Vaccines not responsible for Autism, part 14

My first big splash in the blogosphere will have occurred five years ago in June, when I first discovered the utter wingnuttery that is Robert F. Kennedy, Jr. It was then that I wrote a little bit of that not-so-Respectful Insolence that you've come to know and love entitled Salon.com flushes its credibility down the toilet, a perfect description of an article by RFK, Jr. published in Salon.com and simultaneously in Rolling Stone entitled Deadly Immunity. As I look back, I realize that, as widely linked to and discussed as it was at the time, that post, arguably more than any other, was the one that established me as one of the go-to bloggers when it came to vaccines. Of course, it may also have been the gloriously Orac-ian verbiage I employed. As longtime readers may (or may not) recall, at the time, I referred to RFK's article as the "biggest, steamingest, drippiest turd I've ever seen it [Salon.com] publish, an article so mindnumbingly one-sided and uncritical that in my eyes it utterly destroys nearly all credibility Salon.com has had as a source of reliable news and comment." Nothing in the five years since then has changed my assessment of RFK, Jr.'s investigative prowess. Indeed, if anything, he's gotten worse, such as the time he tried to out-crank CBS News' resident antivaccine propagandist Sharyl Attkisson (who has been in bed with someone at Age of Autism to coordinate counterattacks on its enemies) or the time he teamed up with David Kirby and Generation Rescue to cube the stupidity.

That was over a year ago, and since then RFK, Jr. has been fairly quiet, at least on the vaccine front. Maybe it had something to do with his being ignored by the then-new Obama administration when his supporters lobbied very hard to get him appointed to head the EPA. Or maybe it was embarrassment at having so successfully cubed the stupid. Who knows?

Whatever the reason for his year-long disappearance from the anti-vaccine fray, it would appear that he's been pulled out of storage, dusted off, and sent once again to tilt at mercury windmills. It feels like 2005 all over again. That's because RFK, Jr. has laid yet another one of his steamy, drippy, corn-textured turds on the blogosphere as only he can in the one place where such a stench of bad arguments and pseudoscience can go completely unnoticed among all the other turds that routinely drip from it. That's right, RFK, Jr. has reappeared on that bastion of anti-vaccine pseudoscience, The Huffington Post, and the title of his latest turd is Central Figure in CDC Vaccine Cover-Up Absconds With $2M. In what appears to be an obviously coordinated attack, Generation Rescue's anti-vaccine crank blog Age of Autism is promoting RFK, Jr.'s article and adding a few of its own with titles such as Poul Thorsen's Mutating Resume by the not-so-dynamic duo of fact-challenged anti-vaccine propagandists Mark "Not a Doctor, Not a Scientist" Blaxill and Dan "Why can't I find those autistic Amish?" Olmsted and NBC 11 Atlanta Reports: Vaccine Researcher Flees with $2M, featuring this news report:

http://bcove.me/xd3jkg6t

Looks like the mercury militia got to another reporter. There's Lyn Redwood spewing misinformation and nonsense hither, thither, and yon.

So what's going on here? Let's look at RFK's article and how he starts it:

A central figure behind the Center for Disease Control's (CDC) claims disputing the link between vaccines and autism and other neurological disorders has disappeared after officials discovered massive fraud involving the theft of millions in taxpayer dollars. Danish police are investigating Dr. Poul Thorsen, who has vanished along with almost $2 million that he had supposedly spent on research.
Thorsen was a leading member of a Danish research group that wrote several key studies supporting CDC's claims that the MMR vaccine and mercury-laden vaccines were safe for children. Thorsen's 2003 Danish study reported a 20-fold increase in autism in Denmark after that country banned mercury based preservatives in its vaccines. His study concluded that mercury could therefore not be the culprit behind the autism epidemic.


You know, either heaven shines on them or the anti-vaccine movement must be the luckiest bunch of pseudoscientists in the world. Here it is, a mere couple of weeks after Andrew Wakefield's fall was complete, after he had, in rapid succession, been found guilty of research misconduct by the General Medical Council in the U.K.; had his pride and joy retracted from the scientific literature, his 1998 Lancet paper claiming a link between the MMR vaccine and "autistic enterocolitis," a paper that, with the help of Wakefield himself and the credulous, scandal mongering U.K. press, sparked a fear of the MMR vaccine that persists 12 years later and has resulted in MMR uptake rates plummeting; had his most recent pride and joy, an unethical bit of bad science in which he subjected baby Macaque monkeys to experimentation all in the name of "proving" that the hepatitis B vaccine causes autism and/or neurological damage withdrawn from the literature; and been ignominiously forced to resign from Thoughtful House by, of all people, Jane Johnson, heiress to the J&J pharmaceutical fortune. The result has been some truly tinfoil hat worthy conspiracy mongering from Age of Autism and Jenny McCarthy herself. And what happens? There's a vaccine scientist who appears as though he may have absconded with as much as $2 million dollars, giving Generation Rescue and the anti-vaccine crankosphere an opportunity to go full mental jacket putting a face to vaccine scientists that they could attack. As Paul Offit knows, that's what the anti-vaccine movement does best. (Certainly it's not science that it does best.)

But was Thorsen really the driving force behind the Danish vaccine-autism studies that the anti-vaccine movement hates so much? I've been paying close attention to the vaccine-mercury-autism manufactroversy for nearly five years now, and I've never heard of him, although I had heard of one of his coauthors. If Thorsen was so important to the pro-vaccine movement, you wouldn't know it from the two studies that the mercury militia is hoping to discredit by turning up its propaganda machine to 11 about Thorsen's possible criminal behavior. Those papers are:

Madsen KM, Hviid A, Vestergaard M, Schendel D, Wohlfahrt J, Thorsen P, Olsen J, Melbye M. A population-based study of measles, mumps, and rubella vaccination and autism. N Engl J Med. 2002 Nov 7;347(19):1477-82.
Madsen KM, Lauritsen MB, Pedersen CB, Thorsen P, Plesner AM, Andersen PH, Mortensen PB. Thimerosal and the occurrence of autism: negative ecological evidence from Danish population-based data. Pediatrics. 2003 Sep;112(3 Pt 1):604-6.
It is the Pediatrics paper that the mercury militia appears to be concentrating mostly on because it directly deals with thimerosal in vaccines. But look at the citations above for both papers anyway. Do you notice something? Look where Thorsen's name is in the list of authors in both studies. Notice that it is not first, nor is it last. This is important because author order matters in scientific and medical studies. In straight science studies, the two most important authors are usually the first author and the last author. The last author is usually the senior author in whose laboratory the work was done, while the first author is the person whose project the work represents and who was the primary author of the manuscript. In medical papers, as in Pediatrics or NEJM, the author list usually signifies the relative contribution of each author to the article, the first being the most important and the last being the least important. In both types of articles, there is always designated one author who is the corresponding author. In scientific papers, the corresponding author is almost always the last author; in medical papers it is usually the first author. The corresponding author is responsible for answering inquiries about the study and, way back in the age before PDF files, used to be the author to contact to request reprints. Not only that, the corresponding author is generally considered to be the primary author for the paper.

Notice something else?

That's right. Poul Thorsen is not the first author for either of these studies. He is not the last author, either. He is not the corresponding author; that would be Kreesten M. Madsen, MD, who was corresponding author on both the NEJM and Pediatrics papers. As it turns out, Thorsen is safely ensconced in the middle of the pack of co-authors. That's why, when RFK, Jr. refers to the Pediatrics study as "Thorsen's study," he is either grossly ignorant or outright lying. (Take your pick.) Anyone who knows anything about how the scientific literature works would be able to spot that immediately just by looking at the abstracts of these articles. Trust me, if studies this large really were Thorsen's babies his name would not have been relegated to fourth or sixth on the list of authors. Basically, Thorsen's position in the author lists of these two papers indicates that, whatever leadership position he may have held at Aarhus University and in its vaccine studies group, he clearly was not the primary contributor for these studies, and they were not his studies primarily.

Not that that stops the mercury militia from going out of its way to paint him as such, referring to him as a "central figure." I have to tip my hat to RFK, Jr. his language throughout his article is truly Orwellian, a propaganda masterpiece of prestidigitation of language and innuendo. Here are just a few examples of perfectly loaded phrases sprinkled throughout the article, all designed to suggest concealment and conspiracy:

..."built a research empire..."
"...failed to disclose..."
"...has disappeared..."
"...damning e-mails surfaced..."
"...culprit behind..."
"...leading independent scientists have accused CDC of concealing the clear link between the dramatic increases in mercury-laced child vaccinations."
"...safe to inject young children with mercury..."
"...CDC officials intent on fraudulently cherry picking..."
RFK, Jr. also parrots anti-vaccine lies about the study that were hoary back when David Kirby first published the mercury militia Bible, Evidence of Harm, lies like:

His study has long been criticized as fraudulent since it failed to disclose that the increase was an artifact of new mandates requiring, for the first time, that autism cases be reported on the national registry. This new law and the opening of a clinic dedicated to autism treatment in Copenhagen accounted for the sudden rise in reported cases rather than, as Thorsen seemed to suggest, the removal of mercury from vaccines. Despite this obvious chicanery, CDC has long touted the study as the principal proof that mercury-laced vaccines are safe for infants and young children. Mainstream media, particularly the New York Times, has relied on this study as the basis for its public assurances that it is safe to inject young children with mercury -- a potent neurotoxin -- at concentrations hundreds of times over the U.S. safety limits.
Notice how RFK Jr. really, really wants you to believe that the Danish studies are the primary foundation upon which the science exonerating MMR and thimerosal-containing vaccines as a cause of autism rests, the be-all and end-all of the epidemiology studying thimerosal-containing vaccines, when in fact there are multiple studies and lines of evidence, of which the Danish studies are but a part. Also notice how he conflates a study's being weak with its being fraudulent. The two are entirely different concepts, and it is entirely possible for a study to be poorly designed and executed without even a whiff of fraud. (In fact, fraud is almost certainly far less common than that.) Be that as it may, the Danish studies, although they have weaknesses inherent in a retrospective design, are actually pretty darned good studies. As I said before, RFK's whine in the passage above is the parroting of a hoary criticism of the Danish studies cribbed straight from anti-vaccine sites. The criticism goes like this. Anti-vaccine propagandists argue that because, beginning in 1994, outpatient records were used in addition to inpatient records for case ascertainment in Denmark for purposes of these studies, the whole set of studies must be crap. As Steve Novella points out, this change was not chicanery, and in fact Madsen et al tried to test whether the change in case reporting by doing this was significant. Here is a quote from Madsen et al:

In additional analyses we examined data using inpatients only. This was done to elucidate the contribution of the outpatient registration to the change in incidence. The same trend with an increase in the incidence rates from 1990 until the end of the study period was seen.
In other words, Madsen et al considered the possibility that adding outpatient records to inpatient records beginning in 1994 might change the results. They tested for that possibility and determined that the addition of outpatient cases did not change the trend of increasing autism diagnoses. Again, RFK, Jr. is either grossly ignorant of the facts or lying through his. (Take your pick--again.) The same is true of J.B. Handley when he repeats the same misinformation time and time again, particularly on his Fourteen Studies website, and and of Ginger Taylor when she in her arrogance of ignorance parrots the same lie. Come to think of it, so is SafeMinds when it touts the fact that many of the study authors are employed by Statens Serum Institut (SSI), claiming that it is a conflict of interest because as a "government-owned vaccine manufacturer," supposedly SSI makes a lot of money off of vaccines and would be liable legally if thimerosal in vaccines were found to cause autism. Believe it or not, this distortion was dealt with by a guest blogger Kristjan Wager (whose regular blog is here) way back in 2006. Not surprisingly, it's utter nonsense born of a misunderstanding (either unwitting or deliberate) of the medical and legal systems in Denmark. Unfortunately, anti-vaccine lies never die; like a certain undead dictator, they always rise again.

Meanwhile, Not A Doctor, Not A Scientist (Mark Blaxill, in case you forgot), along with No Longer a Journalist (Dan Olmsted) lay down flaming stupid like this:

Thorsen, of course, is pre-eminently one of those leading scientists and was a co-author of a New England Journal of Medicine study on the MMR. Thorsen and Aarhus, as we've reported for years, made important contributions to some of the most influential autism-vaccine mercury (thimerosal) studies - studies disputed as poorly done and unconvincing by critics that over the years have grown to include the head of a panel mandated by Congress to study the issue. But based on five studies, three of which included Aarhus - and one of which Thorsen co-authored -- the U.S. Institute of Medicine concluded in 2004 that "the evidence now favors rejection of a relationship between thimerosal and autism."
Here's what's going on. In the wake of debacle the implosion of Andrew Wakefield represented, the anti-vaccine movement needed a distraction badly, and they needed it fast. It would be even better if the distraction were one that they could spin to make it look as though there were some dark corruption at the heart of the vaccine science that has exonerated vaccines as a cause of the "autism epidemic." Like manna from heaven, Dr. Thorsen's case dropped seemingly from the sky. I'm going to admit right now that I have no idea of Dr. Thorsen is actually guilty of absconding with $2 million in grant money. He may well have, and if he did justice needs to be done. He needs to be caught and tried. But here's the rub.

It makes absolutely no difference to the science exonerating vaccines or thimerosal in vaccines as a cause of autism whether Thorsen is a criminal and thief or not.

As one of my readers pointed out, trying to argue that because Thorsen may have fled with stolen money is akin to arguing that if the fourth co-author of one of Einstein's papers describing the Theory of Relativity ran off with $2 million it would somehow invalidate the Theory of Relativity. Maybe J.B. Handley, No Longer a Journalist, RFK Jr., or Not a Doctor Not a Scientist can help me out here. Was there an allegation against Poul Thorsen of actual scientific--rather than financial--fraud of which I wasn't aware? Was there an allegation that somehow this alleged financial fraud had anything whatsoever to do with the design or excecution of Danish studies that failed to find a link between either MMR or thimerosal-containing vaccines and autism? Is there any evidence anywhere that Poul Thorsen committed scientific misconduct on the order of what Andrew Wakefield did? Seriously. I don't see anything in any of the number of vicious attacks on Poul Thorsen (who may or may not be a criminal), the SSI (which doesn't deserve them), or Aarhus University in Denmark (which also doesn't deserve them). It's a pure smear against these latter two institutions, guilt by association.

In other words, it's very typical of the anti-vaccine movement. The bottom line is that this is not a scientific scandal. It is a financial scandal that happens to involve a scientist.

Here's the other thing to remember. Even if RFK, Jr., Mark Blaxill, J.B. Handley, Dan Olmsted, and the rest of the merry band of anti-vaccine loons currently attacking these institutions were completely correct and the Danish studies were actually hopelessly tainted by Thorsen's alleged criminality--even if both studies were completely expunged from the medical literature--it would not change the scientific conclusion that neither MMR nor thimerosal-containing vaccines. That's because of a little pesky thing known as reproducibility. The Danish studies are not the only studies exonerating thimerosal as a cause of autism. There are Canadian, U.K., and U.S. studies whose results are concordant with those of Madsen et al.

For the anti-vaccine movement, the problem with the idea that thimerosal-containing vaccines cause autism was always that it makes a testable hypothesis. Remove the thimerosal from vaccines, and autism rates should plummet. This experiment has been tried in at least three countries, and the results have always been the same. Autism rates continued to rise after thimerosal was removed from childhood vaccines. Indeed, thimerosal exposure from the vaccine schedule in the U.S. is currently lower than it was in the 1980s (there is still trace thimerosal in some childhood vaccines, and the flu vaccine still has thimerosal), but there has not been a decline in autism prevalence to what it was in the 1980s. The hypothesis that thimerosal causes autism has been roundly falsified, not just by the Danish studies but by several other studies.

In the end, anti-vaccine propagandists are very much like creationists and other cranks. They focus on the person more than the science, and they labor under the delusion that there is a single study (or tiny handful of studies) that are the whole support for the scientific conclusions they despise and that, if destroyed, would lead to the edifice of the science they hate collapsing. That's why they prefer to attack persons rather than use evidence and reason to argue ideas. It's also why they are always seeking that one study that they can tear down and thus "prove" that evolution didn't happen, vaccines cause autism, the moon landing never happened, or the Mossad and the Bush administration were beind 9/11.