jenny mccarthy wants your kid to get measles: autism, vaccines, and stupid idiots

yes, you are killin it gbx

i could go look at pubmed i guess but i assume there have been like, retrospective cohorts & case-controls done with this kind of stuff?

Hahaha I was in a small group just now but we were just talking about this. It was led by a pediatrician and she was just like "Thank God, you do not know how many hours I have wasted futilely trying to argue with these people". Getting a pediatrician to talk about vaccine truthers is guaranteed to be awesome, btw, unless it is one of the bad ones who believes that crap somehow.

That article about autism incidence in L.A. kind of angers me, weirdly, since tbh the Autism bubble is nowhere near as widespread and serious a problem as the map of asthma incidence that snakes up the 710 freeway.

^^^ well that is the thing, tho, isn't it!

ppl are terrified---TERRIFIED---of their child developing something that falls anywhere on the autistic spectrum, but are very willing to expose their children to any number of other environmental threats that MIGHT KILL THEM. vaccine? just say no to autism! drink all the mountain dews? w/e. care enough to get riled up about evil vaccine manufacturers that want to kill yr children for profit? write a letter, go on TV! get upset by the intimate relationship between poverty and poor health? *cracks a mountain dew*

the autism thing is just ~frustrating~ on a level that i really cant articulate esp because im very interested in own small way in autoimmune rxns to environmental stressors and so much ~work~ and time and energy is getting put into debunking completely retarded theories its just ugh

get upset by the intimate relationship between poverty and poor health? *cracks a mountain dew*

ha im sure ive posted abt this before but it KILLS ME that its so hard to get ppl interested/concerned/upset abt major systemic problems in how health care is delivered and yet ppl refuse their kids vaccinations its just urrrrrrgh

I believe that the public lynching and shaming of Dr. Wakefield is unwarranted and overwrought, and that history will ultimately judge who was right and who was wrong about proposing a possible association between vaccination and regressive autistic spectrum disorder (ASD).

lol sub-bush

To be fair I have had so much soda in my lifetime (I am having a Cherry Coke Zero now!) that if someone tried to speak ill of Mountain Dew in front of me I would be all defensive. "Maybe I WANT to get diabetes!" Plus as long as they are selling Mt Dew Throwback (with an old-timey dude on the can!) I can convince myself that sugar instead of corn syrup makes it OK.

Actually the small group we just had was for Evidence-Based Medicine class, it was a meta-analysis of stroke risk associated with oral contraceptives, and it ended up being that about 400 extra strokes per year are associated with oral contraceptive use instead of condoms, but if all those people used condoms instead of oral contraceptives, it would be associated with about 600,000 extra (presumably unintentional) pregnancies every year, and of those pregnancies there would be some morbidity and mortality associated with pregnancy (but still fewer strokes). That figure totally blew my mind, and I'd never seen it before! I think the freaky, one-in-several-thousand side effects have some extra resonance on people, or something.

PS Mountain Dew Throwback is awesome. It has real sugar and an old-timey cartoon guy on the label! *Pancreas catches on fire*

i think gbx and i have talked abt how u&k soda is during midterms (hes a fan of mt dew but i like mexican sodas)

the oral contraceptives thing is r interesting and i think there is oftentimes a willful ignorance towards the idea that there are always risk and tradeoffs w/ modern medicine ~ need to think more abt this tho

I don't know why I talked about Throwback twice, I think I am v tired today.

Mexican sodas are unfuckwithable between Mexican Coke and Jarritos, though. </Metabolic Syndrome>

there is oftentimes a willful ignorance towards the idea that there are always risk and tradeoffs w/ modern medicine

^^^this. there are few magic bullets in medicine. it's sorta funny that vaccines are actually one of them (most of the time). ;_;

also i have consumed one (1) mountain dew today

other, infuriating, goal post moving anti-vaxx strawman i hate:

pharma makes SO MUCH MONEY from vaccines! *arches eyebrows*

^^^ i had this argument w/ someone b4 and its like "you realize that big pharma doesnt give a fuk about vaccines and makes hardly any money from them" "well that's what they WANT you to think" "..."

other things that cost money

-- trains
-- bicycles
-- wind power generators
-- condoms
-- etc.

the whole argument is predicated on the idea that vaccines are ACTUALLY useless, despite all evidence to the contrary. if anything, the only thing scandalous about $$$ and vaccines is that they're not cheaper and more widely available

just read that whole article and wow, you would think that a goof like kirby who's made his bones trolling the medical community could at least have the sense to do better than that garbage, which is just 700 words worth of confounding variables, small sample sizes, conspiracy theories and str8 misinformation

from what i know of this guy he's a rightwing nut, why does huffpo even run his columns?

huge traffic numbers

from what i know of this guy he's a rightwing nut, why does huffpo even run his columns?

― rasta batman gigolo (k3vin k.), Wednesday, February 3, 2010 9:40 PM (Yesterday) Bookmark

Because Huffington is a fucking moron when it comes to health/diet issues.

Genius w/ nipple slip coverage, tho.

this whole vaccine = autism drives me crazy mad. what the hell is wrong with people?

also i thought autism wasnt curable only manageable? my best friends son is autistic and has read everything on the subject. she believes in the triggered gene argument which im also inclined to believe.

also didnt jenny mccarthy not even notice her kid was autistic until he was in school and the kids teacher informed her?

what would be nice is a set of handy links refuting these anti-vax talking points, none of which has to do with autism:

- vaccines have mercury in them; proper tests have not been done to show that children aren't harmed by the mercury in vaccines (yes i know that in the US vaccines no longer contain thimerosol, but in europe they do, plus the swine flu vaccine definitely has thimerosol in it regardless of where you live)

- vaccines are a cash cow for pharmaceutical companies; we don't need them but big pharma has convinced govt that they are necessary; we are propagandized into believing it - both by the companies theselves and by the government - in order to fill the coffers of these companies

- along the same lines, proper independent testing is never done on these vaccines; if you look at the funding for every group who does testing you can trace it back to a pharmaceutical company or other vested interest; so when you're told "it's safe" that's a lie

- nobody gets measles or mumps any more; why do we need a vaccine?

you can read variations on these points in the comments thread of this CBS News story that implies "vaccine defenders" are paid off by big pharma:

http://www.cbsnews.com/stories/2008/07/25/cbsnews_investigates/main4296175.shtml

the general thrust is that there is a "mandatory vaccine racket" that could be harming children, but we'll never find out, because every study is tainted by pharma cash

haha and just to be clear, that's what CBS HAS TO SAY ABOUT THE MATTER.. so you can imagine the comments

vaccines are a cash cow for pharmaceutical companies

Making this up, but profit from a one-off dose of vaccine must be pretty small beer to corporations whose main income surely comes from regular drug treatments for chronic illness, no? Even when given to large chunks of the population.

Is it hypocritical if my stance is "of course vaccines are a good idea, shut up and take them" but my feelings on psych drugs are "I was on antidepressants and they seemed a) p bad for me personally and b) not scientifically fully understood, and I don't trust the testing methods, so, let some company sell me a bunch of chemicals to wash through my brain every day I THINK NOT" etc?

(wd justify this partly by thinking our understanding of neurochemistry is very far behind our understanding of e.g. immunology, but I'm no scientist)

(No idea on handy links - feel some could probably be obtained from hoking through Bad Science, but don't currently wish to expose myself to the Dawkinsesque smug righteousness of the commenters)

well there were billions of swine flu jabs manufactured i think - volume, baby

"MMR is out of copyright, it’s generic, anyone can make it, you could set up a factory and make it yourself if you wanted; it’s not a money-spinner."
http://www.badscience.net/2003/12/mmr-never-mind-the-facts/

yeah but what about the yearly flu vaccine! it's a racket that is possibly giving our kids mercury poisoning!

damnit where is that graphic of mercury in vaccines vs. mercury in sardines

are you saying that mercury in sardines is good for you?

maybe not if you have lots of sardines every day, just like happens with vaccines!

i am late for school so i'm only gonna address the two i can off the cuff and w/o having to resort to "links"

- vaccines are a cash cow for pharmaceutical companies; we don't need them but big pharma has convinced govt that they are necessary; we are propagandized into believing it - both by the companies theselves and by the government - in order to fill the coffers of these companies

vaccines being a cash cow for the people making them is a strawman argument, and only holds water IF "we don't need them." but we do. and while i realize that being a scion of modern medicine makes my opinion suspect or w/e, pretty much the entire body of medical and public health literature would back me up on that. but i dunno maybe having measles kicking around would be keep things ~interesting~

- nobody gets measles or mumps any more; why do we need a vaccine?

q for u: do you know ~why~ no one gets these things anymore? and psssst btw ppl HAVE gotten measles, recently, in the united states! actually, here is an internet link for you: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5708a3.htm

sweet dude

- vaccines have mercury in them; proper tests have not been done to show that children aren't harmed by the mercury in vaccines (yes i know that in the US vaccines no longer contain thimerosol, but in europe they do, plus the swine flu vaccine definitely has thimerosol in it regardless of where you live)

the cdc has a good page dealing with these concerns and further links to independent, peer-reviewed research. they also have extensive information regarding thimerosal and h1n1 and other flu vaccines. thimerosal is still being used as a preservative in h1n1 and other flu vaccines but a) u can get doses w/o it for v young children and b) the dangers still arent fully understood, anyway. i mean it sounds callous but:

In the meantime, it is important to keep in mind that the benefits of influenza vaccination outweigh the theoretical risk, if any, for exposure to thimerosal. Each year, an average of about 36,000 people in the United States die from influenza, and 114,000 have to be admitted to the hospital as a result of influenza

but i also i mean - if your determined to see the gov't as a propaganda wing of Big Pharama then anything the cdc or the nejm or whomever is going to print is just ~~part of the machine~~. also a lot of the science w/r/t to thimerosal for e.g. is still uncertain esp w/automimmune rxns. and i can see that it seems frustrating or condescending but we ~don't know~ some of this stuff yet - we dont have a complete picture of all the interreactions yet.

so while the weight of the evidence seems to be that no, cf this in pediatrics - i mean its still guarded, y'know?

ilx doesnt seem to like that link but just google Thimerosal-containing vaccines and autistic spectrum disorder: a critical review of published original data.

Will the Vaccine-Autism Saga Finally End?
Not likely. You can retract a scientific paper, but not a mass movement.

http://www.scienceprogress.org/2010/02/vaccine-saga/

haven't read all this thread, and unrelated to autism, so take this as unrelated/in the general, but it kind of bothers me re:flu vaccine the hate that people throw at ordinary people who aren't as smart or well-educated as them, especially when, not to get all tinfoilhat, the paranoia was ramped up by news networks etc. at a time when vaccines were in short supply.

Also my own little anecdote: my friend was in a risk category and worried about the vaccine, and i told her hey these are the people that know shit, that calculated the risks, that did the research, telling you you need this. So she got it, had a reaction almost immediately, and was badly sick for almost a month. Boy, did i feel bad.

these are the people that know shit, that calculated the risks, that did the research, telling you you need this.

This is still true.

the kind of ratings-trolling that US networks have done surrounding vaccines has been disgusting and borderline criminal

ratings trolling?

same kind of ratings-trolling they do on every issue

Laurel: yeah it is and i don't wanna spread more FUD by recounting that

i dnno, i there's more i have to say re that and que's q and stupid idiots but busy and haven't read the thread

zvook i don't think anyone here hates regular people who are skeptical about flu vaccines, i mean it's natural given all the anecdotes you'll hear to be wary of putting anything you're unsure about in your body. doesnt mean they shouldn't get the shot or vaccinate their kids, or that their misinformed decisions are any less dangerous, we just have to do a better job of spreading, yknow, scientific info and reasons why it's important for everyone to get these shots. it's the mccarthys and the wakefields of the world that are the actual evil ones, they're the ones jeopardizing public health by spreading the misinformation/fearmongering and reaching a large and easily-persuaded mass of people with it

man i really hate using such loaded words as "evil" when "ignorant" "foolish" and "should be smacked upside the head with a giant catfish" should suffice

yeah i'm really coming with an axe to grind from out in the world and elsewhere on the net, plus i get that a lot of this anger is concern at root, but sometimes it comes off as, or is, ppl sneering and clapping own back for being well-off/historically not fucked over by authorities more often than not. xp

i think two things a) most ppl itt have been pretty clear and sympathetic towards layman (which most of us are, really) and understand that real ire shld be directed towards ppl fear-mongering and b) in this specific case i *think* the majority of ppl who are really concerned abt this tend to be pretty well-off themselves

i know ive said before itt and c-l and gbx made this point p recently: there are huge problems w/ the way medical information is communicated, with health care practices and with the health care industry in this country. part of my frustration is that we AREN'T spending time and resources on these issues and instead keep having this particular debate

if i ever read the thread i'm sure i'll agree. also agree that i rate everything could deal with this quickfastinahurry

- nobody gets measles or mumps any more; why do we need a vaccine?

mumps outbreak, 2009!

Coincidentally I am working through a lecture about testicular pathology right now!

(Mumps is the major source of acute testicular inflammation in unimmunized populations, with a high risk for permanent infertility, btw)

Have to smile at the ILX-med group avoiding studying by posting here. I've got a formative OSCE in the morning and lack all motivation to review at this late hour so i'm similarly wasting time. A ~lot~ of time, see below ad nauseum.

gbx, I like your attempt to draw parallels between T1DM and ASD. Bbut it doesn't really map out: there is no known brain lesion that causes (or even is associated with) ASD in the way that pancreatic beta-cell destruction renders a patient diabetic. There isn't a plausible mechanism for a connection between a change in immune status brought on by vaccination and a change in the child's socialization/communication skills, so any account of ASD's pathophysiology that relies on autoimmunity is oh-so-much handwaving at this point.

There are lots of brain diseases that we're pretty sure are autoimmune in mechanism, if not in origin (ultimate causes are hard to find in medicine). Multiple sclerosis is the paradigm example of an autoimmune disease of the brain. Another autoimmune neurological disease, ADEM (acute disseminated encephalomyelitis), is similar to MS in several ways, but unlike MS has been associated with vaccination. Most cases of ADEM happen in school aged kids, so the initial MMR is rarely if ever to blame. ADEM also happens after viral infections, far more frequently than post-vaccination, and its thought that vaccination against viruses such as measles actually results in a net reduction of cases of ADEM.

As a side note, the strongest evidence for a neurological disease caused by a reaction to vaccination is Guillain-Barre syndrome (GBS). GBS does occur in kids, but again, mostly school aged. flu shots and "booster" shots are the most likely suspects. Again, GBS is far more often thought to be post-viral or post-bacterial (Campylobacter, Mycoplasma) than post-vaccination.

Another side note: we have a plausible mechanism for post-infectious GBS ("molecular mimicry": Campylobacter epitopes shared with peripheral nerve myelin, immune cells get confused and attack the peripheral nerves once the infection is cleared) but lack any great theory for how a flu shot triggers GBS or how a virus (or less often a vaccine) triggers ADEM.

If you want to draw parallels/contrasts between ASD and autoimmune diseases, I'd suggest you start with ADEM and GBS. I think they have very little in common. For instance, both ADEM and GBS are monophasic, while ASD is not.

The main point i'd like to make is about the nature of autism as a disease. This is tricky to explain. Most of what i want to say is a gloss on Ian Hacking, especially 'Mad Travellers' -- an excellent book that I'd recommend to anyone who found the WSJ article upthread (about the tendency of autism diagnoses in LA to cluster in wealthier zip codes) interesting.

ASD diagnoses have been increasing rapidly. The natural question is why.

One argument, which I think is misguided, is that an increasing number of children are suffering, essentially, some kind of brain damage (or at least brain altering pathology), which is extrinsic to them and changes irrevocably the natural course their lives would otherwise have taken (and this change = autism). The child (and the child's brain) is healthy and normal at point X, then something happens that causes damage (or at least change), so that the same child is autistic at point Y. In its simplest form, this model accommodates a few explanatory pathologies: infection, toxin, malnutrition, etc. You can make the model more sophisticated: the child might be genetically susceptible to whatever the external factor is, so that the same MMR jab given to the child and his sister leaves one autistic, the other unaffected. Or you can have a dynamic, evolving picture, with autoimmunity at the center: something triggers abnormal function of the autoimmune system which either damages the child/brain in a one-shot deal or alters the child/brain's function in an ongoing sense in conjunction with altered nutrition or harmful exposures or whatever.

I would argue that all of those models share a common extrinsicality to their explanation of a given child's diagnosis of autism. They are understandably hugely appealing for reasons i'll come back to after sketching an alternate model.

I would argue that we might consider autism-spectrum behaviors as intrinsic to the life of the particular child in whom they appear. Brain lesions do not explain autism, nor does any other obviously discernable physical state (like seizures, say). Any explanation of autism needs to bridge the bio-psycho-social: the child's brain and biology, the child's experience of living (much of which is often opaque to us given the autism we're trying to explain), and the social (familial, societal) context in which that occurs. Which is not to argue that (given the results in LA county) rich families "cause" autism. Or that modernity (2010 vs 1980) does either. But that what we're seeing in the increasing rates of diagnosed cases of ASD is an interaction between the culture, the times, the families and their ideas, the children and their experiences, and yes, the physiology and pathophysiology of the children and their developing brains.

You might say: why paint with such a broad brush? Is there any evidence that broader social factors cause autism? Any evidence that there is ~no~ specific biological cause of it?

Well, no. But as I explained briefly above we do have several good models of what happens to the brain when it gets "attacked" extrinsically by the immune system (and of course, from other causes as well). Autism, neurologically speaking, doesn't look anything like those diseases. I can't prove a negative (that there is not and never will be any known biological process sufficient to cause autism). And i can't "prove" the model of "intrinsic" ASD, in part because the model is over-determined for multiple causes ("everything" plays into it). I will point out here that, neurologically speaking, it is not at all controversial to argue that experiences modify the brain -- that the life lived by a particular person (say, "enriched" education on one hand, or "traumatic" experiences on the other) is capable of changing the structure and function of the brain, right down to the level of epigenetic factors that modify how and when a gene is expressed by neurons and their supporting cells. We don't know the details of how that happens in a particular person, but we know that real brain changes are happening to all of us, constantly, in response to real/perceived situations. So saying that autism is intrinsic in my sense is not the same as saying that it's imaginary, or "all in the mind", or whatever. Changes in the brain from lived experience are concrete and real, but (unfortunately for science) variable and individual and dynamic, so they're hard to reduce to a purely pathophysiological model (like infection or autoimmunity) that can explain multiple cases across an entire society.

My explanation is probably sloppy, I hope you can follow the gist. I'm not up to writing rigorously at this hour. Recommend again Ian Hacking's "Mad Travellers", which explored this vein in more depth than I can manage tonight.

Back to the original question: why are we diagnosing more and more kids with autism? The extrinsic explanations are appealing: maybe it's an infection, maybe kids are eating too much garbage or drinking from the wrong kind of plastic bottle, or maybe its the MMR, triggering some disordered autoimmunity.

One reason why the extrinsic explanations are appealing is that they lead to testable hypotheses (ie, actual science) and possible interventions. If we can find a murine retrovirus, we can start antivirals. If we can blame thimerosol we can reformulate the vaccines, or cut them out all together and whoops! -- lose herd immunity. While Jenny McCarthy and her minions are certainly anti-Science, they're actually quite scientific in another sense: they've got a cause-and-effect model for what causes autism and they're following through on it. Their absurdity and inhumanity stems from their refusal to consider contrary evidence, but insofar as they get to choose the inputs into their model (heavy on Wakefield, light on everything since), they're at least internally consistent.

Next we could consider a cartoon version of the bio-psycho-social model i suggested above. Many people argue that autism rates have largely been unchanged over the years, "but now doctors are better at recognizing it". That gives some credit to the times we live in and the people we are, so kudos from me. But it raises a difficult question: where were the autistic children in 1975? how about in 1891? Renaissance Florence? Ancient Greece? Underlying this analysis is the assumption that autism is pretty much unchanged over time and across places and cultures. Again, it implies that autism itself is caused by something ahistorical and a-cultural (infection or autoimmunity or what-have-you) and we've just finally discovered a test that reveals the truth that's been hiding in plain sight all these many centuries past.

But that's the thing: there is no objective, impersonal test for autism. We can go back and test the bones of the Romans for lead poisoning but we can't retroactively diagnose one of Bach's kids with autism. in fact, it's hard to even know what that would mean. So here's an even more difficult question for the "just better at recognizing it" crowd: what would it be like to be an autistic child in France in 1891? or the parent of a child with autism in Heian-period Japan? That's a very hard question to answer, as long as you stay in character of the times and the place: we don't know what autism meant to them, the concept would be foreign and anachronistic in that context. Not only the concept of autism itself but many related ideas -- childhood and development, appropriate behavior with the family and at school -- would be similarly foreign and anachronistic. So even though the language we use to define autism seems universal -- delay/difficulty in communication skills, impaired socialization -- it certainly bears the stamp of the time and place of its coinage.

The trouble with the intrinsic model of ASD is that it doesn't lead anywhere fast. If my argument holds, and ASD is the product of some immensely complex and multidirectional interaction of a child's brain, his lived experience and his social context, it doesn't lead to much in the way of prevention or cure. Symptomatic management would be the rule indefinitely, as it is today.

Another major problem with the intrinsic model is that it can come perilously close to blaming. To make it clear on my part: I'm absolutely not saying that autism is the "fault" of the children who are autistic, or their parents, or even our society at large. This isn't meant to be a jeremiad, either -- "look how sick we all are in our modern, toxic world". I think the forces involved are almost completely out of our control as individuals, including as parents (I have a toddler and one on the way). I think the appearance and evolution of new/different ways of being human (like autism) are emergent from the chaos and incredible complexity of our situation as self-aware, recursively constructed entities. It's not your fault, if you've got Asperger's, it's not Jenny McCarthy's fault that her son is autistic, it's not "society's fault", either.

But just because it's not someone's fault, and it's not imaginary, doesn't mean it's "caused" by some incredibly obscure pathophysiological process. That's not how socially constructed conditions work: they don't have a clearcut cause, no one's to blame. They just ~are~ part and parcel of life in our world in the year 2010.

Obviously this is not the usual medical model of understanding autism, or much else really. You could even say the idea that autism is socially constructed and therefore "intrinsic" is incommensurate with the medical approach, because it leads to no tests and no treatments. That's a fair point.

So why bother making this argument at such great length?

Two points: First, I would hope that we might see autism more in terms of other alternate/unusual ways of being than as a disease. I think that's more accurate -- I think autistics have more in common with hikikomori (shut-in Japanese teenagers) than patients with multiple sclerosis (which has its own social and psychological factors but is fundamentally a disease of a biological process damaging the brain). And i think its more humane -- what i've read from Temple Grandin and other high-functioning autistic people is that they themselves see their ASD condition as part of who they are, not as something afflicting them. Having said that, I recognize that the trend in medicine and in the popular mind's understanding of the medical world is precisely in the opposite direction -- I don't think HuffPost commenters are going to be giving up the quest for a magic bullet anytime soon.

Second, personal reasons. I'm almost done my training in Neurology, and i've found precious little in my studies to encourage this kind of thinking about people or diseases. Way back when I read a book of Oliver Sacks case studies (including an account of Temple Grandin) and decided neurology was the place where I would find both objective medical models of biological pathophysiology and subjective accounts from people living through the experiences of diseases of the brain from the inside. Turned out to be much more the former than the latter. My loss.

Anyway, sorry about the length. Thanks for your patience and interest if you've read this far.

I'm skimming at work and there's plenty of reasonable and interesting stuff in yr post there but I think what you're describing is Asperger's or the "higher" functioning end of ASD. Kids with profound Autism are recognisably impaired far beyond potential social causes. I don't think we're gonna find 1 cause of ASD either, which is one reason we talk about a spectrum yeah? But it's important to remember that the deep end of the spectrum is a lot more severe than just oddity or lack of social imagination.