit. Blow are the vaccines containing aluminum, with the corresponding parts per million (ppm) for an infant (~251 mL of blood in the body) and an 80lb. child (~4000 mL of blood); note the two numbers for DTaP represent extreme ranges of aluminum content: (I'm sorry, I tried to make this table all nice for folks, but now I can't get rid of all this extra white space... Stand by for an actual web page with this info.)

ppm (w/v) = (weight in grams of sample/volume of sample in mL) * 106
Vaccine	ppm in infant	ppm in child	age received (in months)
DTaP (170mcg)	.677	.043	2, 4, 6, w/ final ~4-6 yrs
DTaP (625mcg)	2.490	.156
Hep A	.996	.063	12 w/ final ~6 mo. later
Hep B	.996	.063	birth, 1 or 2, final at 6+
HiB	.896	.056	2, 4
HPV	.896	.056	11 or 12 yrs., then 2, 6 mo.
Pediatrix	3.386	.213	2, 4, 6 (in lieu of DTaP, IPV and Hep B)
Pentacel	1.315	.083	2, 4, 6, 15-18 (in lieu of DTaP, IPV and HiB)
Pneumococcus	.498	.031	2, 4, 6, 12-15

• Further, about 71% of the aluminum is excreted from the body after about 5 days or so.


• An interesting source of aluminum is breast milk. After between 51 and 346 days breast feeding, a child will have taken onboard the same amount of Aluminium as from the total US vaccine schedule for a 6 year old child.

Polio

• Pro-disease anti-vaxers claim that polio rates increased after the introduction of the polio vaccine, that OPV spread the disease, and that polio was on a decline before introduction of the vaccine. This is wrong.


• Before the approval of the vaccine, paralytic polio struck 13,000-20,000 individuals every year in the U.S. The number of cases peaked at 21,000 in 1952, only three years before approval of the vaccine. By 1960, there were only 2,525 cases, and only 61 cases in 1965.


• The oral polio vaccine (OPV) was nearly 100% effective in preventing polio, though it did have a very small risk of causing paralytic polio in the recipient. OPV-caused paralytic polio resulted in about 6-8 cases per year. However, when vaccination rates were low, OPV had the added benefit of contact immunity. In other words, the virus from the vaccine was present in the stool, resulting in about 25% of people who came in contact with the immunized person would also become immune.


• With the eradication of wild type polio in the U.S., the OPV vaccine is no longer used, and the less effective inactivated polio vaccine (IPV) is used. This version does not cause paralytic polio. OPV has not been used in the U.S. since 2000.

Vaccine Court and National Vaccine Injury Compensation Program (VICP)

(info available from the Autism Omnibus Proceedings)

• Pro-disease anti-vaxers claim that Hannah Poling and Bailey Banks are examples of successful Vaccine Court cases where vaccines caused autism. This is wrong.


• Hannah Poling was found to have a mitochondrial disorder, and that the vaccine worsened her condition. The court did not rule that a vaccine caused autism. Note, mitochondrial disorder is not autism, though some in the anti-vax camp claim it is.


• Bailey Banks was found to have suffered acute disseminated encephalomyelitis (ADEM). This disease occurs in approximately 1 or 2 per million vaccine recipients, compared with 1 per 1,000 individuals infected with measles and 1 per 500 rubella infections. The court ruled that this is a type of pervasive developmental disorder, but made clear that it is not autism. Like the Poling case, anti-vaxers try to distort the truth to make their case. In the case of ADEM, vaccination helps reduce the risk of contracting the disease by reducing the likelihood of natural infection.


• Despite the low standards of proof in the vaccine court (more likely than not, or 50% + a hair), no one has been able to establish a causal relationship between vaccines and autism.


• In three of the best cases put forth by the anti-vax movement, the court ruled in all three that vaccines did not cause the individuals’ autism.


• Before VICP, the media fueled fears about vaccines, leading to increases in law suits and many manufacturers halting production of vaccines altogether. The VICP was proposed by a coalition of government, health organization, and industry representatives, as well as physicians and ordinary citizens as a means to ensure a suitable supply of vaccines while allowing legal recourse to those injured by vaccines.


• Individuals may still seek damages through the tort system, if they choose, though they must then prove not only that the vaccine caused the injury, but also that the manufacturer was at fault.

Vaccines in General

• Pro-disease anti-vaxers want vaccines that are 100% safe. This is never going to happen, as all medicines carry some risk. However, the relative risk of injury from vaccines is significantly lower than the risk of injury from getting the disease naturally. For more information, see the CDC website.


• Reduced vaccination rates lead to higher incidents of infection. This has been illustrated in the U.K. following Wakefield’s bogus study, in Germany in 2006 (including two deaths in unvaccinated children), in California, in MN (where an unvaccinated child died from hemophilus influenza type b).


• Pro-disease anti-vaxers claim that “Big Pharma” makes lots of money from vaccines. If vaccination rates dropped, however, there would be an increase in preventable illnesses, many of which have high rates of complications resulting in hospitalization and expensive treatment. See the link about Germany above for information on costs associated with the measles outbreak there. The money to be made from the diseases far outweighs any money to be made from vaccines.


• Pro-disease anti-vaxers claim that better hygiene has led to a decrease in disease, rather than vaccines. However, many of the diseases prevented by vaccines are airborne, and are not greatly impacted by improved sanitation or hygiene.


• Pro-disease anti-vaxers claim that too many antigens (the parts that make the vaccines work) are given at once, ignoring that infants and children are exposed to thousands of antigens every day by touching things and putting their hands or the object in their mouth, through absorption or by inhaling.


• They claim that combination shots should be avoided, and that parents should break up the vaccinations into individual vaccines and spread them out. However, this increases the total number of shots received, as well as exposure to those various “toxins” they hate so much.


• There have been no properly controlled studies establishing a causal link between vaccines and autism.


• There have been numerous properly controlled studies sponsored and run by various people and organizations around the world that have shown no link between vaccines and autism.

Population X and Vaccines/Autism

• Pro-disease anti-vaxers claim the Amish do not vaccinate and do not have autism. This stems from a lie by Dan Olmsted from Age of Autism. The Amish do, in fact, vaccinate, and it appears that their rates of autism may be lower than in the general population.


• Some claim that the Chinese do not have a word for autism (they do, it’s 自闭症 [zì bì zhèng]). And simply not having a word for the disease does not mean that it does not exist, merely that it is not recognized as a specific disorder. Did autism only afflict people after someone created the diagnosis? No, but it may have been called something else.


• The same claim about the Chinese has been made about Somalis due to a recent article about Somalis in Minnesota. Again, lack of recognition does not mean that the disease never occurred in the population. Further, the cases in Minnesota do not have a consistent connection to vaccines. Some of those with autism have been vaccinated, some have not. Despite a lack of evidence, Generation Rescue (which runs Age of Autism) has told the Somali parents that vaccines were the cause.


• There is a phenomenon called "Herd Immunity" (Google it). So even if you have your children vaccinated, the irrisponsible pro-disease anti-vax nuttters are still endagnering your child with their antics.

Some additional reading:
The CDC Pink Book has an appendix G with lots of statistics on cases and deaths. Here are some of the data for measles:
Disease: Measles in the USA
Year__Cases___Deaths
1961__423,919_434
1962__481,530_408
1963__385,156_364
(^^ first vaccine licensed)
1964__458,083_421
1965__261,905_276
1966__204,136_261
1967___62,705__81
1968___22,231__24
1969___25,826__41
1970___47,351__89
1971___75,290__90
(^^^ MMR licensed)
1972___32,275__24
1973___26,690__23
1974___22,690__20
1975___24,374__20
1976___41,126__12
1977___57,245__15
1978___26,871__11
(^^^ Measles Elimination Program started)
1979___13,597___6
1980___13,506__11
1981____2,124___2

Pertussis still kills over a dozen American babies every year.

Anyway, about the silly “money trail”… Which makes more money for “Big Pharma”: selling vaccines or by providing supplies and medication to hospitals for those who have been hospitalized due to pertussis, measles, mumps, Hib, etc? Be sure to provide real actual factual evidence of the type I can find in my local medical school library. Something like this:
Arch Pediatr Adolesc Med. 2005 Dec;159(12):1136-44.
Economic evaluation of the 7-vaccine routine childhood immunization schedule in the United States, 2001.

“RESULTS: Routine childhood immunization with the 7 vaccines was cost saving from the direct cost and societal perspectives, with net savings of 9.9 billion dollars and 43.3 billion dollars, respectively. Without routine vaccination, direct and societal costs of diphtheria, tetanus, pertussis, H influenzae type b, poliomyelitis, measles, mumps, rubella, congenital rubella syndrome, hepatitis B, and varicella would be 12.3 billion dollars and 46.6 billion dollars, respectively. Direct and societal costs for the vaccination program were an estimated 2.3 billion dollars and 2.8 billion dollars, respectively. Direct and societal benefit-cost ratios for routine childhood vaccination were 5.3 and 16.5, respectively. CONCLUSION: Regardless of the perspective, the current routine childhood immunization schedule results in substantial cost savings.”

Links to support with actual DATA!

The economic study: http://archpedi.ama-assn.org/cgi/content/full/159/12/1136
The California experience with the 1990 measles epidemic: http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=8855680
Another study on the impact of medical interventions on mental retardation, it notes the effect of measles, Hib an rubella: http://archpedi.ama-assn.org/cgi/content/full/160/3/302
The CDC Pink Book: http://www.cdc.gov/vaccines/pubs/pinkbook/default.htm
And the Appendix G: http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/appdx-full-g.pdf
Just the cases and deaths: http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/G/cases&deaths.pdf

An Interesting article on some possible connection to Vitamin D and autism: http://www.sciam.com/article.cfm?id=vitamin-d-and-autism&sc=DD_20090424 I would caution reading too much into this though since it is very preliminary. After all, there have been correlations of autism with linoleum floors too!

One final addition to the discussion. Many people claim that autism is on some sort of WILD upswing, and is an epidemic of sorts. While I cannot say if there is a rise or not for sure, one thing is quite certain: The autism spectrum is much more understood in this day and age. We are able to correctly identify someone as autistic as opposed to mislabeling them as troublesome, distant, aggressive, impulsive, etc. There is a certain selection bias involved with the autism diagnosis increase claim.

Now, one of the places that a lot of this pro-disease nuttery is coming from is the Huffington Post (proving that woo and delusions know no political boundaries). So a good man who goes by IVAN3MAN happened upon this:

From the Huffington Post article:

Every 20 minutes, a child is diagnosed with autism. In a study of select populations around the United States, the Centers for Disease Control (CDC) found that one in 150 children has the condition. According to the Autism Society of America, this is the fastest growing developmental disability with a 10-17% annual growth rate.

At Least 11% of American Women Smoke During Pregnancy

The negative effects of nicotine exposure to their fetuses and newborns are significant.

Huffington Post:

Throughout Healing and Preventing Autism, Jenny passionately reminds us that she and her dedicated army of advocates for autism are in this for the long haul:

Thousands of parents, like me, have learned so much and the only reason we won't shut up is to teach YOU, so you don't have to walk in our shoes. Dr. Jerry and I want to arm parents with all the tools and information necessary to have the healthiest baby you can. The next generation of kids is counting on it!

Jenny McCarthy SMOKING!

Jenny McCarthy STILL SMOKING!

Make of that what you will. And this is the lady that likes to inject one of the most deadly neurotoxins into her face, but thinks vaccines are bad... Wow... Just wow!

And for all those people who have anectdotal stories remember that the correlation may seem remarkable to you because anomalies always seem remarkable when they happen to you. However, what you need to understand is that in the context of the 360 million people in the United States, anomalies are actually not only expected, it would be remarkable if they didn’t occur. Here’s a back of the envelope explanation why (from another blogger that frequents BA http://padraic2112.wordpress.com/2009/04/25/my-last-vaccination-post-for-a-while/):

There is a simple reason why this is not relevant, take the following facts…
* children take vaccines
* autism displays its first symptoms in childhood
* children under the age of 5 make up ~7% of the population
* there are ~306 million people in the U.S.* about 80% of children are vaccinated entirely
(editor’s note: I didn’t make those numbers up, you can find them with a couple seconds and a web browser)

This means 306 x 0.07 x .8 = 1.7 Million children (roughly) have been vaccinated. With the vaccination schedule being what it is, then, there are somewhere around 100,000 children getting a shot every month (that last one is hand-wavey, it assumes a lot about frequency distributions, but that’s not really germane to my point). Autism rates are estimated at anywhere between 1 in 100 and 1 in 150 children, that means we have about 17,000 diagnosis of autism. If every single one of those autism diagnosis was given to a vaccinated child (they’re not, but again for our sake here it introduces very small error), and those 17,000 have a scatter distribution of vaccination patterns, that means not one, not dozens, not hundreds, but *thousands* of those diagnosis came within days or weeks of a vaccination: yes, this means that dozens will occur within an hour of a vaccination.

Put those thousands of people together on a message board (and since autism is hard to deal with, a very high percentage of these family *do* bond together, like SMA sufferers or MS or cancer or any other family-impacting disease), you’ll have a few thousand people all saying to each other, “Gee… MY kid got a shot right before her symptoms started showing, too! There are thousands of us! THAT CAN’T BE A COINCIDENCE.”

But you can see, it actually *isn’t* a coincidence… it’s exactly what we would expect to happen.