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SEPTEMBER 25, 2008 1:44PM

David Kirby Smacks Me Down

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David Kirby wrote a rebuttal to my book review  in Salon  of Dr. Paul Offit’s new book, Autism’s False Prophets.

 

Here’s a link to his post:

 

“Dr. Parikh, I am Becoming Embarrassed for You.”

  

Far be it for me to change Mr. Kirby’s mind.  On the other hand, I didn’t write the review to persuade him or those like him who religiously believe in this autism-vaccine link.  I write about autism and vaccines to make sure that parents understand that their child’s doctors care deeply about them and that vaccines are safe and effective.  Like anything else in medicine, they have risks.  But autism isn’t one of them, and the benefits of vaccines clearly outweigh the risks for both a single child and our society as a whole. 

 

But since he makes some claims, I’d like to clarify a few points:

 
  • He’s never invited me to “debate” him.  The only invitation I’ve ever received to debate anybody about this came earlier this morning via my email, where the manager of autism one radio asked me to debate Andrew Wakefield.  I declined that invitation because, as one person said, I don’t want to be the one bullet believer amongst a bunch of grassy knoll conspiracy theorists.  But neither Mr. Kirby, nor anybody representing him, has ever contacted me.  But I did email him through his website today to ask him if he’s been emailing the wrong person and to let him know about this rebuttal. 
 
  • He’s right that Autism Speaks does sponsor some anti-vaccine research, but as opposed to Mr. Kirby and the organization that pays him (Age of autism) or Jenny McCarthy’s group (Generation Rescue), they don’t exist solely to try to prove a vaccine-autism link.
 
  • Mr. Kirby’s response is also a pretty clear case study of the usual methods anti-vaccine folks use to defend their point of view
 

·        Attack the messenger:  “Some Pediatricians are thoughtful. Others are just plain, (well, let's be polite) "belatedly informed." 

 

A more typical example of this is when anti-vaccine folks say that doctors who speak to the safety of vaccines are all paid speakers for vaccine makers or are somehow doing it on their behalf.  Mr. Kirby didn’t do that here, but that’s because I added my disclosure to the end of my article: 

 “Dr. Parikh does not have, nor has he ever had, any relationship, financial or otherwise, with vaccine makers or other other pharmaceutical companies.”  

·        Demand we stop speaking up: “Dr. Parikh – Please get your rhetorical ducks in a row, or refrain from participating in this discussion altogether.”

 Letters and emails that I’ve received from past articles I’ve written about autism and vaccines have demanded that I (or my editors) retract what I’ve written.  Mr. Kirby is a lot more restrained here than others, but his point seems to be the same:   View different than theirs should not be allowed. 

 

·        Cite studies that have very little relevance:  “Three projects will focus on the potential role of vaccines, specifically the role of ethylmercury or other vaccine components. These include a project by Dr. Flavio Keller at the University Bio-Medica in Rome, who will study the behavioral and pathological effects of ethyl and methyl mercury on a strain of mice that possess a certain mutation in order to examine gene and environment interactions. Dr. Mark Noble from the University of Rochester will use a genetically modified cell line to study the effects of ethylmercury and aluminum hydroxide on oxidative potential. Finally, Dr. David Baskin from Methodist Hospital in Houston will study cell proliferation in response to thimerosal exposure.”

 

Lately, anti-vaccine folks have been funding and citing a series of animal studies demonstrating thimerasol is toxic.  But none really furthers the case that thimerasol causes autism (I’ll get to aluminum below).  For one thing, the relative concentration of thimerasol animals are exposed to in these experiments is very different than in kids.  Here’s why:  In pediatrics, we dose drugs and therapies by weight, so kids who are heavier get more.  This ensures medicine is effective and safe.  If you give, as has happened in many of thee animal experiments, the same amount of thimerasol to a rat or monkey as to a child, you’re giving much greater relative amount because these animals weigh much less than a child.  Just about anything given in high enough amounts can be toxic.    An example of this is the Ames cancer test, in which you can place any suspect chemical onto a testing medium that reacts if that suspect chemical is carcinogenic.  The thing is, the Ames test reacts to just about everything you put on it if you add enough of it.  Think of these animal thimerasol experiments like placing infinite amounts of mercury onto the Ames test—it will cause a reaction and then every anti-vaccine advocate will declare that they’re right. 

On the other hand, the latest MMR study looking at people (the link is in my review) that came out showing (once again) that there is no link between it and autism was very relevant for many reasons—first, it essentially reproduced what Wakefield did and contradicted his findings.  Second, the study was designed with the input and participation of groups who are against vaccines.  A unique and interesting collaboration. Mr. Kirby hasn’t commented on this study anywhere—he knows about it, since sources tell me he was part of a conference call with the media when the study was released. 

              A couple of other methods Kirby did not use here, but others he supports do use:

·        Move the target:  First it was MMR, then it was thimerasol.  Now that studies have shown they’re both safe, anti-vaccine folks are moving on the aluminum, “antifreeze” (there’s no antifreeze in vaccines), to anything else that helps make the safe and effective.  I’ve even seen studies that blame Tylenol for causing autism coming from this camp.  In short, the whenever scientific research debunks the latest culprit in vaccines, they move the target. 

  • State you're not anti-vaccine:  Mr. Kirby and others (most notably Jenny McCarthy) love to say they are not "anti-vaccine" they want our vaccines to be safe.  On the other hand, isn't that what every study has shown us?  So it's a hard one to buy (perhaps we can call them "pro-infectious disease" instead?)

·        Good P.R:  One page ads in newspapers to scare parents, celebrity endorsements, political hearings—all of these are tools that anti-vaccine folks have used to make their case. Psychologists call this the “principle of social proof” or "social authority."  Advertisers use it a lot to sell products.  Have someone with stature stand next to you and endorse you or what you’re trying to sell.  It’s a quick way to get credibility and publicity for your agenda.  Anti-vaccine folks have been very effective at doing this.  Offit makes this point when he reveals that Generation Rescue (the ones who placed those one page ads) hired the same P.R. agency that those who sued the maker of silicone breast implants used a couple of decades ago.  Lately, that P.R. campaign has taken on the slogan "Green Our Vaccines."  But what, exactly and specificially, does that mean?  Removing everything from vaccines that anti-vaccine folks think are poisonous would, well, be eliminating vaccines.  After all, it's some these components that keeps them safe and effective.  Before thimerasol, for example, some children would die from infection because they were given a vaccine from a contaminated vial. 

 

Again, the question we need to ask of Mr. Kirby’s response (or any other argument coming from anti-vaccine advocates or groups) is the following:  Does anything he said show that vaccines cause autism? Isn't that the question he seems to keep posing? 

I don’t believe so.  So instead of attacking the messenger, citing irrelevant science, moving the target, demanding that alternative views to theirs be squelched, or relying on slick slogans and celebrity endorsements, I would ask Mr. Kirby to clarify why he still believes vaccines cause autism, especially after we see his rationale explained in Dr. Offit’s book.  

  ______________________________________________-

Addendum 9/24/08:  Mr. Kirby has not responded to my email yet.  On the other hand, he's busy briefing a NY congresswoman and 130 other members or staff of other other politicians on the autism issue.  The hearing is run by a congresswoman who is, by her record, is anti-vaccine.  In other words, it will be like Dan Burton's hearing as described in Offit's book.  To make a more modern day comparison, as critical an interview as Sean Hannity interviewing Sarah Palin.  To my knowledge, there are no opposing views being aired. 

  

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Be flattered! They only respond when they are frightened and the truth about vaccines always frightens vaccine rejectionists. How could they have any influence if people learned the truth?
Behind Blue Eyes:

"Then why did the vaccine companies settle?"

Settle what?
Rahul,

Thank you for your well thought out responses to those individuals and groups who oppose vaccinations for children. It is shocking to think how things would be know if these groups had been around in the 1950s when the first polio vaccines were being introduced and during the efforts to rid the world of smallpox.

Vaccines have substantially reduced, if not eradicated, many common, and sometimes deadly communicable diseases. In some respects, I believe this success has allowed many people today to forget what a devastating effect these diseases had on individuals, families, and communities. I worry that if the anti-vaccine groups become more effective in propagating their misinformation, we may see a large scale reemergence of one or more of these diseases.
Behind Blue Eyes:

"Big pharma is trying to bluster that a settlement doesn't mean admitting liability, but it does make you wonder. "

You shouldn't wonder. It's pretty straightforward.

The Polings claimed that their daughter's rare genetic disease led her to have unusual complications after vaccination. The settlement was made in acknowledgement that vaccines cause unusual reactions in children who have this rare genetic disease. That's it.

What's so ironic about vaccine rejectionists publicizing the Poling case is they ignore some basic facts about vaccines and liability. Vaccine manufacturers and the Federal government routinely warn parents that vaccines can cause brain damage and death. The chances are low, but it happens to some children each and every year. The government has actually set up a compensation fund to compensate for brain damage and deaths that the manufacturers and government fully acknowledge as caused by vaccines.

Therefore, it is rather ludicrous to suggest that the same people who tell you that vaccines might kill your child or render your child permanently and profoundly brain damaged are somehow hiding the "risks" of vaccines.
Behind Blue Eyes:
Perhaps this piece I wrote about the Poling autism settlement can help clarify the meaning of that decision, which is not that vaccines cause autism:

"What the Poling Autism Case Means"

http://www.salon.com/news/feature/2008/03/13/poling/index.html
Oh my God! There is a group called Defeat Autism Now? That would be like black helicopters to me. Thank God it's bedtime or I'd go somewhere to huff and puff. Please, Dr. Parikh, I have a semi-quasi-demi-ersatz interest in your work, though I am the complete layman, and I really don't belong at your blog, but at the same time I think I have a question for you. In the month before my father was to take the whole family to French Indochina, I received at least 30 innoculations and/or boosters. I guess there was a lot of shit to be "a-scared of" in those days. Tell me - am I just some Deidre Imus terrorist, using the cover of OS to launch sneak attacks? Or are you sincere about debating it all? Because for me, this shit matters. And Mr. Kirby, you had a fine Pig Shack, until they tore it down, but if I ask, pretty please, would you add to the discussion? A reasoned discussion?
Oh my God! There is a group called Defeat Autism Now? That would be like black helicopters to me. Thank God it's bedtime or I'd go somewhere to huff and puff. Please, Dr. Parikh, I have a semi-quasi-demi-ersatz interest in your work, though I am the complete layman, and I really don't belong at your blog, but at the same time I think I have a question for you. In the month before my father was to take the whole family to French Indochina, I received at least 30 innoculations and/or boosters. I guess there was a lot of shit to be "a-scared of" in those days. Tell me - am I just some Deidre Imus terrorist, using the cover of OS to launch sneak attacks? Or are you sincere about debating it all? Because for me, this shit matters. And Mr. Kirby, you had a fine Pig Shack, until they tore it down, but if I ask, pretty please, would you add to the discussion? A reasoned discussion?
I'm sorry. Call me "thumbs." I had a singular interest.
For the record, I have a close friend involved in autism education, she has been actively involved in the teaching of autistic children for well over a decade now. She's earned a Master's degree from UCLA training under Ivar Lovaas for several years. Sadly, her business is booming. Of course I'm happy for her success because she's genuinely concerned for her clients and does her best to help parents understand the challenges they are facing.

She has two beautiful children and of course, the question begs to be asked and I did ask her several years ago... "What do you think about the vaccine connection? Were your kids vaccinated?"

The look in her eye's was gentle and firm, with a slight shake of her head " No way...".
I'm pro-vaccine, myself.

I take every one I can get.
I've also worked with many wonderful individuals with autism for more than a decade. I would not hesitate to vaccinate my children.

I know more than one child who has never been vaccinated who has also been diagnosed with an autism spectrum disorder. Vaccines most certainly did not cause their autism. Many (but not all) of the kids I've worked with had signs something was wrong well before they were diagnosed or received the vaccine in question.

I've also seen kids go through chelation therapy, which is a common "treatment" often practiced by the same groups which oppose vaccines. It's a violent, painful and confusing experience for a kid who already has a difficult time communicating when something is wrong. Additionally, I've never seen a measurable difference in autism symptoms in a child who has been chelated.

I have seen behavior and attention gains after implementing "the autism diet" (gluten and dairy free), and I know of many parents who saw a decrease in sleep disturbances after starting the diet.

I'm not a doctor or a scientist, so my observations here aren't worth much. I do think it might be beneficial for the individuals who are critical of vaccines to utilize some of their well-honed skepticism in viewing the groups who are encouraging this debate.
Michelle,
you're comments raise a valuable question: How big a distraction is the vaccine discussion, especially when we're at a tipping point in terms of public awareness, support and funding for research into autism? How much of this precious time and money do we want to spend on this when we could be doing so much more valuable research?
Amy,
"be flattered."
Good point. Something Offit wrote in his book must have rubbed Mr. Kirby the wrong way
If you guys read rahul parikh's salon link you'll see that it's perfectly possible for vaccination to have played a role in exposing/exacerbating Hannah Poling's pre-existing condition while at the same time not posing any kind of danger to the vast, vast majority of children who do not suffer from mitochondrial disorders.
Dr. Parikh,

I agree with you completely, and science is on our side. But I fear for the moment that David Kirby and his friends are getting the last laugh. On Wednesday, Sept 24, David Kirby and pseudo-scientist par excellence Mark Blaxill are giving presentations to more than 130 Members of Congress on "the vaccine-autism debate." See http://www.ageofautism.com/2008/09/rep-maloney-to.html and http://www.ageofautism.com/2008/09/is-your-senator.html. As far as I know, there will be no rebuttals by any scientists.
Autism is terrifying. Those childhood diseases aren't, because we've never seen them. So, I can easily believe that someone who works with autistic kids doesn't vaccinate theirs. The autism vaccine connection scare came out when my son (the nephew of a man with autism) was at the age to receive his first MMR. I was scared. My biggest fear when having kids was that I had a gene for autism and that my kids might get it. In the end, my son did get vaccinated and no, he did not develop any autistic symptoms.

In sharing my story, I heard others. A friend had a family problem with febrile convulsions after the DPT. She didn't vaccinate. Her son got Whooping cough -- and got completely better. She said it was the worst experience of her life and when her daughter was born, she vaccinated her.
EpiWonk--

thanks for reminding me--see my addendum
Russell Webb wrote:

"The look in her eye's was gentle and firm, with a slight shake of her head " No way...". "

What did you expect? The lady is a behaviorist and they don't do 'Science'. In any case, i wonder about the critical faculties of anybody who swallows the whole nine yards of Skinner's operant conditioning - psychology 1950s style.
Mr. Kirby is a lot more restrained here than others, but his point seems to be the same: Views different than theirs should not be allowed.

I attended the Autism One conference in Chicago last May. I asked for and received a press pass, and on the second day, during a Q&A with Drs. Poling and Wakefield, I asked Poling if he planned to release his daughter's medical records to the public. It was a reasonable question, given that he and his wife were on a coast to coast media blitz, talking about their daughter's condition to anyone who would listen.

But asking questions is not allowed. I was soon surrounded by hotel security, and escorted from the building. I wrote about the experience here:

http://autism-news-beat.com/?p=62#more-62

I saw the same intolerance in Washington, DC, during the Green Our Vaccines march. While journalist Arthur Allen was interviewing an anti-vaccine activist, a march organizer interjected herself in the interview, and asked our subject if we were bothering her. We clearly weren't, and the interviewee said she was fine with our questions. Here's the video:

http://www.youtube.com/watch?v=giIk40nScuo

David Kirby knows better than to make those claims. He said years ago that if autism rates don't fall five years after thimerosal was removed, then he would reconsider the thimerosal hypothesis. That date came and went three years ago, but Kirby is still here.

Mr. Kirby is not a journalist. He is a public relations advocate, using the tools of his trade, which you nicely outlined, to muddy the waters, confuse, obfuscate, and rile. I find it simply astonishing that Huffington Post and other media are still being played by this person.
Behind Blue Eyes: "Like many doctors, you seem to think...you know more than non-doctors. "

Damn straight. Physicians and scientists who've spent their lives taking care of vulnerable patients and/or researching this subject _do_ know a lot more about immunization than antivaxers like you.

We can't afford to let public health policy be dictated by credulous people who "feel" that there's just gotta be something ominous about giving multiple vaccinations at a time, and who blame vaccination, too much early TV, aluminum or god knows what for autism.

Your willful ignorance seems to be fueled mostly by hatred for physicians (despite your claims to the contrary). Hate doctors? Fine, visit your local homeopath. Just don't drag our kids into your foolish obsessions.





Giving five to ten vaccines in a day seems reckless to me. And the herd immunity of the many is an ends justify the means argument that just doesn't wash.

Autism probably has multiple causes from environmental pollutants to too much tv in the first years of life, but I am not willing to discount the dangers of that much mercury in such a short time.
When I read Kirby's dia(rrhea)tribe, it confirmed my already strongly held opinion of him being a rump. If he should ever decide to write his autobiography he should name it NO Evidence of Charm.

As for Blue Eyes, her mind is made up. She sees vaccines as evil, and no fact or science based logical argument is going to get her to even reconsider her opinion. She is a victim of Autism's False Prophets.

And, Dr. P., you are quite correct. These pro-infectious disease purveyors of disability and death, do not want to allow anyone who disagrees with them to be heard. As Ken Rei pointed out, he was ejected from a meeting although he had duly issued press credentials. Kirby, if he were a real journalist, and not a hack mouthpiece for 'the movement' should have been outraged.

Further, when Kathleen Seidel, of neurodiversity.com was served with a subpoena (that was eventually quashed), by an anti-vaccination attorney (yes, they do exist) it took a public letter from Orac, at Respectful Insolence, to get Kirby, and his henchman, Dan Olmsted (the 'investigative reporter who could not find any autistics in Amish Country-because he forgot to look at the Clinic for Special Children), came out of their caves and criticized the subpoena.

These people are terrified of science, truth and cogent, logical arguments. This is especially so when you have no CoI, as you do (but, I expect their minions to be searching and combing to find one.)

Keep up the great work.
Dr. Bernadine Healy makes many good points:

http://www.ageofautism.com/paul-offit-is-wrong-dr-he.html
Thank you, Dr. Parikh. Thank you for taking on Teresa Conrick and her airheaded antivax on Huffpoof, too. I wonder what it will take to get through to these people that they are acting like they are part of a cult and spreading lies about vaccines.
Anti-vaccine folks now cite Bernadette Healy as an authority on this debate.

She is an accomplished physician and respected medical thinker. But although she was on the Institute of Medicine Committee during the time they issues their vaccine report, she wasn't part of putting that report together. She is very far removed from this debate. However, anti-vaccine folks use her name as yet another endorsement. The principle of authority, as I said in my post.

Again, Doctor Healy's endorsement is not proof that vaccines cause autism. It may be an endorsement to do more research (haven't we done enough?). But let me ask you this: What will you do when all of that research shows nothing other than what we already know--vaccines don't cause autism? My answer to that is the answer we are already seeing in Mr. Kirby: You will obstinately just keep arguing the point by moving the target from one vaccine constituent to another, attacking studies and messengers who try to inform the public about the safety and effectiveness of vaccines, publishing junk science, refusing to let other views go up in your forums to inform readers, and using celebrities, politicians, and others as "social proof" that you are right.

None, however, can supersede the data from a good and relevant scientific study (of which we have dozens).
Dr p-

What about the susceptible group that she refers to? Are you turning your back on them?
Doc Tuteur has a particularly touching post up about how her father was treated while dying. He was essentially tortured by pricks like you and she was a doctor on staff at that hospital. While I like to think most docs are caring and mean well -- the more I run across know it all jack asses like you, the more I'm convinced med school is like law school -- full of unfeeling bastards chasing a buck.

Typical, if you can't fight the logic, go with personal attacks. This is why I reject the anti-vaccine arguments, after 2 posts they start with getting personal because they have no logic, no scientific evidence, to back them up. So they have to get nasty. Like that 's going to convince me
Dr. Parikh, keep up the good work.
By the way, everyone, if you want to see another good example of how anti-vaccine folks respond when somebody writes a piece skeptical of their views, take a look at this:

http://www.motherjones.com/commentary/columns/2008/09/practical-values-immune-to-reason.html
Arthur Allen's article, as usual is excellent. Fortunately, there are people whocan rebut and refute the pro-infectious disease crowd.
Dr Parihk wrote:

"Anti-vaccine folks now cite Bernadette Healy as an authority on this debate.

She is an accomplished physician and respected medical thinker."

I haven't had a very close look at this yet - do we have any real investigative journalists around here? It would seem doubtful that Dr healy is either accomplished (sacked from the Red Cross??) or a respected thinker. The lady is mostly self-serving with a marked predilection for the middle position, justified or not. Her involvement with this nonsense is certainly disturbing:_

http://health.usnews.com/usnews/health/articles/060903/11healy.htm


It was Ben Goldacre of Bad Science in the Guardian who pointed to this article.
Dr. Parikh,

I wish that Teresa Conrick or one of her merry band of moms-in-denial-and-in-desperate-need-of-anger-management-classes would explain which vaccines they think are good and why. I predict that they won't because they see all vaccines as intrinsically evil, their being totally and frighteningly irrational and unable to comment on the facts without totally changing the topic.

They believe, it would seem, that all vaccines should be demolished and all vaccine programs demolished, forever, as they are anti-vaccine. Then I would like to know how they plan on managing the future of mumps, tetanus, diphtheria, rubella, whooping cough, measles and chicken pox.

They seem to agree that the best way to deal with measles, mumps, rubella and chickenpox is with "parties" to make sure the kids get the germs before they turn an age at which it would be unfortunate to get the disease. For instance, they would agree that it's best for a child to get the mumps between age "X" and age "Y". Age "X" would be some time after age ??? 2 or 3 or 5 or 6? And age "Y" would be, some number before puberty hits? And they would manage measles by making sure that the kid gets measles... after... age 2 and before age 20? Whooping cough.. after age ??? 6?? and before age??? 20? I'm assuming they want moms to get rubella and whooping cough before they get pregnant and not get rubella while pregnant or whooping cough with a new baby at home. The baby might die before it's born even, or end up with brain damage, limb deformities or blind or deaf.

And diphtheria? Do they think it's something that one just knocks out with a few drops of homeopathic water under the tongue? Diphtheria came back in epidemic form in the former USSR when their vaccine program broke down as the economy collapsed in the 1990's. http://www.cdc.gov/ncidod/eid/vol4no4/vitek.htm

How about polio? Will they have polio parties? How do you have a polio party? Do you deliberately contaminate food or drink with fecal materia containing polio virus, since that is how it is spread as opposed to coughing...

And the flu? Is the flu our friend? Do we let our infants catch it? Does it matter how many children die from these diseases? I sincerely doubt that Teresa Conrick would care if thousands die from vaccine preventable diseases. All she knows is that someone made her daughter autistic and that someone is probably Paul Offit (don't ask me how she figures this) and that someone must PAY!!!
"Anti-vaccine folks now cite Bernadette Healy as an authority on this debate. "

David Kirby started with the phrase "Tell it to Dr. Healy". Dan Olmsted of the age of autism has picked it up.

The thing is, I did tell my issues with her assertions to Dr. Healy. No response.

http://autismlibrary.org/blog/tell-it-to-dr-healy/

She was a member of the IOM, which, as you point out, is not at all the same thing as being part of the IOM that looked at vaccines. Her assertions about how the IOM work are not consistent with my understanding of the National Academies, so I requested comment from them

http://autismlibrary.org/blog/asking-the-iom-for-clarification/

I would have greatly appreciated Dr. Healy responding. But, "tell it to Dr. Healy" is no the same as "get answers from Dr. Healy".
Hey Parukh,
During the course of your malpractice here, you missed a few things.

You forgot to mention how we prove that mercury caused the autism every time we cure a kid. You see, you nitwits inject our infants who don't have blood brain barriers with mercury and then we have to draw it out ourselves because you bastards won't help us. When we succeed, those cured kids make all of you MD's look like a bunch of retards for shooting 200 times as much mercury into our kids as you thought was safe.

I understand how "standard of care" prevents you from helping us correct your malpractice. You all have to stick together and perpetuate the lie that mercury doesn't cause autism and it can't be cured. If you don't all lie to us, it opens you up to being sued. So, instead of lying to us, why don't you just shut up? Because, the increasing numbers of cured kids make you look worse and worse every day. The more you say, the deeper you dig yourselves into a hole.
How can you say that the mitochondrial disorder that Hannah Poling suffers from is rare? When children are diagnosed with Autism they are not tested for mitochondrial disorder. Parents are now testing their children for this mitochondrial disorder. I have been hearing numbers of over 50% with this disorder which would certainly make it "not rare'.

It is interesting about mithochondrial disorder because in testing drugs on alzheimers patients the drug that works the best and the longest is Dimebon. Dimebon appears to have a potent effect on mitochondrial function. Aren't older people more likely to get those flu shots filled with thimersol and many different antigens every year?