Facts, not Fantasy

Sunday, February 28, 2010

The Shimmering Cloak

"I have never argued with a reasonable man and did not defeat him, but I never have argued with an ignorant man who did not defeat me."

-Ali bin Abi Talib from Nahgul-Balaghah

It is hard to refute the anti-vaccination movement. It is hard the way shoveling snow is hard, the way running errands on a tight schedule is hard. It hard because work is hard. To thoroughly and completely address anti-vaccinationist rhetoric you must be a polymath, you must pore over numerous journals, look up statistics, be somewhat familiar with the basics of toxicology, chemistry, and biology. On the other hand, in order to generate anti-vaccination rhetoric, you don't need to know anything whatsoever, or prove your statements with facts in any way. It cannot be taken for granted: Attacking a non-facts-based movement with facts alone is not enough.

Arguments with people from the anti-vaccination crowd always run the same way: First the allegation is that thiomersal causes autism. Then it is revealed that thiomersal has been removed from vaccines. Suddenly all kinds of new accusations emerge, that vaccines do not cure disease, or that they cause many other adverse reactions too numerous to list. One can only imagine how the vaccinated must function from day to day- poor delicate things that they apparently are.

Suddenly we find ourselves dealing with a dancing, shimmering cloak, concealing the simple fact that the anti-vaccination movement has no case. We address thiomersal, a shimmer and shift later, and thiomersal is no longer the concern. You can address the basis vaccines have in germ theory, the studies that failed to find a link, the fact that the people who design vaccines believe in vaccination, and generate two mountains of answers for every question raised by the anti-vaccination movement. All of this effort goes to waste. There will always be something else.

For parents trying to make the decision to vaccinate, it can be daunting to see a list of reasons not to vaccinate as long as their arms, but see comparatively little in rebuttal. Rebuttals must be well researched, made carefully, qualified adequately, and are by their nature limited and single-subject. Meanwhile the anti-vaccinationists can cite any number of highly questionable sources. Sources that parents cannot divine the value of for themselves. Scientists and doctors take it for granted that parents can distinguish facts, from fantasy. To a doctor- certain statements can be untrue in obvious and clear ways, but that doesn't mean that a layperson will appreciate the physician's promise that the claimants are "talking moonshine". A knowledgeable person is always hedging, always uncertain. The argument from ignorance is strident and sure.

Take for example: the recent retraction by the Lancet of Andrew Wakefield's paper- which in many respects allowed the anti-vaccination movement to catch fire. This retraction has done little to discourage the proponents of the idea that vaccines are a net harm to society. It has also failed to slake the thirst of many a parent who is out for the blood of the pharmaceutical industry. Of course, a parent who truly believes in the existence of a tangible villain that caused their child's illness can hardly be blamed for falling for the very persuasive narrative put forth by the anti-vaccination community.

So a flash, a glimmer, and a shimmer later we're right back where we started, and claims of censorship abound. This is why I do not feel that the anti-anti-vaccination movement can in fact win a battle of facts and evidence. What brought so many into the folds of the anti-vaccination movement was so much more than evidence and so much less at the same time. Less, in that it will never be sufficient to sway the dispassionate currents of reality as they buffet us about the world. More in that they now believe that every wave carries malice and intent, and they know in their hearts they are being borne off to some deserted island to endure the cruel machinations of some sinister force. Reality is not compelling, it's not a story, and human beings think in stories.

I'm not saying that evidence is unimportant and should never be brought into the discussion. Rather that not every one is appropriately primed to receive it, to incorporate it into the narrative that they have so elaborately woven. We've all seen the courtroom drama. The brilliant young lawyer receives a message pointing to some evidence absolving his innocent client of any guilt. He quickly proceeds to get the case thrown out by interrogating the right witness, or demonstrating conclusively in a single swift Cochranesque bit of elegant logic that his client cannot possibly be the perpetrator. However if we watch enough such dramas, we see there is also a completely different archetype:

Sometimes, there is no further investigation necessary by the inquisitive lawyer, and the evidence is lying in plain sight for all to see. The lawyer's task is not to find new ways of showing the jury the evidence, the reason his or her client is on trial has nothing to do with the evidence. It's the system that put them on trial, and it's the prejudices of the jury that will convict. The task of the usually young, usually spunky, lawyer is in fact much more herculean than a simple cold assembling together of the evidence before the jury: The counselor must instead present his or her case in a way that will shatter the illusions of the jury, obstruct the clear line of sight that they have between their world-view and the matter at hand. Our hero must change their thinking about the case from top to bottom as he destroys the persuasiveness of their precious narrative- so that when they finally move to the quiet of the deliberation room, they finally look to the evidence. In this scenario, the evidence is not the means, but the irrevocable end. The jury must now construct the only narrative that now makes sense, having shed their biases, and the verdict can only be a product of the clues gathered before them.

You cannot do battle with the shimmering cloak. It is, after all- an illusion and an obstruction. Yet every illusion presents an edge to grasp and every act of chicanery has stray thread to be pulled at. We long ago established that we have the answers, it is the questions that must fly fast and furious:

Who payed Andrew Wakefield?
How can an anti-vaccination doctor patent a measles vaccine in good conscience?
What did Jonas Salk charge for his polio vaccine patent?
If it's not thiomersal- what is it?
Why are genetic markers turning up for autism?
How many children die as a result of not vaccinating?
Considering this: On the balance, even if vaccines do cause autism, are the inevitable deaths from infectious disease an acceptable price to pay?
What's in a vaccine?

This last one is asked by our opponents, but only as a hollow point of rhetoric. I think it's a legitimate question, as evidenced by the fact that one anti-vaccinationist I talked to truly believed that vaccines contain animal brain matter. Not only is this untrue, but if it were- we would see the evidence of it in the form of an intense increase of neurological symptoms resembling mad cow disease. Brain matter is a very strange thing to pack into a vaccine anyway. I think that vaccines deserve to be demystified, and the story must be told of how they are made.

Each of the questions above, when answered, raise a set of new and more provocative questions, and each of the answers to those form a brief indelible impression on the person's mind. This series of answers comes at the seeker in a flurry of pictures. The mind, being what is, tries to put the pictures together to tell a story. There, suddenly, a zoetrope unfolds and in that flickering motion our thinker spies a courtroom and a jury that is slowly coming to its senses.

Friday, February 12, 2010

Study Confirms Link between Older Maternal Age and Autism

Study Confirms Link between Older Maternal Age and Autism

Maternal age and autism are both on the rise--but only a small fraction of the increasing incidence can be explained by the trend toward later childbearing

By Katie Moisse

It is common knowledge: As women get older, pregnancy becomes a riskier enterprise. Advanced maternal age is linked to a number of developmental disorders in children, such as Down's syndrome. Now, a study has confirmed that older mothers are more likely to give birth to a child with autism, too.

The authors of the epidemiological study, published February 8 in Autism Research, examined the parental age of more than 12,000 children with autism and nearly five million "control" children between 1990 and 1999, all living in California. The researchers found that mothers over 40 had a 51 percent higher risk of having a child with autism than mothers 25 to 29, and a 77 percent higher risk than mothers under 25.

Autism—a developmental disorder characterized by impaired social interaction and communication—appears to be on the rise. The U.S. Centers for Disease Control and Prevention now estimates that as many as one in 110 children in the U.S. has an autistic spectrum disorder—a group of developmental disorders including autism, Asperger's syndrome and pervasive developmental disorder. The prevalence of autistic spectrum disorders in California in 2007 was 12 times that from 1987, representing an average annual growth of 13 percent, according to a report from the California Department of Developmental Services. Only a fraction of these extra cases can be explained by changes to diagnostic criteria and earlier diagnoses.

Maternal age is also increasing in the U.S. A California-based study reported a three-fold increase in the number of births to women aged 40 to 44 between 1982 and 2004. But this trend toward delayed childbearing accounted for less than 5 percent of the total increase in autism diagnoses in California over the decade, according to the study—a finding that surprised Janie Shelton, a doctoral student in University of California, Davis's Department of Public Health Sciences and the study's lead author. "I would have expected to see more of a contribution, because age is a risk factor and women are having kids later," she says.

Earlier work had suggested that both maternal and paternal ages are independently associated with autism risk. But the current study found that paternal age is only a risk factor when the mother is under 30. It follows similar results obtained from the same California sample, published in September 2009 in the American Journal of Public Health, which showed that pooling data artificially inflates the risk of paternal age, and that advanced maternal age likely poses the greater risk. "It's nice to see replication of prior work," says Peter Bearman, co-author of the 2009 paper. Neither research team investigated whether increasing maternal age worsened autistic symptoms, although a 2007 study published in the Journal of Autism and Development Disorders that measured autistic children's cognitive and social function failed to make that link.

Mothers over 35 are at a higher risk for prolonged labor, premature or breeched deliveries, and birth to babies with low Apgar scores (a rating index used to evaluate the condition of a newborn infant)—all factors that have been associated with autism. But they might also be more likely to seek diagnoses to explain their child's abnormal behavior. "That's definitely an important thought, and I think that there is some evidence to suggest that people with higher education and higher socioeconomic status in general are more adept at navigating the diagnostic process here in California," Shelton says. "[Parents] need to be motivated to get the diagnostic and treatment services that are granted to them by the state. There are certain cases we're missing because the parents don't know about the services that are available or they haven't worked out how to navigate the system yet." The proportion of parents of autistic children with fewer than 24 years of combined education in the study was smaller than that of "control" birth parents, (19 percent and 36 percent, respectively).

Other contributors to the increasing incidence of autism remain unclear. "We're doing a lot of research into environmental risk factors," Shelton says, describing ongoing research into possible nutritional factors and toxic chemical exposure during labor and development. It is possible that the increased risk associated with maternal age might reflect the mother's longer cumulative exposure to unknown environmental factors, the authors report.

The research team published an earlier report in the same journal describing high-incidence geographic clusters in California, another finding in line with Bearman's work that suggests environmental processes and social influences (why someone would live in a particular neighborhood) might be contributing factors. Maternal autoimmunity is another theory proposed by the researchers, who previously reported that some mothers of autistic children had antibodies to fetal brain proteins in their plasma. These antibodies (which might increase in number with age) could transfer into the fetus and interfere with early brain development, the researchers report.

Whereas biomedical studies are required to uncover the mechanisms underlying the disorder, Shelton says the present epidemiological study was important in clarifying the nuanced relationship between maternal age and autism, and defining its contribution to the rise in cases. It might have even provided biological clues. "It really is a maternally mediated biological process that's going on," Shelton says.

Although it is rising, the risk of autism is still very low and shouldn't affect the decision to have children at any age, Shelton says. "People should pursue their families whenever it's right for them," she says, adding that soon-to-be parents should "just stay as healthy as possible," and steer clear of dangerous exposures. She also encourages parents with autistic children to get involved in research. "I think parents are anxious because science hasn't figured it out yet. If they have the opportunity to be involved in supporting science and autism research, that's a great thing."

Thursday, February 04, 2010

Dana McCaffery

Sometimes I get asked why I started to run this web page. I think Dr. Plait pretty much reminded us all with this post:

Dana McCaffery

Today would have been Dana McCaffery’s first birthday.

It is in her memory that we must all stand up to unreason. It is in her memory that we must never tire, and never fail.


Wednesday, February 03, 2010

Evolution for kids

I also wanted to post this bit from Dr. Plaits blog, since it does involve education on a subject we cover here as well.

Evolution for kids

Evolution_coverWe’re having a big problem in America these days, with the forces of antireality on the march to deceive our children. Evolution is a big target for them, of course, and I need not belabor the battle here.

But what can we do? We need to excite kids about the real world, and about evolution in particular. And we need to do it in a wonderful way, grabbing their attention, staying positive, and revealing all the beauty and majesty of the way life has self-propagated on this planet of ours.

Daniel Loxton has come to the rescue! He’s the brain behind Skeptic Magazine’s Junior Skeptic, a terrific feature designed to get young kids thinking. His experience putting that together is clear in his new book, Evolution: How We and All Living Things Came to Be. This book has everything for younger readers: excellent writing, simple yet compelling layout, and a diversity of topics in evolution and its related studies which give the reader a solid background in evolutionary biology. That’s critical, as it gives them a basis on which they can build when they read more about the topic.

And Daniel covers a lot of topics, like transitional fossils, population growth, diversity of species, how we know that life changes over time, mutations, natural selection, and more. He even deals simply and efficiently with the topic of religion at the very end, telling the reader to talk to family, friends, and religious leaders about it. While I might disagree with him a bit (really, just a bit) over the boundaries of religion and science we’ve had a few discussion on Twitter about this — I think he deals with the topic elegantly in the book. After all, the book isn’t about religion, and instead of being arrogant or dismissive, he relies on the book itself being an effective treatment of the topic. I think that was a shrewd move.

And I simply cannot praise the illustrations enough, which were done by Daniel himself. WOW! The drawings are simply magnificent; the Archeopteryx on the cover will grab any kid’s attention, as will the gorgeous T-Rex on the first page. My favorite drawing was this one, which he also uses as a banner for the book:


It shows two women of different eras, and it beautifully demonstrates our similarities and differences. And the woman on the right is an actual human — Daniel’s wife! — something of a well-known skeptic herself. I bet if you come to TAM with a copy of the book, you can find her yourself and get both her and Daniel to sign it…

I think this book is absolutely terrific, and if you’re looking for a simple statement about it, then how about this? Simply put, I would’ve loved this book when I was a kid. It would have made me want to be a scientist.

You can get buy a copy of Evolution through the Skeptics.com website, or if you donate $100 they’ll send you a copy for free. I know, it’s not really free then, but you’ll be helping out a good group of skeptics, so it’s a good thing to do. If you prefer, it’s also available on Amazon and Amazon.ca.

My suggestion: buy several copies and give them away as gifts to kids. And maybe one for your local school as well. I know they could use it there

AVN may be closing doors; Meryl Dorey stepping down

The good news for the reality based world keeps rolling in this week. First Wakefield et al are discredited for their shoddy "research" and even have their article retracted (it takes a serious mess up generally for that to happen by the way), now the Australia (anti) Vaccination Network is becoming less visible. I'll leave Dr. Plait to go into all the gory details. Suffice it to say that it's a victory, if not just for reality, but also for the poor McCafferys. Read the article:

AVN may be closing doors; Meryl Dorey stepping down

We have another MAJOR win for reality and skepticism, folks. And this is a good one: Meryl Dorey just announced she’s stepping down as head of the Anti Australian Vaccination Network, and that the AVN itself may shut down.

Ah, the hits keep on a-comin’.

Regular readers may remember Ms. Dorey, that hero of the antivaxxers who has twisted the truth about vaccinations so much it’s shocking her tongue hasn’t turned into a Möbius strip. She has said no one dies from pertussis anymore… when little four-week-old Dana McCaffery died of that very disease, because herd immunity in her area of Australia was so low. Dorey is an HIV denier. She thinks doctors lie and poison babies. She viciously defames those who disagree with her. It goes on and on.

The timing of this announcement is very interesting, seeing as how the Australian Skeptics have been hammering at Dorey and the AVN, and in fact Dorey and the AVN may be held accountable for breaking Australian laws about dispensing medical advice without a license; they are currently under investigation by the New South Wales Health Care Complaints Commission.

They’ve also been getting a lot of negative publicity, which is the very, very least that they deserve. My friend, the tireless Rachael Dunlop, has been instrumental in exposing the truth about Meryl Dorey, and is largely responsible for holding Dorey’s and the AVN’s feet to the fire.

Reading Dorey’s statement on the AVN blog is actually rather interesting. She says:

I am getting older; my children have missed out on so much so I could run the AVN; and at this stage in my existence, I need to be able to work on this subject and still have a life. Without a large injection of capital behind me, I simply cannot continue.

In other words, she’s leaving to spend more time with her family. Hmmmm. Also, her use of the word "injection" nearly made every molecule in my irony gland explode at the speed of light.

OK, no more snark. Dorey, in that blog post, is asking someone to step up and take her place. I have no doubt someone will, so I expect the AVN will go on without her, spreading their falsehoods, slathering their fearmongering over an unsuspecting and trusting audience, and helping thousands of Australian babies be exposed to pertussis, measles, mumps, polio, and all sorts of other preventable diseases that would have been otherwise eradicated by simple vaccinations.

I can hope, though, that without Dorey’s voice, the AVN will be far weaker, and if the charges against them hold up, they may fall apart entirely. That would be a very good thing indeed.

So whaddya know? Dorey claims she wants to save people’s lives. This move on on her part may finally do it.

Tuesday, February 02, 2010

And now, the antivax failure is complete: The Lancet withdraws Wakefield’s paper

Some good news from Dr. Plait's blog. Of course, this is getting reported other places as well, although I wish that the national media would really run with this, since it is over a decade late. It's not enough that it was found that this guy has acted unethically, but to be sure, he LIED beyond just poor ethics. He is indirectly responsible for deaths and suffering that really can't be measured. I only hope that he has everything about him discredited, and that he is made to in some part pay for his deceit.

And now, the antivax failure is complete: The Lancet withdraws Wakefield’s paper

Oh, this is wonderful to hear: The Lancet — a leading UK professional medical research journal — is retracting the paper published by Andrew Wakefield back in 1998 that linked vaccines with autism.

The paper has been found to be multiply and fatally flawed, with Wakefield and his work being thoroughly discredit. As the Lancet editorial itself states:

Following the judgment of the UK General Medical Council’s Fitness to Practise Panel on Jan 28, 2010, it has become clear that several elements of the 1998 paper by Wakefield et al. are incorrect, contrary to the findings of an earlier investigation. In particular, the claims in the original paper that children were “consecutively referred” and that investigations were “approved” by the local ethics committee have been proven to be false. Therefore we fully retract this paper from the published record.

That’s great news, especially after Wakefield had his head handed to him last week by the GMC over his unethical and irresponsible behavior that led to this horrible paper being published in the first place.

The Lancet statement is a bit bloodless… but they are a professional research journal and not a blog, so it’s not appropriate for them to call out Wakefield in more emotional — and utterly deserved — terms. It’s up to the blogs to call out Wakefield for his tireless efforts in creating of the modern antivaccination movement, which is becoming so successful that measles, mumps, pertussis, and other preventable diseases are on the rise again. And to note that not only was his research wrong, but that he may have faked his data. And to say that he has a huge conflict of interest here, since at the time he was involved in creating an alternative to vaccination that would make him very, very rich if people became scared to vaccinate their kids. And to inform people that Wakefield was in the pocket of lawyers trying to sue the vaccine industry. And to basically call out the entire antivax movement for the incredible damage they have done and continue to do to public health.

All that’s left now is for the GMC to officially sanction Wakefield, disbar him, essentially, to finish this all up officially.

Of course, that won’t even slow Wakefield or the antivaxxers. They don’t care for the real world, based on evidence and fact. They are, for all intents and purposes, religious zealots now, believing in Wakefield, Jenny McCarthy, and the rest with such fervor that there is literally no amount of evidence that can ever sway them. And they will continue to spin, fold, and mutilate the truth, while we watch as diseases rise back from the dead, infecting hundreds of thousands of people, and killing many of them.

Never forget what’s at stake here. Never.