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The old Skeptical Raptor is taking a bit of a break over the next few days to recharge his batteries for all of the pseudoscience that will be coming out in 2020. In lieu of new content, I will be republishing the top 10 most read articles on this blog during 2019. Here’s number 8 – the tragic and heartwrenching death of Nicholas Catone.

I thought about not republishing this article, but it was read by nearly 100,000 people last year. And, as tragic as the story is, we don’t want it to be a cause for parents to maybe refuse vaccinations.

On May 12, 2017, the son of retired UFC fighter Nick Catone, Nicholas Catone, by all accounts a healthy, sweet, happy, child, died in his sleep. It’s horrible to lose a child, and I want to start by extending my condolences to the family.

Sadly, I can’t stop there. His parents blame vaccines. The story is being spread in mom groups and understandably scares moms from vaccinating. But Nicholas’ tragic death is not a good reason to refuse vaccines. First, the alleged link to vaccines is extraordinarily weak. There is no good reason to blame vaccines for the boy’s tragic death. Second, even if this was linked to vaccines – and there’s no evidence of that – it’s still safer to vaccinate.

The Nick Catone story

Nick Catone is an athlete, active in mixed martial arts (MMA) in multiple ways. His wife Marjorie is an RN. Their son, Nicholas, was born in September 2015. He was, by their accounts and pictures, a lovely, happy, sweet kid.

The family is understandably reeling from his loss – their Facebook posts are heartbreaking. It’s horrible and tragic to lose a child. It’s hard for me not to take this story personally because their little boy is very close in age to my younger son, who is also a blond toddler.

It’s hard not to think how painful it would be if anything happened to him. It is very, very frightening to think of losing your lively, happy toddler.

The conclusion I reach – that vaccines didn’t kill Nicholas – scares me more than if it was vaccines. If it was the vaccine, you could maybe be more cautious and watch a child right after. When it’s not, it brings back home the reality that our world is not safe, that children can be taken without anything we can do to prevent it. That is hard and scary. We are not built to deal well with things that cannot be explained or handled.

Nick Catone blames vaccines

But sometimes there is no clear explanation. And in this case, the timing is not suggestive of a link to a vaccine – the boy died 17 days after his vaccination, the autopsy does not support a link, and there is nothing else connecting the death and the vaccine. The explanation simply isn’t supported.

According to his parents, during the winter before his vaccine, Nicholas had two colds, one of them lasting three weeks, for which, for an unclear reason, the doctors prescribed antibiotics. There is nothing unusual about a healthy toddler having a few colds during winter. It’s typical – “Babies and toddlers often have 8 to 10 colds a year before they turn 2 years old.”

On April 25, 2017, Nicholas went to the pediatrician and received a single DTaP vaccine. Nicholas has previously received his MMR vaccine at 15 months, and this spread – a single vaccine at a time, spread out – suggests to me his parents were likely already at least somewhat vaccine-hesitant. In a post from June 27, Nick Catone described the events thus:

On April 25th my son got his dtap (sic) shot, I remember he had a rash for a day or so after, had a little cold and runny nose on and off, Sunday May 7th had a fever wasn’t himself most the day. Monday May 8th woke up fine with no fever back to himself for the next 4 days happy, playing, eating running around with his sister then Friday May 12th my son just doesn’t wake up.

In other words, the boy had his DTaP shot on April 25. Then he had a cold. That is likely not related to the vaccine – it is not one of the risks of DTaP, and toddlers, as already mentioned, get many colds. He got a one day fever almost two weeks after the vaccine.

Again, there is nothing linking this to the vaccine. The vaccine can cause a fever – but unlike MMR, which causes fevers 6-14 days later, DTaP fever is shortly after the vaccine –

[the symptoms] begin 1 to 3 days after the vaccine was given and last for 1 to 7 days. Fortunately, fever and fussiness don’t last that long, typically going away after just a day or two.

Nicholas’ fever was over 10 days later. That’s too late, as Dr. Paul Offit, from The Children’s Hospital of Philadelphia, confirmed in an email.

And the mild fever from DTaP is a mild adverse reaction. It’s not dangerous. It just shows a child’s immune system is working to respond to the vaccine, creating antibodies.

At any rate, Nicholas overcame his fever within less than a day, as Nick Catone pointed out, and appeared fine. He died in his sleep on May 12, 2017, 17 days after the vaccine. With no warning, causing his family incredible grief and shock.

In other words, there is not even a close connection in time between the death and the vaccine. There was what looks like at least one viral illness, maybe two, in between. Blaming the vaccine under these circumstances is not convincing.

Examining the link to vaccines

An autopsy was carried out. In his June 27 post, Nick Catone makes it clear the autopsy did not show a link to vaccines:

The more I think about the final results of my sons autopsy report the more pissed off I get. …. Then to find out there was no answer “no medical reason” …. Cause of Death – “Sudden Unexplained Death” , Manner of Death- “Natural” it says on the report.

The report found no medical reason and pointed to natural causes. In her interview, Ms. Marjorie Catone says that “His autopsy showed mild cerebral edema, mild pulmonary edema, and visceral congestion: all signs of vaccine injury.” But that’s not actually true. Dr. Michael Paolini from the Mayo Clinic explained:

By themselves, these findings are non-specific and do not point to a particular etiology. They are common and often related to the dying process, especially if mild.

In other words, these are not unusual and do not show a link to vaccines. The timing does not support one.

Reading about these issues for a law review article I’m writing, I’ve learned that there are limited, and defined, ways that vaccines could kill, and they would likely show up on thorough autopsy. A severe allergic reaction would be identifiable on autopsy.

In any case, the timing – 17 days after the vaccine—is not consistent with an allergic reaction to the vaccine. A severe brain problem – swelling, or something else – would also leave signs, and it did not. A seizure might not, but the seizures associated with DTaP generally happen shortly after, and are fever associated – and there was no fever here.

There is nothing connecting this death to the vaccine. With millions of children vaccinated each year, some deaths from other causes (like SIDS) are going to happen right after vaccines by coincidence alone – it’s inevitable. This was not even close in time to the vaccination.

It appears Marjorie Catone decided immediately the DTaP her son received was to blame. In his Facebook post, Nick Catone says: “My wife knew right away what it was and that we wouldn’t find any answers.” That belief rings throughout her interview.

There is nothing supporting the belief, but it’s clearly powerful. It seems that for some reason, Marjorie Catone decided the vaccine killed her son, and went in search of proof, refusing to accept the results of the autopsy or any other evidence. In fact, Ms. Catone treated the death as sudden infant death syndrome (SIDS) – even though it was not quite that since the child is too old for SIDS. She also seemed to have been willing to accept Vera Scheibner‘s very problematic, ill-supported article on SIDS as proof.

Scheibner’s ideas ignore the many other studies showing that vaccines don’t cause SIDS, or that vaccinations actually reduce the risk of SIDS. In relation to the vaccine in question, DTP and later DTaP, at least one study shows that higher rates of use of the vaccine are correlated with reduced rates of SIDS.

SIDS has been extensively investigated and researched. The evidence shows vaccines do not cause it.

Her pediatrician, those that investigate the death all disagree, but she believes it. This belief is unfortunate. Again, we can all sympathize with Marjorie Catone’s pain – but when her ill-founded belief vaccines killed her child is driving her to scare others from protecting their children from a dangerous, potentially fatal disease, it can only harm.

I would add that the Catones have recently claimed they have new evidence showing the vaccines caused the death. In a radio show with anti-vaccine activist Del Bigtree, Ms. Catone described the evidence as an autopsy by a neuropathologist she was referred to by members of anti-vaccine groups who befriended her after the tragedy – someone who “reviewed Nicholas’ brain tissue” and gave them a report (go to 1:02) that “certain areas of the brain were affected which he has seen a continuous association with vaccine-related injury or death and he had found those things with Nicholas as well.”

This reads as though other anti-vaccine activists helped her found a pathologist friendly to anti-vaccine views and willing to tell her what she wanted to hear (for a fee – as she emphasized – out of pocket). There’s no indication there was anything new or different that would support rejecting the views of the first, unbiased examiner that performed the actual autopsy. Even that pathologist appeared to have highlighted the long interval between the vaccine and the death, and suggested that the maximum time for a link is 72 hours – so even this anti-vaccine friendly source did not support their beliefs. It is clear Ms. Catone decided to blame vaccines immediately (and she said as much in the interview – suggesting that the first thing that came to mind was the last visit to the pediatrician) and went in search of evidence. This situation leaves one very vulnerable to confirmation bias, to accepting anything that supports that belief, however weak.

But they would need extraordinary evidence to overcome the barriers that the timing gap, the non-supportive autopsy, and the lack of actual evidence of a link to claim a link to the vaccine. Maybe they have such extraordinary evidence, but there doesn’t appear to be any. More likely they have something that is far weaker, but that they can latch on to confirm their belief.

The bigger picture

Vaccines save many lives and are incredibly safe. Since I just covered the evidence for that in detail, I will not repeat it.

The DTaP vaccine is an extremely safe vaccine. The common reactions from it are mild and serious reactions extraordinarily rare – and mostly short term.

In contrast, diphtheria and tetanus have a 10% mortality rate even with the best available modern treatment, even though the diseases themselves are now rare, thanks to the vaccine. Pertussis is back and can have serious complications, especially in young babies.

It’s hard not to be affected by a frightening story. But our children deserve better than to be left without protection because of a tragedy blamed on vaccines. We want to minimize tragedies, not increase them – and vaccinating is the way to do that.

Update

This month, the Catones teamed with the anti-vaccine (and very unreliable) organization Learn the Risk to put up billboards stating that their son died from vaccines in several cities. I understand that the Catones are suffering. I understand that they feel broken. But these billboards will not undo their tragedy. It will not lessen their pain. If effective, they could put other children at risk of preventable diseases. Other children dying or hospitalized from tetanus, pertussis or measles, or suffering in other ways from diseases we can prevent is a bad follow up to this tragedy. And that is what this effort is setting up other families for. Notes This article is by Dorit Rubinstein Reiss, Professor of Law at the University of California Hastings College of the Law (San Francisco, CA), who is a frequent contributor to this and many other blogs, providing in-depth, and intellectually stimulating, articles about vaccines, medical issues, social policy, and the law. Professor Reiss writes extensively in law journals about the social and legal policies of vaccination. Additionally, Reiss is also a member of the Parent Advisory Board of Voices for Vaccines, a parent-led organization that supports and advocates for on-time vaccination and the reduction of vaccine-preventable disease. This article was originally published in October 2017. It has been updated to include recent activities, to fix some broken links, and to do some light copyediting. It will be updated in the future as this story develops.

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