Tuesday, September 2, 2014

The Anti-Vaccine Movement Is A Preventable Disease

Albert Einstein made mistakes and misinterpreted data.
He said that his own cosmological constant was a big
personal embarrassment. He put it in, he took it out, he
how he changed his interpretation of his data.
Scientific data can be interpreted many ways. That’s why scientists have conferences, to hash out the different reasons behind some observation…. plus the buffets and travel. One of the most famous arguments over interpretation of data was a series of debates between Albert Einstein and Nils Bohr at the Solvay conferences concerning the nature of quantum mechanics.

Bohr side held that at a quantum level, particles were undetermined until observed; the quantum world was one of probabilities, not observable realities. Einstein retorted, “God does not play with dice.” They both had the same data and they both agree on the data – it was the interpretation that was being debated (Bohr turned out to be right).

Because of multiple interpretations, science doesn’t like to say, “A caused B,” or even, “A correlates with B” unless they have the data to prove it. Premature interpretation can lead to bad data, bad hypotheses, and bad conclusions. And since so much of our culture today is based in science, bad conclusions lead to bad policy.

This means that when NO data exists to support a hypothesis, scientists have a duty to speak out against those making wild assertions. Especially when it leads to dangerous conclusions and actions. Vaccines causing autism is such a situation.

Just this week another scientific paper in the vaccine/autism controversy was withdrawn. A biochemical engineer named Hooker took data from an older CDC study and reinterpreted it. The CDC study had found no link between MMR vaccine and development of autism in children around two years old. They had looked at many factors to see if it occurred in subsets of patients as well, including race. But Hooker’s reanalysis showed that early MMR vaccination in African American boys was related to higher incidence of autism.

Lies, damn lies, and statistics. Do you really think organic
foods cause autism? Well there’s the data. CORRELATION
The paper from Hooker was withdrawn by the editors of the very obscure journal Translational Neurodegeneration because there are serious questions about his methodology and conclusions. Many scientists argue that if you parse the data in enough ways and do it enough times, you will always find a statistically significant number somewhere. As Gregg Easterbrook of the Atlantic Monthly said, “Torture numbers enough and they’ll confess to anything.” The question is whether it actually means anything.

For Hooker (the father of an autistic boy who he describes as "vaccine injured"), this meant taking a case control set of data and running a different style of study with the data (a cohort study). Also, his choice of statistical tests was wrong and he ended up comparing diagnosis at different ages instead of vaccination age versus diagnosis. Of course he found more autism diagnosis at 36 months than at 24 months – autism isn’t usually diagnosed until about 36 months! A great discussion of flaws in this paper is found here.

The vaccine/autism controversy started in the 1980’s, when the Urabe strain of mumps was being used in the MMR. But this was related to other brain lesions, not autism. Andrew Wakefield really got the ball rolling in a Lancet article in 1998. His conclusion was that the triple vaccine was the culprit and it should be given one at a time – anecdotally, the parent so his 12 subjects had said that autism started within days of their vaccination around 14 months.

Thimerosal used to be used as a preservative in vaccines.
It is 42% mercury by weight, and this used to be blamed
for autism. However, even though many studies have
shown it was not harmful, it is no longer used in
vaccines in the West.
Wakefield followed the idea that the MMR should be given separately with papers in 2001 and 2002 that said vaccination should be stopped and that vaccine had been found in the gastrointestinal tissues of children he said had “autistic enterocolitis.” But the papers included no new data, they were just rehashes of his initial paper with more dire conclusions. The media picked on these and more than 1500 articles were written about the “controversy” in 2002.

His co-authors withdrew their names when it became apparent that something was hinky – he was getting paid by a law firm that was suing the vaccine manufacturers (to the tune of a half million dollars). But he stuck by his guns. Then it was discovered that he was a major investor in a company ready to roll out vaccine-alternative products.

Then his data was reviewed in 2009 and was found fraudulent. He had manipulated data, including changing tissue sample results and making up parts of the histories of his child subjects. His license to practice medicine was taken from him in 2010 and I can’t for the life of me figure out why he isn’t in jail.

Anti-vaccine proponents say that vaccination during the months before two years of age alters the development of the brain and predisposes to autism spectrum effects. However, all the data on brain development suggests that the alterations that lead to autism take place in utero either as a result of genetics, trauma, or toxins – long before vaccination takes place.

The news isn’t all bad with autism. The new paper concerning
mTor has an upside. An antibiotic called rampamycin can
restore mTor activity and bring back synaptic pruning. The
authors ay it is reducing autism symptoms in mice, including
adult mice. You see the needed reduction in neural connections
in the above cartoon is between 2 and 4 years of age – right when
autism is diagnosed.
This includes a very recent paper that links autism to defects in a protein (mTor) that works to cut back synaptic connections in the developing brain. Too many connections leads to altered brain function and all too often, autism. But these changes are prior to vaccination or around time of autism recognition.

Research using 1st birthday party videos shows that many children show signs and symptoms of autism by 12 months, many months before most parents see the signs and a full year before autism can be reliably diagnosed. This may be a reason that people anecdotally link vaccines and autism – parents note it about the time a good number of vaccines are given. Some parents see it later using videos and use this regression of ability to damn vaccines - but the mTor paper addresses this well.

Unfortunately, some parents have used the erroneous data to draw a dangerous conclusion – they shouldn’t vaccinate their children. This has led to outbreaks of whooping cough, measles, mumps and other preventable diseases.

You might say that it doesn’t matter; if some parents choose not to vaccinate, then they're only hurting their own kids - but that isn’t so. For a small percentage of the population, especially the young and old, vaccination may not work properly or completely. This doesn’t matter if everyone vaccinates, because the presence of the disease in the population will be so low that their chances of being exposed remain low.

Jenny McCarthy has a son with autism. One can’t blame her
for her initial conclusion that vaccines might have been
involved, since fraudulent papers were out there. Now we
know better, but she hasn’t altered her “view” (although
she claims she has). Too often, I think we look for
something to blame.
But when more people that choose not to vaccinate their children, the presence of the disease goes up. Those who were vaccinated but did not receive full immunity, elderly patients who have lost some of their immunity due to an age-related decline in immune function, and even those people who are immune suppressed due to cancer or immune related diseases then run a much higher risk of being exposed.

Therefore, the “policy” of non-vaccination by some parents is flawed, in that there's no evidence to support their reason for withholding the vaccine, and because it injures other people in the community. Not a big deal? Mumps in adolescent and adult males can lead to sterility.

That isn’t scary enough? Then maybe it will be your child who isn’t as protected as they should be and becomes one of the 150 people a year who die each year of complications due to chickenpox, just because little Johnny’s mother “concluded” that vaccines were dangerous.

Contributed by Mark E. Lasbury, MS, MSEd, PhD

Hooker, B. (2014). Measles-mumps-rubella vaccination timing and autism among young african american boys: a reanalysis of CDC data Translational Neurodegeneration, 3 (1) DOI: 10.1186/2047-9158-3-16

Tang G, Gudsnuk K, Kuo SH, Cotrina ML, Rosoklija G, Sosunov A, Sonders MS, Kanter E, Castagna C, Yamamoto A, Yue Z, Arancio O, Peterson BS, Champagne F, Dwork AJ, Goldman J, & Sulzer D (2014). Loss of mTOR-Dependent Macroautophagy Causes Autistic-like Synaptic Pruning Deficits. Neuron PMID: 25155956

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