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Just when I thought I was out… they pull me back in.

Michael Corleone in The Godfather, Part 3

I hadn’t planned on doing two vaccine posts with such a short interval between them, but all too often, as the they say in the weakest of the Godfather movies, I get pulled back in again. So, after noting last week that 2009 was shaping up–fortunately–to be a very bad year for antivaccinationists, I should have expected a counterattack from the antivaccine fringe. Indeed, the only thing that surprised me after the twin blows of the revelations about scientific fraud on the part of the originator of the claim that the MMR vaccine causes autism, Andrew Wakefield, and the resounding defeat of the first three test cases of the Autism Omnibus proceedings, was that it took longer than I had expected. True, a group had formed, proclaiming that “we support Dr. Andrew Wakefield.” Also true, the antivaccine activists at the Age of Autism have been working overtime to attack the Autism Omnibus as being hopelessly rigged. Indeed, our “old friend” Dr. Jay Gordon has even likened attempts to refute antivaccine pseudoscience to tobacco companies’ P.R. and astroturf campaigns back in the 1950s through 1980s to cast doubt on the strong scientific and epidemiological evidence showing that cigarettes cause lung cancer.

But those contortions of science, epidemiology, law, and logic were merely a warmup for the real counterattack. On February 25, Generation Rescue purchased this full page ad in USA Today:

Unfortunately, the advertisement above was only the beginning. Generation Rescue managed to team up the chief progagandist for the antivaccine movement, David Kirby, along with Robert F. Kennedy, Jr., whom I have discussed before for his total support of the antivaccine movement. The question then becomes: Where would these two team up to spread their message against vaccines? Do you even have to ask?

Their twin articles appear on that repository of all things antivaccine, The Huffington Post, under the title Vaccine Court: Autism Debate Continues. As I will explain, these twin articles represent yet another example of what I have at times referred to as the “incredibly shrinking vaccine-autism hypothesis.”



Let’s take a look first at the article by RFK, Jr., Another Autism Case Wins in Vaccine Court:

The New York Times joined the government Health Agency (HRSA) and its big pharma allies hailing the decisions as proof that the scientific doubts about vaccine safety had finally been “demolished.” The US Department of Health and Human services said the rulings should “help reassure parents that vaccines do not cause autism.” The Times, which has made itself a blind mouthpiece for HRSA and a leading defender of vaccine safety, joined crowing government and vaccine industry flacks applauding the decisions like giddy cheerleaders, rooting for the same court that many of these same voices viscously derided just one year ago, after Hannah Poling won compensation for her vaccine induced autism. But last week, the parents of yet another child with autism spectrum disorder (ASD) were awarded a lump sum of more than $810,000 (plus an estimated $30-40,000 per year for autism services and care) in compensation by the Court, which ruled that the measels-mumps-rubella (MMR) vaccine had caused acute brain damage that led to his autism spectrum disorder.

Yes, it’s the Hannah Poling case all over again, except this time the antivaccine movement is not rebranding autism as a mitochondrial disorder. What it is trying to rebrand autism as again, you will see in a moment. In the meantime, RFK, Jr. spins and twists:

The family of 10-year-old Bailey Banks won their case quietly and without fanfare in June of 2007, but the ruling has only now come to public attention. In the remarkably clear and eloquent decision, Special Master Richard Abell ruled that the Banks had successfully demonstrated that “the MMR vaccine at issue actually caused the conditions from which Bailey suffered and continues to suffer.” Bailey’s diagnosis is Pervasive Developmental Disorder — Not Otherwise Specified (PDD-NOS) which has been recognized as an autism spectrum disorder by CDC, HRSA and the other federal health agencies since at least the 1990s.

PDD-NOS is indeed one of the conditions that fall under the category of disorders known as autistic spectrum disorders (ASDs) and is thus considered an ASD. The ruling concluded that, in the case of Bailey Banks, the MMR had caused a condition known as acute disseminated encephalomyelitis (ADEM). Here is the passage that RFK, Jr. quotes in his HuffPo article:

The Court found that Bailey’s ADEM was both caused-in-fact and proximately caused by his vaccination. It is well-understood that the vaccination at issue can cause ADEM, and the Court found, based upon a full reading and hearing of the pertinent facts in this case, that it did actually cause the ADEM. Furthermore, Bailey’s ADEM was severe enough to cause lasting, residual damage, and retarded his developmental progress, which fits under the generalized heading of Pervasive Developmental Delay, or PDD [an autism spectrum disorder]. The Court found that Bailey would not have suffered this delay but for the administration of the MMR vaccine, and that this chain of causation was… a proximate sequence of cause and effect leading inexorably from vaccination to Pervasive Developmental Delay.

This is not an exact quote of what Special Master Richard Abell’s ruling. Note the term “an autism spectrum disorder” in brackets. There’s just one problem. PDD is not an autistic spectrum disorder. Let’s look at the very beginning of the Special Master’s ruling:

On 26 June 2002, the Petitioner filed a petition for compensation under the National Childhood Vaccine Injury Act of 1986 (Vaccine Act or Act)2 alleging that, as a result of the MMR vaccination received on 14 March 2000, his child, Bailey, suffered a seizure and Acute Disseminated Encephalomyelitis (“ADEM”),3 which led to Pervasive Developmental Delay (“PDD”), a condition from which he continues to suffer (the “Petition”).

Note the difference. The claim in the ruling is not that ADEM led to pervasive developmental disorder, not otherwise specialized (PDD-NOS). The ruling is about pervasive developmental delay (PDD). The difference is more than a matter of semantics, as Kev points out. PDD is not the same thing as PDD-NOS. In fact, the ruling itself makes this point very, very clear in one of its footnotes:

Pervasive Developmental Disorder, Not Otherwise Specified (PDD-NOS) is a ‘subthreshold’ condition in which some – but not all – features of autism or another explicitly identified Pervasive Developmental Disorder are identified. PDD-NOS is often incorrectly referred to as simply “PDD.” The term PDD refers to the class of conditions to which autism belongs. PDD is NOT itself a diagnosis, while PDD-NOS IS a diagnosis. The term Pervasive Developmental Disorder – Not Otherwise Specified (PDD-NOS; also referred to as “atypical personality development,” “atypical PDD,” or “atypical autism”) is included in DSM-IV to encompass cases where there is marked impairment of social interaction, communication, and/or stereotyped behavior patterns or interest, but when full features for autism or another explicitly defined PDD are not met.

In fact, PDD-NOS is a subset of PDD, but there are other forms of PDD. This is what RFK, Jr. says about it:

Bailey’s diagnosis is Pervasive Developmental Disorder — Not Otherwise Specified (PDD-NOS) which has been recognized as an autism spectrum disorder by CDC, HRSA and the other federal health agencies since at least the 1990s.

It’s not. Read the decision. Granted, the terms PDD and PDD-NOS seem to be used almost interchangeably and sloppily so, but latching on to that doesn’t “prove” anything. In fact, if you read through the ruling, you’ll also see that even the facts of the case do not represent the slam dunk that RFK, Jr. seems to think they do. Indeed, the Special Master even acknowledges that and feels the need to justify his decision:

Despite their accord on certain factual predicates contained in Bailey’s medical records, there is, unsurprisingly, a pronounced conflict between the parties as to the following issues: whether a biologically plausible link exists between ADEM and pervasive developmental delay (PDD) in a direct chain of causation, whether Bailey did in fact suffer from ADEM, and ultimately whether the administration of the MMR vaccine to Bailey actually caused ADEM which would then cause PDD that currently besets Bailey today.

Note that Special Master Abell referred to PDD as “pervasive developmental delay.”

I’ll grant you (and even the antivaccine movement) that Abell seems to flip back and forth between using PDD to mean pervasive developmental delay or PDD-NOS in a confusing manner, trying to explain himself in the footnotes and failing. My point is not that Bailey Banks doesn’t have PDD-NOS. Rather, it is that the antivaccine fringe reads far more into the terminology than is warranted. Reading the entire judgment, whatever neurological disorder Bailey has, I consider it arguable whether Bailey actually has an ASD. He very well might have PDD-NOS; he might not. In fact, the title of the ruling should tell you how sure Special Master Abell was that the MMR caused Bailey Banks’ autism: Non-autistic developmental delay; Acute Disseminated Encephalomyelitis; Expert Credibility; Evidentiary Reliability; Scientific Validity; Burden of Proof; Causation in Fact; Proximate Causation.

More importantly, even if Bailey does have PDD-NOS, the chain of causality gets more strained when we consider ADEM. For one thing, it’s not even entirely clear that Bailey actually had ADEM, as the testimony in the case reveals. However, clearly something happened; so, for the sake of argument, let’s say for the moment that he definitely did suffer a vaccine-induced incident of ADEM. Here’s where the problem comes in: There’s close to no scientific literature to support an epidemiological or pathologic link between ADEM or PDD (or PDD-NOS, for that matter). Basically, the ruling is best read as saying that in this case MMR probably (i.e., with a 51% or more probability) caused Bailey’s ADEM, a rare condition after vaccination that is compensable, and that Bailey’s ADEM further might have resulted in PDD or PDD-NOS. That’s a lot different than RFK, Jr.’s confident assertion that this case is a slam-dunk indication that the Vaccine Court has accepted the general principle that vaccines can cause autism. Such nuances undermine the antivaccine spin on the case, however; so they can’t be mentioned.

What I find more troubling, however, is this statement in Special Master Abell’s ruling, quoted by David Kirby in his article:

In response, Respondent’s expert stated that, although ADEM may result in “permanent neurological sequelae,” nevertheless “all the medical literature is negative in that regard;” however, soon thereafter, he corrected this statement by clarifying, “I can find no literature relating ADEM to autism or [PDD].” Tr. at 84-85. It may be that Respondent’s research reveals a dearth of evidence linking ADEM to PDD, but that is not the same as positive proof that the two are unrelated, something Respondent was unable to produce. Therefore, the statement that “all the medical literature is negative” is incorrect.

I have one request of anyone who fervently believes that the Vaccine Court is overwhelmingly biased against the petitioners who bring cases before it. Read the above paragraph. Then read it again. Then read it over and over. That single paragraph tells you all you need to know about the true attitude and “bias” of the Vaccine Court, which most definitely are not what Kirby represents them as. The above paragraph reveals a Special Master of the Vaccine Court bending over backwards to give the petitioner’s experts the benefit of the doubt even in the absence of any positive peer-reviewed medical literature supporting the petitioner’s hypothesis of causation for the vaccine injury claimed. Abell even appears to be chiding the government’s expert witness for being too particular about actually requiring some evidence published in the peer-reviewed journals to back the petitioner’s claim that the MMR caused ADEM, which resulted in PDD-NOS. Moreover, Abell’s statement above that the observation that there is a “dearth of evidence linking ADEM to PDD, but that is not the same as positive proof that the two are unrelated” suggests that he think that science can ever “positively” prove a negative. It cannot; it can only suggest probabilities. In any case, the Special Master appears to be going beyond even that. He appears to be looking for a reason to reject the Respondent’s defense.

Now don’t get me wrong. Special Master Abell’s misunderstanding of how science works aside, for the most part, as a matter of public health policy this bias of the Vaccine Court towards granting petitioners’ claims is probably a good thing. After all, if we as a society are going to require mass vaccination programs of our children, even though the benefits far outweigh the risks, there are small risks, and there will always be a small number of adverse events. Children who suffer an adverse event deserve to be compensated in an expeditious fashion. Indeed, the Vaccine Court was set up to do just that by streamlining the compensation process. Given that Bailey had a reaction close enough to his vaccination that the law considers it likely that the vaccination caused it as a matter of law, it is probably not unreasonable that the Vaccine Court decided to compensate him. But, please, let’s not confuse a legal ruling with science. As I pointed out when I discussed the recent rejection of the claims of causation by the first three test case petitioners in the Autism Omnibus, I was pleasantly surprised that, in the instance of the Omnibus at least, the law got the science right. Far too often, it does not. The rulings and litigation over silicone breast implants that bankrupted Dow-Corning in the 1990s come to mind.

To boil it all down, the antivaccine movement is doing nothing other than what it did in the Hannah Poling case, attempting to “rebrand” autism. RFK, Jr. and David Kirby are throwing people a big red herring. What the court admitted is that Bailey’s seizures occurred soon enough after the MMR to be considered a vaccine injury and accepted that his neurologic problems could be the result. It did not “admit that vaccines cause autism” any more than it did in the Hannah Poling case. Indeed, it bent over backward to give the petitioner every opportunity to come up with a concept of how vaccines might contribute to autism and argue it, primarily based on the relatively close temporal proximity. It even in essence ignored testimony that there was no convincing evidence in the peer-reviewed medical literature linking ADEM to PDD. I did the PubMed searches myself, and there really isn’t much of anything.

David Kirby, characteristically, is a bit more careful–and, of course, weaselly–about the issue. Clearly he is the smarter and cleverer of the two. What Kirby does is to throw Andrew Wakefield under the bus, metaphorically speaking, at least as far as how he claimed that MMR caused autism:

Is vaccine-induced ADEM (and similar disorders) a neurological gateway for a subset of children to go on and develop an ASD? That question will now become subject to debate. Thousands of parents have reported similar reactions and symptoms following vaccination, yet they lack radiological proof of ADEM or related disorders in the form of an MRI. Meanwhile, most children with autism do not present with myelin damage, but many do test positive for antibodies to myelin basic protein (MBP).

But what were these reactions? Kirby described them earlier:

Most cases of ADEM (80%) are in children. Symptoms usually appear within a few days to a couple of weeks. They include: headache, delirium, lethargy, seizures, stiff neck, fever, ataxia (incoordination), optic nerve damage, nausea, vomiting, weight loss, irritability and changes in mental status. I know of thousands of parents who witnessed many of these same symptoms afflict their children shortly after vaccination, most typically the MMR. Did these children with autism also suffer initially from ADEM or some subclinical version of the disorder? We may never know (physical signs like myelin damage are transitory).

This is yet another “I’m just asking” gambit by David Kirby, the same sort of rhetorical prestidigitation he performed for the Hannah Poling case, connecting condition after condition without any firm scientific evidence that a connection is warranted, each connection getting more tenuous as he continues. He’s also playing a subtler game that that in that he is implicitly attributing all sorts of nonspecific neurological symptoms to “regressive autism” without specifically saying that that’s what he’s doing.

Let’s look at it this way. Again, let’s go beyond what we conceded to the antivaccine movement for the sake of argument. Let’s concede that, in the case of Bailey Banks, MMR caused ADEM, which then lead to PDD-NOS or even full blown autism, exactly as David Kirby and Robert F. Kennedy, Jr. are claiming. Here’s the problem. ADEM occurring after vaccination is very rare–so rare that, epidemiologically, it has been very difficult to determine whether it’s even correlated with a vaccine at all. For example, this study looking at post-marketing adverse events from vaccines in Japan reported the total estimated incidence of serious neurological incidents, including ADEM, encephalitis or encephalopathy, and Guillain-Barré syndrome, after vaccination as being in the range of 0.1-0.2 per million immunization practices. That’s incredibly rare. Fellow SBM blogger Dr. Lipson has pointed out that the incidence of ADEM after measles and some other viral infections is 5,000 to 10,000 times higher than after vaccination, on the order of 1 in 1,000. In other words, even in the worst case scenario and granting every single link between vaccines, ADEM, and ASDs that David Kirby and RFK, Jr. speculate about, the risk of a child’s suffering a bout of ADEM after getting the measles is several orders of magnitude higher than it is after MMR vaccination–if there even is an elevated risk of ADEM after MMR vaccination at all! By David Kirby’s and RFK, Jr.’s own arguments, vaccination with MMR is vastly safer and vastly less likely to result in neurological sequelae than not vaccinating.

Of course, Kirby has a ready answer for this:

ADEM is said to be rare, but the disorder may be grossly under-diagnosed (or misdiagnosed). Even the government’s chief witness against Bailey’s case testified that he sees patients with ADEM “on a fairly regular basis.

Note the cleverness, so pathognomonic of Kirby’s writing style. ADEM itself may not be incredibly rare, but ADEM associated with vaccination is very rare and much more common after at least one of the diseases that vaccination prevents. At the end of the article, Kirby repeats the sentiment:

People will argue that ADEM is rare; that vaccines “only” caused PDD in Bailey; and that this was a legal and not scientific decision. The problem is we don’t know how prevalent ADEM is because we never looked; while “PDD” is interchangeable with “ASD” in the language of public health. And, the three cases that lost were also “legal” decisions.

This is just plain incorrect. Scientists and doctors have looked. There are numerous epidemiological studies and post-marketing surveillance studies looking for neurological sequelae after vaccination, be it with MMR or any other childhood vaccine. These studies just haven’t found what Kirby wants them to find. I strongly suspect that Kirby’s definition o which is why his definition of “look” is to do CT scans and MRIs on every child brought to the emergency room with any complaint at all after vaccination. Also remember that Bailey underwent an MRI because he had a seizure associated with fever.

I have on occasion referred to the vaccine-autism hypothesis as the “incredible shrinking causation hypothesis.” This tag-team assault by two luminaries of the antivaccine movement is yet more evidence of just how puny this hypothesis has become. Remember, the original claim of the antivaccine movement was not that a couple of very rare conditions predispose a child to vaccine injury, which predisposes them to developing autism. It was not that vaccines might cause autism in one or even two in a million children. No! It was that vaccines are a major cause, if not the main cause of an alleged “autism epidemic” that has been going on since the mid-1990s. Of course, the real cause of the apparent increase in autism diagnoses appears to be largely due to diagnostic substitution and the broadening of the diagnostic criteria for autism, but to antivaccine advocates, correlation must equal causation, and the increase in autism diagnoses correlated roughly with an increase in the number of vaccines in the recommended childhood vaccine schedule.

In the case of the discredited hypothesis that the mercury in the thimerosal preservatives in vaccines causes autism, Generation Rescue, for example, before its shifting of the goalposts declared autism to be a “misdiagnosis for mercury poisoning” due to vaccines. After the science became so overwhelming that even antivaccine activists had a hard time blaming autism on thimerosal anymore, GR describes autism in much vaguer terms:

We believe these neurological disorders (“NDs”) are environmental illnesses caused by an overload of heavy metals, live viruses, and bacteria. Proper treatment of our children, known as “biomedical intervention”, is leading to recovery for thousands. The cause of this epidemic of NDs is extremely controversial. We believe the cause includes the tripling of vaccines given to children in the last 15 years (with unstudied ingredients like mercury, aluminum and live viruses); growing evidence also suggests that maternal toxic load and prenatal vaccines, heavy metals like mercury in our air, toxic ingredients in our water, pesticides; and the overuse of antibiotics are also implicated. Generation Rescue’s mission is to support continued research on causative factors and treatment approaches for NDs.

So what do we have now from the antivaccine movement, now that the thimerosal hypothesis has been discredited scientifically and Andrew Wakefield’s MMR work has been thoroughly repudiated? Vague ideas about “toxins” in vaccines. I want to emphasize it again: What we now see now is truly the incredibly shrinking hypothesis. By latching onto a rare mitochondrial disorder as the “linking factor” between vaccines and autism last year and now latching onto a very rare possible complication of vaccination, ADEM, as a “gateway” to autism, using only a questionable legal ruling and in essence no science, Kirby and Kennedy are showing just how small the vaccine hypothesis for autism has become. Even if such a link exists between the MMR and ADEM and autism and is ultimately scientifically confirmed (unlikely) it could not possibly account for very many cases of autism–just as mitochondrial disorders couldn’t account for very many cases. Moreover, even more so than neurological complications in children with mitochondrial disorders, neurological complications due to ADEM are more likely to occur in the unvaccinated because measles is more likely in such children. Science, facts, and reason notwithstanding, look for a lot of very bad “science” to pour out of the “labs” of Thoughtful House, Mark and David Geier’s basement, and Boyd Haley’s lab, wherever that may be these days.

I also find it rather convenient that the antivaccine movement seemingly forgot all about this particular ruling. After all, the ruling was originally issued in 2007 and Kathleen Seidel even blogged about it and other similar rulings nearly a year ago. One wonders why Generation Rescue waited until now to trot it out. Coincidence? I think not. Here’s what I think, and I believe I have good reason behind my thinking: Pre-Autism Omnibus ruling, even the antivaccine movement considered the Banks case thin gruel, too thin to make much of a stink about. Indeed, if that weren’t the case, the Banks case would almost certainly have received major hype when its ruling was originally announced a year and a half ago. I also don’t buy the argument that this ruling was “hidden.” The antivaccine movement is very aware of rulings made by the Vaccine Court, as they are always looking for a ruling to use. Now, post-Autism Omnibus ruling and Andrew Wakefield revelations, the antivaccine movement needs something to distract people from the drubbing they’ve taken scientifically and legally. So they pull an old ruling out of the closet, tart it up a bit using their post-Poling spin skills, and send it flouncing down the runway in the hope that it impresses.

And if that doesn’t work, RFK, Jr. in his own inimitable fashion cranks up the paranoia:

Although the vaccine court is mandated to fairly serve the victims of vaccine injuries, their primary purpose and raison d’etre is to protect the vaccine program and vaccine makers. Damages are doled out from a 75-cent tax on every vaccine sold and not from the vaccine makers. “You can understand why special masters, burdened with their duty to protect vaccine programs, might be unwilling to make the direct causal link between autism and vaccines,” Krakow observed. “If you ask the big question and answer it in the affirmative, there is a sense that it will damage the vaccine program irreparably.” Vaccine Court judges are equipped with a draconian armory of weapons deployable against plaintiffs intent on proving the causal connection between vaccines and autism. Jury trials are prohibited. Damages are capped; awards for pain and suffering are strictly limited and punitive damages banned altogether. Vaccine defenders have an army of Department of Justice attorneys with virtually unlimited resources for expert witnesses and other litigation costs. Plaintiffs, in contrast, must fund the up front costs for experts on their own. In a cultural choice that clearly favors defendants, vaccine court gives overwhelming weight to written medical records which are often inaccurate — over all other forms of testimony and evidence. Observations by parents and other caretakers are given little weight.

I have one question for David Kirby and RFK, Jr.: If the proceedings of the Vaccine Court are so rigged against the petitioners, why is it that the U.S. government pays their legal fees, win or lose? Readers may or may not have heard of a certain lawyer named Clifford Shoemaker, who abused the subpoena process to punish Kathleen Seidel. What caused him to go after Kathleen Seidel with legal thuggery? What led him to take abusive retaliatory legal action was Seidel’s revelation of just how much money he had made from representing Vaccine Court petitioners. In fact, the Vaccine Court goes beyond paying legal fees, even for those who lose. As Kathleen Seidel has explained, the law guarantees payment of attorney’s fees and costs incurred by petitioners in presenting a claim to the Vaccine Court, as long as the claim is brought in good faith and the costs are deemed reasonable and necessary.

Particularly odd to me is RFK, Jr.’s rant that the court gives overwhelming weight to written medical records. What on earth else is the court supposed to give the most weight to when considering medical-legal claims? Humans are very prone to confusing correlation with causation, as well as confirmation bias, and the tendency to subconsciously adjust memories to conform to beliefs. Medical records may indeed be fallible, but eyewitness testimony is even more fallible. Indeed, the Michelle Cedillo case shows that, given how the parents insisted that her neurological problems started after her vaccine. Videotapes made by her parents before she was vaccinated and before her neurologic symptoms manifested themselves to her parents showed that her abnormalities were pre-existing. Experts could see the early signs; her parents didn’t know what to look for and did not.

Finally, to cap off the advertisement in USA Today and the tag team crankfest of David Kirby and RFK, Jr., Generation Rescue pulls out all the stops, trotting out–yes, you guessed it!–Jenny McCarthy and Jim Carrey. Check out this press release:

“It was heartbreaking to hear about Bailey’s story, but through this ruling we are gaining the proof we need to open the eyes of the world to the fact that vaccines do, in fact, cause autism,” said Jenny McCarthy, Hollywood actress, autism activist, best-selling author and Generation Rescue board member. “Bailey Banks’ regression into autism after vaccination is the same story I went through with my own son and the same story I have heard from thousands of mothers and fathers around the country. Our hope is that this ruling will influence decision and policy-makers to help the hundreds of thousands of children and families affected by this terrible condition.”

Chiming in immediately after is her boyfriend:

Jim Carrey, Hollywood legend and Generation Rescue board member, reacted to the news, “It seems the U.S. government is sending mixed messages by telling the world that vaccines don’t cause autism, while, at the same time, they are quietly managing a separate ‘vaccine court’ that is ruling in favor of affected families and finding that vaccines, in fact, were the cause. For most of the autism community the question is no longer whether vaccines caused of their child’s autism. The question is why is their government only promoting the rulings that are in favor of the vaccine companies.”

No, Jim, the question is why you and Jenny think your Google University education and personal anecdotal experience trumps science, epidemiology, and the accumulated knowledge based on mountains of epidemiological and scientific evidence, and why you think that a legal ruling on science decides science.

I could go on, so much misinformation is there, especially in RFK, Jr.’s article, where he complains to high heaven about how plaintiffs’ attorneys supposedly can’t get access to the Vaccine Safety Datalink. Likely this is another one of RFK, Jr.’s exaggerations, but even if it weren’t, I’d have to wonder if, assuming the court may be indeed reluctant to give plaintiff’s attorneys access to the VSD, this reluctance has anything to do with concerns about the confidential medical information under HIPAA for the millions of medical records contained in that database. Or perhaps it is knowledge of how Mark and David Geier once tried to alter file extensions and merge datasets, very possibly to match names with cases. True, they denied it, but as Kathleen Seidel wrote:

To justify their attempt to merge datasets, they refer to the absence of direct identifiers in patient records, apparently unaware or dismissive of the well-documented fact that aggregation of indirect identifiers (such as race, sex, birthweight, APGAR, maternal age, gestation, and date of vaccination) would compromise the confidentiality of private health information. Modern data mining software heightens the risk that patient confidentiality might be compromised by statistical researchers, hence the proliferation of guidelines for the conduct of such research.

Of course, legitimate researchers can get access to the VSD. Even lawyers for petitioners for the Vaccine Court can get access. Indeed, numerous studies have looked at the VSD data on vaccines, none finding any correlation between vaccines or thimerosal in vaccines and neurodevelopmental disorders. If the antivaccine movement had any scientists other than crank scientists, it could do studies using the VSD data too. All it takes is a protocol that can be approved by an IRB.

What we are seeing here is desperation. The leadership of the antivaccine movement sees the writing on the wall. Study after study have failed to find even a whiff of a link between mercury and autism or vaccines and autism. The Vaccine Court, which, as the Banks case shows, is about as petitioner-friendly as can be, has recently conclusively ruled against the vaccine-autism hypothesis. The hero of the antivaccine movement has been revealed for the world to see as not just a dishonest man in the pay of lawyers suing vaccine manufacturers and hiding his conflict of interest, not just an incompetent scientist, but as an outright scientific fraud. They know that, in the reality-based world, the last nails are being driven into the coffin of the vaccine-autism hypothesis, which, zombie like, keeps pounding on the lid of the casket to try to loosen them and get out.

Science does not support them; so all that is left is spin and P.R.