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:
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.