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Autism's False Prophets
"Book Is Rallying Resistance to the Antivaccine Crusade" is a New York Times article about Paul Offit's book, "Autism's False Prophets." Dr. Offit is a pediatrician and chief of infectious diseases at the Children’s Hospital of Philadelphia.
Dr. Offit’s book traces the history of autism theories, starting with the child psychologist Bruno Bettelheim’s blaming “refrigerator mothers.” It describes early false cures, including “facilitated communication,” in which assistants helped mute children type their thoughts; head-squeezing by osteopaths; cod liver oil; diets; and a 1998 fad for secretin, a pig hormone. It sums up 16 epidemiological studies showing no link between autism and either measles or thimerosal, a vaccine preservative [which was removed from most vaccines as a precaution in 2001 -- LDSSR].I'll be putting this on my to-read list. I've followed the controversy at a more popular level, and my own training is in microbiology and immunology, so I am pretty familiar with the concept of vaccines and how they work. However, I am not a physician so I don't know the clinical side well, and I could use some more information on the history of the movement as well as the epidemiological studies.
To the newer argument that vaccines overwhelm babies’ immune systems, Dr. Offit notes that current shots against 14 diseases contain 153 proteins, while babies cope with thousands of new foreign proteins daily in food, dirt and animal hair, and that the smallpox vaccine that nearly every American over age 30 got as a child contained 200 proteins.
You can read an excerpt from the book here. Also, Dr. Offit was interviewed on the podcast, "The Skeptic's Guide to the Universe," which is available here.
12 comments:
I think these guys are quacks but I think its a bit disengenuous as well to tie eating food with getting a slew of vaccines in the blood at the same time. That's not terribly convincing.
To get more links to science articles about autism, go to my blog and click on the autism category (label). I currently have 7 links there.
Clark,
The American Academy of Pediatrics makes the same comparison (here). I think the point is that number of antigens is a red herring. Maybe a better comparison is a toddler skinning their knee.
And just to nit-pick, most vaccines are injected into muscle or skin, not directly into the bloodstream. It's a nerd point, but it makes an immunological difference.
Note that I didn't say they were injected into a vein just that they end up in the blood. But also where they are injected makes obviously a lot of difference and even good nurses or doctors screw up. I get allergy shots once a week and how well they give the shot is the difference between a slight burn and tenderness and a large welt and rash.
But my larger point was that the issue wasn't about the different kinds of proteins. Clearly the physiological reaction of a vaccine shot and a bunch of proteins during a scrape is significantly different. I don't think anyone disputes that even in adults. However to assume that doing more vaccines at once has no difference from one seems highly dubious. To argue against the question on the basis of an analogy to a scrape is simply silly and confuses the question of intensity with the question of diversity. I'm not saying there is an issue here. Just that the arguments put up against it seem very dubious. At a minimum some study into this should be made.
There seems to be a "guilt by association" in that because the quacks are turning to the question that it's somehow not a reasonable question at all. Yet it seems to me that if there is some "shock" (using the term loosely - don't get pedantic) associated with a single vaccine that it would be worse if you got 2 and worse yet if you got 3. I don't recall how many they typically give small babies at once, but I seem to recall it being fairly sizable. Ditto for toddlers.
Vaccines don't end up in the blood, they go into the lymph and drain to the lymph nodes. For your allergy shots, are they changing (increasing) your dosage on some weeks to build up your tolerance? Does this play a role in the severity of your reaction?
The idea that having two or three vaccines at once would be too much of an antigenic overload or shock to our immune system is extremely silly, whether you consider diversity OR intensity. Our cells are constantly sampling antigens from our GI and respiratory tracts, which are loaded with a vast, dense microbial community from birth, and taking them to our lymph nodes. So when you say that at minimum, the issue needs further study, it is very difficult to see how such a study could be done. What would be your comparison groups?
David, I've been in maintenance for several years. It's all about where they put the needle in.
But certainly during the first year when dose would increase the size of the dose has a huge effect. Indeed when they change bottles they drop the dosage down significantly so as to not cause dangerous physiological responses if the content doesn't exactly match the older bottle.
Compare the reaction of kids with one vaccine versus several. Or spacing shots over two or three weeks rather than all at once. It seems an easy study to do. I'm surprised you can't imagine how to do such a study.
If what you say were true then the dosage of a vaccine shouldn't matter. Clearly it does. So clearly there is some physiological effect of dosage. The question is what all the side effects of dose are.
Once again I'm not arguing one way or an other. But it seems to defy common sense to assert that it doesn't matter.
BTW - how on earth do vaccines end up in the lymph if they are injected in the leg without entering the blood? I assumed that was how they got there. If they aren't in the blood (and thereby potentially having other interactions) how to they reach the lymph? (Honest question)
Clark,
I take your point. I don't think it is a silly question, and I don't dispute the notion that a high enough dose could cause problems. My response would be that, first of all, those kinds of studies have been done. If you would like to dig some on this, you can start with the MMWR's recommendations here. "Simultaneously administering the most widely used live and inactivated vaccines have produced seroconversion rates and rates for adverse reactions similar to those observed when the vaccines are administered separately (13--16)."
Second, perhaps a better comparison would be to natural infections. For example, most bacteria have many more proteins than either viruses or the whole group of vaccines. But I can't think of a single case where pathogenesis of a natural infection is attributed simply to the number of proteins. And I don't have numbers handy, but I can pretty well guarantee that the number of virus particles of an attenuated-virus vaccine dose is miniscule compared to the number of particles circulating in your body during a natural infection.
As for lymph nodes, see wikipedia's article on the lymphatic system. The immune system is pretty complicated so it would be wrong to speak in terms of all or none. However, I should also point out that for attenuated-virus vaccines, the virus does replicate and spread through the body. But because it is weakened, the immune system is able to deal with it more easily.
Clark - I didn't understand your initial question, sorry. I think you are right to say that dosage of vaccine matters, but what I would not agree with is that higher amounts or diversity of antigens delivered in multiple vaccines at once could cause harm. I would also guess that what causes most of the adverse reactions after vaccination is the adjuvants in the vaccine, not the antigens.
Right, David. I can buy that. However I'd just note that the responses by scientists to the public really isn't saying this. One frustration I'm noticed with my wife towards doctors is that she can't put into words what seems obvious to folks with science backgrounds like you or I. Then doctors respond, often snarkily, to people with very valid concerns who perhaps don't ask the question just right.
When I look at the responses to this I simply don't see doctors answering the questions people have or else missing the point entirely.
Now Jared's comment that this has been studied is the perfect response. Why don't we see that being made in the press more?
While the quacks and scaremongers in all this are quite dispicable the response by the scientific establishment to real concerns and fears of parents has been amazingly incompetent.
To add, if one is allergic to some of the adjuvants then one would expect a stronger reaction the more there is. Especially when dealing with the body weight of infants. Further allergies can cause severe inflammation and not be caught by doctors (since they'd just assume it was a standard reaction to the vaccine)
Once again I'm not claiming anything. I do think these things need studied. Not having an account on a med research index I wonder if you know of studies on this.
Clark,
On adjuvants, this looks like a nice place to start.
Also, anybody can search PubMed for free. Getting to actually read an article is another matter--although some are available for free.
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