Thursday, June 23, 2005

The IOM slaps down RFK Jr.

Dr. Harvey Fineberg, President of the Institute of Medicine of the National Acadamies, has slapped down RFK Jr.'s shoddy paranoia piece in this letter. In it, he points out even more of the selective and deceptive quoting RFK Jr. engaged in and pointed out other factual errors and distortions.

Orac sez: Read it!

Also, Rolling Stone has "updated" RFK Jr.'s article to "correct several inaccuracies":
NOTE: This story has been updated to correct several inaccuracies in the original, published version. As originally reported, American preschoolers received only three vaccinations before 1989, but the article failed to note that they were innoculated a total of eleven times with those vaccines, including boosters. The article also misstated the level of ethylmercury received by infants injected with all their shots by the age of six months. It was 187 micrograms - an amount forty percent, not 187 times, greater than the EPA's limit for daily exposure to methylmercury. Finally, because of an editing error, the article misstated the contents of the rotavirus vaccine approved by the CDC. It did not contain thimerosal. Salon and Rolling Stone regret the errors.

I'll bet they do. One only hopes they are starting to regret having published such a trashy piece of "investigative journalism."

Hat tip to Autism Diva.

14 example(s) of insolence returned:


At 6/23/2005 9:43 AM, Anonymous Flex said...

Hmm,

There are two additional questions I have about the retraction.

First, it implies, but does not state directly, that the 187 micrograms of ethylmercury is a cumulative amount spread over six years. It could be inferred that each shot contains 187 micrograms of ethylmercury. Which is the correct conclusion. I suspect the first possibility, but don't have enough knowledge to be certain.

Second, the statement about the level of ethylmercury being only 40% greater than than the EPA's limit for daily exposure needs clarification. Is that the adult limit? The limit for newborns? Or something in between? A child develops very rapidly in the first six years of growth, I would not be surprised if the acceptable limits changed as well. Particularly if the limit is a fixed amount, like 130 micrograms.

Not that I believe that there is any link between autism and thimerosal. I think that this whole controversy derives from the concerns over the MMR vaccines in England a decade ago. The MMR to autism link was shown to have no causal link, so now a new culprit has been found. Unfortunatly, this new culprit ties well into our culturally learned fear of toxicity. Mercury = Bad has been a mantra for so long that any mention of mercury raises alarm.

As I am continually reminding people here at work. The poison is in the dose.

Keep up the good fight,

-Flex

 

At 6/23/2005 5:11 PM, Anonymous Anonymous said...

the statement, as quoted, compares the vaccine dosage's content of ethylmercury to the daily exposure limit for methylmercury. is this a typo, an oversight, or a necessary compromise due to some circumstance left unstated?

 

At 6/23/2005 6:09 PM, Anonymous Anonymous said...

Last night ABC news ran a very rational piece on RFK Jr.'s stories as were published in Rolling Stone and on Salon.com. Surprisingly enough, the story was completely lacking in sensationalism, at least in my opinion. The focus was to reveal that hard science has yet to find a causative link between immunizations and autism and to clarify that RFK Jr. took many of the comments he used in his articles out of context, twisting the true nature of the information. Within the segment there was a video clip of the head of the IOM making a credible statement about the professional and impeccable means by which this body considers scientific data and makes decisions. At the conclusion of the piece, Dr. Timothy Johnson stated that as a physician and grandparent he feels the benefits of immunization far outweigh the risks.

After reading all the posts and comments here lately, I guess my point is that it was refreshing to see a mainstream news organization handle a controversial and timely topic with some dignity and sanity.

 

At 6/23/2005 9:14 PM, Blogger Orac said...

I missed the ABC report, but my wife told me about it. No doubt the mercury-autism crowd will claim it was bought and paid for by the pharmaceutical companies.

 

At 6/26/2005 5:25 PM, Anonymous Anonymous said...

I am sorry. You may be smart, but you aren't doing your homework very well. There are credible studies linking thimerosal exposure with neurological problems. See Hornig's study of mice and Jill James study of methylation pathways in children diagnosed with autism--(perhaps wrongly--maybe these kids were just mercury poisoned and true autism is something else entirely). There is a huge amount of evidence of the toxicity of mercury. The EPA safe dose is 0.1mcg per kg. That means a safe dose of methylmercury for a 10 pound baby (and that is a big baby) would be 0.5 mcg. From what I read, the amount contained in many vaccines for infants is 25 mcg per 0.5 ml dose. Some kids get several vaccines at once. While the content is ethylmercury not methylmercury and some have argued that this entirely different, a recent study by Burbacher et al. showed that in fact, in a lab test with monkeys, injected ethylmercury gets deposited in the brain in larger amounts than injected methylmercury, suggesting that if anything, ethylmercury is potentiallly more dangerous. If the information on the inability of some kids to excrete mercury is correct, then many kids have gotten cumulative doses of mercury far in excess of 187 mcg from their shots alone. They could well have gotten additional mercury from foods, air pollution, or other sources. It is interesting that some species of yeast that occur in the intestines are methylators of mercury.

There may be a lot more to the autism mystery than just thimerosal, and I really can't comment on the political intrigue aspects of the controversy that RFKJr. reports. But I am convinced that this issue demands further study, and I think RFKJr has shown tremendous courage in coming forth with his concerns.

I personally think that you are on the wrong side of a flat earth argument here. I suspect the real problem, more than any conspiracy, is that too many people relied on others for information instead of investigating the facts for themselves with open, skeptical minds. It seems likely that a combination of factors are involved, perhaps including environmental levels of mercury and other contaminants, antibiotic use, and maybe nutrient-poor diets. Nevertheless, I think there are excellant reasons to suspect thimerosal as a triggering factor and to question why on earth it was not immediately withdrawn from use given the lack of evidence that it is safe, in contrast to the evidence that it may be extremely harmful. How many years did it take the propoents of the H. pylori bacteria hypothesis as a cause for ulcers to convince the medical community? How many years was continental drift rejected?

I urge you to look into the thimerosal question more thoroughly and with an open mind.

Sue

 

At 6/26/2005 8:38 PM, Blogger Orac said...

I have looked at it. The evidence for a connection between thimerosal and autism is weak to nonexistent. The Geiers' studies are a complete mess, so much so that even the NYT cited the methodological problems with them. Hornig's studies do not show mice getting autism, claims of activists to the contrary, as the mice develop problems that do not resemble autism. Even Hornig herself does not make that claim, if you read the complete actual paper.

Similarly, you seem to be missing studies on the pharmacokinetics of thimerosal that show that it is rapidly eliminated in the stools of infants and does not accumulate above safe levels in the blood. There are also the five large studies that have failed to find a link.

Epidemiological evidence tends to trump all these theoretical concerns. As I have said before, I'll happily admit I was wrong if autism rates in the U.S. plunge over the next 5-10 years. If they do not, then will you admit there was no link?

As for your suggestion that I'm "on the wrong side of a flat earth argument," well, that's just hyperbole, and the next few years will tell us who's the flat-earther, won't they? Somehow, even if autism rates don't fall, I predict that they'll still be pushing a mercury-autism link.

Finally, I never said that thimerosal is completely benign. It may or may not be. I simply said that the evidence for a link between its presence in vaccines and autism is very, very weak. There may be other reasons for getting it out of vaccines, but a highly dubious link to autism isn't one. If it weren't so weak, David Kirby and RFK Jr. wouldn't have had to resort to the distortions they have. I don't think RFK Jr. was "courageous" at all in coming forward with this, and I think he deserves a lot of what is coming his way.

 

At 6/26/2005 8:39 PM, Blogger Orac said...

Correction: I meant to say that I'll happily admit that I was wrong if autism rates plunge 5-10 years from now, now that the thimerosal has been removed from childhood vaccines in the U.S.

 

At 6/30/2005 4:40 AM, Anonymous Anonymous said...

You state, ”I have looked at it. The evidence for a connection between thimerosal and autism is weak to nonexistent. The Geiers' studies are a complete mess, so much so that even the NYT cited the methodological problems with them. “

I wouldn’t use the NYT as an unbiased source for science critiques. Their latest piece was an editorial, not a news report. That said, I am not convinced by the Geier’s either. They do have a conflict of interest. But neither am I convinced by the epidemiological studies. Without actually seeing the original data, or having a third neutral party see it, it is impossible to evaluate how accurate the analyses are.

So why won’t CDC allow independent researchers all the original data they relied on in their big report? Why has the data apparently been lost or corrupted? Given that they won’t hand it over for analysis by an independent group of scientists, and the strong reasons that public health and pharmaceutical companies have to cover up results that aren’t in their favor, it seems reasonable to me to set aside the epidemiological studies and just look at other evidence to see what it shows.

I have read Hornig’s work. The mice in her study develop odd behaviors. Kids being diagnosed with autism today have odd behaviors: hand flapping, irritable and constant tantrumming, chewing on all kinds of stuff like beavers, head banging, poop smearing...the list goes on and on. So the fact that very odd mouse behaviors resulted from injecting a strain of mice with compromised immune systems with thimerosal in dosages comparable (when adjusted for body weight) to those injected into humans indicates to me that it is plausible that injected thimerosal could cause neurological damage and lead to odd behaviors in children with compromised or unusual immune system responses.

As for the studies on what happens when thimerosal is injected, you don’t seem to have read Burbacher et al.’s recently published (April 2005) work (injecting monkeys with mercury) which found that ethylmercury clears from the blood rapidly, but unfortunately some of it gets converted to another form of mercury and ends up trapped in the brain rather than being excreted. So, the defense of thimerosal claims that ethylmercury is somehow less toxic than methylmercury must be strongly questioned, if not thrown out entirely.

As for the five large studies, I am afraid I can’t debate you if I don’t know precisely which studies you are referring to. If you mean the epidemiolgical evidence, then I already told you why I think it is reasonable to set aside one of those studies to see what other kinds of investigation show. By their nature, epidemiological studies may be helpful and provide clues, but by themselves, they do not provide “proof” of no connection, even assuming that they were reasonably well designed, the data collected fairly, and analyzed properly. There are just too many variables involved when you are trying to find the effects of something on a small portion of a population (with a different genetic mix) that lives in a very different environment and was subjected to a very different vaccine schedule. On top of that, given the high stakes in this issue, it is not inconceivable, that there might be something fishy about the way the studies were run. That is why I think it is imperative to look at other kinds of evidence--pro or con. The main evidence in favor of “no harm” is that millions of kids were vaccinated and are doing great. But that doesn’t prove that no children are harmed; or that no children end up with autistic behaviors due to thimerosal in vaccines.

I'll very happily admit I was wrong--I actually would like to be wrong--if autism rates in the U.S. remain level or continue to increase over the next 5-10 years AND it can be independently confirmed that all the lots of childhood vaccines, flu, and Rhogam shots, (and any others yet to be mandated) in use in the U.S. for children and pregnant women were indeed thimerosal free during this time period. Looks like we aren’t going to have that situation. Independent tests of some of the supposedly thimerosal-free vaccines showed that they were not truthfully labeled. And infants and pregnant women are advised to get the thimerosal laden flu shot. Rhogam shots still have thimerosal. Actually several shots for kids are still being produced with thimerosal in them--look here: http://www.vaccinesafety.edu/thi-table.htm Indeed, there seem to be thimerosal laden shots of various sorts with expiration dates as far out as 2006. Why?? Since not all manufacturers use this preservative, I have to conclude it is not essential.

It seems to me that the government missed a perfect opportunity to get some relatively fast and real answers to this question when it was decided by Congress that thimerosal should be removed to ensure vaccine safety. Why didn’t they just err on the side of caution and pull the thimerosal versions completely from the shelves everywhere, or at least within a year or two? Too expensive? For whom? Billions of dollars get wasted on all kinds of things--is protecting kids from possible harm so unimportant that it is better to err on the side of the bottomline of pharmaceutical companies, than to err on the side of the health of thousands of kids?

I used what you call hyperbole to express my contention that I think you are on the wrong side of a losing argument. I didn’t accept that there was a connection for quite a long time. In fact, I began investigating it five years ago when a friend reported that her child, who reacted to a vaccination and was later diagnosed as autistic responded to alternative medical treatments with remarkable improvements. I was very skeptical of the explanation involving mercury in vaccines which she was convinced of at the time. I remained very skeptical for years, but found reasons to continue paying attention to the hypothesis and related research. I changed my mind as I watched her boy continually improve, read and heard about many vaccine reactions followed by similar partial or complete “recoveries” from alternative treatments, and finally when the recent studies emerged, providing a plausible model of why some children may be affected while most aren’t. I now think the hypothesis that mercury in vaccines is involved is very likely correct.

But accepting this possibilty required me to make a major paradigm shift and accept that the vaccine program might not be as beneficial to everyone and as safely run as I had been taught, and always believed, and that, despite the charlatans and highly questionable treatments involved in some alternative medicine, the essence of holistic medicine, and perhaps some of its criticized treatments, might be valid. (It should be said though that chelation is the mainstream medical method for treatment of heavy metal poisoning, so if these kids have this, and their lab reports show they do, chelation is not an alternative medical treatment, it is the accepted and only one available. )

I made the paradigm shift and reached my current opinion well before Evidence of Harm or Kennedy’s article came out. I am glad they have brought this question to the forefront now so that perhaps the truth can be discovered. I think this debate has turned into a real science investigation finally--now all the results of all research are getting carefully critiqued by everyone--not just peers who face a lot of subtle and not so subtle pressure to maintain the status quo and may be unwilling or unable to see what is right in front of them. How long did it take medical doctors to accept that hand-washing between patient visits might be a good idea?

Once you make the paradigm shift, and start looking at the arguments suggesting that mercury might be involved with the increase in autism, and possibly a variety of childhood developmental problems, the hypothesis starts looking very plausible. It is impossible to deny the similarity between the symptoms of mercury-poisoning and the behaviors and health problems parents are seeing in their kids diagnosed with autism. It is impossible to deny that there are many, many kids who seemed healthy and normal who mysteriously suffered abrupt changes in mental and physical health immediately or soon after receiving vaccinations. Only someone who is in complete denial could fail to admit that this suggests the possibility that certain kids have serious problems with something in the vaccines. So the question then is what is different about these kids, and what could they be reacting to? The JIll James studies showing that severely autistic kids have impaired methylation pathways, and are potentially less able to excrete toxins like heavy metals, definitely supports the mercury hypothesis, as do the studies by Hornig and Burbacher et al. mentioned above.

Most confounding, while mainstream medical doctors are telling parents that their kids are destined for institutionalization, or can only be treated by expensive, intensive behavioral therapies and often dangerous antipsychotic drugs--which often seem to cause as many problems as they cure, many parents are finding that in fact they can greatly improve their kids’ behaviors and abilities by changing their diets, giving them vitamin and mineral supplements, probiotics, and treating them with chelating chemicals that remove mercury and other heavy metals from their bodies. These parents are finding, whether you like it or not, that these kids do have heavy body burdens of mercury and other metals, and removing these often leads to remarkable recoveries. Many of these reports include medical reports and video documentation.

Now how much of their mercury body burden comes from thimerosal in vaccines is a good question, but given the discovery that mercury is somehow involved, it seems ludicrous to continue injecting any mercury into any kids!! And one has to ask, why in the world isn’t the mainstream medical establilshment--the CDC, the FDA, the AMA, beating a path to the doors of the parents and doctors claiming these recoveries to investigate their claims and figure out what is going on?? Do they care about kids, or just statistics, population studies, and figuring out how best to prove that they really didn’t make a huge mistake?

I am glad you admit that thimerosal is not completely benign. Don’t you think you are understating its toxicity, just a bit?? Personally I wouldn’t even want to have to handle the stuff or I’d be conducting some experiments and submitting grant proposals myself.

As I previously stated, I don’t think the thimerosal in the vaccines is the sole part of this big puzzle of increasing “autistic spectrum” behaviors among children. But I think it is a contributing, perhaps triggering factor, and possibly the key to unlocking exactly what is going on. I suspect we are looking at the results of a combination of factors, including rising levels of environmental mercury contamination, the grain and sugar-rich American diet, antibiotic overuse, and the varied ability of individuals to excrete mercury and other metals, which may be related to varied genetics, immune stress, varied microbe populations in the human gut, associated toxin loads, or all of the above. Getting rid of mercury in vaccines probably won’t get rid of all autistic disorders, but it seems very likely to be a big step in the right direction. I suspect it would, hopefully will, lead to a decline in autism incidence.

David Kirby showed great skill in writing a compelling account of one of the most intriguing medical mysteries of our time from the perspective of a group of folks who have been unfairlly maligned as a lunatic fringe, when in fact they include many doctors, nurses, chemists, and other well-educated, thoughtful people who feel that the government has not been honestly investigating the possibility of a mercury connection. He states in the introduction that he is intentionally writing the book from the perspective of the parents who brought forth the mercury hypothesis, so criticisms of his writing style or presentation fall flat.

Robert Kennedy Jr. is not a scientist. He presents the case as any effective lawyer should, in a manner which states the evidence in the strongest possible terms. I understand why scientists like Fineberg are reacting so vehemently. I think it is quite likely most, maybe all scientists involved were just trying very hard to balance their uncertainty against the huge costs and allowed their doubts to prevail due to the paradigm from which they viewed the issue at that time. As a scientist who has worked for government (in a different field), I have seen the wording of reports and recommendations modified to suit superiors, or in favor of outside interest groups when an alternative decision was more justified by available information, so I know this sort of thing happens. A lot of scientists say it is happening more blatently and frequently now than ever before. So, unfortunately, Kennedy’s approach may be just what is required to get more serious attention paid to the very plausible hypothesis that toxic mercury in vaccines may be at the root of the growing incidence of childhood developmental disorders, and to get precautionary decisions enacted.

Whether or not there is a conspiracy to hide the truth, or just a lot of people following directions from their superiors, relying on what they were told instead of investigating for themselves, or just seeing the world through a paradigm that doesn’t allow, or can’t consider, the possibility of such a huge mistake, or the possible value of alternative medical views, ......or exactly what is going on, I certainly can’t say. But I do think that the mercury hypothesis ought to have been, and must now be, investigated much more aggressively. And in the meantime--until we know for sure what is going on, all mercury needs to be removed from all vaccines.

Agencies entrusted with public health ought to be clearly erring on the side of caution to protect health. Mainstream medicine also needs to take a long hard look at all the reports of kids “recovered” by alternative medicine that are flooding the internet consciousness of America and beyond.

Before long, everyone is going to know firsthand of a child who “coincidentally” developed autistic behaviors following a vaccination and later was restored to at least a semblance of health by the very methods and doctors that are currently being characterized (by some i.e. the NYT) as expensive snake-oil. Unlike many highly trained scientists and doctors, most people tend to believe what they see with their own eyes over what they are told or read in some report. If a study’s findings don’t match personal observations, then a reasonable assumption is that something is wrong with the study.

Suffering and recovering children are the catalyst powering hundreds, maybe thousands, of passionate, intelligent parents, as well as many politicians, scientists, and journalists in this debate. You can label them all lunatics, or start listening.

Sue

 

At 7/12/2005 5:54 PM, Anonymous CurtCameron said...

Sue wrote:
As for the studies on what happens when thimerosal is injected, you don’t seem to have read Burbacher et al.’s recently published (April 2005) work (injecting monkeys with mercury) which found that ethylmercury clears from the blood rapidly, but unfortunately some of it gets converted to another form of mercury and ends up trapped in the brain rather than being excreted. So, the defense of thimerosal claims that ethylmercury is somehow less toxic than methylmercury must be strongly questioned, if not thrown out entirely.

I've read that study, and it doesn't seem to say what you think it says. A higher percentage of the mercury in the Thimerosal-injected monkey brains was the inorganic form (as compared to the methyl-mercury injected ones), but this is relative to a much lower overall level of mercury. A higher percentage of a much lower number is an amount that's about the same. But that's just the inorganic part - the amount of mercury was dominated by the organic kind in each case (ethyl for the Thimerosal group, methyl for the others), and the total mercury was very much lower in the case of ethyl.

 

At 7/13/2005 12:45 AM, Anonymous Anonymous said...

I invite you and others to reread the paper as I just did to be certain that I had not misinterpreted the authors’ findings. Here is a link: http://ehp.niehs.nih.gov/members/2005/7712/7712.pdf

I stand by my statement and interpretation. Please note that the author states the average *absolute* concentration of inorganic mercury left in the brain 28 days after thimerosal injection was 16ng/ml (p 16, 1st paragraph) whereas the average brain concentration 28 days following injection of the same amount of methylmercury was only 7-8 ng/ml in the 10 monkeys (of 17) in which it was found in ANY detectable amount (p 14 second paragraph).

Here are some passages selected directly from Burbacher et al.’s paper:

“Absolute inorganic Hg concentrations in the brains of the thimerosal-exposed infants were approximately twice that of the MeHg infants. Interestingly, the inorganic fraction in the kidneys of the same cohort of infants was also significantly higher following i.m. thimerosal than oral MeHg exposure (0.71±0.04 vs. 0.40±0.03).”

“Data from the current study predicts that while little accumulation of Hg in the blood occurs over time with repeated vaccinations, accumulation of Hg in the brain of infants will occur. Thus, conclusion regarding the safety of thimerosl drawn from blood Hg clearance data in human infants receiving vaccines may not be valid, given the significantly slower halflife of Hg in the brain as observed in the infant macaques.”

“Results from an initial Institute of Medicine (IOM) review of the safety of vaccines found that there was not sufficient evidence to render an opinion on the relationship between ethylmercury exposure and developmental disorders in children (IOM 2001). The IOM review did, however, note the possibility of such a relationship and recommended further studies be conducted. A recently published second IOM review (IOM 2004) appears to have abandoned the earlier recommendation as well as back away from the American Academy of Pediatrics goal. This approach is difficult to understand, given our current limited knowledge of the toxicokinetics and developmental neurotoxicity of thimerosal, a compound that has been (and will continue to be) injected in millions of newborns and infants.“

from: "Comparison of Blood and Brain Mercury Levels in Infant Monkeys Exposed to Methylmercury or Vaccines Containing Thimerosal" Authors: Burbacher TM, Shen DD, Liberato N, Grant KS, Cernichiari E, Clarkson T. 2005. National Institute of Environmental Health Sciences, April 21, 2005


In my opinion, based on this study, the potential harm from mercury in thimerosal can not be predicted based on previous studies of the effects of methylmercury as these two forms of mercury do not clear from the blood or brain in the same ways. If inorganic mercury in the brain is at the root of most of the neural damage caused by mercury exposure, then ethylmercury may be far more toxic than methylmercury. So, based on the findings of this study, all assertions about the comparative safety of ethylmercury and thimerosal must be strongly questioned.

Sue

 

At 7/23/2005 1:41 AM, Anonymous Anonymous said...

One correction to my post above. In Burbacher et al.'s study, the monkeys "ingested" the methylmercury, it was not injected. So the results indicate that injected thimerosal is likely more toxic than ingested methylmercury.

Sue

 

At 7/29/2005 3:54 PM, Blogger Rockstar Ryan said...

Jesus L. Ron Hubbard Christ Sue. Get off the soapbox and get your own f___ing blog. Comments are cool, articles are not. Man that irritates me.

 

At 7/29/2005 4:30 PM, Blogger Orac said...

Hmmm. Perhaps you have a point, Rockstar. In my belief in free speech, I may be running too loose a ship.

This is my blog! I'm the only one allowed to post long-winded meandering commentary!

 

At 8/01/2005 10:11 PM, Anonymous Anonymous said...

Hi. I'm the parent of an autistic 8 year-old boy, and I'm searching for answers or something that might help. I've only recently learned about the thimerosal issue, (because of the RFK Jr. article) and I appreciate the opposing arguments shared here. This whole back and forth is going on in my head right now too. Please don't ask folks to keep it short. You're helping. If we don't like it, we can always skim and skip. I intend to read every research article mentioned. I'm going insane over this stuff. I need to know the truth, so I can help my son.
Jane

 

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