Locked in Ignorance

The other day, I got into a discussion with someone calling for Congressional hearings on the DeStefano 2004 study that is the latest to-do in anti-vaccine circles. I won't go into the background; you can read about it here. Instead, I'll just present the Storify curation of tweets. My interlocutor just didn't understand what she had read. There is nothing wrong with that. We all have areas in which we lack the requisite knowledge to fully grasp the subject. The real trick is figuring out where we are ignorant and put in the effort to learn and grow. I'm presenting the whole conversation here in the hopes that others might learn from it. It's a bit long, but it gives a good pictures of how our preconceptions can lock us into a state of ignorance.

Here are a few resources for your reference as you read through this.

• MMR, the CDC and Brian Hooker: A Guide for Parents and the Media 
• Age at first measles-mumps-rubella vaccination in children with autism and school-matched control subjects: a population-based study in metropolitan atlanta (Original study from DeStefano et al.) 
• A look at the analysis plan for DeStefano’s MMR study: no evidence of fraud (includes a link to the 2001 Draft Analysis Plan) 
• Measles-mumps-rubella vaccination timing and autism among young african american boys: a reanalysis of CDC data (Brian Hooker's retracted study)

Ignorance is not bad, unless we make no effort to overcome it. Being wrong is not bad, unless we do not accept that we are wrong.

MMR, the CDC and Brian Hooker: A Guide for Parents and the Media

The anti-vaccine community has been in a tizzy lately over a supposed "CDC whistleblower", Dr. William W. Thompson, who, according to them, revealed fraud at the United States Centers for Disease Control and Prevention (CDC). To bolster their claim, they point to a new study from one of their own, Brian S. Hooker, that purports to show evidence of an increased risk of autism among African American boys who receive their first MMR vaccine late. However, the claims appear to be hollow and unfounded, and so they have chosen to rely on emotional arguments that may sound convincing to those who are not familiar with the issues and people involved. In a truly egregious fashion, they have erroneously and cynically compared this whole thing to the Tuskegee syphilis study, and equated the CDC with Adolf Hitler, Josef Stalin and Pol Pot, combined.

With that in mind, here is a brief FAQ for parents, news media and others to help them understand what the claims are and what the evidence actually says. The questions below have been raised or implied by anti-vaccine activists. Hopefully, this will prevent inaccurate reporting and help parents feel reassured about the MMR vaccine.

CDC Whistleblower William Thompson Breaks Silence

Things have certainly been progressing quickly in wooville, specifically in the anti-vaccine neighborhood. Earlier this month, anti-vaccine activist and petitioner in the Vaccine Injury Compensation Program, Brian S. Hooker, PhD, published a study in the journal Translational Neurodegeneration titled Measles-mumps-rubella vaccination timing and autism among young african american boys: a reanalysis of CDC data. [Update (10/4/14): Hooker's study has been fully retracted by the journal.] Basically, Hooker took a dataset that was used by CDC researchers DeStefano et al. in their 2004 study looking at whether on-time, slightly late or late MMR vaccination was more common among autism cases than among controls. It was a case-control study that looked at both a large population, as well as a smaller population limited to those who had a Georgia birth certificate. After receiving word from a whistleblower that the DeStefano study found an association among African American males, but did not include that in the finished report, Hooker waded in to find the holy grail of government malfeasance and cover-up. Except, he did not use the same methods to examine the data that the CDC did. Using a dataset designed for a case-control study, he conducted a cohort study, applied statistics inappropriately and reached a spurious conclusion.

Although it made a splash among the conspiracy-minded, it didn't garner much attention right away. Science bloggers held off putting up any immediate posts, opting instead to examine the study to see if Hooker's methods were sound, particularly since his conclusion had no plausible biological basis. In the interim, the British doctor who engaged in research fraud and was stripped of his medical license, Andrew Jeremy Wakefield, put together a video in which he exploited the victims of the Tuskegee syphilis experiment in a cynical attempt at using the race card to drum up outrage at the CDC. At the same time, he said the CDC was actually worse than Hitler, Stalin and Pol Pot. Wakefield also included in his video carefully edited snippets of audio recordings that, presumably, are the whistleblower. He released two versions of that video, one with the whistleblower's name bleeped out and his voice distorted, and one where the audio is unobscured and his name, William Thompson, is plainly stated. Interestingly, anti-vaccine blogger Jake Crosby condemned Wakefield for outing Thompson without Thompson's permission, an allegation that Wakefield strongly denied.

Early this week, science bloggers began posting their analyses of Hooker's study, noting the flaws and questioning the validity of its conclusions. They also pointed out that not one anti-vaccine activist called out Andrew Wakefield for race-baiting, but instead praised and shared his video, the implication of which is that one of the original DeStefano authors was a race traitor.

On Tuesday evening, the Wakefield/Hooker sycophants threw a collective tantrum on Twitter, whining about how no one takes them seriously.

That brings us to the momentous events of Wednesday.

New Report from HHS on Vaccine Storage

I heard something on the news this morning that I figured would get the anti-vaccine crowd into a fervor of excitement. It is something that they could spin to make it seem like vaccines really are dangerous or that they really don't protect people. Images leapt to mind of writers and commenters alike over at Age of Autism crying out, "See! We're not dumb for refusing vaccines!" Barbara Loe Fisher at the National Vaccine Information Center floated before my eyes, declaiming that vaccines are not safe. I could almost hear Mike Adams or Gary Null snidely claiming that this report proves (proves, I tell you!) that vaccines are ineffective. And so, I figured I should probably take a closer look into it before the wacky misinterpretations and outright lies began to flow.

What brought all this to mind? As reported by ABC news, some doctors may not be storing vaccines properly. The story is based on a new report from the Department of Health and Human Services' Office of Inspector General (OIG), titled Vaccines for Children Program: Vulnerabilities in Vaccine Management (the PDF of the full report can be found here). Briefly, the OIG found that providers of vaccines made available through the CDC's Vaccines for Children Program (VFC) (a program that provides free vaccines to kids whose families might otherwise be unable to afford to get their child immunized) were frequently storing vaccines in inappropriate conditions, potentially reducing their potency and efficacy.

There are a couple ways that I could see this report being spun by opponents of vaccination. Let's take a look...

A Little Bit of Poison in a Sweet, Inviting Wrapper

If you follow me on Twitter (and if you don't, why aren't you?), you have likely already heard about a PSA put out by the National Vaccine Information Center (NVIC) and Mercola.com, two slick anti-vaccine organizations. The PSA is being run on Delta Airlines flight. You can read more about it at Skepchick and Respectful Insolence. The Skepchick article includes steps you can take to combat the propaganda, including a link to a petition to get Delta to stop showing it on their flights.

The video is available on YouTube (Update: It looks like NVIC removed the video at that link, but it is still up here and here [Update: looks like it has been removed from Facebook, now, too]), but cannot be embedded. Comments have also been turned off, perhaps to avoid inconvenient critiques from science-minded individuals. On the surface, it appears to be pretty good advice, so why all the fuss?

Because the PSA includes some iffy information and, more importantly, directs people to the NVIC web site, which is rife with misinformation and distortions of fact.

On the Impact of a Flu Vaccine and Health Care Workers

The latest issue of the CDC's Morbidity and Mortality Weekly Report contains a notice to readers, advising them of revisions that were made to the estimated impact of the 2009 H1N1 Influenza vaccine. Before I get into the specifics of the notice, I just want to point out how cool it is that organizations like the CDC that are based in science will readily correct themselves, even before anyone outside the organization points out an error. This is something that I don't think I've ever seen from an anti-vaccine organization, even when glaring errors are highlighted for them.

So, what does the CDC say?