Via Scientific American, I see that the Institute of Medicine is releasing a new report about the adverse effects of vaccines. Or, perhaps more accurately, the lack thereof. From the article:
Vaccines are largely safe, and do not cause autism or diabetes, the US Institute of Medicine (IOM) said in a report issued today. This conclusion followed a review of more than 1,000 published research studies.
“We looked very hard and found very little evidence of serious adverse harms from vaccines,” says Ellen Wright Clayton, chairwoman of the reporting committee and director of the Center for Biomedical Ethics and Society at Vanderbilt University in Nashville, Tennessee. “The message I would want parents to have is one of reassurance.”
The report, commissioned in 2009 by the US Health Resources and Services Administration, covers the eight vaccines that comprise the majority of claims filed with the National Vaccine Injury Compensation Program (VICP), which compensates people for adverse health effects from any of 11 vaccines.
The eight vaccines under review were those for chickenpox; influenza; hepatitis B; human papillomavirus; diphtheria, tetanus and pertussis (DTaP); measles, mumps and rubella (MMR); hepatitis A; and meningococcal disease.
Raise your hands up real high if you think this will make the slightest dent in the armor of the “vaccines cause autism” movement. Let’s see, shall we? From Age of Autism, my one-stop shopping destination for anti-vaccine tomfoolery:
The Institute of Medicine’s Panel on Adverse Effects of Vaccines issued a report today on the evidence and causality of vaccine harms. Despite a glowing press release, the report does little to allay public concerns over adverse effects of vaccines and suggests that we urgently need more science on vaccine adverse effects.
The IOM report took two years to produce, mostly behind closed doors, and was paid for by the Department of Health and Human Services, the government agency which is also a defendant against the vaccine-injured in the government’s vaccine court.
Sigh.
How is Age of Autism spinning the IOM’s findings that vaccines likely cause some adverse outcomes?
The report found likely causality of immune dysfunction, seizures and encephalopathy from some vaccines. These conditions are often found in individuals with autism. “It is plausible that a subset of children became autistic because of these adverse events from their vaccines. There are many cases of autism compensated by the vaccine court after having one of these conditions,” noted Lyn Redwood, RN, Director of SafeMinds.
And what does the report actually say?
According to the report, evidence “convincingly supports a causal relationship” for only 14 specific adverse effects, including a range of infections associated with the chickenpox vaccine; brain inflammation and fever-induced seizures related to the MMR vaccine; allergic reactions to six of the vaccines and fainting or local inflammation caused by injection of any of them. The report noted that many of the more serious events, such as those linked to the chickenpox and MMR vaccines, only occur in children with weakened immune systems. [emphasis added]
In other words, the severe outcomes Age of Autism cherry-picks occur only when live-virus vaccines (such as MMR and varicella) are inappropriately given to children with some form of immunodeficiency. In patients with healthy immune systems (the only patients who should be receiving these vaccines), they do not cause encephalopathy, seizures or anything else that can plausibly be linked to autism. To suggest otherwise is to deliberately misread the report’s findings.
I like this quote in the article from Paul Offit, a man who has worked as hard as anyone to promote vaccination as the safe, healthy and appropriate choice for children.
“For those parents who are on the fence, this will be another piece of reassuring evidence, although I don’t know how many more pieces of reassuring evidence you need,” says Paul Offit, chief of the infectious diseases division of The Children’s Hospital of Philadelphia in Pennsylvania. “For those who are committed to the concept that vaccines are harmful independent of what the data say, it won’t matter.”
For the record, it does not appear that the full report is available for public review at this time. I have not read the whole thing. Offit (typical of a responsible scientist) mentions some concerns he has with the study’s design, even though he agrees with the conclusion. And that’s the kind of thing that will make this a never-ending controversy. Here’s how Age of Autism interprets other findings and moves the goalposts:
Due to a narrow set of objectives defined for the IOM by the government, the report only looked at a small set of published research studies linking just two vaccines to developmental disorders such as autism. Only four epidemiological studies were considered of sufficient quality to evaluate the MMR vaccine in relation to autism and no studies were deemed of sufficient quality for the DtaP vaccine and autism analysis. The committee did not attempt to evaluate six other vaccines for autism causation, the safety of the cumulative vaccine schedule and health outcomes like autism, or the safety of vaccine ingredients like mercury and aluminum in the context of chemical exposures from other sources like air pollution or consumer products.
The report considered 158 potential adverse outcomes from vaccines. Of these, 135 or 85% were found to have inadequate research to accept or reject a causal association. [emphasis added]
There are numerous things to say about this:
1) Science should always concern itself with narrow questions. The more specific and focused the question, the more likely a study is to answer it appropriately. The phraseology chosen above clearly implies that “the government” conspired to exclude meaningful information from study, rather than commissioning an appropriately-focused report.
2) The overwhelming majority of the studies included in the report were found to have inadequate evidence to draw any meaningful conclusion. Not having been able to review the whole report, I can only guess at what the flaws or weaknesses may have been. However, I can say that it takes a very, very large and powerful study to reach a convincing negative conclusion. (It’s hard to prove a negative, in other words.) The authors of the IOC report prudently determined that they couldn’t be used to make causal analyses, but scientific prudence can be repackaged to create the appearance of inauthority, impropriety or uncertainty, as it was here.
3) This whole controversy started with a fraudulent study linking the MMR vaccine with autism, long since discredited and now retracted. So the anti-vaccine crowd went after thimerosal, which contains a safe form of mercury. After studies showed no link between thimerosal and autism, they started blaming aluminum. Looking at what they write now, they somehow want a study to evaluate the routine vaccination regimen in the context of exposure to air pollution and consumer products. I will tell you now that they are asking for the impossible, which doubtless makes them happy. So long as there is something, anything they can couple with vaccines into some horrible, malevolent autism-causing chemical boogeyman, they will be able to trumpet their agenda and undermine confidence in vaccines.
I am glad to see that scientists continue to address this question. It is incredibly important to the health of the world’s children that vaccination continue as comprehensively as possible. If taking the concerns of the anti-vaccine crowd seriously will aid in that pursuit, then it’s worth the time, effort and money. But at a certain point we have to recognize that science is not what that crowd respects, and there will always be something they can use to discredit it.
Same as it ever was. You would think that the 1000 or so studies themselves would have closed this issue already. But once more conclusive evidence is not going to convince those people that choose not to vaccinate their children. I think the problem is more psychological now; if you don’t have your children vaccinated then you are intentionally exposing them to potential harm and thus you are a bad parent. Nobody wants to admit to themselves that they are a bad parent, especially those zealous enough about their children’s health to forego vaccination. (exaggerated for emphasis, please don’t excoriate me). It almost begs for social psychology experiment akin to the Stanford prison experiment. How about this: Get a large group of people in an isolated environment for a variable length of time. Now give each person some object, say a lanyard or something like that, lets say shoes. Put up posters that say that wearing shoes protects your feet and have experimenters consistently tell people that wearing the shoes is good for your feet. Now set up some kind of punishment like removing a subject or isolating a subject or something to that effect. Completely at random periodically impose the punishment on some of the subjects. Have one experimenter tell everyone excitedly that wearing the shoes will cause the punishment, then remove that experimenter from the subjects. Have the other experimenters rebuke this. After a time survey them on how they feel about the shoes and monitor how many of them wear shoes. I’d wager that you’d find a group mentality similar to the antivaxers form even if you exposed that the punishment selection process was completely random.
I can’t do the anti-antivax thing right now. It makes me freak out.