Saturday, December 8, 2007

Comment-Autism and Journalistic Integrity

This item was emailed to this blog. -AR


To Ashley Reynolds and KOMU,

Thank you for delving into one of the most controversial areas of medicine and pediatrics with an open mind and a fair voice for individuals to share their stories. Autism is probably the most
complex neurobehavioral developmental disorder we will ever know on such a grand scale in our society. Dysfunction in the immune system, the gut and within critical hepato-renal detoxification enzyme pathways are making this an enigma for medicine and science. Focusing on one variable in such a multi-variate problem is in large part why its understanding is so elusive.

In a small but ever growing population of people, vaccines can have deleterious effects. There are small populations for which many seemingly innocuous insults to others are, in these individuals, quite deleterious. An average medical student can name one of the classic examples of such subpopulation susceptibility; xeroderma pigmentosa, in which individuals who have a genetic impairment that prevents correction of DNA damage suffered by ultraviolet light.
Miniscule amounts of UV light in these individuals leads to skin cancer. So too it is with autism, miniscule amounts of heavy metals are in many instances creating the initial havoc that leads to this derailment of development. Global intra-body increased half-life of heavy metals appears to exist in these children because one or a couple of a many genes involved in methylation and/or sulfation are poorly functioning.

Mercury and aluminum in vaccines are implicated in potentiating the derangement in this subpopulation, in addition to ambient heavy metals and other toxins in the environment. Its the heavy metals that medical science controls that are really the most important, simply be the fact that they are controllable exposures. Those who have the funds and research capabilites to prove this association definitively have yet to investigate the connection thoroughly in the
susceptible population for obvious legal and ethical ramifications of ignoring mothers for 20 years on this issue. Recall that for the first 20 years of autism being a named syndrome, the mothers were blamed for being the causative factor, that was when medical students were lucky to ever see an autistic child during their training.

Now that the epidemic is upon us, medical professionals need to pull our collective head out of the sand that keeps getting piled up by the last great American industry (pharmaceuticals) and start doing the brave science that will help these children. In many ways this could re-instill confidence by pursuing safer vaccinations and in particular safer vaccination protocols. The current protocols have NEVER be tested against lighter schedules even using the same vaccines (decreased boosters, more age appropriate timing of vaccines, etc). This comparison will lead to saving money in healthcare as a direct result of decreased vaccine purchasing and administration as well as indirectly through decreased incidence of side effects, speech delay being the most obvious and easiest to test as a safety indicator against the current ever burgeoning protocols.

Last month the New England Journal of Medicine published a paper by Amanna, Carlson and Slifka that indicates the duration of coverage of many vaccines exceeds the life span of the study population, by centuries in a longitudinal regression analysis of titer decay rates. This is good science to say we need to cut back on early life vaccinations. One shot may be all many children may need for coverage until much later in life on many of these childhood diseases. Boosters are likely causing much more harm than good for the profit of vaccine corporations.

The hypothesis that there really is a connection between vaccines and speech delays as well as an acceleration of autistic behaviors in a subpopulation that is susceptible to immunodysfunction and high heavy metal half-lives is a valid one that needs urgent study. The CDC and the FDA will be the last "watchdogs" to protect that science, for it is the very hypothesis that will prove a connection once the appropriate at risk population is selected. Thank you for protecting
the collective conversation and thought that can lead to such a hypothesis through investigating the stories of those like the Weinmasters who have legitimate concerns that this hypothesis may be correct, as do I.


Edward F. Fogarty, M.D.
Chairman of Radiology at the University of North Dakota School of
Medicine

6 comments:

Autism News Beat said...

Dr. Fogarty, thank you for taking time to comment here.

As I'm sure you know, thimerosal has been removed from scheduled childhood vaccinations since 2002. If there was a link between TCVs and autism, we would see a decline in autism among today's 3-5 year old cohort. But rates have not declined. Can you explain why? Also, could you explain the concept of "dose response" as it pertains to thimerosal exposure?

Thank you.

Anonymous said...

Who wrote the headline? What does it have to do with the letter?

Anonymous said...

Autism News Beat,


Good question which has a complex answer.
First, my understanding of this most complicated situation has evolved, I don't think it is smart or intellectually appropriate to parse out one variable as if there is a direct cause and effect relationship to autism, permutations of genes, toxins, immunodysregulation, neuroactive peptides and leaky gut exposures shows how there are hundreds of ways into the autistic state. But specifically as thimerosal is concerned, the statistical lack of a major drop in autism rates after is removal is confounded by many issues (some of the same issues that have led many to say it has been on the rise for 20-30 years simply by better diagnosis). So as the "better diagnosis, better exposure and understanding of clinical presentation" argument goes, that could be a continuing diagnostic rise to fill the gap of decrease from thimerosal exposure. As irrational as that sounds, it is the same rationale for saying there is no increase or epidemic confronting us. More significant though is the thimerosal that actually was dosed out in childhood vaccines into 2005-2006 and continues to be through flu-shots. As handled in most US clinics and hospitals, multi-dose vials are considered useable until the expiration date. Here is an example of how the University of Utah handles this:
http://uuhsc.utah.edu/pharmacy/alerts/73.html


So the "lie" that thimerosal was out of childhood vaccines was perpetuated on my children whose pediatrician used multi-dose vials that had thimerosal and were not expired until 2005 (I asked and trusted his misunderstanding that it was out). The real way to show the thimerosal related drop in autism rates would have been to take 1 date (should have been 01/01/01) and across the nation have all vaccines convert from thimerosal containing to single dose non-thimerosal containing vaccines. A REAL SCIENTIST interested in the truth of the epidemiological effects of removal of thimerosal from the vaccine schedule and its correlation on autism rates would have done this. It would have been the best proof for either side of the debate that there is or is not a problem with that specific compound in vaccines. The long shelf-life of multidose vaccines extending into 2005-2006 and the introduction of flu-shots into now 6 month olds which contain thimerosal is creating a continuum of dosing of this substance into the pediatric population and is clearly muddying the waters for those who trust the intentions of good people in medicine and creates a real question as to an intended effect for those who believe the CDC and the thimerosal-makers as well as vaccine companies are making a unethical end-run on softening the fall of autism rates by this slow-leech of thimerosal dosing from the population. Then again, maybe its not thimerosal, the complexities of dendritic cells and antigen presentation within the immature immune system and neurologic system raises serious concerns in my mind that birth-dose Hepatitis B shots (even without thimerosal) maybe a major player in autism regardless of the potentiation of syndromic features by thimerosal.


As a metavariable, all vaccines with and without thimerosal need to be studied as to the their effects on a genetically susceptible sub-population. A dose response curve is a useful mathematical tool that should be employed in studying all vaccines and their potential for developmental delay related side effects. Certainly a dose response curve strictly for the induction of autistic symptoms in primates with temporal weighting could be a simple way of showing that the doses of thimerosal given in the 1990's to US kids would be enough to induce autistic traits in a higher primate at certain levels for a genetically heterogeneous population. So as the dose goes up there becomes a robust mathematical relationship to the percent of autistic individuals in the population.


The REAL SCIENCE that needs to be done, but that probably scares the "you know what" out of all the defenders of vaccines and or thimerosal is this:


Select the at risk population with parental screening urine porphyrin levels (mother's levels being a better risk assessor than father's, but a father with higher levels would be important to know).
Urinary porphyrins are good marker for derailment of hemoglobin synthesis by heavy metal exposures and or sensitivities.


Then in the at risk population study the current high dose early age vaccination schedule against the following schedule:
2 Months: DTaP
3 Months: PCV
4 Months: Hib
5 Months: Rotavirus
6 Months: IPV
12 Months: Measles alone
No thimerosal in any of these vaccines
NO HEPB unless in risk appropriate situation (this would be VERY few-certainly not my kids)
Rotavirus, varicella, hepatitis A and Varicella as single dose could be added to create "medium" schedule.
NO ONE GETS A BOOSTER UNTIL LOW TITER PROVEN BY BLOOD WORK at 8 months and 14 months (yes, its arduous to get blood from all these kids but thats part of doing the right study).
NO ONE GETS A BOOSTER IF THEY CAN'T SPEAK 3 WORDS BY 15 MOS.


Also add an additional experimental group of the current high dose vaccine schedule with ALL of the vaccines given to CONTAIN thimerosal; if its so safe then lets prove it that way. Either get it out or do the right science that will prove that it is safe for all of us and the third world countries that need the cheap preservative. If that is an ethical problem that prevents the study then you need to question the ethics of the very person saying its a problem and still advocating the safety record of thimerosal; again if its so safe, just add it in back into everything and examine it against the current schedule without it. I do think there is a linear statistically significant relationship to the number of vaccines given and most sensitive and most easily assessed sign of childhood neurological injury which is speech delay. As a radiologist I know of evolving functional neuroimaging studies that might be quite powerful in proving this out as well but it also raises the cost of study. Some the the images of brain inflammation and neurodysfunction evident between pre-and post vaccination neuroimaging studies might convince the world quite quickly of the issues at hand. Picture says a thousand powerful words when it is a medical image.


Ted Fogarty

ANB said...

Here's the graph of the CDDS 3-5 yr old caseloads for the last 5 years, quarter by quarter:

http://www.autismstreet.org/weblog/?p=155

Notice how straight the line is? How likely is it that additional reporting would near exactly replace a decline in cases from the elimination of thimerosal from scheduled vaccines beginning in 2002?

In 2004, Dr. Mark Geier told a judge that he could not cite a single study that conclusively demonstrated a link between thimerosal and autism, or even mercury and autism. When Geier isn't under oath, he tells his patients quite the opposite.

Why do you suppose that is? These are serious questions, ones a scientist such as yourself should be interested in hearing.

It seems that some practitioners are preying on vulnerable parents. What advice can you offer parents for separating the wheat of truth from the chaff of nonsense?

lindaweino said...

ANB

I would like the documents where Mark Geier said what you claim. That was almost 4 years ago. The amount of science has changed since than.

Why not talk about the case that was conceeded last month. The Department of Justice agreed that thimerosal contributed to the child's autism.

What are you hiding? We all post with our names because we speak the truth.

Since not all thimerosal was recalled, a lot of the vaccines did not expire until 2005. Most children are not diagnosed until an average of 4 years old, that would put the off the full effect of the removal of thimerosal to 2009. You also must consider that pregnant women and babies of 6 months and older started to receive thimerosal containing flu vaccines in 2002. The thimerosal in flu vaccines given to pregnant women will show the same increases that the RhoGAM did with RH negative mothers. As Dr. Fogarty said they only way to get a clear picture is to stop all thimerosal containing vaccines on the same date. Than the picture will be clear.

ANB said...

A study by the CDC in Feb., 2002, found that only 1.9% of scheduled childhood vaccines in doctors' office still contained thimerosal. So children born after 2001 received far less thimerosal than children born before 2001. Question: why isn't the lower exposure rate reflected in rate of autism diagnoses?

It's not really the "amount" of science that matters, as you say, but rather the quality of the science. Can you cite any peer reviewed studies published since 2004 that conclusively demonstrate a link between thimerosal and autism?

The DOJ did not concede that thimerosal contributed to autism. The government is conceding that in one of the three upcoming thimerosal cases, vaccines caused significant aggravation of an underlying condition.

The government looked at one of the three omnibus cases and conceded "that vaccines caused a significant aggravation of an underlying condition". Yes, in rare instances people have adverse reactions to vaccines. That's why the gov't established the compensation fund. But in the case you cite, the government is not conceding thimerosal had anything to do with the adverse reaction. Apparently the respondents decided it is an already tabled case where causation has been established. The petitioners had three test cases ready, now they only have two, and the court said they can search for a new third case.

Linda, why do you need to case aspersions on my character? We both want the same thing - accurate, evidence-based reporting about autism. There is still much that is not known about autism, and the fund of information does not grow any larger when we cling to innuendo and misinformation. Open your mind. There's still so much more to learn.