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June 19, 2005

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It's true that thimerosol is no longer allowed in new vaccine manufacture, but companies were allowed to sell their current stock that is preserved with mercury -- it pays to ask your doctor about the vaccines that you are getting for your children.

Perhaps it's coincidental, but since the use of thimerosol has been phased out, the rate of autism has gone down substantially in California. I don't believe that it's coincidental at all, but it is hard to know for sure. In any case, the reduction of mercury exposure in infants and toddlers is a very good thing.

The numbers that the Autism Diva bandies about concerning autism rates in California are misleading at best, and I have to believe that they are intended to mislead. There is a huge increase in autism in California, but of course 1 in 166 people in California aren't affected, because older people don't develop autism. D'uh. It's kids that get it. If the rate of autism is increasing quickly, it will manifested overwhelmingly in young children. And in plenty of school districts in California, way more than 1 in 166 kids have autism. It's also true, (and thankfully so) that the rate of kids being diagnosed with autism is going down. You absolutely can't explain that by broader diagnostic criteria or rent-seeking -- as those would make the number of cases go up or at least stay level. 800 new cases of cases per quarter, (assuming that these are all newly diagnosed children) is actually a huge number, on the order of one in 300 kids. (Assuming that of the 35,000,000 californians, that 1/35th are kids of the age that would be diagnosed, and 3200/year is 1 in 280 of that group.) That's an epidemic in my book.

I'm not a disinterested observer -- I have an eight-year-old child with autism. In his 100-person first grade class, Thomas has four classmates with autism, too. Of these kids, none of them are marginal cases. Obviously, this is just an extremely small sample -- but just as obviously, autism among 8-year-old kids in Los Angeles is not rare by any means.

Thad Beier

Everything I've read re vaccination and autism has led me to believe that the thimerosol hypothesis is junk science resulting from the emotions generated by the tragedy of children facing enormous challenges plus the usual human lack of instinctive statistical sophistication, and my first thought on reading the above post was that I'll have to recalibrate my respect for Kennedy. That said, I'll go check with some health policy experts I trust when they get back from the Amazon.

I've also read about genetic factors that might influence autism. Curiously, it's Ali-G's brother, Simon Baron-Cohen, who has advanced the most extreme argument; he suggests that the reason there's a concentration of autistic cases around places like Silicon Valley and Cambridge might have to do with the genotypes of the parents who are drawn to such places, genotypes that in certain forms express aptitudes for abstract, systemic thinking.

Don't shoot me; I'm only reporting what I've read!

But one of the reasons I'm posting on this subject I know so little about is that I've been amazed at how suddenly the public debate has moved from the awareness of concentrations of autism in certain areas to a certainty that vaccines are to blame. Hilzoy's post in this respect seems to balance the line very well: addressing the specific chemical of concern, yet reminding everyone that vaccines represent the vanguard of civilization against the scourges that have destroyed us, as individuals and as civilizations.

Tangent alert--contents only 18.736% on target...

There is a lot of new research on autism pointing to how it is likely linked to some sort of mirror neuron dysfunction. This hopefully means that someone will soon be able to test these hypotheses regarding chemical versus genetic causes.

I ran across all this while doing research for a conference presentation on video games and elearning, of all things. Wild stuff.

Welcome back, Rilkefan.

I don't know about the thimerosol hypothesis, but I do know that Japan has recommended merc free vaccines, and the topic is rather close to home, as my uni has a Minamata studies department. This article may be of interest, though it is from a site with a vested interest in promoting the story. What I think elevates this from a mere accusation of junk science is the fact that mercury poisoning symptoms seem to be mirrored by autistic children (which can, as the article points out, have a great variability of effects) and the prevalence of mercury in our environment (link)

Combined with this is the fact that the schedule for vaccinations in the US is much faster than other places, as it pointed out in this wampum blog post

I think the most recent article on Autism rates is the March Issue of Pediatrics, which argues for increasing rates

Thus, I always cringe a bit when I read people open up on those who raise questions (like the post by Orac). There almost seems to be a religious fervor involved when dealing with this (there is a comment by Bertrand Russell, I think, about a particular period in every intellectual's life that the answers seem particularly clear and that anyone with a different approach deserves all the derision and mocking available, which he appropriate decries. But he goes on to note that a person who has never felt that way has never truly known the happiness of an intellectual) It is disturbing to think of all the things that have been presented as being harmless, but have actually ended up being truly harmful, so one goes off on a rant at their own peril, I think.

As a Briton, I don't know anyone here who wouldn't have taken 'fixed' to mean anything other than the sense of being rigged and altered to suit oneself.

None of my Cambridge tutors ever used fixed in the sense Lindberg is proposing. Mind you, 'dons' are strictly Oxford, so maybe he's getting confused.

would, not wouldn't, in the above.

Any Brits who are reading this should feel free to weigh in.

This odd redefinition of "what Brits mean by fixed" actually came up on a copyediting list I belong to, and several Brits agreed with my native assessment - Tod Lindberg was making stuff up, or had got profoundly confused, or both.

Just to clarify matters: The Times is a right-wing newspaper that opposes Tony Blair. The reason The Times published the memo, in the run-up to the UK General Election this May, was in the hope that proving that Blair had lied to the people of the UK about the war on Iraq, would turn some floating voters off Blair, thus off the Labour Party, and with any luck in the direction of the Conservative Party.

To a certain extent, this kind of worked - though most people who were not inclined to vote Labour because of Blair & Co's support for the Iraq war, were equally - if not more so - not inclined to vote Conservative, since Conservative MPs had supported the Iraq war with considerably more enthusiasm.

While I certainly hope that Bush is damaged by the production of these memos, he was never The Times target: he was collateral damage.

While I certainly hope that Bush is damaged by the production of these memos, he was never The Times target: he was collateral damage.

As with all victims of collateral damage, I'm sure he'll be relieved to find that out. :^/

Ethyl and methyl mercury as organic contaminants would contribute to a cumulative, synergistic contamination of infants through several streams:
1)thimerosol
2)coal fired power plant fallout
3)long-lived fish and seafood, such as tuna
4)exposure through breast milk (including the portion of the mother's exposure transferred thereby).
You certainly could make a case for ethyl/methyl mercury overexposure in infants. It is bad stuff.

Interesting bit about the current thinking on thimoserol: a young cousin of mine is/was diagnosed as autistic/learning-disabled; his mother, who became (as so many have had to) a self-made activist on the subject, told me that the thimoserol angle has so far, been ruled out as "cause" of autism - although she was short on details. However, since we do live in a litigious culture-of-liability in which "fault" must be fixed for virtually every human tragedy, I doubt whether this will be the last hear of thimoserol; science notwithstanding.

As for your first two items, these are just more examples of why, IMO, the blogosphere will never make it to the level of a viable, credible, "alternative media", like some of its louder proponents tend to argue. Captain Ed's nonsense about the Downing Street Memos is just a typical example: an ideologically-driven opinion-blogger trying desperately to deflect negative news away from his pet cause by alleging "fake documentation" - evidence of such being made of out of thin air -and relying on an uncritical echo-chamber to promulgate these "charges" - one supposes, in hopes that eventually enough people will accept the supposed "falsity" of the DSMs, if only on the grounds that bloggers must "know something" - especially if it fits their preconceptions and/or prejudices in the first place.
Pathetic. really.

boing!! -- yes, I agree about mercury in general. As I said, I really don't know enough about this to take a position; I just wanted to provide some posts with links, and also to make the point about current vaccines clearly. If I had to guess (Karnak alert!), I'd say that the reason people who disagree with the Thimerosal hypothesis get upset, rather than just disagreeing calmly, is because vaccination is so hugely important.

these are just more examples of why, IMO, the blogosphere will never make it to the level of a viable, credible, "alternative media",

go check out Neiwert's latest post on how the professional wingnuts are spinning this Durbin thing. the difference between what the MSM people are saying and what Powerswine are saying isn't so great...

ex., two talk radio hosts on Durbin:

John Carlson:

    This man is simply a piece of excrement, a piece of waste that needs to be scraped off the sidewalk and eliminated.

Limbaugh:

    These are the same people they say they support the troops. This is how they do it, huh? They give aid and comfort to the enemy.

these guys are mainstream Republican entertainment. the only difference between them and the clowns who say the DSMs are fake is the medium they work in.

If I remember correctly some recent research suggests that there may be a link with women becoming mothers at an older age. Still a tenuous link.

And although I believe all states have required vaccinations for some time, the rates of occurence may be quite variable.

Difficult question.

Umm cleek, Powerline thinks the memos are almost certainly genuine.

Sebastian, yes. my bad. in my defense, it's easy to mistake one batch of wingnuts for another.

Re autism and mercury: Is the rate of autism going up or is the diagnosis of autism becoming more common as the diagnostic criteria become clearer and more pediatricians are aware of the diagnosis? Perhaps some children diagnosed as mentally retarded in the past might, if they were born today, be more accurately diagnosed as autistic. Additionally, a child with Asperger's might in the past have been considered weird, but have no formal diagnosis. From what I've read there doesn't seem to be a clear consensus on this issue. It seems premature to assign blame for the increase in autism before it is clear that this increase represents a change in the biology of the population rather than a change in awareness of the diease.

Re autism and mercury: Is the rate of autism going up or is the diagnosis of autism becoming more common as the diagnostic criteria become clearer and more pediatricians are aware of the diagnosis?

This was (according to my rather weak grasp of statistical argumentation) dealt with in the Pediatrics link that I gave earlier. The article uses statistics of children who are judged to be eligible for programs. If autism was merely misdiagnosed and those children were previously grouped in other categories, one would see a reduction in those categories to match the rise in autism diagnoses. That doesn't seem to be what the figures suggest.

Sebastian, yes. my bad. in my defense, it's easy to mistake one batch of wingnuts for another.

Well, you'll be glad to know the wingnuts of Tacitus.org think the memos are fake.

The universe remains as it should be.

Um, I'm not sure if that sort of sentiment is expressable here, even if TTWD is banned, 2shoes.

If I had to guess (Karnak alert!), I'd say that the reason people who disagree with the Thimerosal hypothesis get upset, rather than just disagreeing calmly, is because vaccination is so hugely important.

I'll second your Karnak and agree regarding this speculation. But their upset is misdirected, as people have every right to get a little crazy about this issue.

I have never been a fan of the thimerosal/autism link (I know a plaintiff's attorney who is very active on this, as well as the mercury dental filling debate, and know a lot about this issue; I represented him in a libel action concerning his public statements about mercury risk).

But let's be clear about this. It is criminal that thimerosal was ever used at all -- injecting mercury into the young with no study whatsoever that this was a safe practice. (And this is one of many many episodes in which other checmicals end up in vaccinations without study or even thought as to the potential risk -- read The River about the HIV/polio vaccine link about the same type of error. The active ingredient gets studied to death, but then various "harmless" additives show up with no study whatsoever). And it took a lot of the crazy screamers about thimerosal/autism to motivate the health community to recommend withdrawal of thimerosal. This happened not because it was a known health risk, but because there was no good science saying that it was without risk, or that the known risk merited the benefit from its use as a preservative.

If people have become suspicious about vaccinations, it is because they are alarmed to discover shocking facts such as injections that include an unknown and undisclosed mercury risk. The average person has to rely on trust in the medical community, and that trust is mightily shaken by this type of episode.

Sadly, getting rid of this atrocious practice probably required some craziness, so even though the science may not support the scare, the scare did finally force a needed change in policy.

It's too bad that a more sane discourse did not achieve that result.

Paradoxically, all too often, it takes some degree of craziness to get people to act sanely.

People with autistic children are people (a number of whom blog). They are under many times the strain on parents of non-autistic children.

There is very little question that there has been a surge in autism incidence in the U.S. and U.K., followed by what appears to be a decline (years need to pass before the decline can be considered certain).

This country has a long history of closing the barn door after the horse is gone where pharmaceutical manufacturers are concerned. It has a recent history of open alliance between big pharma and the ruling party, whose propaganda apparatus stands ready to savage anyone raising uncomfortable questions, and whose governing apparatus is prepared to suppress research that might come to unwanted conclusions.

For all these reasons, I would be very slow to jump to any conclusions about the thimerosal hypothesis, much less throw terms like 'junk science' around. Far better to support as much sound research as possible, to assure its independence from corporate and ideological pressure, and to wait for results.

"The article uses statistics of children who are judged to be eligible for programs. If autism was merely misdiagnosed and those children were previously grouped in other categories, one would see a reduction in those categories to match the rise in autism diagnoses."

That makes the theory (that is, movement from one diagnosis to another) I mentioned considerably less likely, at least in this context. However, the article you cited also discussed the possibility that the increase (or some part thereof) may be due to the recent introduction of the autism as a special education catagory and the gradual incorporation of it into special ed classes. The authors also reference two other articles which suggest that the true prevalence of autism is increasing and one that suggests that it is not. I'm afraid that my conclusion is still that it is not entirely certain whether the increase is real or not, although I do think that it is most likely that there is some true increase, overlaid by some increase in clinical awareness. I'd like to see more research both into the etiology of autism and its epidemiology. I also think it would be a bad idea for people to concentrate solely on thimoserol or to conclude that the problem has gone away because thimoserol has been removed from vaccines. Some other environmental toxin may be involved (ie mercury from fish.)

Nell: I would find your analysis of the possibility of a coverup of a relationship between thimoserol and autism convincing except for one thing: pharma companies don't like making vaccines. In fact, it is extremely hard to get a pharma company to sponsor a vaccine trial or even agree to manufacture a vaccine that has passed phase III trials (been proven safe and effective). They just don't make enough money with them, strange as that may sound in light of the $100 a dose hepatitis B vaccine. Certainly, the MMR is, if not a money loser (I think it is sold for $10 and costs about 8 cents to make), not a big money maker. Also I'm not sure big pharma is that into this administration. They court it, of course, as they would any administration. However, a lot of clinical trials and manufacturing of pharmaceuticals has been going overseas in the last 5 years. Might not have anything to do with Bush, but it might. He's been putting roadblocks to research in place just as fast as he can--the stem cell restriction being just one of the more prominant ones. On the other hand, I would imagine that the pharma companies are scared witless of the possibility of being sued by every person with autism in the country if a link ever is proved, so maybe you are right.

For what it's worth, I'm not a Briton, and when I first read the passage about the intelligence being "fixed around the policy", my first thought was that it was in the sense of being fixed in place, rendered immovable. That is, that Bush had already decided what the "facts" would be on the basis of policy, and would not allow his foregone conclusions to be changed by something as insignificant as real evidence. This seemed bad enough, and also consistent with what we've observed. I was surprised to see this meaning used in his defense.

As a DES daughter I am suspicious of the pharma-sector, but my brother in law is autistic and my mother in law was accused of being a 'fridge mom' since that was the hyped explanation for the cause of autism at the time. So I am also a bit sensitive about possible causes and populair theories.

Our National Institute for Public Health and the Environment pointed to a study in Japan (publicized this month) that disproved the connection. I looked it up in pubmed and the summary states (ASD=autistic spectrum disorders I assume):

This study examined cumulative incidence of ASD up to age seven for children born from 1988 to 1996 in Kohoku Ward (population approximately 300,000), Yokohama, Japan. ASD cases included all cases of pervasive developmental disorders according to ICD-10 guidelines. RESULTS: The MMR vaccination rate in the city of Yokohama declined significantly in the birth cohorts of years 1988 through 1992, and not a single vaccination was administered in 1993 or thereafter. In contrast, cumulative incidence of ASD up to age seven increased significantly in the birth cohorts of years 1988 through 1996 and most notably rose dramatically beginning with the birth cohort of 1993. CONCLUSIONS: The significance of this finding is that MMR vaccination is most unlikely to be a main cause of ASD, that it cannot explain the rise over time in the incidence of ASD, and that withdrawal of MMR in countries where it is still being used cannot be expected to lead to a reduction in the incidence of ASD.
.

I would like to add that most of our biblebelt does not vaccinate. Approximately 5 years ago we had a measles epidemic in that region. 3500 People got measles, 3 children died and over 130 kids landed in hospital with complications.

This whole thimeserol brouhaha was started by a study in the Lancet back in the late 1990s, which connected autism to the vaccinations. Last year, the editors could no longer stand by the study's results and reported so.

hyper Short version
Agree with Dianne
Japanese vaccine and autism rates is not cut and dried
as the vaccine was replaced by three individual shots.

More on chas later

Evidently, one of the urls that I use has typepad flag the comment as spam, though I don't see any problem with the site. Anyhow, search for an exact phrase and you should get the link.
There's some background to the MMR in Japan that makes me wonder about the study. The MMR was stopped all over Japan because of a linkage to non-viral meningitis and other side-effects, and it was replaced by separate vaccines for measles, mumps and rubella, and I'm not sure if those vaccines are thimerisol free. As with the US, manufacturers were allowed to get rid of their current stock before selling new vaccine. Still more worrying is this

The researchers tracked the records of 31,426 children born in one district of Yokohama between 1988 and 1996. Study results revealed that autism cases doubled even after the combined vaccine was
withdrawn: there were 48 to 86 cases per 10,000 children prior to withdrawal of the vaccine and there were 97 to 161 cases per 10,000 children afterward.
The triple vaccine was removed in Japan in 1993.

and

On the face of it "resoundingly negative", as one of the authors, Hideo Honda, of the Yokohama Rehabilitation Center, claimed. They had found a similar trend to what is happening in the UK and US and concluded: "The withdrawal of MMR cannot be expected to lead to a reduction in the incidence of autistic spectrum disorders." But is it so straightforward? Hostility over the MMR controversy is such these days it is very unpopular to mention the name of Andrew Wakefield, the gastro-enterologist at the centre of the storm, let alone report his words. But with Dr Carol Stott, an academic psychologist at Cambridge, he has raised serious questions about the Japanese data and what they purport to show.
Unlike the US and UK, where the autism trend is steadily upwards, the Japanese data shows a strikingly "different" dip at the time that Japanese public confidence fell in MMR and vaccination generally. Autis rates had risen 85.9 per 10,000 for children born in 1990, but then dropped to 55.8 per 10,000 for children born in 1991 when MMR uptake was falling ahead of its total withdrawal. Rates started to rise again at the time when the Japanese public started to accept the notion of three separate vaccines.

Wakefield and Stott suggest that, because the three separate vaccines were given as little as four weeks apart (there is evidence to suggest that some children had all three jabs on the same day), it was the same as being given MMR. Therefore, they argue, the "dip" in autism rated at a time when the children were not receiving measles, mumps or rubella vaccines in any form may indicate the opposite of the conclusion given to (sic) the Japanese paper.

A similar verdict on the Japan paper was also reached by US paediatrician Edward Yazbak, who in a commentary on it said that while MMR vaccination rates were high and rising in the UK, and low to nil in Japan, "autism increased more substantially in the UK".

One of the co-authors of the Honda paper was Professor Sir Michael Rutter, of the Institute of Psychiatry, who had prepared a draft report for GlaxoSmithKline, one of the defendant drug companies in the UK litigation but who was not retained by them. He told the Eye that as he was not an immunologist he could not comment on the suggestion that giving three separate vaccines a short time apart was the same as administering the MMR triple vaccine. But he added that although it was unfortunate there was little relevant material published on any possible interference between vaccine components, immunologists who he had consulted doubted that this was a significant issue.

Chas doesn't post a cite, but the journalist who 'revealed' the problems with the study was Brian Deer. A look at his site reveals a bit of leaning to the hyperbolic.
Private Eye on Deer

Deer's reply

Also, the article itself has a very narrow focus, so whether it is refuted or not does not answer the larger question of a possible link between mercury and autism.

These folks (from the Nat Acad of Sciences Etc) say:

In 2004, the IOM's Immunization Safety Review Committee issued its final report, examining the hypothesis that vaccines, specifically the MMR vaccines and thimerosal containing vaccines, are causally associated with autism. In this report, the committee incorporated new epidemiological evidence from the U.S., Denmark, Sweden, and the United Kingdom, and studies of biologic mechanisms related to vaccines and autism since its report in 2001. The committee concluded that this body of evidence favors rejection of a causal relationship between thimerosal-containing vaccines and autism, and that hypotheses generated to date concerning a biological mechanism for such causality are theoretical only.

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