DEBUNK IT

4. IMPLACABLE FOES OF REASON: THE ANTIVAXERS

Dan Burton, a US Congressman from 1983 until retiring in 2013, has a habit of thinking he knows more about medicine than medical professionals do.

In 1977, for example, he believed he knew more than the FDA did about Laetrile, a chemical that was supposed to be effective in curing cancer. The FDA, which has a “controversial” habit of investigating purported cancer cures, said that not only did Laetrile not work but that patients who used the stuff ran the risk of cyanide poisoning.¹ Even so, Burton fought hard to have the use of Laetrile legalized in his home state of Indiana. According to a 1999 report:

“I think every opportunity should be given to people,” [Burton] stated, “so that they can survive and have a healthy life, and many times, hope alone and belief that they are going to get better is one of the ingredients that makes them get better.”

Yes, optimism can be a good thing when you’re sick. Cyanide? Not so much.

Dan Burton has always been a great supporter of the supplements industry. He’s one of the reasons why the US, unlike the rest of the developed world, has no proper regulation of the contents of those cute little bottles of vitamins and minerals that tempt you from the supermarket shelves. Congress has hugely limited the powers of the FDA to do anything to control the supplements manufacturers: you have no guarantee that the pills or capsules contain what the label says they do, there’s no proper hygiene oversight of their manufacture, et cetera. The one thing the FDA can do is take action after the contents of the bottle have been discovered to be actually poisonous.

It did this in 1997 when new scientific research raised the alarm about a substance called ephedra. Ephedra, derived from certain species of thistle, has been used in Chinese and other traditional medicines. The new research showed that even small quantities of ephedra had caused cases of cardiac arrest, horrendous mental problems, and even death. The FDA therefore tried to ban it from use in supplements.

Dan Burton again thought he knew better. Thanks to his efforts, it took until 2004 before the FDA could get this potentially lethal substance removed from sale.

DR. WAKEFIELD’S CONTROVERSY

So it’s hardly surprising that Dan Burton took UK physician Dr. Andrew Wakefield to his heart when Wakefield, the darling of the antivaxers,¹ came to the US.

Almost since the principle of vaccination was discovered by Edward Jenner ¹ in the late eighteenth century, people have been looking for reasons to be frightened of it. Jenner’s breakthrough was to infect people with the relatively mild disease cowpox and thereby give them immunity to the extremely dangerous disease smallpox. Thanks to the vaccination, smallpox rates fell, and then, in the twentieth century, plummeted; the disease was finally eliminated in 1977.

Even from early on, although vaccination against smallpox obviously had the power to save millions of human lives, many otherwise intelligent people campaigned against it. One of them was the playwright George Bernard Shaw; his antivaxer vehemence was all the more astonishing because the disease had nearly killed him in childhood.

Andrew Wakefield first hit the medical headlines in 1995. He and his colleagues at the Royal Free Hospital in London had been working on Crohn’s disease, a disease of the gastrointestinal tract with complications that can be extremely serious; no one’s yet sure what causes it. When the team published a paper in the major medical journal Lancet called “Is Measles Vaccination a Risk Factor for Inflammatory Bowel Disease?” there was a minor sensation.

They proposed that Crohn’s disease was caused by the measles virus hanging around in the body long after the actual measles has passed. Though wrong, this wasn’t a totally outlandish idea. (For example, the chickenpox virus remains in the body after the chickenpox has gone, and years or decades later can cause the quite different disease called shingles.) What raised the furor was that the team claimed the measles vaccine¹ could give the same result—i.e., that being vaccinated against measles could lead to getting Crohn’s disease.

Scientists worldwide worked to replicate the team’s results, but couldn’t. In August 1998 the team published another paper, this time in the Journal of Medical Virology, which basically admitted they’d gotten it wrong.

By then, however, Wakefield had a new and improved hypothesis: the MMR vaccine could cause autism. The idea was that the vaccine did physical damage to the intestine that released toxic proteins into the bloodstream; when those proteins reached the brain, they made the person autistic.

He and his colleagues outlined this hypothesis in another Lancet paper, but before it was published, Wakefield called a press conference to tell the world about his deductions. Since Wakefield is a very persuasive speaker, what should have been regarded as at most a tentative hypothesis was taken by the journalists to be cutting-edge science. The UK news media went into full-scale panic mode . . . and stayed that way long after medical science had determined that the conclusion was false.

One of Wakefield’s senior co-authors,² Simon Murch, perhaps said it best:

This link [between MMR vaccination and autism] is unproven and measles is a killing infection. If this precipitates a scare and immunization rates go down, as sure as night follows day, measles will return and children will die.

Murch was proved exactly right. Measles had been virtually eradicated from the UK and Ireland but, after the media scare campaign, many parents were reluctant to have their children vaccinated with MMR. Whole communities lost their herd immunity (see sidebar). Now, measles has become an endemic disease in England and Wales; there have been several deaths. An outbreak in Dublin in 1999–2000 hospitalized over a hundred children, of whom a dozen required intensive care and three died. Other countries have had similar experiences. As well as deaths, there have been instances of people being afflicted so badly they’ll be disabled for the rest of their lives.

THE BODY COUNT

If you want a sobering experience, look at the website Anti-Vaccine Body Count.¹ The site keeps a running total of the number of vaccine-preventable illnesses and deaths in the US since June 3, 2007. (2007 was the year a number of celebrity antivaxers began to make a noise.) As the website says, “The Anti-Vaccination Movement has a body count attached to its name.”

When I last checked, in November 2014, the figures had last been updated on September 6: The number of preventable illnesses stood at 139,199 and the number of preventable deaths at 6,265. The number of autism diagnoses scientifically linked to vaccinations stood, as it always has, at 0.

In the US it’s been a bit different. The disease was essentially eliminated from the country by the early 2000s. However, thanks to the efforts of US antivaxers, there have been several outbreaks since then. Unvaccinated people who go abroad to countries where measles is prevalent can bring the disease back with them. And they can infect unvaccinated people in the US—or even people who have been vaccinated but the vaccination hasn’t taken.

And it’s not just measles. In late 2010, because of falling vaccination rates against whooping cough (pertussis), California suffered its worst outbreak of that disease in over half a century: thousands were infected, and at least ten babies died.

It’s not all bad news, however. Although antivaxer campaigns in some countries have increased the measles rates in those regions, globally the picture is improving. In early 2014, the World Health Organization revealed that, between 2000 and 2012, annual deaths worldwide from measles went down from over 562,000 to about 122,000. That’s about a 78 percent drop. Reported cases of measles dropped by almost exactly the same percentage. There’s no room for complacency—measles is still a killer disease and the death toll is still horrific—but progress is being made.

And it’s coming about almost entirely because of vaccination.

INCOMPETENCE OR FRAUD?

A journalist called Brian Deer was suspicious of Wakefield’s claims from the outset, and for years he researched the background of that notorious 1998 Lancet paper.

He unearthed that Wakefield had been paid chunky sums of money by a lawyer called Robert Barr, who was involved in a class-action lawsuit against the manufacturers of the MMR vaccine. It just happened that the conclusions of the Lancet paper were very useful to Barr’s case. Of the twelve children who were the subjects of Wakefield’s work, several were the children of Barr’s clients. The antivaxer group JABS (for Justice Awareness and Basic Support) was also involved with Wakefield, and had supplied some of the other children. There were errors in the way the experiments were done and the results recorded.

Worst of all, the team had committed ethical breaches. For example, they had subjected eight of the children to colonoscopies even though there was no good medical reason to do this. A colonoscopy involves (to simplify) sticking a camera up your rear end, and the sensation is highly unpleasant. It can be risky, too—in fact, one of the unfortunate kids suffered accidental damage to the colon. Techniques like colonos-copies are called “invasive procedures” (you bet they are!), and there are strict rules about their use in research. The subjects here were autistic children. Inflicting colonoscopies and other invasive procedures on them was nothing short of abuse.

By 2004, Deer had found so many reasons to doubt the veracity of Wakefield’s paper that ten of Wakefield’s co-authors on it had withdrawn their names.^* The General Medical Council (GMC), which regulates the medical profession in the UK, set up an inquiry. Years later, in 2010, the investigation reported a whole string of dishonesties and abuses associated with the paper and the GMC decided that Andrew Wakefield and one of his co-authors, John Walker-Smith, should lose their licenses to practice as doctors. In 2011, the British Medical Journal published three articles by Brian Deer arguing that Wakefield’s work wasn’t just flawed and dishonest, but actually fraudulent.

THIOMERSAL—THE WRONG SUSPECT

By the time Deer’s article was published and Wakefield lost his license to practice medicine, he was already living in the US, having left his homeland early in the 2000s. He was greeted as something of a hero by the antivaxer community in this country, which included several important politicians: John Kerry, Chris Dodd, Joe Lieberman, and our old friend Congressman Dan Burton, who in 1997 had become Chairman of the House Government Reform Committee, a position of considerable power.

Burton’s grandson Christian began showing symptoms of autism in infancy. Looking around for something to blame, the distraught grandfather connected this to the batch of vaccinations the child had received a few weeks earlier.

In particular, Burton focused on a substance called thiomersal (or thimerosal—both versions are correct), an antiseptic of which tiny quantities were added to vaccines as a preservative.¹ thiomersal is a compound of mercury, and mercury is known to cause brain damage. The connection was obvious.

Well, not really.

Whenever you talk about whether or not something’s poisonous, one important factor is the dosage. Although we’ve all read detective stories in which the murderer used arsenic to kill the victim, your body needs very small quantities of arsenic in its diet if it’s to function properly. (There have even been cases of arsenic addiction.) On the other side of the coin, everyone knows that water is vital to life . . . but if you drink too much of it you can actually kill yourself. In both cases, what’s important is the dose. The amount of thiomersal used in vaccines was so tiny that it was hard to understand how it might do any harm.

Another point worth remembering is that mercury poisoning produces very specific symptoms. No one’s ever reported thiomersal producing those symptoms.

One more thing. Thiomersal is a mercury compound. Compounds usually behave very differently than do the elements of which they’re made. For example, you wouldn’t want to swallow sodium, because it bursts into flames when put in water, and chlorine was used in World War I as a weapon—it’s a poisonous gas. But if you put the two together you get sodium chloride: table salt. Similarly, the mercury in thiomersal is tied up with other elements. When the thiomersal hits the bloodstream it breaks down, with one of the products—the mercury-containing one—being ethylmercury. This flushes from the body within about two and a half weeks.

Of course, it’s all very well to say that thiomersal shouldn’t cause any harm. That doesn’t mean that in practice it can’t.

Several huge sets of clinical trials have shown no adverse effects of the use of thiomersal in vaccines. But you could argue that a link between thiomersal and autism might not be easy to spot.

Except that we have the best test of all. From the late 1990s, because of the activities of the antivaxers, the vaccine manufacturers found substitute preservatives in place of thiomersal. They didn’t do this because they thought thiomersal was dangerous. It was just that, with memories of legal farragoes like the silicone-breast-implant panic fresh in mind (see page 140), they didn’t want to find themselves at the wrong end of multi-billion-dollar class-action lawsuits with outcomes decided on the basis of pseudoscience.

If Burton and the other antivaxers had been correct about the dangers of thiomersal, we’d surely have seen a decline in the rates of autism now that the substance wasn’t being used. In fact, the autism rates continued to rise.

This is all the more remarkable because, as we saw, vaccination rates have fallen calamitously because of the panic.

Let’s get this straight. Fewer children are being vaccinated but more children are contracting autism. If the antivaxers were right, the autism figures should be dropping along with the vaccination rates, shouldn’t they?

Unless, of course, the antivaxers are wrong.

That’s the simplest explanation of all these contradictions, isn’t it?

A NEVERENDING STORY

Wakefield’s 1998 Lancet paper didn’t suggest that thiomersal played any role in autism; it fingered the dead measles virus as the culprit. This didn’t stop Dan Burton from welcoming Andrew Wakefield as a kindred soul. In 2000, Burton, as Chairman of the House Government Reform Committee, held a hearing on the relationship between the MMR vaccine and autism. He called for testimony from a parade of the very few scientists he could find to support his belief, and Andrew Wakefield was his star turn.

Congress was wise enough to recognize this performance as just a piece of theater, and declined to ban vaccination, which was what Burton wanted. However, the “news” media and the public went wild. The flames were fanned again a few years later, in June 2005, when Robert F. Kennedy Jr.’s article “Deadly Immunity” appeared in Rolling Stone. Kennedy accused thiomersal again.

People began to believe that the way to cure autism was to get the infant’s body to expel all the mercury left over from the vaccination. Soon there was a new term on everybody’s lips: chelation therapy.

Poisoning by heavy metals like mercury, iron, arsenic, and lead is no joke. One way to reduce the quantities of these elements in the body is to introduce substances that combine with them to produce harmless compounds that then easily flush out. Used professionally, chelation therapy can be very helpful in cases of acute metal poisoning.

Some of the parents whose children suffer from autism, believing the problem is some kind of mercury poisoning because of the thiomersal, have tried chelation therapy to reduce the (supposed) mercury levels.

As we saw, mercury poisoning isn’t the problem in cases of autism—especially since thiomersal is rarely used in vaccines now!—and any self-styled “chelation therapists” who sell their services to parents as an autism cure are effectively taking money for nothing. The same goes for the marketing of chelation therapy to cancer and cardiovascular patients: you’d be just as well off clutching your lucky shamrock. The American Cancer Society (ACS) states bluntly:

According to a number of well-respected organizations, including the American Heart Association, the American Medical Association, the Centers for Disease Control and Prevention, the American Osteopathic Association, the American Academy of Family Physicians, and the FDA, there is no scientific evidence that chelation therapy is an effective treatment for any medical condition except heavy metal poisoning.

In fact, you might be better off with that shamrock, because the ACS adds:

Chelation therapy may produce toxic effects, including kidney damage, irregular heart beat, and swelling of the veins. It may also cause nausea, vomiting, diarrhea, and temporary lowering of blood pressure. Since the therapy removes minerals from the body, there is a risk of developing low calcium levels (hypocalcemia) and bone damage. Chelation therapy may also impair the immune system and decrease the body’s ability to produce insulin. People may also feel pain at the site of the EDTA injection. Chelation therapy may be dangerous in people with kidney disease, liver disease, or bleeding disorders. Women who are pregnant or breastfeeding should not use this method.

Two of the physicians offering chelation therapy as a treatment for autism, the father-and-son colleagues Mark and David Geier, also theorized that, since far more boys than girls suffer from autism, the problem might relate to the unlucky boys having too much testosterone. So the Geiers began using a chemical-castration treatment alongside the chelation therapy . . . Luckily, before this went too far, the scientific community had demolished most of the Geiers’ claims.

With huge trials having shown zero connection between vaccination and autism—such as the one run in Denmark in 1991-98 that studied over half a million children—and with overwhelming evidence having emerged that autism is a genetically based condition, it might seem that it was long past time for the antivaxers to shut up shop. No such luck.

Although many antivaxers have recognized that the absence of thiomersal from vaccines means its mercury can no longer be blamed for autism, some have shifted their attention to formaldehyde. While formaldehyde isn’t good for you if you have too much of it, our bodies need small amounts to function properly. It’s used during the preparation of vaccines and, even though it’s removed before the vaccine is delivered, there are tiny amounts still left. These are far lower than the levels the Environmental Protection Agency (EPA) considers safe—far lower, too, than the amount you’d take in if you ate an apple! Since we don’t see antivaxers warning you about the gross dangers of eating apples . . .

If formaldehyde won’t fit the bill, what about antifreeze? A number of antivaxers have kicked up a furor over the fact that vaccines contain polyethylene glycol. Antifreeze uses ethylene glycol, which is toxic. Surely those two substances are the same? Well, no, they aren’t. They’re different substances with different properties, as you’d expect from the fact that one has a “poly” in its name and the other doesn’t. The most important difference in this context is that, while ethylene glycol is toxic, polyethylene glycol isn’t.

SO WHY HAVE THE AUTISM RATES CONTINUED TO RISE?

Since the causes of autism are so very poorly understood, no one’s really sure why the rates continue to rise. (Similarly not well understood is why about four times as many boys as girls are affected.)

One factor might be that fewer cases are going unreported. In the past, many parents and even doctors probably thought children whom we’d now say were autistic were merely mentally retarded. As more and more physicians and others have become aware of the disease, it’s likely to be diagnosed earlier and more frequently.

CHICKENPOX PARTIES

Perhaps the most horrifying antic of this country’s antivaxers is the so-called Chickenpox Party. Chickenpox isn’t as dangerous a disease as measles, although it too can kill; it’s more dangerous if contracted in adulthood. The idea of a Chickenpox Party is to immunize a whole bunch of kids by gathering them together with an infected child. That way the children can catch the disease and, after some suffering, be immune to it for the rest of their lives (although vulnerable to shingles later on—see page 163). Of course, the children would be significantly safer if they were vaccinated instead, but try telling this to a fanatic.

The same approach has been taken by some misguided parents to other diseases, including measles, mumps, and hepatitis A. These are seriously life-threatening illnesses, so grouping uninfected children with an infected child is really a murderous activity. Even worse, campaigns have been mounted on the internet persuading gullible parents to send each other infected items—typically lollipops—so that kids can infect each other by mail. This is actually against the law but, more importantly, while the chickenpox virus is unlikely to survive long enough on the lollipop to infect the recipient, other viruses that the donor child might have—some of them deadly—could very well do so.

Another factor is that several neurodevelopmental conditions once thought to be distinct from autism are now recognized as being related to it. These include Asperger Syndrome and Rett Syndrome. Doctors now talk about an autism spectrum rather than about a single disease. So part of the apparent increase in rates of autism may be that some kids are being included in the tally today where previously they wouldn’t have been.

In a scientific paper published in March 2014, Philippe Grandjean and Philip J. Landrigan pointed the finger at environmental pollution by various industrial chemicals that are known to be developmental neurotoxicants—i.e., to damage the brains of developing infants. Among the conditions they include is autism. According to the Harvard School of Public Health press release about the paper, Grandjean and Landrigan forecast that many more chemicals than the known dozen or so identified as neurotoxicants contribute to a “silent pandemic” of neurobehavioral deficits that is eroding intelligence, disrupting behaviors, and damaging societies. But controlling this pandemic is difficult because of a scarcity of data to guide prevention and the huge amount of proof needed for government regulation. “Very few chemicals have been regulated as a result of developmental neurotoxicity,” they write.

Susanne Atanus, a 2014 nominee for Illinois’s 9th Congressional District, has a rather more radical explanation for autism. According to the local newspaper, the Daily Herald, in January 2014 she said “she believes God controls the weather and has put tornadoes and diseases such as autism and dementia on earth in response to gay rights and legalized abortions.”

OTHER VACCINES

Some antivaxers have moved on to mount scare campaigns about other vaccines. A frequent claim is that the incurable disease polio is spread by the polio vaccine. Since the disease was initially identified in the first half of the nineteenth century and polio vaccines didn’t come along until the middle of the twentieth, after which polio rates plummeted, this might seem a difficult case to make.

According to one version of this conjecture, polio was just about to die out anyway when the appearance of the vaccines revived it. The figures tell a different story. In the developed world, polio rates did indeed gently decline from the late nineteenth century onward, primarily because of improving hygiene. But they remained obscenely high by today’s standards. The first polio vaccine to come into widespread use was developed by Jonas Salk and licensed in the US in 1955. Official figures show that, between 1954 and 1961, the annual US polio rate dropped about 96.5 percent, from 38,476 cases to just 1,312. By 1994 the disease had disappeared from the Americas. That doesn’t really indicate a big revival caused by the vaccine!

Another favorite antivaxer target is the annual flu vaccine. Frequently there’ll be reference to the fact that the US swine flu vaccination program in 1976 killed more people than the flu itself did. This sounds pretty grim until you think about it: the more effective the vaccine, the fewer deaths from the flu! But there’s another sense in which it’s misleading.

The 1976 swine flu outbreak started in February of that year: it killed one soldier and hospitalized four others at Fort Dix, New Jersey. The medical authorities discovered that the strain of flu involved was very like the one that had killed millions worldwide in 1918, so they advised a mass vaccination. Because of political and other wrangles, the vaccination didn’t start until October—months after the flu had defied all predictions by failing to spread further than Fort Dix. Three elderly people died soon after being vaccinated; although there was never any medical reason to believe the deaths were related to the vaccine, the media had a field day.

There were also claims that some people contracted the nasty neuro-muscular disorder Guillain-Barré syndrome (GBS) through being vaccinated. Later studies showed that it’s possible there was a very slight increase in rates of GBS onset—about one case per 100,000 vaccinations. Studies of the vaccines used in other years almost invariably show no such increase; in a couple of instances, there might have been an increase of perhaps one case for every million vaccinations.

Overall, then, the 1976 situation was a very unusual one. The outbreak was, unexpectedly, very brief and confined to a very small area. Also, the vaccination campaign was botched. All told, at the very most, about twenty-five people died because of the vaccine; it’s quite possible the figure was much lower, and feasible that no one did. That was in consequence of 48,161,019 people being vaccinated. To get the figure in proportion, about fifty people die each year in the US—twice as many—through being struck by lightning.

And what if the 1976 swine flu had indeed spread as it could have done? We might have expected at least as many deaths as in the average flu season. That number, for the US, is about 30,000.

Think about that number the next time someone tells you flu shots are dangerous.

A POTENTIALLY DEADLY DOSE FOR GIRLS?

If I asked you to name some supposedly fact-based TV shows or channels that habitually purvey purest bullshit, I’m sure you could reel off half a dozen before I’d even finished the question. There’s that much bullshit on TV.

But sometimes the bullshit-mongers can be harder to spot, especially when the purveyor is otherwise a respected journalist. Here’s an example from December 2013. The respected broadcaster was Katie Couric, the show was the ABC daytime talk show Katie, and the press materials issued before the airing read in part:

A NEUROTOXIN BY ANY OTHER NAME . . .

Jenny McCarthy, maybe the world’s highest-profile antivaxer, has frequently argued that vaccines must obviously be dangerous because thiomersal contains mercury and mercury is a neurotoxin. As we’ve already noticed, this is to ignore two facts:

• Thiomersal isn’t used in vaccines any more.

• Some things that are poisonous in larger doses are harmless or even beneficial in tiny ones.

A good example of the latter is the botulinum toxin, among the most deadly neurotoxins known. In tiny doses, however, it has useful medical properties—as McCarthy should know. “I love Botox, I absolutely love it,” she declared in 2009. “I get it minimally, so I can still move my face. But I really do think it’s a savior.”

And the active principle in Botox is . . . ?

The HPV vaccine is considered a life-saving cancer preventer . . . but is it a potentially deadly dose for girls? Meet a mom who claims her daughter died after getting the HPV vaccine, and hear all sides of the HPV vaccine controversy.

In the broadcast, Couric interviewed

• the mother of a girl who died a couple of weeks after receiving the vaccine,

• a young woman who suffered multiple unexplained symptoms not long after receiving the vaccine, and

• Dr. Diane Harper, one of the rare qualified physicians who has given support to the antivaxers.

Set against this array was a single physician to express the consensus view of qualified doctors and medical scientists all over the world that the HPV vaccine is overwhelmingly safe. In other words, viewers were asked to compare the reasoned, dispassionate voice of science with the emotional personal testimonies. No wonder that many people came away from the show believing there was a raging controversy over the vaccine’s safety.

Yet, if you look at the first two testimonies above, you can see that neither is very persuasive. Both, in fact, fall into the trap of confusing correlation with causation. People get ill and even die all the time; inevitably this sometimes happens not long after they’ve been vaccinated. It also sometimes happens not long after they’ve watched the Super Bowl!

HPV, or human papillomavirus, is very nasty indeed. Every year, in the US alone, it causes thousands of cases of cervical cancer, throat cancer, and anal cancer. These are particularly life-threatening cancers. Anything that can be done to help prevent them is surely a good thing.

So, what’s this controversy about the HPV vaccine that Couric and her producers talked about?

So far as medical science is concerned, there isn’t a controversy. In a paper published in 2013 in the British Medical Journal, Scandinavian researchers reported on a study they’d done between October 2006 and December 2010 of 997,000 teenaged girls. Of these, 296,000 had been given at least one dose of the HPV vaccine.

In this massive study—nearly a million subjects!—the researchers could find no indication that the HPV vaccine caused any health problems whatsoever, in either the short or the long term.

In the US, the CDC tracked, between 2006 and 2009, the recipients of over 600,000 doses of the HPV vaccine. Again they could find no health risk from the vaccine.

Other studies have come to the same conclusion. The “controversy” that Katie Couric talked about in her TV show was a complete invention—bullshit deployed in hopes of attracting gullible viewers and consequent advertising revenue, no matter the number of people who might die because frightened off the vaccination.