Your theory holds up if you read the comments under CBC’s reportage of the story yesterday…a good chunk of commentators are still digging in their heels. Read and tear out hair here:

http://www.cbc.ca/health/story/2010/02/02/autism-mmr-lancet-wakefield.html

The anti-vaccination movement has edged away from the autism stuff anyway, and like all good denialist movements, it has changed its claims.  Now it’s less panicking over autism, and a lot more demands for “green” vaccines and vague panics about “toxins”.

Another tailor-made issue for Oprah to be concerned about. If it isn’t Jenny McCarthy doing a return visit to promote her re-jigged cause, it’ll be some other celebrity who’s discovered the Q-Score benefit of pitching woo to panicky exurban safety moms.

So yeah: vigilance.

When my daughter was born a few years ago, I knew I’d have to face the decision about vaccinations, and I was aware of the anti-vaccination movement.  I’m a born skeptic, of course, so I looked into as many reputable sources as I could find.  Long story short, I wound up vaccinating my daughter.  But, Amanda, I think you’re painting everyone who’s skeptical about vaccines (whether involving the autism link or not) under an unnecessarily broad and clumsy brush.  The reason for my skepticism, and what made me give some anti-vaccination voices a listen, wasn’t any “anti-science” tendency.  On the contrary, I was fully aware of what vaccines are supposed to do, and of just how bad things would be without them.  The issue for me was the increasingly lax (or nonexistent) regulatory environment surrounding the industries that produce and market the vaccines.  This didn’t begin with the Bush administration (my daughter was born in 2005), but it was certainly ramped up in those years.  In the end I felt the gamble of not vaccinating, not to mention facing all the official pressure as well, carried far shorter odds of a bad outcome than just going ahead and doing it.

It’s my belief that the anti-vaccination crowd could be whittled down to a few right-wing conspiracy nuts if we could get Obama and the Democrats to build some teeth and muscle into our regulatory agencies, particularly the ones governing the pharmaceutical agencies.  Even if I’m wrong, such regulatory fervor would be welcome all the same.

Motivated by this thread, I’ve made plans to see Inglorious Basterds on Friday.

Oops, wrong thread.

Amanda, I spend a lot of time talking to new parents who tend to fall into the “crunchy” category, but I generally avoid vax discussions because it gets unpleasant quickly. Anyway, I had not heard about the “green” vaccine discussions and am curious about what “toxins” you are referring to…after all, the US has just started to mandate removing BPA from kid’s toys and bottles, but only after lots of community activism against this toxin, which had already been banned elsewhere.

Can you provide some links to the discussions you have in mind?

And while I am pro-science, and believe that vaccinations are necessary, I want to speak up for those who are parenting in this country, in a climate in which funding for environmental protections has been slashed repeatedly and corporations hold so much power, that the realization that you and your kids are in fact eating and drinking and breathing in substances which may be harmful, all the time, and there is no way of avoiding them or knowing what their longterm effects are, that those parents don’t deserve scorn.

For many people, becoming a parent is their first true awakening to the environmental crisis we live in; they may not care about their own bodies, but their child’s bodies and lives are a different story. Suddenly the presence of chemicals from rocket fuel in tapwater and thus breastmilk is not something they are able to ignore or make jokes about. Suddenly when their child (as mine is) is born with even a mild disability, the question of whether it was just an accident of genes or a result of decades of exposure to pollutants becomes too troubling too ignore.

I only wish that Wakefield could be held responsible for those deaths he has caused with this hoax.

Unfortunately, not many people know the history behind the MMR-autism hoax, and that includes anti-vaxxers.  Since many of the don’t even realize that this is what started it all, they’ll continue to believe McCarthy or other spokespeople for the movement.  I bet a lot of anti-vaxxers don’t even know about Wakefield or the Lancet in general.

Sam, care to give specific examples of lax regulation of vaccine production, and of problems caused by said lax regulation? Given the public health stakes, such charges should not be made lightly.

the fault doesn’t lie with their genetics, but with the choices made by experts, who can be easily villainized

Unfortunately, that’s an all too common American trait: hatred of the intellectual.  Nevermind that the whole country was founded by highly educated, erudite men, our popular media is full of ‘scientists = evil’ and hero stories where the hero just has an instinctive knack that scientists, with all their studying, simply can’t match.  Tom Cruise made a billion-dollar career with this movie, and Avatar is just the latest example (Sully instinctively runs and controls his avatar, while the scientists who have trained for years are less comfortable in their ‘skins’.)

Why should anti-vaxers acknowledge facts when it’s so much easier for them to believe in woo and place the blame on someone else—anyone else.  Knowing neither the cause nor the cure is frustrating and stressful, and many many people find it comforting to believe anecdata and spend a lot of money on anything that might help, since, you know, it helped this one kid, once, and if they follow the magic steps, their child will be a miracle baby, too.

The fact that scientists would love to find a demonstrable cure is beyond them, that if many children really were cured by a gluten-free diet, scientists would publish these findings is unacceptable.  Better to believe in the Secret and Woo and pray for the miracle.

And the anti-vaxxers give them a very flattering answer, which is that the fault doesn’t lie with their genetics, but with the choices made by experts, who can be easily villainized.

It’s interesting that the parents of JV Diabetes children (the type 1 insulin dependent), have never had this need to cast blame on something other than their own chance genetics for the cause of their child’s medical condition.  Or the parents’ of Down’s Syndrome children.

I’m in the former - my daughter was diagnosed last month at age 5. (Doing just fine)  My ex, whom is in the latter and whom I consider the Debil in most things, is in the latter.  (her child is doing just fine as well).

SPOT ON, Amanda.  I’m a former “anti-vaxer”, or at least “vax-skeptical” parent.  Without going into the whole long story, I will say that from the perspective of a new mom who has always prided herself on being a skeptic about all things, the anti-Pharma aspect of the anti-vax message drew me in and gave the arguments a certain credibility.  I held off vaccinating my daughter while I looked into the issue thoroughly, and the first red flag I had (followed by about 60 million in rapid succession) was that the anti-vaxxers do not want people to ask questions, unless they are questions which by their nature reinforce the anti-vax paradigm, which as you correctly note is not primarily concerned with a link to autism, but rather to the idea that vaccines are “toxins” which are just another way we are being poisoned by Big Corporations and the environment…but in the anti-vax view, an even more noxious form of poison as it’s being injected directly into the bloodstreams of babies.  It’s kind of ironic then that these folks use the same M.O. as global warming deniers or evolution deniers to solopsistically shield their flimsy, easily refutable “arguments” from any and all criticisms.

Digging into the ACTUAL science underlying vaccines, as well as combing through the skeery skeery anti-vax sites with their science-y jargon, I actually learned a lot about evaluating arguments and evidence, and was lucky enough to know some real scientists and to have enough basic scientific literacy to do so.  This is one issue where despite the endless smoke, there is NO fire, and on the contrary the anti-vaxxers have done real, physical harm with their movement to “save” children from “toxins”.

I’ll stop there, but I have to say that I do think there is a link between the *actual* nefarious corporatism of our big-biz “health care system” and the turn to Woo by people who really should know better. If you would like to post about this, I would be eager to read what you would have to say.

Steve, I’m talking about a general relaxation and hamstringing of our regulatory agencies, including the FDA.

The issue for me was the increasingly lax (or nonexistent) regulatory environment surrounding the industries that produce and market the vaccines.

That’s a legitimate general concern, especially in these days of regulatory capture by megacorps. I don’t think this post is about you, but rather people with a denialist mentality who’ll latch onto any excuse to keep their hobbyhorse o’ fear rocking away.

Sam, there is no doubt that anti-vaxxers are well-researched.  But it’s not good research, and the anti-vaccination hysteria comes from a certain class for a very good reason that shouldn’t be ignored in order to play nice.

Here you go, em.  They just list the chemical names of ingredients in vaccines in order to scare people.  The new slogan is “green our vaccines”, a vague demand.  Here’s an overview from an expert in the field.

Steve, I’m talking about a general relaxation and hamstringing of our regulatory agencies, including the FDA.

That, to put it very kindly indeed, is not nearly good enough. Are you even aware that regulation of vaccine production (since vaccines are given to healthy children) has always been separate from and more stringent than regulation of drugs?

Back it up with specific, relevant facts, or your charge is simply irresponsible. Again, I remind you of the very high stakes- in terms of the potential loss of children’s lives, which could be catastrophic should the reservoir of immunity in the population to deadly childhood diseases fall too far- involved in fanning irrational suspicion of vaccines.

teabea, there’s other, nicer skeptics than me writing about it.  I get really impatient with the controlling aspects of the hyper-parenting culture, and that comes across as unsympathetic to parents who are living with that pressure/end up perpetrating that pressure.  Big Pharma is a really easy villain, and so people end up citing emotional investment in genuine anger at Big Pharma as if it’s a mitigating factor, and I’m impatient with that because it takes legit outrage and misdirects it.  People see, in this case, malice where there’s more banal greed.  Big Pharma would love nothing more than to crank out Viagra all day, but that doesn’t mean the actual researchers on the ground don’t care about children or are actively out to get them.

Gracchus, I think it’s really complicated—-a lot of smart, well-meaning people are easily duped by the hobbyhorse types because they feed them a story that fits pre-existing understandings of how Big Pharma and government regulation work.  But that it feels right is not evidence, and like Steve said, in this case, the stakes are simply too high.

I feel strongly that people need to vax their children.

However, is there any negative to a slightly slower vax schedule that doesn’t group so many together?  Vaccines do cause fevers and distress to some children and are done on a different schedule in different countries.  Have there been any studies on this?

You’re preaching to the choir, Steve, so lose the high-and-mighty tone.  I did my homework already; did you miss the part where I said I have a child and got her vaccinated?  My point isn’t that the anti-vaccination people are right, my point is that they feel they are right and that no facts—especially if conveyed to them in a patronizing tone by someone calling them idiots—will change them over.

Try and use a little empathy for a moment: if you’re a brand-new parent who’s been raised to not trust your government, and one of the few things you’ve noticed is the revolving door between industry and the regulatory agencies, who are you going to believe?  Someone who’s suffering through having a child with autism and appears to be standing up and fighting the system; or some smug, know-it-all prick who’s rolling his eyes and telling you what an idiot you are for not trusting in science?

Not to put too fine a point on it, but this is why the GOP is so successful, especially when they’re in the minority.  They know how to capitalize on fear and resentment.  This is also why the Democratic Party finds ways to fail even with huge majorities: sometimes being 100% right isn’t enough.  You need to know when to use honey and when to use vinegar, especially in a nation that was founded in a glorious, sparkling cloud of cognitive dissonance.

While not a mother myself, I had experience with a friend who became a new mother and discovered the anti-vax stuff.  It was the first I had heard of it, so I looked into it as well.  The conclusion I came to was that, even if there are toxins that cause autism (which I don’t know, but something has to be causing the increase), it is far more likely that it comes from our air, food, and water.  I mean, which of these things do children do most often: breathe, eat, drink, or get shots? I told my friend that if you are really worried about mercury poisoning your child, cut down on the tuna

Luckily she saw sense and got her kid vaccinated.

Gracchus, I think it’s really complicated—-a lot of smart, well-meaning people are easily duped by the hobbyhorse types because they feed them a story that fits pre-existing understandings of how Big Pharma and government regulation work.  But that it feels right is not evidence, and like Steve said, in this case, the stakes are simply too high.

I agree, and apparently so does Sam, since that one concern about Big Pharma (which is about more than just vaccines) didn’t prevent him from vaccinating his daughter. In short, he came precisely the correct conclusion, so I’m not gonna come down too hard on him.

By all means let us return to the days where Polio and other illnesses not only struck down children but also adults (FDR, anyone?)  I wonder how many of the anti-vaccinators would be pleased to spend weeks confined to their houses under yellow-card quarintines - unable to go to work, nor to shop, nor to send their children to school.  Vaccination is not a lifestyle choice, it’s a public health issue. 

By the way, I’m all for a constant critical re-examination of the vaccination system - which is, of course, part of the foundations of the Scientific Method - but I sincerely believe that any conversation about vaccination MUST take place in an atmosphere where the alternatives and historical record of disease epidemics must be thoroughly understood.  Not enough appreciation is given to the influence of vaccinations and the impact it has on our society - urbanization, mass schooling, even global commerce, since now travelers and businessmen can be vaccinated against diseases which would devastate international travel.  Imagine a world where jet travel is restricted if an epidemic breaks out in the destination country - and that would happen very frequently.

Just as an example, from 1916-1949 there were over 10 major polio epidemics, with an intense outbreak from 1945-1949 which averaged 20,000 cases per year in the U.S.  Certain strains of polio have a very poor prognosis, with nearly 50% of the victims never fully recovering from the nerve damage.  Considering the 2009 H1N1 outbreak (a much milder disease) caused around 3,000 total attributed deaths in North America, one can imagine the panic and fear that a Polio epidemic would engender.

Again, I’m all for critical discussions, but these facts should be at the forefront of everyone’s awareness.

It’s interesting that the parents of JV Diabetes children (the type 1 insulin dependent), have never had this need to cast blame on something other than their own chance genetics for the cause of their child’s medical condition.  Or the parents’ of Down’s Syndrome children.

Interesting?  People motherblame parents of autistic children for their skills as a parent far more than parents of kids with Downs Syndrome or Type I Diabetes.

Intensely involved early intervention with therapy is supposed to help the functionality of kids with autism—not so much with Downs Syndrome (nobody expects dramatic leaps) or Type I Diabetes (no established medical authority is telling you that you can reverse the lack of a functional pancreas). To be a parent of an autistic kid is like having a Mommy Drive-By sign pinned to your back, to be thought of as a Refrigerator Mom(that still lingers even if it’s not a current theory) and to be blamed for the interval between your children (waves to my aunt). Autistic kids are seen as rude, bratty and strange. The average person doesn’t think “genes”, they just think “bad parent”.

The conclusion I came to was that, even if there are toxins that cause autism (which I don’t know, but something has to be causing the increase)

It’s generally understood by serious researchers to be a function of genetics, rather than parenting skills (e.g. the discredited “refrigerator mother” theory) or external toxins (as the anti-vaxers would have it).

A lot of what drove the anti-vaxer parents of autistic children was their reluctance to acknowledge that they might somehow be to “blame” for their child’s condition.

I’m firmly in the vaccination of children camp.  The hyper-parents are just out there to create a new layer of class.  “My child is so perfect s/he doesn’t need the vaccinations!”  So when that child gets sick with measles and starts to expend healthcare funds over what could be an easily stopped disease we’ll begin to see the states start digging in as the health insurance corporations dig in as well. 

I’m with a good many school districts around here, if you do not vaccinate your child you must home school them or give them to the state.  It makes them seem callus but sometimes you need to legislate safety because people are willing to believe idiots.

Alix, yes and I think a lot of parents are choosing to do that.  Sometimes those parents get grouped in with the anti vacciners (who IMO are a smaller number) as totally crazy when I think those are two completely different people.  The ones who don’t vaccinate their children are indeed crazy or ignorant but I don’t think there are very many of them.

Victoria—I’m sure there have been studies on that.  Check the Google.  And, ok, some kids have minor reactions to vaccine shots—low fevers, achy arms, etc.  Personally, I’d rather have that all done at once (as when I had the HPV shot in one arm and and a tetanus booster in the other at the same time a couple years ago), than have a fever this week, and an achy arm six months from now.  Going to the doctor or getting a shot is not fun; that’s just the way it is.  Plus, from a public health standpoint, especially in a country that doesn’t have a health care system that does much for low-income families, it’s easier to get it all in one go that risk that some not be gotten by necessitating patients make repeat visits.

The hyper-parents are just out there to create a new layer of class.  “My child is so perfect s/he doesn’t need the vaccinations!”

There’s also the “Princess and the Pea” class factor: “My child is such a delicate and sensitive flower that a vaccination will upset my child’s equilibrium and do lasting damage.”

Or the parents’ of Down’s Syndrome children.

Well, that might be because Down Syndrome is caused by an easily identifiable genetic disorder.  There may be strong suspicions that autism is genetic, but no one’s found a smoking gun, as far as I know.

My point isn’t that the anti-vaccination people are right, my point is that they feel they are right and that no facts—especially if conveyed to them in a patronizing tone by someone calling them idiots—will change them over.

Nice backpedalling, but no, that’s not what you wrote. THIS is what you wrote:

“The issue for me was the increasingly lax (or nonexistent) regulatory environment surrounding the industries that produce and market the vaccines.  This didn’t begin with the Bush administration (my daughter was born in 2005), but it was certainly ramped up in those years.  In the end I felt the gamble of not vaccinating, not to mention facing all the official pressure as well, carried far shorter odds of a bad outcome than just going ahead and doing it. “

That indicates that believe YOU had and have a reasonable concern that in the end was outweighed by the benefits of vaccines. Yet in fact you are unable to provide any facts justifying such a concern, only generalized paranoia. Your way of speaking about this is, at the very least, culpably careless. I frankly don’t give a rat’s ass whether you enjoy being told that.

So once again I say, in the charged atmosphere surrounding vaccines such content-free expressions of “concern” only feed the very hysteria you claim to want to alleviate.

Plus, from a public health standpoint, especially in a country that doesn’t have a health care system that does much for low-income families, it’s easier to get it all in one go that risk that some not be gotten by necessitating patients make repeat visits.

I’m convinced this is the reason our vaccine schedule is the way it is:  health insurance companies will only pay for a certain number of doctor’s visits a year, so if the doctor doesn’t get all the vaccinations in at once, there’s a good chance that the child won’t get all of the necessary vaccinations.

But, of course, we can’t discuss practical things like people having limited access to healthcare because the anti-vaxers are busy insisting that vaccinations are poison.

Okay, I have to ask.  What’s the point of this discussion?  Is it to pat ourselves on the back because we’re smarter than those idiots who won’t vaccinate their children?  Or is there really a concern here that the anti-vaccination movement will have a serious effect on public health?  Because if it’s the latter, and this is a problem that requires action, I don’t think calling these people idiots and lunatics is a workable solution.  Neither is telling them to take their kids home and rot (or worse, threatening to come take their kids).

As someone once said, the solution to bad speech is more speech.  I recommend constructive, compassionate speech, the kind of thing liberals are supposed to be good at.  Would it be so difficult to have Dr. Benjamin do a prime-time PSA where she introduces some scientific facts and says some reassuring things about the manufacture and regulation of vaccines?  Maybe bring out some parents who can talk about their doubts and explain how they got their kids vaccinated and everything’s a-ok.  I think that might do more good than telling these people to go fuck themselves.

Steve, you’re shadow-boxing.

Sam, you’re concern trolling.

It’s generally understood by serious researchers to be a function of genetics, rather than parenting skills (e.g. the discredited “refrigerator mother” theory) or external toxins (as the anti-vaxers would have it).

How would researchers be meaningfully able to tease out an environmental factor which is essentially ubiquitous, such as the hormone-imitating soup which is our air and drinking water?

I still think that the only way to convince people that science knows what it’s damn well doing is to educate the populace about science more thoroughly.  Scientists are, as you might imagine, relatively united around the fact that science works.

I like to be the “nice” fluffy liberal sort and assume it’s just ignorance, willful ignorance at worst.  That doesn’t mean it’s an easy problem to solve, though.  In any case, it’s really an argument about education, and that sort of thing takes generations to correct.  And that’s IF relevant governing bodies get off their asses and make an honest effort to make things right.

I don’t even think it’s an issue about partisanship.  People on the left, right and center agree with science as long as it reinforces their prejudices, and think peer review systems are “elitist” and “biased”. (Teh irony, it burns!)  Personally I think that’s like buying orange juice because you like the color, but what the hell does this engineer know.

I’m not holding my breath for a Quality Education turnaround.  I pretty much think we’ve irreparably screwed ourselves for the next several centuries.  At this point I’m considering moving to a more sensible country.  Which, now that I think about it, leaves my options pretty open.

What’s the point of this discussion?  Is it to pat ourselves on the back because we’re smarter than those idiots who won’t vaccinate their children?  Or is there really a concern here that the anti-vaccination movement will have a serious effect on public health?

Both. The second obviously the more important.

Because if it’s the latter, and this is a problem that requires action, I don’t think calling these people idiots and lunatics is a workable solution.

Not being the MSM, we can’t really address the second goal by pretending the anti-vaxers are reasonable or have point.

How would researchers be meaningfully able to tease out an environmental factor which is essentially ubiquitous, such as the hormone-imitating soup which is our air and drinking water?

It’s more that they’ve done studies of family histories and genetic surveys, and found that this is by far the more probable cause of autism than an immediate toxin or parenting style.

Obviously external toxins can have effects on genetic factors that have long-term, multi-generational consequences, but autism (under different classifications) was been around a long time before vaccines or fluoridation or the chemical industry, etc.

Most autism research of any validity is indicating that it’s likely genetic.  Why is a question—-some theories are that better testing has found more positives, also that older parents might be a contributing factor.  But it’s not vaccines.  It’s almost surely not “toxins”.

There’s also a pretty solid economic reason to get all the vaccinations at once, because our health care system is such a joke.  If you take your kid once to get 3 vaccines, you maybe pay your $20 copay, if you’re lucky enough to have insurance.  If you take your kid 3 times to get the same 3 vaccines, you now pay $60.  That’s not a luxury all, or even many families have.  And if you don’t have insurance, it’s just that much worse.

Sam, while you have a point, I don’t believe in coddling idiot ideas. 

It doesn’t matter what someone ‘believes’, until it comes into direct conflict with facts, and tiptoeing around doesn’t stop the Birthers, the Global Warming Denialists, or the Anti-Vaxxers.  In the comments of the linked article, they are STILL whining about mercury!

There’s no question about whether or not mercury preservatives caused autism.  They didn’t.  If they had, then when they were removed from vaccinations, we would have seen a dramatic drop off in autism rates.  That didn’t happen; therefore it is plainly obvious that whatever deleterious effects mercury may have on a child, causing or contributing to causing autism is not one of them.

As for Down Syndrome parents having it easier than autistic parents?  Once at the Museum of Science and Industry in Chicago they had an exhibit about gestation and genetic/congenital problems, where they oh so kindly let it be known that Down Syndrome is caused by the MOTHER’S egg having too many chromosomes.

No mention of the fact that a sperm with an extra 21st chromosome causes the same syndrome.  Just motherblaming.

And while autistic kids might be considered brats, DS kids can often be recognized on sight, and if you think that makes people be even the slightest bit kinder, I’d like to introduce you to most of my life. 

Not to turn it into the Disabled Olympics, but the point is people are assholes.  If someone came out with a diet/exercise/chelation “treatment” that they claimed improved DS, people would jump on the bandwagon just as easily as autistic antivaxers.  Hell, some assholes still have surgery performed on their kids so their eyes will be rounder and their tongues smaller.  B/c removing most of your taste buds is a small price to pay for looking slightly more “normal”.

People are assholes, but facts are facts.  Somehow we need to re-educate our populace so that they understand what a ‘fact’ is, and that ‘belief’ doesn’t affect a fact one way or another.

Punditus Maximus, the way to do that is looking at the big picture, much as they do with cancers. Does autism show up in *families* or *neighborhoods*? Pollution thickens and thins in areas, and sensitivity to it can be assumed to be spread fairly evenly among large populations.
For example, living within 1/2 mile of a freeway *definitely* increases your children’s chance of being asthmatic. It’s environmental.
I haven’t heard of autism clusters being discovered.

As for a rise in the number of cases, considering it was classified relatively recently, and the spectrum means nuances between high function, low function, Aspies, and (I think?) other less known autism related disorders—there may be no more cases now than 200 years ago. But then, they would be “peculiar”, “idiots”, “insane”, “possessed”, etc, depending on the degree of impairment and sophistication of the people they interact with.

Fibromyalgia used to be called rheumatism, because the science wasn’t good enough to tell the difference between actual joint damage in rheumatoid arthritis and the non-anatomical pain of fibromyalgia. Skeptics (who don’t believe in subjective pain issues)call fibromyalgia a “new” disease, because it’s a new classification for an old problem.

Would it be so difficult to have Dr. Benjamin do a prime-time PSA where she introduces some scientific facts and says some reassuring things about the manufacture and regulation of vaccines?

We’ve actually been having this selfsame discussion at Balloon-Juice and it’s astounding how you can present reams of evidence to people and they will still ignore it all in favor of their “feelings.”  Sure, we have a hundred studies showing that thimerosol in vaccines has no effect on the autism rate, and we can show longitudinal studies demonstrating that autism rates did not decrease one iota in the 10-year period after thimerosol was removed from vaccines and in fact continued to increase, but as long as people are encouraged to go by what they “feel” is correct and not the facts, we will continue to have people claiming that mercury in vaccines causes autism.  No amount of PSAs is going to change that, especially since a good half of those people are patting themselves on the back for being so much smarter than all of the sheeple who get their kids vaccinated.

I don’t want to be this harsh, because I think a lot of people in the anti-vaccination movement got there because they’ve been traumatized by having an autistic child, and they’re looking for answers.  And the anti-vaxxers give them a very flattering answer, which is that the fault doesn’t lie with their genetics, but with the choices made by experts, who can be easily villainized.  The narrative established is hard for some parents of autistic children to resist—-that they are 100% blameless, that this disease was caused by doing the right thing in vaccinating your children.

Sorry, Amanda, but this is not entirely accurate.  I think it’s pretty much agreed upon in the medical and scientific community that autism isn’t a genetic disorder in the same way that, say, the Down syndrome or Tay-Sachs disease are genetic disorders.  Rather, autism has a genetic component—meaning, genetic error (or a combination of errors) is only one of the ingredients necessary for the child to be autistic.  The other ingredient is the so-called “environmental trigger”.  At this point we don’t know what the environmental trigger is (and in reality, it’s probably an array of triggers), though various candidates have been proposed.  So, please—we KNOW our genetics aren’t entirely to blame.  That’s a given, whatever your attitude to vaccination.  Also, the fact that parents of autistic children are obsessed with determining what triggered their children’s condition isn’t as simple as an issue of guilt—and I hope you’ll forgive me for saying that as a mother of an autistic toddler, I find your comment a bit patronizing.  There are MANY reasons why we want to know.  On some level, I presume most of us want closure, yes, but a lot of us also want to have more children—and not willing to risk having another autistic child, we are really interested in prevention.  We are also interested in prevention because believe it or not, having come face to face with this devastating disorder, we are concerned for other children and their parents—and the fact that the prevalence of autism-spectrum disorders and severe developmental delays has been increasing so astronomically, it in no way can be explained by greater awareness or better diagnostic techniques alone.  As to the parents who blame vaccination, you also have to understand that in at least some cases, autism has certain manifestations that characterize it as probably an autoimmune condition—which, of course, would make them question any environmental influence that significantly interferes with the immune system.

Finally, a small minority of ASD cases are caused by a mitochondrial disorder—and in those cases, autism-like symptoms ARE triggered by vaccination, specifically multiple shots delivered within a short period of time.  And I understand, of course, that it’s easy to dismiss small minorities as insignificant if you are talking about millions of children and in the abstract; much harder to do so, when you are talking about your own child and know from personal experience how unremittingly horrible autism is.  One’s own child is impossible to reduce to a “negligible” statistic.

Additionally, it should be pointed out that people aren’t simply either pro-vaccination or anti-vaccination.  It’s more complicated than that.  Many people who support vaccination in principle have, I think, legitimate concerns about the wisdom of giving an infant nine different shots in a single visit, about the timing and scheduling of inoculations, about the lack of disclosure to patients of the ingredients of vaccines (with accompanying statutory immunity for vaccine manufacturers), and about state laws which compel vaccination for children with well-documented medical histories of severe reactions to vaccines or family history of mitochondrial disorders (which, of course, shows that administrative convenience in this case is prioritized over the well-being of individuals).  I think Sam Holloway is right to say that those concerns should be addressed seriously and in good faith, as opposed to just calling people who have them deranged.

The fact that scientists would love to find a demonstrable cure is beyond them, that if many children really were cured by a gluten-free diet, scientists would publish these findings is unacceptable.  Better to believe in the Secret and Woo and pray for the miracle.

Yes, any scientist who could actually identify a cure for autism would be rushing to publish it as fast as possible! This part of the anti-science trend really frustrates me, that many people seem to think that there is some benefit to scientists based in academia to “suppress the shocking truth” when in fact nearly every scientist DREAMS of that day when s/he can discover something NEW, something BIG, something SURPRISING!  That is what absolutely MAKES your career, maybe for a lifetime! 

Reinforcing the status quo gets you very few citations and very little acclaim.  And citations and acclaim are THE currency of academia.

The concerns about giving them all at once are a tad overblown.  I suppose if you have the time and money and the inclination to spend them on making sure your kid doesn’t run a slight fever or have achy arms, then go for it.  But there’s a very good reason to do them all at once, and that’s that many, probably most parents don’t have that luxury.

What’s the point of this discussion?  Is it to pat ourselves on the back because we’re smarter than those idiots who won’t vaccinate their children?  Or is there really a concern here that the anti-vaccination movement will have a serious effect on public health?

Both/and blog.  I’m not entirely convinced that calling people idiots is such a bad strategy.  They won’t change their minds and it scares off new recruits to think that they’re buying into blatant idiocy.

Of course, that has to be part of a larger strategy that involves other skeptics being kinder/gentler.  You throw a bunch of different tools at a diverse problem, knowing different messages work on different people.

*lays hand to forehead and sighs*

I think it’s pretty much agreed upon in the medical and scientific community that autism isn’t a genetic disorder in the same way that, say, the Down syndrome or Tay-Sachs disease are genetic disorders.

I don’t know about that—twin studies are showing that when one identical twin develops an autism disorder, the other twin will also develop one 88 percent of the time.  That’s a pretty high average.

It’s not a “genetic disorder” in the sense that there’s something physically wrong with the chromosomes as there is with Down Syndrome, but there’s very clearly a strong genetic component, much stronger than environmental factors.

Not only that, but I suspect that there are some things being grouped under “autism” right now that don’t have the same causes.  If your child is exhibiting autism-like symptoms because of a mitochondrial disorder, is it really medically helpful to group him/her with a child who has similar symptoms because of a different disorder?

Point taken, Amanda.  I believe that calling tea baggers idiots is usually warranted.  But I tend to tread more carefully on this one, precisely because I know a lot of parents with autistic kids, and I’ve been at the point of decision myself.  Also because when someone’s heart is in the right place, and they are legitimately looking for answers, they can more easily be converted with a no-nonsense (yet compassionate) approach.  They’ll also make a hell of an advocate for seeing the light, as it were.  But lumping all who have questions (and may be letting understandable emotions get the best of them) into the denigration bin isn’t going to thin their ranks very much.

One additional thing before I get back to work:  it makes perfect sense to me that people who have a family history of autism (already have an autism-spectrum child, have a sibling or other relative with an autism-spectrum disorder, etc.) would be wary of vaccinations.  The brother of one of my co-workers is autistic, so they chose to go with the slower vaccination schedule to be extra-cautious given the family history.

But there’s a difference between taking precautions because of a family history and deciding that vaccinations are unsafe because Jenny McCarthy told you they made her kid autistic.

Chemicals can cause mutations.  So, in the spirit of both/and, just because a disease (or a cancer) is genetic doesn’t mean that a chemical or virus didn’t cause that mutation. 

And I’m glad Redisca brought up the mitochondrial issue—it’s nice not to be the only person on this blog that believes that triggering is a possibility, for at least some cases.

When it comes to vaccines, a lot of people seem unwilling to question.  It is not “anti-science” for me to look at what chickenpox means for kids, and look at what the vaccine means for kids, and say, you know, I really hope it doesn’t become part of the vaccine schedule.  Or to be concerned about whether bundling of vaccines increases or decreases their efficacy.  The last vax. thread, we had some discussion about that.  Point is, that information should be publicly available.

And lest people blow their tops, and start calling me all kinds of idiot, I got hep b, am still considering the hpv vax, but I never get the flu vaccines.  I did get a respiratory flu, and it sucked, but it was the first time I’ve had a flu in five years.  That’s a personal choice.  (And yeah, I stayed home and didn’t infect anyone else.)

I think one of the things that makes it hard for me to be polite is that failure to vaccinate is not a victimless crime. It’s not the parents who are going to be getting sick, it’s their kids. And it’s not just their kids, but infants and others with screwed immune systems that their kids infect. It’s free-riding while riding around in your car shooting at other people.

You can’t shoot the other people unless:

1)  They have also chosen not to be vaccinated
2)  Their vaccination doesn’t work

So they are free-riding, but not perhaps to the extent that you think.  And where does it start/end?  HPV?  Hep B?  Chicken pox?  The flu?  What is the line, where should it be, and why are people bad if they don’t agree where it falls?

Isome,
my neice is immune compromised because of leukemia.  If she gets chicken pox or a severe case of the flu, it could kill her.  Also, part of the reason H1N1 is such a big deal is because the complications showed up mainly in young children.  Young kids that wouldn’t have died from the seasonal flu died from H1N1.  My sister deliberately sent my neice to a small, private K-4 so she could ensure that all the kids were up to date on their vaccinations.  You talk about toxins and such, but the research on vaccinations doesn’t really back up anything you say.

I hear many anti-vaccers complaining how all these shots come out just to make BIGPHARMA a ton of money, but from what I understand, vaccines are not where the big money is.  Viagra and Prozac are where the money is

But, Amanda, I think you’re painting everyone who’s skeptical about vaccines (whether involving the autism link or not) under an unnecessarily broad and clumsy brush.

There’s a great solution for the anti-vac skeptics out there - travel to a developing country.

You really only have to see one person permanently disfigured from polio to change your mind about how “dangerous” vaccines are.  Or, for that matter, enjoy food from a street stall knowing that, thanks to the typhoid vaccine you got before you left home, you’re not risking your life.  Or, shit, decide you’re desperate to see Macchu Picchu or Carnaval or Timbuktu before you die, and thus find yourself legally required to get the yellow fever vaccine before you can enter the relevant country. 

I really think all this “skepticism” comes out of an amazing level of naivete on behalf of people in the developed world.  That’s really all there is to say about it.

Ismone:

...
3) the immunity conveyed by their vaccination has deteriorated (as it can for some diseases, e.g. tetanus where people with potential exposure are recommended for boosters every 10 years)
4) as kitten parade said, they’re immunocompromised
5) they’re not of an age to have had that particular vaccine yet.

The fact that antivaxers are only shooting at the most vulnerable members of the population doesn’t endear them to me.

Wrong everyone, the only rational explanation is that the new world order has got to the Lancet now too. First fluoride and now this…

Having lived in developing countries and having known people who have lost children to a lot of these diseases, I agree that there is a lot of naivete on the part of people who live in the developed world about the dangers of these diseases. I want to stress that I am pro-vaccine and anti-free rider.

What I want to throw out is a few other factors that I think contribute to anti-vax rhetoric finding traction.

There are way more vaccines being given these days than there were even when I was a kid (I’m in my early 30s), and they’re being given for diseases that have much lower rates of death and disability than the biggies like polio, measles, whooping cough, etc. So as a new parent, you go in and you’re being asked to vaccinate your kid against stuff you’ve never heard of and that pre-vaccine killed something like 200 kids a year in a country of more than 300 million people. They’re giving these vaccines because the risk of an adverse outcome still is less than the risk of getting the disease - vaccines are that safe, and that’s how public health decisions like which vaccines to put in the schedule get made - but without more extensive education and just having it sprung on you in the doctor’s office, it does make it harder, I think, for parents to see it in life and death terms.

In terms of vaccines not being safe, there was a vaccine (I’m about 90 percent that it was a rotavirus vaccine - this is a virus that causes diarrhea and kills a lot of kids in poor countries but very few in rich countries, even without a vaccine) that turned out in the late 1990s or early 2000s to cause bowel obstructions at a rate that greatly exceeded the number of children that were protected from getting the disease. That vaccine was actually removed from the schedule. I don’t know if there was evidence of inadequate testing or it was simply something that had to be used in a very large population for the rate of adverse reaction to become apparent, but when you’re told 1) vaccines are really important and life-saving, except 2) this one which we swore up and done you needed actually did more harm than good, that helps prepare the ground for more vaccine skepticism.

Lastly, particularly among the crunchy set, you’ve just come off of pregnancy and childbirth, where there is tremendous overmedicalization, pushing of procedures that are not shown to improve outcomes, “doctor knows best” type stuff. You go from one situation where skepticism and questioning is absolutely warranted and may protect you to another where your skepticism is much less warranted and may hurt your child or someone else’s. But it’s hard for a lot of people to make that shift or to understand that skepticism also has to respond to evidence.

There needs to be a lot more education about how science works and how vaccines work. There are people who won’t be satisfied no matter what the evidence shows, but I do think that education could address some of the issues that help those people get traction.

You know, as someone with a family history of autism with a child with ASD who nonetheless strongly believes in vaccination and had all the children vaccinated on schedule, even when they were still using that shitty DTP instead of the DTaP, I would ask the people sneering at skepticism of Big Pharma to kindly cram their clueless, entitled attitudes up their asses. Hard. As has already been pointed out, when your entire argument to quell people’s panic about autism and vaccines is “you’d trust For-Profit Science if only you weren’t such an ignorant, baby-hating ninny,” then of course they’re not going to listen to you. The pharmaceutical industry in the US has earned every iota of its bad reputation. And you think that’s going to go away by telling people no, really, that misbehavior is only for stuff like Vioxx or Yaz, the vaccine wing is totally safe?

(And, by the way, let’s not forget the shitty attitudes of some medical professionals as far as actually informing people of what side effects are likely to occur, how to deal with them and when you should and shouldn’t worry about them.)

As some have already said here, the way you fight the Jenny McCarthy idiocy is with information - about what really is in vaccines, and the horrible diseases they prevent - not with rolling our eyes collectively about somebody who’s terrified that they’ll give their kid autism because they were afraid of chicken pox.

When it comes to vaccines, a lot of people seem unwilling to question.

Magic. Just magic. Because the scores of highly trained and knowledgeable scientists who dedicate their lives and careers to constantly testing and improving vaccines don’t count. And people who take the advice of these scientists are what, sheep? Are idiots for not going and getting their own Ph.D.s in immunology and virology, spending years studying, starting their own labs, and then finally being able to verify for themselves that the very well documented consensus says vaccinate your kids?

The whole haphazard cry that people need to be “willing to question” is just ridiculous. Do you have any idea what kinds of questions to ask in the first place? Beyond asking a doctor or two, or someone knowledgeable about public health, if you should vaccinate, what other questions do you propose to ask (questions that haven’t been answered a thousand times before in scientific journals around the globe?) People with no scientific training at all asking stuff like “what about the tooooxins!??” is just like a toddler screaming “whazzat?” except that the toddler is more likely to listen when you tell them. Anti-vaccers seem to be too busy “questioning” to listen to the answers.

And seriously. If all the scientists in the world decided they loved *nothing better* than poisoning kids I’m pretty sure that inventing a system of vaccinations with an incredibly high success rate and unprecedented safety is not the way to go about it. Be paranoid on your own immune system, and leave the kids that anti-vaccers kill out of it. They don’t want your H1N1 or your measles. If you’re going to spread disease, please keep it in your own damn family.

As has already been pointed out, when your entire argument to quell people’s panic about autism and vaccines is “you’d trust For-Profit Science if only you weren’t such an ignorant, baby-hating ninny,” then of course they’re not going to listen to you.

As has already been pointed out, that is *not* the entire argument. The entire argument is decades and decades of research, mountains of data, piles of articles, crowds of scientists and doctors, and a decent dose of polio-will-fuck-you-up-NO-REALLY from the older people out there. The entire argument is being ignored by anti-science nuts who think that somehow the mercury in a vaccine *that has no mercury in it at all* will damage their child. Or that a vaccine that has “chemicals” in it (yanno what has chemicals in it? Pretty much EVERYTHING) accounts for a kid with a lot of autistic relatives turning up autistic.

Most of the “if only you weren’t such an ignorant, baby-hating ninny” from my end, at least, is a fair bit of justifiable anger that spoiled parents with their snowflake children hold their dainty fingers into their ears and shout “LA LA LA” when PubMed is free to anyone with a computer and the entire medical and scientific community says “not vaccinating your kids will kill other people’s kids. And maybe your kids too. It does *not* cause autism.”

It’s like this weird pet peeve of mine where I get upset when people are willfully ignorant about science and health to the point that children die because of it and then they turn around and criticize the tone of the people who have been begging them to vaccinate.

Right, everybody has a computer and access to PubMed and the background and understanding to benefit from it. Also, a swimming pool, a Lexus and a six-figure income. Christ on a cracker.

When you lump in professional lying assjacks like McCarthy and Wakefield in with people who are actually concerned about their kids’ long-term welfare, and bitch that they’re ‘spoiled’ and think of their kids as ‘snowflakes’ instead of, oh, assuming that if they get autism you can just stick them in an institution and grow a new one, you are not going to communicate the necessary information - the mountains of data, the piles of articles, the crowds of scientists and doctors, and the wisdom from older people who remember what it was like to have their friends crippled for life or killed by polio. All you are going to do is feed the liars’ message that the drug companies are (again) hiding something from them.

Yes, I know that there are idiot parents who are simply woo-woo and wrapped up in their self-image as squishy nature-loving hippies. I have lived for the past umpty years in urban Oregon and California where these morons grow thick on the ground, and no amount of science is going to help them, because they are more interested in preserving their self-image as Natural Pioneers than anything else. I also know that there are people who may not be educated, polymath Internet savants who can whisk over to PubMed and sift out the good from the bad - and we have to reach these people in some way other than yelling “obey science, bitches!”

Oh, speaking of online articles and PubMed and all, the Lancet didn’t even fucking get around to formally retracting Wakefield’s 1998 paper until yesterday. There weren’t even concerns raised about it until 2004.

When it comes to vaccines, a lot of people seem unwilling to question. 

Sorry, the greater issue is that people are allowing their “willingness to ‘question’” to matter more than basic realities.

Not only that, but I suspect that there are some things being grouped under “autism” right now that don’t have the same causes.  If your child is exhibiting autism-like symptoms because of a mitochondrial disorder, is it really medically helpful to group him/her with a child who has similar symptoms because of a different disorder?

As well as a lot of things that were simply dismissed as personality quirks back in the day that are only now being recognized/grouped under the general category of autism spectrum disorder.

To use fictional examples, right now on television are several characters that the writers have generally protrayed as having mild versions of the various things lumped under the autism spectrum,  and yet when you compare those contemporary characters to characters from older fiction, you don’t seen anything new or groundbreaking.  Socially awkward, intensely focussed interest on a single subject, not recognizing when people don’t want to hear them go on and on about said subject they find so utterly fascinating…did I just decribe someone with Aspberger’s or any number of the stereotypical scientists who have populated fiction since the early part of the 20th century?

I strongly agree with Victoria’s comment (#19). Although the CNS was considered a “privileged site” (sealed apart from the rest of the immune system), the brain and the immune system do interact. The field of neuroimmunology is still in its infancy. It would make sense that immune responses (which are complex and systemic) from vaccinations could have effects on the developing child brain, especially when the system overall is defending against several antigens from several vaccinations simultaneously.  The fevers Victoria mentioned aren’t random; they care complex and they suggest multisystem activity. I am far more suspicious of a compressed vaccination scheduling than I am of various vaccine preservatives, which have been villainized.

I think that it wrong to dismiss the concerns of mothers re: vaccinations & autism out of hand. I met a mother who noticed autism symptoms in her child within days of receiving several vaccinations but not before (the kid was later found to indeed have autism). Mothers do have a special sense when something is wrong with their babies, and I think it’s bad medicine to disregard their impressions. On one hand, it is harsh. On the other hand, mothers are right about what’s wrong with their babies about 60-70% of the time. Granted, they may be wrong many times, but they’re right more often than not.

Amanda, I think you’re treating this important and sensitive subject with a lot of stereotyping (e.g. “yuppie parents”), condescension (e.g. “mommie instinct”), and unfair association (climate change denialists). Autism has an unknown cause still; it’s not like climate change at all.  There could be an environmental etiology that is yet undetermined, and there appear to be genetic factors. It is unclear of the rise in incidence is improved diagnosis or high penetrance in the population. Disragarding the opinions of mothers is the kind of paternalistic medicine that is finally on its way out, and it’s weird to have you make an argument for it.

Sorry for the typos.

Jeez irv4u2, way to undo the attempts to invoke a nuanced understanding of why parents might be concerned about vaccinations.  Just shut up already about vaccinations and autism.  Your anecdote is worth absolutely zilch when placed against numerous meta-studies following thousands upon thousands upon thousands of children.  That ship has sailed.

For the record, I am a mother of a 2 year old in the UK.  I don’t have detailed knowledge of the vaccination clustering you are talking about in the US.  Here, on the NHS (hence no worries about multiple co-pays) we have early years vaccinations spread over the first year or so.  <checks child health record book> Yep, she had something like 12 vaccinations spread over 13 months, and the next ones are due somewhere between 3 and 5 years old.

Because I am part of a group of extended breastfeeders (who are often the hippy type) I have a number of friends who havent vaccinated their children.  I find it easiest simply to just not have the conversation.  By this stage, opinions are set and no good can come of it.  You are only going to clash about whether or not you have put your child at risk of death or injury, and that is never going to go well.

However, the people you can reach with reasoned and respectful arguments are the new parents who are just dipping into the whole thing.  It’s difficult not to be affected by the utterl skewed and ignorant media coverage of things like the vaccination/autism “link”, since the media did it really really well/badly.  Talking to such people, with open minds but as-yet unformed and un-informed opinions, with facts and respect for their concerns - that could work.

Sorry, I meant to say - my daughter had something like 12 vaccinations spread over 5 scheduled visits.  That’s what it looks like under (one particular) public funded system where concerns over costs of multiple visits aren’t a concern.  I don’t know how that compares to, say, Canada or France.

assuming that if they get autism you can just stick them in an institution and grow a new one

“Get” autism? Really? Is that something a kid catches on the playground? And it’s not even *about* autism any more—that has been debunked incredibly thoroughly. It’s not about not caring if kids wind up on the autism spectrum somewhere, it’s about people letting children die of preventable diseases because they don’t want to sully their precious pure offspring with “chemicals” or whatever.

I also know that there are people who may not be educated, polymath Internet savants who can whisk over to PubMed and sift out the good from the bad - and we have to reach these people in some way other than yelling “obey science, bitches!”

And I honestly don’t know how the scientific/medical community can be clearer than they are being without way more education for the populace, and less bullcrap being smeared all over the media. When your pediatrician tells you to vaccinate your kid that’s pretty straightforward, yeah? Scientists aren’t a moral or religious authority; they can tell you that *every single piece of evidence out there* has shown that vaccines are astonishingly safe and have *no* link to autism but there’s not really a lot more that can be done by science—you can lead a horse to water, and all that. People have to decide on their own whether or not it’s worth the lives of children and the immunocompromised for them to keep their ignorant heads up their asses.

If the media wants to step up and non-scientist parents want to step up and help educate people that’s great. But once a bunch of dumbasses with a chip on their collective shoulder have worked themselves into a frothing science-hating snit the word of some doctor or researcher isn’t gonna do it anymore. You don’t have to yell at people to “obey science”—you’ll obey it one way or another eventually. I’m just disappointed that we’re going to be obeying it the hard way, with little kids dying for no reason because their parents refuse to let themselves be educated.

Scientists aren’t telling people that vaccination saves lives ‘cause they like the attention, they’re saying it ‘cause it’s true. And it’s true that kids have died because of those oh-so-sympathetic parents who couldn’t be ass’ed to pick up a pamphlet. And it’s probably true that a lot more kids will die until the fear of disease is put back into people and they remember why we vaccinate in the first place. We’re not going to reduce autism rates by skipping vaccinations, we’re just going to get a lot of kids who are diagnosed with Aspergers and then die of tuberculosis right after. Sorry if that’s not sugar-coated enough for people.

Thank you, Katherine, for a welcome dose of sobriety (@74).  Most of the people I know who’ve recently been new or expecting parents fall into the latter category you describe.  They were raised in our haphazard, for-profit medical system, and they had been getting the sort of mixed messages that you describe from our corporate media.  None of them are “dumbasses” who “have worked themselves into a frothing science-hating snit”; they were just people who wanted to do the right thing and didn’t have enough correct information.  I’m glad they didn’t step into a caustic, self-righteous echo chamber to get it.  Seriously, people, lighten up.  If this is anti-vaccination thing is such a serious problem that it requires public policy action, no reasonably sane administration is going to follow the “fuck the idiots” approach that seems to be in fashion here.

If you’re going to spread disease, please keep it in your own damn family.

This. If you don’t want to vaccinate, you need to live in the no-vaccine world if you don’t want your children, or their immuno-compromised grandmother to die choking on their bloody own throat from diphtheria. That means adhering to pre-vaccine community health precautions, and that means quarantine. Might your child have been exposed to mumps? Then they need to be off school for four weeks, at home, isolated from all contact. Have you been to a party and one of the children there later developed chicken pox? Then you can’t take that flight for a family holiday you were intending next week. Has your child a sniffle? It could be polio, don’t let them get out of bed when they feel better, they might develop paralysis.

This is the pre-vaccine world, which funnily enough I don’t see the anti-vaxxers promoting in its full implications. They piggy-back on people who have had the vaccines, benefiting from herd immunity themselves (until it starts to fall when too many get in on the act – anti-vax is the pyramid scheme of health choices) all the while risking the health and lives or the immuno-compromised minority who really need that herd immunity.

I understand Katherine’s point that many new parents are just confused - I’ve known people like that, and when the GP explains the rationale, they accept it and the child has the vaccines. They are people who have been bamboozled by the media and anti-vaccine campaigners. But they aren’t the people in question here - the people in question are those who look at the GP, who has explained calmly and rationally, and sympathetically, and still claim that this woman is a stooge of evil powers and wants to poison their children.

not with rolling our eyes collectively about somebody who’s terrified that they’ll give their kid autism because they were afraid of chicken pox.

Oh yeah, who’s afraid of a little chickenpox, huh? Well, here in the UK, we don’t routinely vaccinate for it. When I caught chickenpox as an adult from someone’s unvaccinated kid, I nearly died, due to inflammation of my airways. So, yeah, I’m afraid of chickenpox.

Quite a thread. Here’s what it comes down to: is childhood vaccination a demonstrated net public health good? Yes or no? (not being a fan of rampant whooping cough and polio and measles, my answer is yes)

If your answer is yes, then you’d better have a bloody good reason for not vaccinating your child.

Hint: a good reason isn’t one where you can say “vaccines are bad because of X,” where X is a variable that can be swapped out to Y (or Z, or A, or B…) when X is discredited. I mean, this isn’t about autism anymore, and yet they keep rolling along.

And no, a justified suspicion of Big Pharma’s business practises isn’t close to enough to demonstrate that a net public health ill exists that outweighs the good.

The maddening thing about this for me, personally, is that my young niece and nephew attend a public school where the vaccination opt-out rate is ~20%—a school with educated, affluent parents who should know better, a school where some of kids are taken on vacation trips to countries where people still get the mumps. The class-based aspects of this scare are disheartening.

A couple of points:

Big Pharma deserves a huge heaping of scorn — but because they charge outrageous prices on vital drugs, try to manipulate the system to keep control of valuable drugs forever, and have politicians in their pocket.

What they are not is in the regular habit of foisting off snake oil on an unwary public, falsly claiming to treat things.  Sure there have been drugs that caused harm, but the world is a complex place and it’s not always possible to predict when problems will come up.  And a properly funded and properly authorized system of government regulation is critical.

Also, trying to blame scientists for not explaining better the data behind the safety of vaccines before you get your child vaccinated is like complaining that they need to explain General Relativity better before you get in your car to drive somewhere. 

If you’re not educated and experienced enough to participate in the discussion at their level, no amount of simplification will will convince you, unless you have a certain amounts of… trust, for lack of a better term.  I don’t understand every single element of how a computer works, and I have a degree in Computer Science.  However, I trust that computers generally work as expected, and when they don’t, I know there is some concrete cause.  I don’t worry that the gods have cursed my magical device and must now sacrifice to appease them.

Does this mean that we have to blindly believe that everything is hunky dory at all times?  No, but we need to maintain some kind of ability to reason, even when it involves our kids — or especially when it involves our kids…

“The maddening thing about this for me, personally, is that my young niece and nephew attend a public school where the vaccination opt-out rate is ~20%—a school with educated, affluent parents who should know better, a school where some of kids are taken on vacation trips to countries where people still get the mumps. The class-based aspects of this scare are disheartening. “

Yep, you get opt-outs in large clusters.  Because the vaccination doesn’t always take, you actually have even a lower percentage of children who are actually immune.  Therefore, even a 20% optout rate dips the entire population below herd immunity and can cause outbreaks.  The Wired magazine article has really good information on the subject.

http://www.wired.com/magazine/2009/10/ff_waronscience/

“Finally, a small minority of ASD cases are caused by a mitochondrial disorder—and in those cases, autism-like symptoms ARE triggered by vaccination, specifically multiple shots delivered within a short period of time.  And I understand, of course, that it’s easy to dismiss small minorities as insignificant if you are talking about millions of children and in the abstract; much harder to do so, when you are talking about your own child and know from personal experience how unremittingly horrible autism is.  One’s own child is impossible to reduce to a “negligible” statistic. “

What you stated above has not been proven by science or printed in a reputable scientific journal.

“Big Pharma deserves a huge heaping of scorn — but because they charge outrageous prices on vital drugs, try to manipulate the system to keep control of valuable drugs forever, and have politicians in their pocket.”

There are good reasons pharmaceutical companies charge big bucks for drugs - it’s because
a) only a small percentage of prospective drugs end up in clinical trials, and a small percentage of those go on to FDA approval.
b) drug companies only get 20 years of exclusive sales of a drug, by law

So, 20 years of earnings has to cover the cost of researching that particular drug, along with the research costs of all the other drugs that failed to come to market, plus marketing costs.  Hence the high prices.

“Also, trying to blame scientists for not explaining better the data behind the safety of vaccines before you get your child vaccinated is like complaining that they need to explain General Relativity better before you get in your car to drive somewhere.  “

Newtonian Mechanics, but otherwise your analogy is sound.

Amanda, did you happen to see the op ed in Nature about how people believe with their tribe when confronted with factual scientific evidence, rather than process the evidence as factual and meaningful in and of itself? 

Dan Kahan NATURE|Vol 463|21 January 2010

Mike:

actually they are in the regular habit of foisting off snake oil on an unwary public, falsely claiming to treating things, but only when it’s massively profitable. Antidepressants, antiinflammatories, weight-loss drugs, cognitive enhancer, gene-engineered clot busters. But the common feature of all of the drugs that are marginally better than placebo or cheaper treatments or that treat made-up diseases is that they generate a huge cash flow. Either one dose costs several hundred dollars, or it’s a few bucks a pill and you take it every day forever.

Vaccines just aren’t a cash cow. We’re talking a few hundred million a year, which is probably what big pharma spends on oversize pens and other swag for doctors who prescribe viagra and cialis.

pete zero one writes, mournfully: “
There are good reasons pharmaceutical companies charge big bucks for drugs - it’s because
a) only a small percentage of prospective drugs end up in clinical trials, and a small percentage of those go on to FDA approval.
b) drug companies only get 20 years of exclusive sales of a drug, by law “

Um Pete?  You kind of left out the most important piece here: all or most of that cost is covered or heavily subsidized by THE UNITED STATES TAXPAYER!

Poor drug companies?  Oh please.  Take your talking points to the local health fair ... people here are a bit more sophisticated.

Dunc, that means we should be vaccinating adults who do not titer.  Where is your own responsibility here, knowing that you were an adult and weren’t immune? 

The chicken pox vaccine mandate for children was the result of extortion, pure and simple.  There is and was no VALID EPIDEMIOLOGICAL REASON to mandate the vaccine and expend the resources for this disease.  I think I’m professionally qualified to make that statement, as are my colleagues who agreed with me at the time.

What the mandate did do: it fueled the antivax movement with a clear example of heavy-handed nonsense in the pursuit of nothing.

Katherine, I was contributing to the conversation. You’re the one saying things like “just shut up” when you admit you know nothing about the specific *scientific* issue I was talking about: vaccine clustering. There have been a lot of studies that show that vaccines are safe and important for public health. Giving all of them in the same month sounds like it could be dangerous, given what I know about neuroimmunology. If you know of a study that looked at that issue (not the “cocktails” or preservatives) & brain effects, I’d love to read it.

There is and was no VALID EPIDEMIOLOGICAL REASON to mandate the vaccine and expend the resources for this disease.  I think I’m professionally qualified to make that statement, as are my colleagues who agreed with me at the time.

But do they agree with this, from JAMA?:

Conclusions   Varicella disease has declined dramatically in surveillance areas with moderate vaccine coverage. Continued implementation of existing vaccine policies should lead to further reductions of varicella disease in these communities and throughout the United States.

Link

Giving all of them in the same month sounds like it could be dangerous, given what I know about neuroimmunology.

Unfortunately, given the way our system is structured here in the US, many parents don’t have any choice.  Either they immunize on the insurance company’s preferred schedule, which limits the number of doctor’s visits each year, or they try to follow a schedule that’s more similar to the ones they have in Europe, which means paying out-of-pocket for the full cost of the doctor’s visit plus the vaccine.

Frankly, at this point, telling parents that they need to demand a slower vaccine schedule from their doctors is just loading more guilt onto people if they don’t have the money to pay for it out of pocket.  Not to mention that it makes the parents the sole responsible ones once again—if they have to follow the current schedule for financial reasons and something does happen, well, why didn’t they demand the slower schedule even if it meant not buying groceries that week?  So I do have a lot of sympathy for people who have to immunize on a schedule that may not be the best one, medically.

Of course, as many people have mentioned, this debate in the US is very much tied up in class.  It’s the upper-middle-class parents who have the luxury of deciding that their child won’t be exposed to any nasty diseases and so doesn’t need to be vaccinated.  The measles outbreak in San Diego a couple of years ago was triggered because an unvaccinated child brought the measles back from a family trip to Switzerland.

But, hey, Sam says I shouldn’t be so mean to the people who are putting children’s lives at risk by not vaccinating them, so I guess I shouldn’t point out that these parents’ negligence led to four hospitalizations.  After all, it would be uncivil for me to mention that they almost killed the children that their infected children came into contact with.

Finally, a small minority of ASD cases are caused by a mitochondrial disorder—and in those cases, autism-like symptoms ARE triggered by vaccination, specifically multiple shots delivered within a short period of time.

What the fuck?

Chemicals can cause mutations.

Are you dunking your baby in a vat of ethidium bromide? 

Mothers do have a special sense when something is wrong with their babies, and I think it’s bad medicine to disregard their impressions.

Getting knocked up does not imbue you with special knowledge. You having sex and a scientist spending years researching vaccines are not equivalent activities that give you the same ability to speak on the subject of vaccinations.

Sorry, there was only one hospitalization out of the 12 who were identified.  But these are the perfectly rational parents that Sam says we need to be so very kind to:

“I refuse to sacrifice my children for the greater good,” said Sybil Carlson, whose 6-year-old son goes to school with several of the children hit by the measles outbreak here. The boy is immunized against some diseases but not measles, Ms. Carlson said, while his 3-year-old brother has had just one shot, protecting him against meningitis.

That’s right—her child actually goes to school with the same kids who spread measles and she’s still perfectly willing to put everyone else’s child at risk so her special little snowflake doesn’t run the terrible, life-threatening risk of being vaccinated.

We’ve actually been having this selfsame discussion at Balloon-Juice and it’s astounding how you can present reams of evidence to people and they will still ignore it all in favor of their “feelings.”

Although there were always be conspiracy nuts and the predators that are willing to exploit nut fear to make money, I blame our broken health care system and systemic sexism for the traction the anti-vaccination crowd has received. Doctors don’t have enough time with patients to properly explain medical situations. If you are uninsured or under insured you might be using over simplified medical sites to self-diagnose. Women often feel condescended to and patronized by the medical community starting with the first pap they were forced to get when all they wanted was some birth control. That breeds distrust that carries over during pregnancy, labor and delivery, then to the pediatrician. So all it takes it some pretty celebrity to come along and say “Hey you were right in mistrusting those docs, they were trying to kill you and your children” or some such nonsense. McCarthy is exploiting a real issue without understanding the underlying cause.

Nice Straw Man, Mnemosyne.  But thanks for underscoring my question: if this is a problem, what is your suggested solution?  Smugness, snark, and insults are helpful if you want to feel superior, but they obviously aren’t getting some of these people to vaccinate their kids.  Perhaps all you sensible folks can buy some ad time and tell these people what selfish, foolish assholes they all are.  Or maybe you can convince the Obama administration to form a federal something-or-other that will force vaccinations on all the recalcitrant parents’ little ‘snowflakes.’  I’m sure that will go over well.

Newsflash: human beings have a tendency to behave irrationally.  Sometimes under emotional pressure we convince ourselves that our counterproductive behavior has rational justification, kind of like when millions of us marched out and voted for a pro-corporate, center-right shill as a response to eight years of being flogged by a pro-corporate, far-right shill.  See how easy that is?

Dark Avenger - I NEVER said the vaccine was ineffective.  What I and others STILL MAINTAIN is that it was a huge waste of money and public health resources to require vaccination against a largely inconsequential infection in people whom it is least consequential.

VERY BIG DIFFERENCE, if you actually understand such things.  So there is a hangnail vaccine and a reduction in hangnail.  So what?  doesn’t make it cost effective to require that vaccine in people not likely to suffer from hangnails in the first place, now does it?  Test anyone over age 10 for varicella and vaccinate those with no or low titer.  Those people are your risk group. 

Vaccinating the kids and denying coverage to adults because it is mandated in kids is a monumental waste of public health resources, most professionals and even lay people realize that, and that very simple fact (plus the threats by the vaccine manufacturer to completely stop all vaccine production if public health authorities did not require it for all kids) has stoked the whole antivax brigade!

BTW, all adults should be screened for immunity to “childhood diseases”.  us 40-somethings needed a boost for MMR because we didn’t get the full protection from our baby shots.  My husband wasn’t vaccinated against measels, mumps, etc. at all!  Neither was my mother - she got mumps at age 41.

If you don’t know if you were vaccinated against whooping cough, measles, mumps, etc. that are hideous in adults, and you don’t remember having them, ask your doctor to catch you up on your shots.  That goes for chicken pox, too, which is generally minor in kids but heinous after puberty.

My husband nearly died from whooping cough - he also got measles, whooping cough, scarlet fever, and mumps in the same year - all pre-vaccinations.  I nearly died from measles - there are three weeks missing from my memory of that year, because I was unconscious and fighting for my life.  I am lucky to only have a couple of small scars and no shingles from chicken pox, but a friend gets regular and debilitating outbreaks of shingles.

My mother remembers wards full of people in iron lungs, and the terror of getting even a mild fever.

Vaccines changed the world.  Anti-vaxxers will change it back.  It may not be what they’re thinking about, but it’s where they’re going, all the same.

A lot of discussions of autism among people who have no experience with the disorder ultimately boil down to this:  Why can’t those pesky parents of those bizarre children just fucking take it easy like the rest of us?  The truth is, of those who smugly talk about autistic children and their parents, very few can even describe coherently what autism is, never mind its effects on the family.  (One commenter above has casually described autism as a state of being “bratty”, for crying out loud.)  How many here really know autism? The condition, even in its “mild” form, is horrific.  A child’s inability to imitate or interpret non-verbal cues from the environment means that he or she needs INTENSIVE one-on-one care every waking minute; and failure of sensory integration means that the child gets easily overwhelmed by ordinary sights and sounds just like you “normal” people would be if every sensation felt like nails on a chalkboard.  In many families, one of the parents must abandon his or her career to care for the child full time—usually the mother.  Because the care required is so intensive, every minute of every day is about the child and the child’s autism.  Once you get the diagnosis, you life will contain nothing else.  There is no respite, EVER.  At least, not for many years. 

The insurance industry’s position is that autism is an incurable psychiatric disorder.  The state’s position is that it just doesn’t want to spend money on autistic children, except to keep them out of the way somewhere.  So if you hit this jackpot, you are on your own.  You guys complain about the cost of regular doctor visits—haha! The only type of treatment that’s been shown to be effective for autism costs over $100,000 per year—none of which is usually covered by insurance OR the public fisc.  And no, I am not exaggerating:  an autistic child needs at least 30 hours per week of ABA instruction for at least 48 weeks a year; schools that provide these services charge about $8K per month.  Nobody wants to pay for that—not the insurance companies, not the government.  This means that only the affluent can afford real treatment, and most of those people are thoroughly ruined financially before they are out of the woods.  By the way, among those who CAN afford the treatment, the results are surprisingly good—probably more than half of autistic children who begin intensive treatment before the age of 4 eventually improve to a point where they either don’t show any symptoms at all, or have symptoms so mild they don’t really interfere with their normal functioning.  And yet, a LOT of people (insurance carriers first and foremost) are really invested in promoting the dogma that autism is absolutely incurable—because to concede otherwise is to open the door to having to pay for the treatment, as well as entertaining the possibility that there are environmental factors at play.  $100K per year, per child, for 5 years or more—that’s a lot of money that has to come from somewhere and so to think that finance or politics play no role in how autism gets “scientifically” described and ultimately addressed in individual cases is an exercise in denial.  So this is what you face as a parent of a child who has just been diagnosed: losing your house, your assets and your savings, and getting heavily into debt; losing your career; likely seeing your relationship deteriorate; indefinite litigation with the school district and insurance companies; negotiating with doctors and educators who are under intense pressure to encourage parents to simply write their children off as hopeless, and at least several years of living in a reality that consists of nothing but your child’s autism.  It is indeed a wonder why parents of autistic children can’t take a page out of their neurotypical peers’ book and just be cool already.

By the way: believe me, guilt isn’t the foremost psychological issue for us.  Raising an autistic child is an ongoing uphill battle.  Guilt is more suited to disasters that have finality to them.  I suppose if autism was physically lethal, like cancer, then a lot of people would agonize over the issue of guilt.  As it is, however, you spend years watching every aspect of your life slowly crumble before your very eyes; and the obsession, therefore, is to stem the hemorrhage, rather than to assign blame.  I cannot, of course, speak for everyone —but in general terms, I think it’s error to believe that guilt is the main concern in a situation where the hammer falls not once, but constantly and repeatedly, for many years—and sometimes, for the rest of your life.

kitten parade,

I hear you.  It is really hard for immunocompromised individuals.  But I didn’t mention toxins, let alone toxins in vaccines, just chemicals.  Not a fan of BPA, for one, but that has to do with chemicals in the environment that are problematic.

It is also really hard for people with overactive immune systems. (Raises hand.)  When I get stressed out, I react to foods that I can normally eat.  So for me, getting vaccinated when my immune system is flipping out and doctors are recommending steroids to tamp down my allergic reaction to food seems like a really bad idea.

Paul,

3) You don’t get tetanus from other people.  http://www.health.vic.gov.au/ideas/bluebook/tetanus
4) See my above
5) Re: there not of age to have that vaccine—I am concerned about the lack of research, in general, about the appropriate age to give vaccines, and whether boosters are necessary when we move vaccines up.  But yes, in general when you are sick, you should avoid the young and the elderly.  (I know for some diseases those two groups are not the most vulnerable populations)

Amanda,

It is one thing to group all vaccines together/assume that they cause autism when the data shows the don’t (except for in persons with mitochondrial issues, who might be triggered by something else anyways, not sure)/and not consider the risks of not vaccinating.  Believe me, I know because I had an uncle who didn’t vax his family for whooping cough, they all got it, and some became dangerously ill with it.  It is quite another to assume that all people who have questions about the timing/grouping/necessity of individual vaccines are anti-science idiots.  I took a degree in biology.  The most cautious person in my family regarding vaccines (other than idiot uncle, who never does any sort of intelligent cost-benefit analysis, regarding vaccines or any other life decision) has a bachelor’s degree in bio., two masters’ in medically-related fields, and kids who, like me, have really hyper immune systems.  That changes the calculus.

If it really is that simple, then tell me, should the chicken pox vaccine be added to the list of required vaccines or not?

And I know about Iron lungs and the polio vaccine.  Here’s something interesting about the polio vaccine—the one I got is more modern and more effective than the one my mother had.  She may be vulnerable to polio.  And yet, there is no push for re-vaccination.  This is why although I would agree that Jenny McCarthy is crazy-pants, the rest of us could benefit from critically engaging with how vaccines are scheduled, bundled, etc.

Entomologista—run a search for BPA exposure on pubmed, and you will see a whole host of articles associating BPA with problems both in adults, and in children who were exposed in utero.  (And in mice and rats, of course.)

Bagelsan,

Okay, I’ll bite.  I question giving Hep B vaccines to infants when their mother both has the vaccine and does not have the disease and when there has been no testing to determine whether infant vaccines are sufficient to provide the same protection as vaccines for older children.

My concern for this is based on the fact that I studied immunology and virology and am concerned based on my knowledge that because infant immune systems are not as robust as adult immune systems, immunity conferred early on may not be as strong as immunity conferred by vaccination after age two.  So that’s an example.

Here’s a study showing that fevers caused by vaccines (or caused by other things) could lead to the onset of autism among a subset of autistic people, those whose autism is caused in part by a mitochondrial disorder:

Autistic spectrum disorders encompass etiologically heterogeneous persons, with many genetic causes. A subgroup of these individuals has mitochondrial disease. Because a variety of metabolic disorders, including mitochondrial disease show regression with fever, a retrospective chart review was performed and identified 28 patients who met diagnostic criteria for autistic spectrum disorders and mitochondrial disease. Autistic regression occurred in 60.7% (17 of 28), a statistically significant increase over the general autistic spectrum disorder population (P < .0001). Of the 17 individuals with autistic regression, 70.6% (12 of 17) regressed with fever and 29.4% (5 of 17) regressed without identifiable linkage to fever or vaccinations. None showed regression with vaccination unless a febrile response was present. Although the study is small, a subgroup of patients with mitochondrial disease may be at risk of autistic regression with fever. Although recommended vaccinations schedules are appropriate in mitochondrial disease, fever management appears important for decreasing regression risk.

http://www.ncbi.nlm.nih.gov/pubmed/19773461?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=6

This is what I believe both Redisca and irv4u2 were referring to in their posts.  Interestingly, the abstract suggests that controlling the fever may prevent the onset in this subset of persons with mitochondrial disease. 

The fact that the symptoms of autism can be triggered in a small subset of autistic patients following a fever caused by vaccine explains two things—why the parents of some autistic children with delayed onset are *certain* that vaccines “caused” their child’s autism, and why all the meta-analyses showed no such effect—because most people with autism don’t have the mitochondrial disorder.

>>The conclusion I came to was that, even if there are toxins that cause autism (which I don’t know, but something has to be causing the increase)<<

It’s generally understood by serious researchers to be a function of genetics, rather than parenting skills (e.g. the discredited “refrigerator mother” theory) or external toxins (as the anti-vaxers would have it).

A lot of what drove the anti-vaxer parents of autistic children was their reluctance to acknowledge that they might somehow be to “blame” for their child’s condition.

That and the expansion of the autistic spectrum in general. It’s gotten wider.

Ok, here’s a question. 

Lets pretend for half a second that somehow vaccines cause bad things like autism to happen.  So, if a kid gets a vaccine, has some kind of reaction, there’s a fever caused by some immune response, as Ismone is talking about about, etc., they end up with autism.

Why doesn’t just getting sick do it?  What’s so special about vaccines?  Why doesn’t the first cold the kid gets do it too?  Or one of those worse-than-a-cold illnesses like chicken pox, measles, mumps, rubella, polio, whooping cough, tetanus, etc?  I assume there’s a drastic immune response, including fevers, to most of those diseases.  Wouldn’t that then also cause this special kind of autism?  If yes, it’s only a matter of time before the kid catches something, so might as well vaccinate anyway.  If not, why not, and again, what’s so special about vaccines?

its interesting that you bring that up rowmyboat, because the current hot theory on what causes childhood leukemia is a genetic predisposition coupled with catching a virus.  I have no idea if anyone has researched the topic pertaining to autism, but it is interesting.
Redisca - I understand your frustration - but that points more toward the inadequacies of our medical system than to whether or not vaccines cause autism.

But thanks for underscoring my question: if this is a problem, what is your suggested solution?

At this point, I propose taking kids away from those negligent parents before they manage to cause a major epidemic.  Of course, that will never happen as long as childhood immunizations are considered a matter of parental choice and not something that impacts public health, so I suppose I’m going to have to stand by and watch a few hundred children die needlessly before their idiot yuppie parents realize that their children are not magically immune from infectious diseases just because they have money.

Given the low rates of immunizations in some areas, we will have a major epidemic of a preventable disease here in California within the next 10 years, and probably within the next five, and these same people are going to scream about how nobody told them that not immunizing their child against measles or pertussis was dangerous so therefore their child’s death or permanent injury will be—guess what?—someone else’s fault.

If we want to have a debate about when to immunize and if the current immunization schedule is optimal, fine.  But there is no debate about whether or not the majority of children should be immunized against measles, mumps, rubella, polio and pertussis.  None.  Anyone who thinks it should be optional to immunize children against deadly diseases is evil.

rowmyboat,

It sounds like for the subset of autistic people whose autism is caused by the mitochondrial disorder listed in the abstract, just a plain fever will suffice.  The reason the article is so interesting to me is that *some* parents of autistic children with late-onset autism noticed autism happening right after a vaccination.  The one story I heard firsthand was from a friend of mine who told me her younger brother wouldn’t stop screaming after getting vaccinations, and that he lost his (fairly advanced) linguistic abilities. 

So some parents noticed autism following vaccine, drew a causal link, and were told they were full of shit.  Turns out that maybe they weren’t—for some it could just be random chance that their child had delayed-onset autism and began to show symptoms, but for others, fevers caused by vaccination did cause/trigger the autism.

I think the reason that vaccines are “special” is that because the parents noticed a correlation, and the docs. told them they were full of shit.  But now, based on this research, the public health advice can be “Vaccines don’t cause autism.  But for a subset of people who develop autism because of a mitochondrial disease, a fever, which can be caused by a vaccine or by other illnesses, can precipitate the onset of autistic symptoms.  Controlling a child’s fever who has such a rare mitochondrial disorder may prevent the onset of autism at that time.  But research has not yet determined whether persons with that mitochondrial disorder will, at some point, be triggered by another fever or incident.”

Yeah, that’s complicated, and yeah, it’s wordy, but this kind of nuanced answer can reassure people that while vaccine =/= autism, in a very small subset of autistic people vaccine + fever or just fever can = the onset of symptoms.  With the caveat that the symptoms may eventually be triggered no matter what.

Okay, Mnem, but what about what form the vaccines should take, what ages they should be given at, whether they should be grouped, whether the potential insurance problems listed above should be addressed (i.e., multiple visits = multiple copays—should we regulate that out of existence?)

So then we say, “Fevers trigger (not ‘cause’) autism in this subset of people with this mitochondrial disorder.”  Not, “Vaccines trigger/cause autism.”  Because, really, what’s the world record for highest age before a child’s first fever?  4? 5?  If a fever trigger is true, it’s going to happen.  Not, as you say, “may eventually,” but it will definitely, sooner or later. 

You might as well, in a way, protect them from diseases via vaccination and trigger the autism sooner, so the kid can start various learning/occupational/speech/etc therapies sooner.

It’s not just about public health, I fail to see why the child who’s parents don’t want to vaccinate them shouldn’t be protected against diseases, children aren’t their parents possessions.

rowmyboat,

I don’t know if that is better or worse, though.  I don’t know what the mechanism is for that mitochondrial disease.  Later might be better.  The answer that the article gives seems to be give medication to control the fever, don’t delay vaccination. 

radfemhedonist,

They aren’t the government’s property either, right?  As much as I don’t like all kinds of fundy, anti-science parenting, and as much as idiot uncle should’ve let his family get the pertussis vaccine, I don’t like the alternative much either.  It’s a sticky issue, because the kids are too young to make the decision (according to the courts of law) but I wouldn’t want the government being able to force medical treatment on my potential-future-kids either.  For example, antibiotics are still the standard of care for sinus infections—I stopped taking them years ago, which is a good idea because they *don’t work.*

Dark Avenger - I NEVER said the vaccine was ineffective.  What I and others STILL MAINTAIN is that it was a huge waste of money and public health resources to require vaccination against a largely inconsequential infection in people whom it is least consequential.

I had a case of chickenpox when I was a child which from my readings seems to have been the typical experience, and to say that a disease that gave me pain and suffering for two weeks is inconsequential demonstrates a lack of empathy and understanding that is truely shocking from one who works in the field of medicine.

VERY BIG DIFFERENCE, if you actually understand such things.

Well, I have a BS in Medical Science which included being in the same medical school classes some years ago when I got it as a consulation prize for flunking out of grad school, so perhaps my understanding isn’t as limited as you paint it.

Your patronizing tone makes your argument sound better than it actually is, to paraphrase Mark Twain on the music of Wagner.

So there is a hangnail vaccine and a reduction in hangnail.  So what?  doesn’t make it cost effective to require that vaccine in people not likely to suffer from hangnails in the first place, now does it?  Test anyone over age 10 for varicella and vaccinate those with no or low titer.  Those people are your risk group.

Except that I would’ve traded the worse hangnail in history for my typical case of chickenpox, and I think mitigating the suffering of small children is something worthy of the medical profession.

Vaccinating the kids and denying coverage to adults because it is mandated in kids is a monumental waste of public health resources, most professionals and even lay people realize that, and that very simple fact (plus the threats by the vaccine manufacturer to completely stop all vaccine production if public health authorities did not require it for all kids) has stoked the whole antivax brigade!

Routine vaccination against varicella zoster virus is also performed in the United States, and the incidence of chickenpox has been dramatically reduced there (from 4 million cases per year in the pre-vaccine era to approximately 400,000 cases per year as of 2005).

and

Mortality due to primary varicella has declined significantly in countries which make wide use of the varicella vaccine.

Link

But how can an illness you’ve just compared to hangnails have a declining mortality?

Yes, let’s just set aside the millions of kids who never had to experience what I went through, and because they are assholes about adults, let’s just call the whole thing off.  The mortality was going too low anyway.

Okay, Mnem, but what about what form the vaccines should take, what ages they should be given at, whether they should be grouped, whether the potential insurance problems listed above should be addressed (i.e., multiple visits = multiple copays—should we regulate that out of existence?)

Silly me, I thought I was being clear.  Let me dumb it down for you even more:

Debating the form and administration of vaccines = good

Claiming that vaccines will kill your children so you shouldn’t vaccinate them at all = evil

Simple enough for you?

This may seem like a silly question, but isn’t a large part of the increase in autism diagnoses also tied to the fact that it gets correctly diagnosed now a whole hell of a lot more than it did 20 years ago?  The anti-vaccine crowd likes to throw environmental causes out there, but isn’t it just as likely that it’s because doctors are a wee bit more aware than they were 20 years ago?

And I grew up in the age before the chicken pox vaccine, so I got sick as a teenager and managed to infect my siblings in the process.  It wasn’t pleasant for me (and REALLY unpleasant for my infant brother), so people should try to remember that before declaring that these diseases aren’t so bad and risking infection.

Redisca - I understand your frustration - but that points more toward the inadequacies of our medical system than to whether or not vaccines cause autism.

You bet—but those “inadequacies” help explain why so many parents believe vaccines are to blame for their children’s autism.  It’s easy to simply dismiss parents of autistic children by claiming, in so many words, that they are wrong in the head by virtue of being “traumatized”—but it wouldn’t be accurate.  Unfortunately, examples abound of public officials and insurance companies acting in shockingly dishonest and underhanded ways towards autistic children for the sake of saving money.  And they’ve done so with impunity.  A few years ago, one district in New Jersey instructed its schools—in writing, no less!—to submit false information regarding the numbers of autistic students, in order to prevent a new private ABA program from obtaining state certification.  (To explain the motivation: the existence of a better, private program, would mean that the district might be compelled to send at least some of the students to that program at the district’s expense.)  Luckily, the fraud was uncovered, and the private school was certified.  But the official who perpetrated the fraud, after being fired with fanfare, was quietly rehired at a different district a few months later, with a higher rank and a bigger salary.  Early Intervention officials routinely tell parents that scheduling more than about 10 hours of ABA per week would be harmful to their child—which those parents eventually discover to be a blatant lie.  And there are numerous examples of districts, at least in New Jersey, actually falsifying evidence during litigation in order to make their programs appear better than they actually are.  On top of that, there is the culture of invalidating parents’ personal experiences, often to their faces—because saying all the time that autism is unavoidable, incurable, untreatable and not increasing in prevalence means we don’t have to spend any money on preventing and treating it, you know?  With all that happening, can you really blame a parent for suspecting his kids are being injected with poison because pharmaceutical companies are greasing the wheels in the state government?

It wasn’t pleasant for me (and REALLY unpleasant for my infant brother), so people should try to remember that before declaring that these diseases aren’t so bad and risking infection.

Thank you very much.

You know, mnemosyne, I don’t get it.  This is the first time I’ve gotten this kind insulting behavior from you, maybe because we usually agree.  I hadn’t seen your most recent post when I drafted mine, because I hadn’t gotten all the way down the thread.  Clearly that makes me an idiot.

But other than that, it seems that you and I at least agree that while there are a certain subset of vaccines that are so safe (and the diseases so dangerous) that everyone should have them, it isn’t somehow anti-science to question how and when vaccines should be administered, and to think seriously about what other vaccines to add to the list.

well ismone, it is kind of maddening when upthread someone claims the autism is triggered in some children with a mitochondrial disorder, and then you agree, even though there is no science to back this up, which is one of the main points of the post.

and please don’t claim that a one court case is the same as something being proven by science - cause its not

Kitten parade, please see my comment 100.  That is a published, peer-reviewed article.  Yes, in the subset of autistic persons who are autistic as a result of a mitochondrial disorder, some of them began displaying symptoms after running a fever, and that fever was caused for a subset of them, by vaccines.

That’s right—for some autistic people, vaccine causes fever causes onset of autistic symptoms. 

This reminds me of the thread where I got jumped on for stating that autism has auto-immune aspects.

It is a study, not a court case.  I don’t know where you’re getting court cases from.

http://www.newscientist.com/article/mg19726464.100-autism-payout-reignites-vaccine-controversy.html?feedId=online-news_rss20

“How many here really know autism? The condition, even in its “mild” form, is horrific”

Well - I don’t know about that.  What is generally called Asperger’s syndrome is a “mild” form of autism and it’s not really, as far as I can tell, a problem.  Kids may need a little extra explaining about social niceties, people who interact with them may need a bit of education.  Otherwise?  Not so much a tragedy as different.

Okay, that’s nice, kitten parade, but that isn’t what I cited at my comment #100.

And re: viruses and Leukemia, HTLV1 is the number one cause of Leukemia in Japan and the Caribbean (or at least it was in 1999).  It is a retrovirus, and fortunately, most of the people who catch it do not develop cancer.

Ledasmom:  My son has a “mild” form of autism.  He needs a lot, a lot more than “a little extra explaining about social niceties”.  In fact, we’ve never had a problem with “social niceties”—but despite smiling a lot and being really friendly and affectionate, he has tremendous difficulty communicating with people, and was virtually unable to do so before we started him on intensive ABA.  He goes to a private school that’s geared towards children with mild-to-moderate ASD; as far as I can tell, all of them need A LOT more than “a little extra explaining about social niceties”.  All of them need intensive one-on-one instruction for many hours a day.  And even Asperger’s Syndrome is much more debilitating than you can observe from casual interaction.  It’s one of the biggest misconceptions about autism that it’s basically “bratty behavior”.  Bad behavior is only one of a myriad of possible manifestations of a person’s inability to interpret non-verbal cues or to engage in two-way communication.  You can drill it into a child’s head that he is not under any circumstances to roll on the floor screaming—but just because he’s learned not to do that behavior doesn’t mean that the underlying reason for it—i.e. inability to function cooperatively, maintain attention span, etc.—has resolved.  Many autistic children are exceptionally well-behaved, but still very autistic.  If you are interested in seeing what autism is really like, I suggest you contact a private school in your area for a tour.  They give them regularly.

How many here really know autism? The condition, even in its “mild” form, is horrific.

Well, whatever you seem to think that pro-vaxxers believe, I can tell you that anti-vaxxers believe that autism is more “horrific” than dying. That’s right, you got an autistic kid? Anti-vaxxers think ze is better off dead. They would prefer that children die of really, literally gut-wrenching rib-breaking blood-coughing diseases rather than inflict their autistic selves on the world.

People who support vaccinations aren’t the enemy, even if we’re snarky sometimes. The enemy, if you have to have one, are the people who think your child’s life is worthless. They are the people who are so horrified of PWD that they think it is worth little children winding up dead as long as they don’t have to have a damaged one. They know that kids die from not being vaccinated—they think it’s worth it as long as they get to maintain the conceit that they can control their children’s lives and make them perfect in every possible neuro-typical way.

So I try to give people the benefit of the doubt—maybe they don’t realize how bad childhood diseases are. Maybe they’re truly desperate to find something to blame for their child’s autism. But then you get people who have every resource in the world and the best doctors and best science at their fingertips who then turn around and say “fuck the herd, I don’t want a retarded kid.” And they get nothing but contempt.

Well, Bagelsan, you touch on something that I wanted to bring up— that is, that the debate over whether vaccines cause autism was always pointless.  Suppose, hypothetically, that it was proven in every conceivable way that MMR triggers autism in about 1 out of 100 children. What would be your response to that?  Well, based on your post, you would probably say we shouldn’t change a thing.  Because 1 in 100 children is a price “we” can afford.  Did I make the right inference here?  If so, then whether or not vaccines cause autism really doesn’t matter.

Apart from that, you merely confirm what I already pointed out in the post that you quoted: you conflate autism with retardation; you trivialize autism to the level of a mere “imperfection” and vilify parents who aren’t happy with their children being autistic.  My husband and I have thrown everything behind making our son recover from autism.  I guess that makes us tyrannical freaks who want to control our child’s life and make him perfect in every possible neuro-typical way.  Maybe good parents should just let their child be as autistic as possible—non-verbal, non-communicative, illiterate, eating puree’d food, shitting in his pants, chewing on furniture, hurting himself, biting people and screeching for no apparent reason.  What, you think autism is cute?  Charming? Quirky? That it’s a choice that parents frustrate?  Do me a favor—get a fucking clue.  I am not desperate to find something to blame—I am desperate to enable my son to lead a normal life, and as far as I know, that’s the obsession of every parent with an autistic child, except those who have given up.  If you can’t understand even that, you have no business lecturing parents of autistics about how they should relate to their children.

And by the way—I don’t think the so-called “anti-vaxxers” are the only ones who think my child’s life is worthless.

Did you read the article Ismone?  There are other articles related to it if you decide to use the Great Gazoogle. Most of the research has pointed to interesting correlations between mitochondrial disorders and autism, but the consensus basically is that mitochondrial disorders do not cause autism.  You even admit so much.  However, you cherry pick the one article that questions the correlation between fever and autism.
Ismone, you can question the motives of big pharma all you want, but the science is basically all in on this one - vaccines are safe and necessary for public health.  If you want to convince anyone otherwise, the burden of proof is on you and “feeling” that chemicals are not good for you doesn’t count.

But the point is Redisca - the vaccine doesn’ t cause autism.  Just like power grids didn’t cause my neice’s leukemia (there was some early research that suggested living near power grids may cause leukemia, but most of it has been largely debunked)  I think it fucking sucks ass if you have a kid that is sick in any way, and every day must be a fucking trial, but grasping at a myth isn’t going to make your child well.

I am not desperate to find something to blame—I am desperate to enable my son to lead a normal life, and as far as I know, that’s the obsession of every parent with an autistic child, except those who have given up.

Then why are you talking about vaccines? The two are entirely unrelated. Vaccines don’t cause autism. And talking about vaccines and whinging about scientists doesn’t fund therapy and school programs. So why are you on this thread at all? Clearly, if you’re not one of those ignorant fools lashing out at people because they need someone to blame, then when I’m talking about ignorant fools who lash out what I’m saying is not about you. Scientists don’t control public school funding and doctors don’t decide how much people are willing to pay in taxes to support education. I realize that you are screwed, but it is unrelated to vaccination.

If you vaccinated your kid, that’s fantastic. I’m glad you won’t be killing any children in his school any time soon. Cookies for everyone. I’m not talking about you.

Suppose, hypothetically, that it was proven in every conceivable way that MMR triggers autism in about 1 out of 100 children. What would be your response to that?

My response would probably be along the lines of “HOLY FUCK THERE ARE FLYING DOLPHINS AND I CAN READ MINDS” because then I would be in an alternate universe. Do you not understand? Promoting vaccination doesn’t have anything to do with triggering autism in children. It would be like me saying, “well, I believe that taking algebra triggered my clinical depression ‘cause they sort of started around the same time” and then flipping my shit when people continue encouraging kids to take algebra and screaming that they clearly hate depressed people. Obviously that would be ridiculous.

And what’s this “so-called anti-vaxxers” business? Do you think that there aren’t people who genuinely want to stop vaccinating children? What else would you call them? Saying stuff like “so-called” makes me think you have more of a dog in the anti-vax fight than you claim to.

If you can’t understand even that, you have no business lecturing parents of autistics about how they should relate to their children.

Why do I care how you relate to your child? I just want you parents to vaccinate the germy little bastards. I’m not talking about your parenting, seriously, relax. I’m talking about the public health, and those assholes who jeopardize the lives of perfect strangers because they think that the *imaginary* risk of autism is worth the *actual* risk of deadly and debilitating childhood illnesses.

the *imaginary* risk of autism

To be really, really clear before you somehow wind up accusing me of thinking that autism is imaginary: “the *imaginary* risk of autism [from vaccines].” I figured I should clarify that, because you seem to think that any text, in quotes or not, that appears in my comment is 100% endorsed by me the author.

I just want you parents to vaccinate the germy little bastards. I’m not talking about your parenting, seriously, relax.

Ahhh… but, you see, for the parent of an autistic child, so many things are out of their control, but vaccination is something they can control, so telling them that they should vaccinate is, to them, commenting on their parenting, and allowing them to believe that vaccination was a cause of their children’s autism is the last thing that they’re able to “hold on to” to maintain a sense of control, so claiming otherwise is considered somewhat of an imposition on their parenting decisions, if not an insult.

so claiming otherwise is considered somewhat of an imposition on their parenting decisions

Isn’t claiming that they poisoned their kid kinda worse, though? That’s what the anti-vaxxers are saying. I mean, I totally get it that these parents are under a ridiculous amount of stress and, just like everybody else, can have a hard time being perfectly rational about it. But Redisca seems to be saying that it’s not just about trying to have a little control or some place to lay the blame… so I really don’t know what to think, honestly. Admitting that a lot of parents have it tough and make bad choices about vaccinations because they’re hurting and stressed is the most charitable reading I can possibly give the whole situation. Saying that’s not true leaves me looking at the less flattering explanations.

Because not vaccinating your child, except in very special circumstances, is *wrong* and demonstrably very harmful. That’s not even up for debate among most people (including pretty much the entire scientific and medical community.) So I’m just trying think up some reason for this bad behavior besides sheer willful maliciousness and a near-sociopathic level of disregard for the health and safety of the people around you.

Redisca, both my sons are Asperger’s kids.  So am I, in all likelihood, though it seems pointless to get a formal diagnosis.  I rather like them the way they are.

Why do I care how you relate to your child? I just want you parents to vaccinate the germy little bastards.

Nice.  I nominate Bagelsan for the next HHS secretary.  A few public, official displays of that kind of compassion will destroy skepticism of government, corporate pharma, the compromised medical system, and vaccines.

So I’m just trying think up some reason for this bad behavior besides sheer willful maliciousness and a near-sociopathic level of disregard for the health and safety of the people around you.

If you’re a parent, Bagelsan, I’d hate to be one of your kids.  As something of a liberal (this thread is encouraging me to qualify my definition of the term), I recognize my responsibility to the larger community.  But as a typical parent, I recognize that my first duty (and biologically ingrained desire) is to look after the health and well-being of my own child.  As a human being who’s met lots of different people with lots of different views who exist outside of this echo chamber, I can empathize with a lot of different perspectives (most of which I may not agree with).  So when I say that all this enthusiastic denigration of the anti-vaccination crowd—a crowd which some of you at least admit contains a spectrum of beliefs—isn’t constructive, it isn’t because I’m supporting the anti-vaccination people’s actions.  I’m saying it because it is a problem that needs attention, and the kind of attention I’m seeing from most people here isn’t going to do anything but make the problem worse.

See, Bagelsan, just like you don’t give a fuck about Redisca’s kids, all the anti-vaccination people don’t give a fuck about you.  Their first concern is their own children’s well-being.  Don’t like how they go about it?  Fine; call them evil idiots, demand that they do the right thing, or tell them to go fuck themselves; it won’t matter, because they aren’t going to listen to you, and it might just redouble their resolve.  If you want to solve this problem, you and your fellow liberals (or whatever you call yourselves) might want to climb down off your collective, smug high horse and treat these people like human beings.  I’d love to hear someone come up with a solution that doesn’t come out of the Bolshevik playbook.

Ledasmom @ 136: Thankyou for providing something other than autism=doom to this thread.  I have aspergers, and what made my childhood difficult was by and large things my parents and other adults did and said and all the bullying I was subjected to, not my condition.  Sometimes all I needed was for someone to not be a douchebag about stuff like my poor bladder control and things would have been fine.

Sam, as a parent, “germy little bastards” is a good way to describe young kids.  My baby is 7 months old and goes to daycare 3 days a week.  She brings home nasty colds CONSTANTLY.  (She herself, for whatever reason, barely gets sick while her dad and I wind up in total misery.) And this is at a good daycare, with rigorous handwashing and strict illness policies.

And hey guess what else?  They are total vaccine cops and won’t take babies who haven’t gotten all their shots on the CDC schedule.  They have pro-vaccine posters everywhere, too.  Because children, especially in the infant room, are germy little bastards.

And FURTHERMORE. I reserve the right to be smug/nasty/meeeeeean to the assholes who won’t vax their preshus widdle snowfwake.  Because MY snowfwake, while up to date on vaccines, is too young to have had all the ones out there.  She still needs herd immunity!  Contrary to what the boob cops might claim, my breastmilk doesn’t have superpowers!

Yawgmoth- fucking-A right and thanks for posting that. I still have bad memories of being sick half the damn time when mine was little.

Their first concern is their own children’s well-being.

And yet they’re actually endangering their own children, and not in the abstract.  As quoted above, at least one mother watched a measles outbreak at her child’s own school and still refuses to have her child vaccinated against measles.

Clearly, what’s at work here is the mother’s ego, not any concern for her child’s well-being.  If she was truly concerned for her child’s well-being, her reaction would have been, “Holy shit, my kid could have caught a deadly disease from that kid who sits next to him in class!  I’d better try to protect my child from that deadly disease!”  Instead, she doubled down on the denialism and refused to get her child the protection he needs because otherwise it would mean that she was wrong to not get him vaccinated in the first place.

Sorry, but it’s hard for me to look at someone like that and think they’re well-meaning but misled.  She’s more interested in being “right” than in her child’s well-being.

On the other hand, telling them what stupid assholes they are might prevent more people from thinking they have a point…

This is correct only if all those who might be inclined to question vaccination are on the same frequency and wavelength.  Since I can speak from personal experience in saying that they are not, your concept is One Big Fail.  Are there some people who will cling to the fallacy no matter what?  Sure, but the key is the “what.”  Don’t be so arrogant as to assume that everyone knows everything that you know, or sees things exactly the way you do.  If this issue is so vital, and it’s true that those in error constitute a potentially pandemic risk, then it follows that they need to be brought around, one way or the other.  For the umpteenth time, how the fuck do you propose to do that? People who believe that they are protecting their children—and your smug dismissal of their motivation doesn’t amount to one piece of squirrel shit—won’t respond to verbal bullying and shaming; they’ll likely see it as proof of their conviction.  So either you find a way to coddle their “fee-fees” that will let the facts sink in, or you force their kids to the needle at gunpoint.  Since I’m a grown-up who’s not always so enamored of my cynicism about others and their motivations, I believe it’s possible to do the former in a way that will drastically minimize need for the latter.  Maybe it is helpful to ask yourself: What Would Obama Do?

As something of a liberal (this thread is encouraging me to qualify my definition of the term), I recognize my responsibility to the larger community.

Are you preparing, not just for a thread flounce, but for an entire liberalism flounce? Because some liberals coddle dangerous idiots less than you prefer? Welp, whatever floats your boat… :p

This is correct only if all those who might be inclined to question vaccination are on the same frequency and wavelength.  Since I can speak from personal experience in saying that they are not, your concept is One Big Fail.

I think the Big Fail has been treating the anti-vaxxers as though they have some kind of point instead of treating them as the irrational Luddites that they are.  By listening to their point of view and treating it as a rational argument, we’ve given them much more power.  Heck, even you admit that you thought at first that they might be right, until you actually went and did your own research.

To paraphrase John Cole, on one side you have people who want to go to an Italian restaurant for dinner and on the other you have people who want to have burning tires and broken glass for dinner.  And you’re telling us that we should respect the point of view of the broken glass people because their insanity has been persuasive enough that they’ve gotten people to think they may have a point and broken glass may actually be better for you than gnocchi.

Yes, kitten parade, I did.  But it isn’t a study.  I don’t take the opinion of one scientist who speaks off the cuff in an article over a study that shows that some autistic people had symptoms onset after a fever caused by a vaccine.  I also read some of the other abstracts on medline re: the mitochondrial mutation. 

And I’m not “questioning the motives of big pharma.”  I’m pointing out that some of the parents who said a vaccine triggered autism in their children were undoubtedly *RIGHT*, that controlling fever might help that teeny subset of people who have a mitochondrial disorder.  And the persons in the study I cited were diagnosed as autistic.  Don’t play this “oh, they aren’t really autistic” game—autism has multiple etiologies.  They got a diagnosis.  Deal with it.  I don’t admit that the consensus is that mitochondrial disorders cannot cause autism.  I instead acknowledge is is only one of many causes, and it applies to only a small section of the relevant population.

“Ismone, you can question the motives of big pharma all you want, but the science is basically all in on this one - vaccines are safe and necessary for public health.”

Which vaccines?  Under what circumstances?  What about people with hyperactive immune systems like me? 

And regarding chemicals, I could be just as patronizing as you, and give pubmed a cutesy nickname, but I won’t.  I suggest you, however, go on pubmed, look up BPA exposure, and look up pthalate exposure, and check out the abstracts.  There are chemicals that are heavily in our food, water, and cosmetic-type products (including shampoos and soaps, which just about everyone uses) that are very bad for fetuses in utero. 

Stop trying to pin other people’s stupid arguments on me.  It won’t wash.  You’re being really intellectually dishonest here.

Kitten parade,

Even the article you link to in your 122 has a link titled “can autism be a mitochondrial disease,” and says the following:

“Can autism be a mitochondrial disease?

FOR some years now, researchers have known that children with mitochondrial disorders can develop autism-like symptoms, or even full-blown autism. A 2005 study of 69 Portuguese children with autism found mitochondrial abnormalities that disrupted energy production in five of them, (Developmental Medicine and Child Neurology, DOI: 10.1017/S0012162205000332).”

Note the part where it says “or even full-blown autism.”

Mitochondrial disorders are one among the many distinct causes of autism.

As a human being who’s met lots of different people with lots of different views who exist outside of this echo chamber, I can empathize with a lot of different perspectives (most of which I may not agree with). 

Ne, too! But as a mature, thinking adult, I am able to put aside my empathy when it comes to people being stupid and destructive. I have begun to understand why people have irrational fears of vaccines and why parents of autistic children irrationally lash out at vaccines because of their need to affix blame somewhere, but I also reject those beliefs and demand that people snap out of it and stop spreading destructive lies that harm everyone.

I don’t take the opinion of one scientist who speaks off the cuff in an article over a study that shows that some autistic people had symptoms onset after a fever caused by a vaccine.

This is what you’re not making clear, though—are you saying that there’s something special about a high fever caused by a vaccine that can trigger autism in a person with a mitochondrial disorder?  Right now, it sounds like you’re arguing that only a high fever caused by a vaccine would be the trigger and high fevers from other causes wouldn’t.

If the trigger is the fever and not the vaccine, then it’s useless to talk about vaccines as a trigger, because a high fever from a natural case of measles or even chicken pox would trigger autism in same people.  Avoiding vaccination won’t help, because a fever from another cause would be the same trigger.

So, no, the parents who claim that the vaccine itself triggered autism in their child who has a mitochondrial disorder are not right.  The fever triggered the autism, and a fever from any cause would have done the same thing.  The fact that that particular fever was caused by a vaccine doesn’t make vaccinations bad.

And, frankly, if you do have medical issues that mean you can’t be vaccinated, you should be really pissed off at these people for compromising the herd immunity that would protect you.  They have raised your chances of catching measles or pertussis by letting their kids run around unvaccinated.

http://www.aan.com/elibrary/neurologytoday/?event=home.showArticle&id=ovid.com:/bib/ovftdb/00132985-200806050-00001 says:

Many of the mitochondrial diseases do not appear until the child is a toddler, said Dr. Hirano, and infections, whether an ear infection or a flu, can aggravate the symptoms. But patients with mitochondrial diseases generally tolerate vaccinations and should have them, he said, because while a healthy child might be able to recover from an attack of the measles, it could be devastating to someone with a chronic disease.

The consensus is to recommend vaccines, even to children with mitochondrial disorders, he said. An infection could be harmful and it is important to protect them from being devastated by other illnesses.

In short, the same thing that makes children with Mt disorder more susceptible to problems with vaccinations also makes them more susceptible to problems with the diseases we vaccinate against. 

But the risks associated with getting the disease, even in Mt disorder children, is greater than the risk associated with the vaccine against it.

Getting vaccinated is still less risky than not getting vaccinated for these children, according to this article.  They have more problems than children without Mt disorder either way.

Public shame and opprobrium so people know not to align themselves with a dangerous group of anti-scientific luddites.

Ha!  Good luck with that, Chet.  There’s a nation of people out there just waiting to be scolded by left-wing bloggers.

Mnemosyne and oldfeminist,

This is what I’m getting at, taken from my comment 100:

Here’s a study showing that fevers caused by vaccines (or caused by other things) could lead to the onset of autism among a subset of autistic people, those whose autism is caused in part by a mitochondrial disorder:
. . . .
The fact that the symptoms of autism can be triggered in a small subset of autistic patients following a fever caused by vaccine explains two things—why the parents of some autistic children with delayed onset are *certain* that vaccines “caused” their child’s autism, and why all the meta-analyses showed no such effect—because most people with autism don’t have the mitochondrial disorder.

And from my comment 105:

I think the reason that vaccines are “special” is that because the parents noticed a correlation, and the docs. told them they were full of shit.  But now, based on this research, the public health advice can be “Vaccines don’t cause autism.  But for a subset of people who develop autism because of a mitochondrial disease, a fever, which can be caused by a vaccine or by other illnesses, can precipitate the onset of autistic symptoms.  Controlling a child’s fever who has such a rare mitochondrial disorder may prevent the onset of autism at that time.  But research has not yet determined whether persons with that mitochondrial disorder will, at some point, be triggered by another fever or incident.”

Yeah, that’s complicated, and yeah, it’s wordy, but this kind of nuanced answer can reassure people that while vaccine =/= autism, in a very small subset of autistic people vaccine + fever or just fever can = the onset of symptoms.  With the caveat that the symptoms may eventually be triggered no matter what.

Let me be crystal clear—I’m not saying that people shouldn’t vaccinate. 
But I am saying that people who observed the onset of autism following a vaccination may have been correct.  Yes, the vaccination only causes the onset if it causes a fever, according to that study.  But the information is still important because it validates the observations of parents, it suggests a solution (treat the fever, because it may delay/prevent the onset of autism), and IT HAPPENS TO BE TRUE.  We should not lie to parents about what happened.  And if we let them know that any fever is good enough, and there is no way they could have known that since it was such a rare form of a rare disease, it takes off a lot of the guilt.  These are all good things.  Mnemosyne, I understand your point that the vaccine didn’t directly cause the autistic symptoms, because you also need the fever, but because the vaccine caused the fever, it was, in some cases, the proximate cause.  That doesn’t mean you don’t vaccinate, it does mean that maybe you monitor fevers post-vaccination a bit more aggressively.  Or maybe you don’t, because the odds of your child having a rare mitochondrial disease and then being one of the rare subset who develops autism as a result are pretty low.  And triggering may be inevitable.  We don’t know.

I see no problem in having a group of people who think anti-vaxxers are self-centered ignorant assholes and saying so, and another group of people who will take individual parents and walk them lovingly through the steps from anti-vaxxer to vaccination-savvy.  Some of us are good at mockery, some of us are good at respectful friendly education.

Both/and, right?

Yeah, but people who want to mock them as “anti-science” should really know what they are talking about.  Otherwise they’re just being jerks.  And inaccurate jerks, at that.

Especially since even without all children being special flowers bullshit—if I have children and they take after their mom, they’re going to have issues with an immune system that likes to jump at shadows, too.  That changes the calculus.

Frankly, trying to center the issue of autism *at all* in this thread is just a giant derail. There is *no* link between autism and vaccination, so it’s somewhat silly to keep harping on how terrible autism is. Yeah, I get it, there’s virtually no support system in place for families and people dealing with autism. That’s really miserable, and should be changed.

That has absolutely nothing to do with the anti-vaxxers, though, because they don’t even *care* about autism! They just picked that as something they could use to sell their anti-science and anti-public health agenda. They could have randomly decided that vaccines cause some other disease/condition and we’d have people dealing with *that* disease on here screaming that scientists hate people with fill-in-the-blank.

Like it says in Amanda’s post:

I’d argue most of the true believers at this point are yuppie parents of mentally normal children who are refusing to vaccinate for a bundle of reasons, the two big ones being the hyper-parenting culture that leads you to believe you can control everything with nutrition and good parenting, and probably a dose of exceptionalism that comes with their class status.

These aren’t people dealing with autistic children, they’re people who don’t give a shit about autistic children (or any other children besides their own.) Parents of kids with autism got roped into this bullshit to give it a sympathetic face—the anti-vaxxers need an excuse to basically say “screw your kids, mine are gonna skate by on herd immunity!” without coming across as the massive douchebags they really are. So they targeted a vulnerable group and set them against doctors (“they want to poison your babies!”)

You know who really, demonstrably loves kids and wants the best for them? The people spending their entire lives developing and testing and retesting and tweaking vaccines for childhood illnesses. You think scientists get rich off that? You think doctors are pocketing millions ‘cause they convince parents to get their kids protected against the measles? The people who demonstrably *don’t* care about the welfare of children are the ones rabidly promoting this anti-health agenda in a bid for attention and the consuming desire to be special and “counterculture” and pure pure pure. They look at little kids dying and don’t change their behavior in the slightest. They just don’t care.

That’s evil.

Especially since even without all children being special flowers bullshit—if I have children and they take after their mom, they’re going to have issues with an immune system that likes to jump at shadows, too.  That changes the calculus.

Pretty much it means that, if this anti-vac crap gets off the ground in a big way, your children will just be particularly specially screwed. Seriously, I totally understand what you’re saying. No one is advocating that children who *will* react poorly to vaccination get stuck no matter what. We’re saying that, for all the people who don’t have a medical reason to avoid/delay/space out vaccination, it’s *really* important that they keep up with their vaccinations. Because that is the only way that people with immune systems that like to “jump at shadows” can safely avoid harmful vaccinations. A good herd immunity allows a small percentage of people to not get vaccinated—an small allotment of get-out-of-vaccine-free cards before the population is underprotected and the diseases can get the upper hand.

If you’ve got kids with really sensitive immune systems, those get-out-of-vaccine-free cards are theirs and you should be ridiculously pissed off that people who don’t need them are taking them. Some kids really *are* “special flowers” if by that you mean they have special medical needs—the anti-vaxxers’ kids are not those children. And all the people they try to convince to skip vaccinating aren’t those people either.

Every day I commute through a VA hospital. I’m a perfectly healthy individual with a normal immune system, and there’s no real reason I need to get a flu shot—I’d pull through just fine if I got sick, no problem. But I get the flu shot anyways because I don’t want to kill old people who may not be able to get vaccinated or to sustain a good immune response for whatever reason. All it costs is a poke to protect the lives of other people, and the anti-vaxxers think that is just too much to ask of them.

Bagelsan,

I agree with you that freeriders are troublesome, and that in general herd immunity is a good thing.  The only reason I’m here arguing with people is that it irks me that people with my issue or people like my sister who has a relevant background in biology and medicine get thrown in with a bunch of idiots.  I choose to get certain vaccines and not get others, and she makes the same choices for herself and her children, and they are very educated choices.  I don’t want to kill old people either, or even infect young ones, so any time I am sick and could be infectious, I stay away.  I stay home.  A lot of people don’t do that, and considering the fact that we don’t always pick the right flu strain, I think that’s a bigger problem than people not getting flu vaccines.

And the only reason I bring up the autism point is to show that people aren’t as crazy as they were painted to be.  Sometimes, vaccines can cause rather profound negative issues.  (I do recognize it is likely, although not certain, that for children with mitochondrial disease those profound negative symptoms were probably going to be caused at some point anyways.)  And although people should reject or accept vaccines based on an intelligent weighing of the costs and benefits, not every vaccine is a good idea.  Not even every vaccine on the current schedule is probably a good idea. 

In the spirit of both/and, I think the correct response to the crazies is a straightforward C/B/A, shooting down their false assumptions, not simply telling them their choice is wrong wrong wrong.

Yes, the vaccination only causes the onset if it causes a fever, according to that study.  But the information is still important because it validates the observations of parents, it suggests a solution (treat the fever, because it may delay/prevent the onset of autism), and IT HAPPENS TO BE TRUE.

And yet that’s not the solution that was chosen.  The solution that was chosen was to not vaccinate, because vaccine=autism.

Tell me, how many websites are devoted to keeping your child’s temperature down?  How many articles?  How many celebrities go on Oprah to talk about how potentially dangerous a high fever can be?  Now compare that to the people who talk about the inherent dangers of being vaccinated.

That’s what’s making me angry here.  Parents didn’t hear “high fever = autism,” they heard “vaccines = autism,” so they stopped having their kids vaccinated, which is counterproductive since the diseases their kids were being vaccinated for often come with high fevers which could themselves trigger autism.  So they not only have not dodged the problem, they now have a false sense of security because they don’t realize that the problem is the high fever, not the vaccine.  And by continuing to buy into that frame (the parents were right!  the vaccine caused autism!) you’re actually perpetuating the problem.

Mnemosyne,

That’s because they probably didn’t have the study at the time.  You’re exactly right that the focus is wrong, but I think the better answer is to say, guess what, you may’ve been right on correlation, but you’re wrong on causation.

And there are inherent dangers to vaccination, and parents who aren’t in the anti-vaxxer crowd as such will tell you about how they’re discouraged from reporting these issues.

Ismone, I think we’re at least somewhere in the same book, if not exactly on the same page. :p I agree that not everyone who takes issue with the vaccination schedule is automatically an idiot, and I’ll *never* object to a spirit of healthy scientific inquiry.

But I give the anti-vax movement, in general, a lot less benefit of the doubt than you do—not to get all “one true Scotsman” or anything but I think that people like you, who have a little background and some rational reasons to take some care with vaccinations (at least, I’m assuming you have a reason beyond “chemicals!”), aren’t really the “anti-vaccers” I am referring to. It’s like the “pro-lifers”—sure, I’m sure there exist some pro-lifers who genuinely do it for the baybies but the movement as a whole is aaaaall about the slutty vagina control. Anti-vaccers are all about the control and the purity and the hatred of science.

And, in the vein of “healthy scientific inquiry”... I don’t think that anti-vaccers are doing anything of the sort. They reject studies that don’t show what they want to hear, demand more studies, and then shift the goalposts when these new studies continue to show no link between vaccines and autism/etc. Now that mercury has been both debunked *and* removed, it’s about the “chemicals” or the “antigens” or whatever. They have no goddamn clue what they’re talking about, but they won’t let that stop them from giving (devastatingly wrong) medical advice. If they went about this like scientists, the whole thing would have gone like this:

Parent: “My child was diagnosed with autism soon after ze was vaccinated a bunch. Correlation—> causation in this case, yes/no?”

Scientists: *do lots of studies* “Hmm, looks like that’s a ‘no’—go ahead and keep immunizing kids and we’ll keep looking for the real causes of autism.”

Parent: “Okay. Let me know if you find anything.”

Woulda been nice, yeah? Unfortunately, I think the response was a lot more like “But, but! My kid ‘got’ autism like right afterwards! I’m sure it was the vaccine!” and once that was thoroughly shown not to be the case “well, maybe they don’t *always* cause autism but they probably sometimes do! I’m sure there’s something wrong with them, and until you have proven to *my* satisfaction that vaccines could not be more perfect if they shat diamonds, I’m gonna stop getting ‘em! And I’ll tell my friends not to, either!”

Worse, the other parents saw that this one parent’s pain was causing all sorts of delightful attention-grabbing drama and hopped on the bandwagon. And those are the people I’m most pissed at.

Yeah, but it seems like they were right.  That’s the bitch of it.  A bunch of them were probably also wrong, grasping at straws, but some of them were right. 

And when you observe something, and the doctors say “you’re wrong” (because usually they don’t just say hmm, no correlation has been found yet), the instinct is to reject/question everything they say.  Not everyone is sophisticated enough to do so intelligently.  But I remember a friend telling two different docs. that her daughter would get hives when my sister ate dairy and then nursed, and they told her it wasn’t possible because the antigenic proteins couldn’t be passed through breast milk.  My friend, being my badass friend, decided they were wrong.  About six months later, I was hanging out with a pediatrician who was a friend’s cousin, and mentioned that, and she said it was well known that children could react to dairy that their mothers ingested.  So. 

But nice to be in the same book with someone.    Both/and and all.

Ismone, you’re conflating two kinds of doctors—research scientists and practicing physicians.  In the case you cite, I’m going to guess it wasn’t research scientists that said to your sister that your niece couldn’t react to cow’s milk antigens passed through her breast milk, it was practicing doctors.  Relating outdated information.

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Anybody want to stay with my friend’s son so she can go to work?  The kid has chickenpox at age 11 because of vaccine fail.

He was vaccinated.  It didn’t work, apparently (although he has strep, too, which might have something to do with it).  Of course the parents were scolded for not getting some “booster” which has yet to be recommended or required by the schools - can’t say the fucking vaccine just failed, can we?  Oh no!

“A study has been released by U.S scientists working for the Centers of Disease Control, Atlanta, that suggest immunity from chickenpox conferred by Varicella vaccine may wane over the years, and even result in a more severe form of the disease. The study findings encourage a booster dose of the vaccine.”

Would have been nice if this information had been communicated to the HMO and they had their doctors tell people about it so they could get their kid updated.  Always the parents must not have done their job, though - can’t have the patriarchal healthcare system be at fault, now can we?

Makes me glad that my kids got them at very young ages - my older one was set before the vaccine debuted.

He was vaccinated.  It didn’t work, apparently (although he has strep, too, which might have something to do with it).  Of course the parents were scolded for not getting some “booster” which has yet to be recommended or required by the schools - can’t say the fucking vaccine just failed, can we?  Oh no!

There is always a small, but across-the-board failure rate for vaccines.  That this isn’t part of the public discussion is unfortunate, but it points up the lack of understanding about vaccines at large.

There have been cases of people who died of a disease despite being vaccinated because of an overinfection of the virus or germ, I’m not going to suggest that this was what happened here, as nothing in medicine is 100% except mortality and arrogance

Makes me glad that my kids got them at very young ages - my older one was set before the vaccine debuted.

Yah know what?  My brother had it at an early age, and he got a bad outbreak of shingles when he was undergoing radiation treatment at the age of 19.

And if you didn’t have to stay at home because they were sick, you were somewhat lucky or had excellent back-up, as they say, YMMV.

Would have been nice if this information had been communicated to the HMO and they had their doctors tell people about it so they could get their kid updated.  Always the parents must not have done their job, though - can’t have the patriarchal healthcare system be at fault, now can we?

Or perhaps doctors aren’t doing their due diligence with regard to the latest findings:

So far, clinical data has proved that the vaccine is effective for over 10 years in preventing varicella infection in healthy individuals and when breakthrough infections do occur, illness is typically mild.[2]. In 2007, the ACIP recommended a second dose of vaccine before school entry to ensure the maintenance of high levels of varicella immunity.

Link