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Anonymous wrote:This study will be a real example of fraud waste and abuse since there are already dozens of studies showing there is no link between vaccines and autism.
The validity of these studies are in question. You cannot trust the manufacturers or those who directly financially benefit from the products to be able to do an unbiased study.
https://pmc.ncbi.nlm.nih.gov/articles/PMC1124634/
No one serious is questioning the validity of those studies. At this point the only thing that we are sure doesn’t cause autism is the MMR vaccine.
- mother of a kid with autism
I'm not an antivaxxer, but let me play devil's advocate: the study you cited describes itself as a "retrospective cohort study" (rather than a prospective, double-blind, placebo-controlled study like the kind you often see in the drug-approval process). It also seems like it doesn't test vaccinated vs. unvaccinated but instead tests kids who got one particular vaccine (MMR) against those who did not. You could imagine an RFK acolyte say, "show me a placebo-controlled test where some of the kids were vaccinated and the rest weren't." What's the answer to that? Is it that that study has already been done? Is it that it hasn't been done but it's not worth doing? Is it that that study could be informative but would be unethical? Is it that that's a good idea and we should do it if it'll allay concerns?
It doesn’t appear that you are an expert in evidence based medicine. I don’t consider myself to be one either, but I did a residency in evidence based internal medicine at ucsf and there is way too much boring info I could spout about the merits and feasibility of different types of studies for different situations. I reviewed the “autism” link as a case study during my residency and I can tell you that many many smarter people than myself looked into it and agree that it’s a load of horses&$t and there is no need to squander more time or money on this. It deserves as much merit as the theory that has long prevented Pakistan from eradicating polio - that the polio vaccine was deployed by the CIA as a means to sterilize Muslim men. That theory resulted in 20k cases of polio a year in the 90’s.
And you can trust me, I’m an mit grad, and obviously a genius who is qualified to be an ATC. Actually only the first part is true.
I'm the poster you responded to. Thanks for the civil and interesting response. You're 100% correct that I'm not an expert in evidence-based medicine (or any kind of medicine), and, not to belabor the point, I'm also not an antivaxxer. But I think your message hits the nail on the head with what I'm grappling with: there are (I assume) as you point out a lot of ways to design a study. I certainly haven't read the autism-vaccine studies, and I'm definitely not questioning their conclusions. But is a foreign retrospective study without a vaccine-free control group really the most rigorous study we have that exists? (I'm not saying it is; I don't know!) If it is (or is at least close to it), then asking for a more rigorous study strikes me as... somewhat less crazy than I might have assumed?
I get your point that smart people have looked at this and said this has been conclusively proven. I'm not disputing that.
NP. There is no “vax vs unvax” study. None. There never has been, and there probably never will be. People claim that it would be unethical to deny people vaccines so they can’t have a proper control group. They are deliberately ignoring the fact that there are thousands of unvaccinated children in the US that they could use for study participants. I know for a fact that there are many people who would willingly allow their kids to be tracked and their health monitored as part of a study but nobody is attempting those studies. In order to do that, you’d need to release findings of complications - i.e. adverse reactions to the vaccine. These are hidden behind the sealed walls and files of vaccine court. Yes, there is a special secretive court in this country where vaccine injury claims are tried, and nobody is allowed to know what goes on there, what the complications were, how much people were awarded for those damages, etc.
I’m the one who has been replying to PP. Perhaps you know this already, but
every vaccine was originally tested in a “vax vs no vax” study, if by “vax vs no vax”, you mean a double blinded placebo controlled RCT. The covid vaccine was tested in that manner.
Your suggestion to find the parents who are willing to be tracked but would choose to be in the placebo group is not feasible because then the study would not be a placebo controlled double blinded RCT. The “R” means random. Having parent choose no vax is not random. You are suggesting a prospective cohort study or a case control in which two groups (one group who chose vaccination and one group who did not) are followed over time. There have been many such studies involving well over 1 million kids. See my previous post.
I am sure you're well intentioned, but is this actually true? I cannot imagine that, in a study for the approval of, say, an MMR vaccine, they would withhold, say, the polio vaccine. Removing multiple shots to determine the safety and efficacy of just one of them would pretty obviously be a confounding variable, no?
(One note: I recognize that anti-vaxxers would probably try to jiujitsu this into saying that this distinction means there has not been a study showing the relative health of totally vaccinated children vs totally unvaccinated children. But of course the purpose of these studies isn't to anticipate and refute the arguments of people with a particular agenda.)
Vaccine approval process in the U.S.
https://www.cdc.gov/vaccines/basics/how-developed-approved.html
The first MMR was approved in the 60’s after a series of clinical trials. The patients were divided into three group - vaccine, vaccine plus immunoglobulin (this was done because the incidence of fever was not uncommon with attenuated virus vaccines), and placebo plus immunoglobulin, and natural infection. Studies were also done in Nigeria.
You can read it here
https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.52.Suppl_2.16
The CDC is not responsible for placating irrational anti vaxxers by wasting money on studies that are not indicated. Having a layperson come in and say, what about totally unvaxxed vs blah blah blah should not drive what type of studies are done. I am furious that we are allocating time and money to study autism and vaccines. We may as well put time and money to investigating the four humors or whether earth, air, water, and fire are truly the four elements.
I am not sure what you mean by saying the polio vaccine is a confounding variable. Are you saying that you want to see studies of kids who just have MMR and no other vaccine vs unvaxxed? That is unethical since the polio vaccine was developed before MMR, and it is unethical to withhold a proven lifesaving vaccine for the purpose of a study. We are truly lucky that smallpox was eradicated before anti vaxxers invented themselves.
There are many poignant stories from the current and past measles outbreak in the U.S. about three generations of family members brought together in the icu by measles - the unvaccinated child intubated with pneumonia, the parents who chose not to vaccinate their child, and the distraught grandparents who suffered through measles themselves and did not hesitate to vaccinate their children, now parents of a child afflicted with measles.
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