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.

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."

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.

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

We’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.

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.

Andrew Wakefield Unethical so Age of Autism Stands By Him

All too often, I am shocked and dismayed, but not at all surprised, at how unethical some people will behave to promote their anti-reality agendas. So, it's of course no surprise that I see this information posted throughout the web. I am shocked and puzzled why anyone would bankrupt any shred of morality they may have to continue to perpetrate these lies and deceptions. I guess after a while, there is no moral ground to stand on, so throwing out any lie or accusation they can make up off the top of their heads should be easy enough...

Here are a couple stories on this latest fiasco that clearly demonstrates the level of dishonesty we are dealing with here:

Andrew Wakefield Unethical so Age of Autism Stands By Him

The British General Medical Council (GMC) has just announced its verdict in their investigation into Andrew Wakefield, ruling that he had acted dishonestly and irresponsibly:

The verdict, read out by panel chairman Dr Surendra Kumar, criticised Dr Wakefield for the invasive tests, such as spinal taps, that were carried out on children and which were found to be against their best clinical interests.

The panel said Dr Wakefield, who was working at London's Royal Free Hospital as a gastroenterologist at the time, did not have the ethical approval or relevant qualifications for such tests.

[…]

Dr Kumar said he had acted with "callous disregard for the distress and pain the children might suffer".

He also said Dr Wakefield should have disclosed the fact that he had been paid to advise solicitors acting for parents who believed their children had been harmed by the MMR.

[My bold.]

In 1998, Wakefield claimed to have found a link between the measles virus in the gastrointestinal (GI) tract of children (following the MMR vaccine), and autism. Wakefield’s small study, popularized by idiotic news media, led to an MMR-autism scare, a significant drop in vaccine rates and a resurgence of measles in the UK. Wakefield may claim he didn’t say that MMR causes autism, but he certainly implied it strongly enough (and again, with the help of the press), that many people believed (and still believe) that the MMR vaccine causes GI problems which causes autism. The evidence though, from a panel of 28 experts, clearly showed that this was not true. The GMC have now, with this ruling, confirmed that in addition to Wakefield’s conclusions being false, he also acted unethically. We still have to wait to see what sanctions they hand down.

Various vaccines-cause-autism groups immediately revised their positions, based on the conclusions of this independent expert body, and stated that they were wrong previously to claim that the MMR vaccine causes autism.

Ha – just kidding. Of course they haven’t. Nothing would ever convince these people that their previously determined conclusion could ever be wrong. Just take a look at the flurry of activity from the Age of Autism blog in the last three days:

A Sad Day for the Future of Children – where they “unequivocally renounce the GMC’s findings” – no evidence, nothing they can say that is wrong with the GMC’s findings – they just renounce them because, well, because they do, so there.

Then from Mark Blaxill we have Naked Intimidation: The Wakefield Inquisition is Only the Tip of the Autism Censorship Iceberg - where he smears the witnesses in the case, oh and anecdotes, anecdotes I tell you (un-sourced) about anti-vaccination scientists being censored. And “the only thing for the autism community to do now is stand by Andy Wakefield” – because clearly “the only thing” you can do when a discredited doctor is also found guilty of ethical violations, is to “stand by” him. That’s “the only thing” you can do. No other options, obviously. Their hands are tied, you see.

And if that wasn’t clear enough, we have National Autism Association Supports Dr. Andrew Wakefield – the title says all you need to know.

Celebrity idiot Jenny McCarthy’s charity chimes in with Generation Rescue Supports Dr. Andrew Wakefield - (beginning to see a trend here).

Finally, we have fearless conversation advocate and fearless litigant to anyone who disagrees with her, Barbara Loe Fisher, who writes Vaccines: Doctor Judges & Juries Hanging Their Own – a touching story of the first time she met Wakefield. (Why? Who knows.)

And a couple more that I couldn’t be bothered to read.

Nothing could possibly ever convince these people that they might have been wrong. Nothing. Ever. If you want to read some good sources on the GMC’s verdict, see below.

Further Reading

Steven Novella writes Andrew Wakefield “Acted Unethically”.

Investigative reporter Brian Deer (writing a year ago) MMR doctor Andrew Wakefield fixed data on autism – on how Wakefield changed and misreported results in his research:

Although the research paper claimed that problems came on within days of the [MMR shot], in only one case did medical records suggest this was true, and in many of the cases medical concerns had been raised before the children were vaccinated. Hospital pathologists, looking for inflammatory bowel disease, reported in the majority of cases that the gut was normal. This was then reviewed and the Lancet paper showed them as abnormal.

Ben Goldacre The Wakefield MMR verdict.

And finally, there is the GMC’s actual report.

Antivaxxer movement leader found to have acted unethically

Continuing a month of skeptical victories, the UK’s General Medical Council has found that Andrew Wakefield — the founder of the modern antivaccination movement — acted "dishonestly and irresponsibly" when doing the research that led him to conclude that vaccinations were linked with autism. This is being reported everywhere, including the BBC, Sky News, the Yorkshire Evening Post, and more.

The GMC (the independent body of medical regulators in the UK, rather like the AMA in the US) didn’t investigate whether his claims were correct or not — and let’s be very clear, his claims have been shown beyond any doubt to be totally wrong — only whether he acted ethically in his research. What they found is that his research (involving spinal taps of children) was against the children’s clinical interest, that Wakefield was unqualified to perform the test, and that he had no ethical approval to do them.

Wow. Again, let’s be clear: that’s a whole lot of ethical damnation from the UK’s leading medical board.

Not to pile on here, but I was rather surprised that they didn’t mention the claims — supported by a lot of evidence — that on top of all that unethical behavior, he may have faked his results, too. There’s also no mention of his grave conflict of interest– at the time he published his paper slamming vaccines and which started the antivax craze, he was developing an alternative to vaccinations, so he had a very large monetary incentive to make the public distrust vaccines.

The GMC has not announced whether he (and two of his cohorts) will be sanctioned or not. I’ll be very curious to see what they do.

Will this deter Wakefield and the antivax movement? Ha! Of course not. Note that supporters of Wakefield heckled the GMC members as they read their announcements.

Also, the evidence was already overwhelming that Wakefield was wrong, just as it’s overwhelming that vaccines are totally and completely unrelated to autism. But the antivaxxers’ world is not based on evidence. It’s more like a dogmatic religion, since many of its believers will twist and distort the truth to fit their views, even, tragically, if it means babies will die.

The antivax movement is resulting in the deaths of children from preventable diseases, many of which were all but gone in the United States. We’re seeing the return of measles, mumps, pertussis, even polio — polio, which was eradicated entirely in the US by 1994. Because vaccines are so effective, people don’t remember these diseases and how they would kill, and now the antivaxxers are paving the way for their return.

This ruling against Wakefield is a step in the right direction, but the path is long and the antivaxxers will be there at every one of these steps, trying desperately to trip up reality. It’s up to us to make sure that we keep walking.

Childhood Vaccine Schedule Updated

The co-director of the University of Alabama at Birmingham (UAB) Division of Pediatric Infectious Diseases is a member of the committee that this week issued updated guidelines for childhood and teen immunizations to include formal recommendations that children older than 6 months get the H1N1 influenza vaccine to guard against swine flu, and that combination vaccines are generally preferred over separate injections.

The revised childhood vaccine schedule is published in the January issue of Pediatrics; the annual update is issued by the American Academy of Pediatrics, the Centers for Disease Control and Prevention and the American Academy of Family Physicians.

UAB's David Kimberlin, M.D., is a member of the American Academy of Pediatrics Committee on Infectious Diseases and a liaison to the Centers for Disease Control panel that helped author the recommendations.

"Most of these recommendations are for vaccines and boosters that almost every pediatrician and family physician knows about and already is using. It is good practice to issue a clear, concise vaccine schedule that anyone can refer to," says Kimberlin, a UAB professor and associate editor of the American Academy of Pediatrics' Red Book, a revered pediatric treatment manual.

"The bottom line here is vaccines save lives, improve the health of all children and benefit families and communities," he says.

The updated schedule reflects new vaccines approved by the U.S. Food and Drug Administration that include the H1N1 vaccine and a human papillomavirus vaccine for girls, known as the HPV2 vaccine, designed to protect females from two strains of the virus associated with more than 70 percent of cervical cancer cases, says Kimberlin.

The new schedule states it is permissible for doctors to recommend the earlier HPV4 vaccine for boys ages 9 and older, offering protection from four strains of the virus and reducing the likelihood of male genital warts. The recommendations also say children considered at-risk for meningococcal disease, especially those with immune-system disorders and other conditions, should get a booster shot of meningococcal conjugate vaccine, known as MCV4, three years after their initial MCV4 dose at ages 2 through 6.

The update also says that after four scheduled doses of inactivated poliovirus vaccine, the fifth dose of the same vaccine should be given on or after age 4 and at least six months after the previous dose.

Kimberlin says vaccine considerations always should consider health-care provider assessment, patient preference and the potential for adverse events. Providers who need more details should refer to the comprehensive recommendations issued by the Centers for Disease Control Advisory Committee on Immunization Practices, available by visiting www.cdc.gov/vaccines/pubs/acip-list.htm. Clinically significant adverse events that follow immunization should be reported to the Vaccine Adverse Event Reporting System at www.vaers.hhs.gov or 800-822-7967.

How Organisms Can Tolerate Mutations, Yet Adapt to Environmental Change

Biologists at the University of Pennsylvania studying the processes of evolution appear to have resolved a longstanding conundrum: How can organisms be robust against the effects of mutations yet simultaneously adaptable when the environment changes?

The short answer, according to University of Pennsylvania biologist Joshua B. Plotkin, is that these two requirements are often not contradictory and that an optimal level of robustness maintains the phenotype in one environment but also allows adaptation to environmental change.

Using an original mathematical model, researchers demonstrated that mutational robustness can either impede or facilitate adaptation depending on the population size, the mutation rate and a measure of the reproductive capabilities of a variety of genotypes, called the fitness landscape. The results provide a quantitative understanding of the relationship between robustness and evolvability, clarify a significant ambiguity in evolutionary theory and should help illuminate outstanding problems in molecular and experimental evolution, evolutionary development and protein engineering.

The key insight behind this counterintuitive finding is that neutral mutations can set the stage for future, beneficial adaptation. Specifically, researchers found that more robust populations are faster to adapt when the effects of neutral and beneficial mutations are intertwined. Neutral mutations do not impact the phenotype, but they may influence the effects of subsequent mutations in beneficial ways.

To quantify this idea, the study's authors created a general mathematical model of gene interactions and their effects on an organism's phenotype. When the researchers analyzed the model, they found that populations with intermediate levels of robustness were the fastest to adapt to novel environments. These adaptable populations balanced genetic diversity and the rate of phenotypically penetrant mutations to optimally explore the range of possible phenotypes.

The researchers also used computer simulations to check their result under many alternative versions of the basic model. Although there is not yet sufficient data to test these theoretical results in nature, the authors simulated the evolution of RNA molecules, confirming that their theoretical results could predict the rate of adaptation.

"Biologists have long wondered how can organisms be robust and also adaptable," said Plotkin, assistant professor in the Department of Biology in Penn's School of Arts and Sciences. "After all, robust things don't change, so how can an organism be robust against mutation but also be prepared to adapt when the environment changes? It has always seemed like an enigma."

Robustness is a measure of how genetic mutations affect an organism's phenotype, or the set of physical traits, behaviors and features shaped by evolution. It would seem to be the opposite of evolvability, preventing a population from adapting to environmental change. In a robust individual, mutations are mostly neutral, meaning they have little effect on the phenotype. Since adaptation requires mutations with beneficial phenotypic effects, robust populations seem to be at a disadvantage. The Penn-led research team has demonstrated that this intuition is sometimes wrong.

The study, appearing in the current issue of the journal Nature, was conducted by Jeremy A. Draghi, Todd L. Parsons and Plotkin from Penn's Department of Biology and Günter P. Wagner of the Department of Ecology and Evolutionary Biology at Yale University.

The study was funded by the Burroughs Wellcome Fund, the David and Lucile Packard Foundation, the James S. McDonnell Foundation, the Alfred P. Sloan Foundation, the Defense Advanced Research Projects Agency, the John Templeton Foundation, the National Institute of Allergy and Infectious Diseases and the Perinatology Research Branch of the National Institutes of Health.

Skeptics – Getting Under Their Skin

A blog entry from Steven Novella that is encouraging. Granted, he and the folks he mentions are much more visible in the skeptic world, so they are obviously targets. And I am in a way glad that I have not received this sort of attention from the woos and IDiots out there. Just because I don't have the time to deal with them, and let's be honest, are such people even worth the time?

Skeptics – Getting Under Their Skin

by
Steven Novella, Jan 25 2010

As the activist skeptical movement grows and increasingly networks, thanks largely to social media, we seem to be irritating those who are the targets of our critical analysis. This is a good thing. It’s a sign that we are doing our job and having an impact.

Recently there has been an increase in those attacking skeptics and skepticism. One tactic is to attempt to intimidate critics and silence public debate through libel lawsuits or the threat of such suits. The blustering by Bonnie Vent and her minions following Mark Edwards’ latest post is a good example. Clearly, they are not familiar with libel laws in the US, or they hope that we are not, or they simply don’t care.

To be clear, we take very seriously our responsibility to be fair and factually accurate, and we will happily correct mistakes if they are pointed out to us. The original version of Mark’s article contained the word “apparently” to refer to second-hand information. This was probably enough of a qualification, but we strengthened it to “allegedly” just to be sure, and even added the caveat about the original source. (Read the post for details.)

Fortunately in the US we have rational libel laws. In order to prove libel the plaintiff will have to prove that the defendant wrote something that was wrong, they knew it was wrong, and they did it deliberately out of malice. In some states you also have to prove harm, but a few have what is called “libel per se” which means that certain accusations are considered automatically damaging to one’s reputation.

On the other hand, some states also have anti-SLAPP laws – strategic lawsuit against public participation. In essence, if you use a libel suit to silence a critic and remove their right to participate in free speech, you may be counter sued under anti-SLAPP laws. The courts, in short, have recognized the threat that SLAPP suits pose to first amendment rights.

The Canadian Supreme Court recently recognized this as well, ruling in one case:

The Supreme Court said it examined laws in other countries with similar legal systems, such as the United Kingdom and Australia. It found that Canadian law was strict by comparison and did not give enough weight to the value of free expression.

“This, in turn, may have a chilling effect on what is published,” said the text of one of the rulings. “Information that is reliable and in the public’s interest to know may never see the light of day.”

Unfortunately, English libel law is still in the dark ages, as some of our colleagues across the pond have discovered. Simon Singh is currently defending a libel suit in British court against the British Chiropractic Association (BCA). Apparently he stung them and made it hurt when he pointed out they promote treatments that are not supported by evidence. This resulted in a backlash against the BCA and a campaign to reform English libel laws.

Previously Ben Goldacre and The Guardian were the target of a libel suit from one Matthias Rath, for selling dubious treatments for serious illnesses, like AIDS, in Africa. Ben emerged victorious from this suit.

Back on this side, Robert Lancaster was threatened with suit by Sylvia Browne for his website, stopsylviabrowne.com. Robert refused to back down or be intimidated by Browne, who had not case against him. Unfortunately, Robert suffered a stroke and during his recovery period it appears that the registration for the domain name lapsed and the url was picked up by a psychic promoter.

Paul Offit and Amy Wallace from Wired Magazine have also recently been sued by anti-vaccinationist Barbara Loe Fisher, the head of the National Vaccine Information Center (NVIC). This one is over the claim by Offit printed in Wired Magazine that “she lies” – referring to Fisher. If it actually gets to court it is likely, in my opinion, that Offit will be able to demonstrate that Fisher has made comments that are less than truthful. But usually in such cases the point of the suit is not to defend it in court, but simply to force a settlement.

Threat of libel is not the only way that the cranks of the world are trying to fight back against skeptics. They are also trying to take us on in their own critical writing, which of course they have the right to do. But just like with the libel suits, this strategy has been backfiring more often than not. It seems that if we irritate them enough, we can goad them into embarrassing themselves by trying to do something they clearly are not good at – critical analysis.

Recently Deepak Chopra, Rustom Roy, and Larry Dossey attacked Science-Based Medicine in the Huffington Post. Invariably such attempts butcher the skeptical position (always a marker of intellectual sloppiness) and just provide more fodder for us to criticize, and this was no exception. In the world of alternative medicine defenders on nonsense, like the three above, have an especially hard time because they do need to seem scientific while attacking science and defending pseudoscience. So it is easy to trip them up in self-contradiction. As David Gorski writes:

Dr. Dossey just spent two articles whining that his beloved CAM is being treated so very, very unfairly by promoters of science-based medicine, but from my viewpoint it’s being treated more than fairly these days; it’s being given a free pass, by and large. Again, that’s why I’ll repeat it one more time. If Dr. Dossey really wants CAM to be evaluated on a truly equal scientific footing with science-based medicine, I have one thing to say to him one last time:

Bring it on!

Mike Adams, editor of NaturalNews.com, has also felt the sting of skeptics and decided to fight back with his own rhetoric. In it he raises an army of particularly flimsy strawmen against skeptics, easily dismantled. He was joined by fellow natural guru Joseph Mercola, who attacked one of our Australian colleagues, Rachel Dunlop. Mercola’s comments were in such poor taste that his own followers flinched.

Speaking of which, the winner of the most callous, distasteful, and strategically moronic attack on skeptics of 2009 goes to the Age of Autism for their photoshopped picture of various critics of the anti-vaccine movement (including yours truly) eating a baby at Thanksgiving dinner. Even some of their devoted followers were put off by this despicable (and mysogynistic) display, and they quickly decided to take it down.

Conclusion

As the skeptical movement grows we will increasingly become the targets of counter-attacks like those I discuss above. Like it or not, we are engaged in conflict with the promoters of pseudoscience and an anti-scientific world view, and they will fight back. But we have shown in recent years that we can stick together and we will not be intimidated. Try to silence one of us, and the criticism will only be magnified 100 fold.

Bonnie Vent could have just taken Mark’s criticism and moved on, but instead she chose to try to have the criticism taken down, resorting to empty libel threats as an intimidation tactic. But all she has accomplished is to focus our attention on her all the more.

The BCA was soundly embarrassed by the attention they received as a consequence of their lawsuit. It even led to skeptical activists reporting instances of chiropractors making false claims, which in turn led to one chiropractic group advising their members to take down all claims on their websites (which seems like a curious admission that their claims do not hold up to scrutiny).

I am particularly amused when the purveyors of pseudoscience try to engage skeptics in critical analysis. That is our arena, and we will be happy to trounce them all day long. In fact, we want a serious discussion of logic and evidence – that is what skepticism is all about. If we can get them engaging us in such discussion that can only serve our ends. Even if they can demonstrate that they are correct about a claim – that is all we want, to base claims on logic and evidence.

More likely, however, we will get what Mike Adams served up – a frothing rant that is so disconnected from reality it accomplishes our work for us.

So keep it up, fellow skeptics. We are having an impact, and the cranks of the world are feeling the pain.