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In reply to the discussion: Nikki Haley HPV Bill Veto: Bakari Sellers' SC Vaccination Measure For Middle Schoolers Fails [View all]proverbialwisdom
(4,959 posts)29. Last off-topic post on this thread by me.
http://www.ageofautism.com/2008/07/dear-dr-novella.html
Dr. Jon Poling to Dr. Steven Novella: Don't Attack the Moms
Managing Editor's Note: The following is a letter sent to Dr. Steven Novella, a neurologist at Yale University, from Dr. Jon Poling. (We've printed the letter with permission.) Dr. Novella is the founder of The New England Skeptical Society (meetings, 1st Tuesday of the month, on the lawn of the House of the Seven Gables, Salem, MA. BYOB (bring your own blinders.) and is a contributing editor to Quackwatch. Dr. Poling is a neurologist/PhD and the father of Miss Hannah Poling.
Posted by Age of Autism at July 22, 2008
Dr. Jon Poling to Dr. Steven Novella: Don't Attack the Moms
Managing Editor's Note: The following is a letter sent to Dr. Steven Novella, a neurologist at Yale University, from Dr. Jon Poling. (We've printed the letter with permission.) Dr. Novella is the founder of The New England Skeptical Society (meetings, 1st Tuesday of the month, on the lawn of the House of the Seven Gables, Salem, MA. BYOB (bring your own blinders.) and is a contributing editor to Quackwatch. Dr. Poling is a neurologist/PhD and the father of Miss Hannah Poling.
Dear Dr. Novella,
Your assertion that the scientific question of Autism etiology belongs to the medical community rather than Hollywood Stars is correct. I also agree that Hollywood opinions are more likely to be broadcast to millions because of their position in the media. This heightened awareness is nothing but a positive thing for the million families struggling with this difficult, and all too common, disorder. Jenny McCarthy is an Autism Mom looking for answers and rattling some cagesgood for her. Amanda Peet is a new mom who believes in the importance of vaccines to protect her babygood for her too. Dont attack the moms, listen to them.
These issues are very complex as we exchanged before and not amenable to soundbites. Regarding your entry on Hannahs case, your blog entry unfortunately propagates several of the mistakes from the media.
In criticizing the journalism of Mr. David Kirby, you wrote:
ActuallyHannah has diagnoses of DSM-IV Autism (by JHU/KKI psychology) and mitochondrial disorder (by two metabolic experts). The only degeneration that occurred (along with 6mos of total growth failure) after 18mos of NORMAL development followed vaccination and nothing else! Of course, any scientist can obviously point out that temporal correlation in a single case never proves causation. Rule number one of pediatrics though is LISTEN TO THE MOM. Are 10s of thousands of autism moms over the last decade suffering from mass hysteria induced by Hollywood? Not likely.
You also noted:
The only thing unique about my little girls case is the level of medical documentation5 to 20% of patients with ASDs have mitochondrial dysfunction. Many other cases where mitochondrial testing is WNL is because "we never looked" not because the testing would be "within normal limits." Most mitochondrial experts will tell you that the dots of autism and mitochondrial disorders are strongly connected.
Finally, you say:
The case was not settled, it was conceded by medical representatives of Sec HHS. We are obviously pleased with the HHS decision to concede our case, but we had NOTHING to do with the concession. This was a unilateral decision from HHS (recall that HHS is the respondent, rather than the vaccine maker, as manufacturers have blanket liability protection afforded by the Vaccine Injury Program established in 1986) I will not speculate on the obvious questionwhy concede? Hannahs case was positioned to set precedent as a test case in the Omnibus Autism Proceedings for potentially thousands of other cases.
With regard to the science of Autism, I have no argument with the assertion that a single case does not prove causation of a generalized autism-vaccine link. What the case does illustrate though is a more subtle point that many physicians cannot or do not want to comprehend (ostensibly because vaccines are too important to even question). Autism is a heterogeneous disorder defined by behavioral criteria and having multiple causes. Epidemiological studies which have not found a link between autism and aspects of vaccination do not consider the concept of autism subgroups. Indeed, in a heterogeneous disorder like Autism, subgroups may indeed be vaccine-injured but the effect is diluted out in the larger population (improperly powered study due to inability to calculate effect size with unknown susceptible subpopulation). I think former NIH Director, Dr. Bernadine Healey explained it best in that population epidemiology studies are not granular enough to rule-out a susceptible subgroup.
Furthermore, science has not systematically studied the children who fell ill following vaccination to determine what the cause(s) for their adverse reaction was. It would follow that if you never tried to understand why a single child developed encephalopathy following vaccinationyou wouldnt have the first clue as to what aspects of vaccination you could alter which could increase the relative risk of that adverse event (whether it be thimerosal, live virus, or too many). Could the susceptibility be a mitochondrial genetic haplogroup similar to Chloramphenicol toxicitysure it could! Why did a few Alzheimers patients die of fatal encephalitis following administration of the failed AN-1792 vaccine, but the majority had no ill effects (vaccine didnt work though)?
Definition: Autism is a heterogeneous systemic disorder with primary neuropsychiatric manifestations due to complex genetic and gene-environmental interactions likely affecting synaptic plasticity early in childhood development. This new theory of Autism is rapidly replacing the old guard dictum that Autism is a genetically predetermined developmental brain disorder of synaptic formation/pruning that is set in motion prenatally. By the 10 year rule of science, your time is about up!
Until the biological basis of ASD subgroups are better understood, further epidemiological and genetic studies regarding Autism causation will be relatively meaningless. We need good science to be able to address these complex issues which parallel nicely the emerging story of genetic and environmental influences in Parkinsons disease. Perhaps some Parkinsons researchers want to take a crack at Autism?
Recommended SCIENCE reading for the evening:
Thank-you Dr. Novella and his band of skeptics for continuing the debate.
Dr. Jon Poling
Jon S. Poling MD PhD
Managing Partner, Athens Neurological Associates
Clinical Assistant Professor, Department of Neurology, Medical College of Georgia
Diplomate, American Association of Neuromuscular and Electrodiagnostic Medicine
ASN Certified in MRI and CT Neuroimaging
Your assertion that the scientific question of Autism etiology belongs to the medical community rather than Hollywood Stars is correct. I also agree that Hollywood opinions are more likely to be broadcast to millions because of their position in the media. This heightened awareness is nothing but a positive thing for the million families struggling with this difficult, and all too common, disorder. Jenny McCarthy is an Autism Mom looking for answers and rattling some cagesgood for her. Amanda Peet is a new mom who believes in the importance of vaccines to protect her babygood for her too. Dont attack the moms, listen to them.
These issues are very complex as we exchanged before and not amenable to soundbites. Regarding your entry on Hannahs case, your blog entry unfortunately propagates several of the mistakes from the media.
In criticizing the journalism of Mr. David Kirby, you wrote:
He refers again to the Hannah Poling case, a girl with a mitochondrial disorder who developed a neurodegenerative disorder with features of autism after getting a fever from vaccines.
ActuallyHannah has diagnoses of DSM-IV Autism (by JHU/KKI psychology) and mitochondrial disorder (by two metabolic experts). The only degeneration that occurred (along with 6mos of total growth failure) after 18mos of NORMAL development followed vaccination and nothing else! Of course, any scientist can obviously point out that temporal correlation in a single case never proves causation. Rule number one of pediatrics though is LISTEN TO THE MOM. Are 10s of thousands of autism moms over the last decade suffering from mass hysteria induced by Hollywood? Not likely.
You also noted:
This special case - which is not a case of autism being caused by toxins in vaccines - says nothing about the broader vaccine-autism debate.
The only thing unique about my little girls case is the level of medical documentation5 to 20% of patients with ASDs have mitochondrial dysfunction. Many other cases where mitochondrial testing is WNL is because "we never looked" not because the testing would be "within normal limits." Most mitochondrial experts will tell you that the dots of autism and mitochondrial disorders are strongly connected.
Finally, you say:
The case was settled (not judged in Polings favor, but settled) because both sides realized it was a special case that could not be extrapolated to other vaccine-autism cases.
The case was not settled, it was conceded by medical representatives of Sec HHS. We are obviously pleased with the HHS decision to concede our case, but we had NOTHING to do with the concession. This was a unilateral decision from HHS (recall that HHS is the respondent, rather than the vaccine maker, as manufacturers have blanket liability protection afforded by the Vaccine Injury Program established in 1986) I will not speculate on the obvious questionwhy concede? Hannahs case was positioned to set precedent as a test case in the Omnibus Autism Proceedings for potentially thousands of other cases.
With regard to the science of Autism, I have no argument with the assertion that a single case does not prove causation of a generalized autism-vaccine link. What the case does illustrate though is a more subtle point that many physicians cannot or do not want to comprehend (ostensibly because vaccines are too important to even question). Autism is a heterogeneous disorder defined by behavioral criteria and having multiple causes. Epidemiological studies which have not found a link between autism and aspects of vaccination do not consider the concept of autism subgroups. Indeed, in a heterogeneous disorder like Autism, subgroups may indeed be vaccine-injured but the effect is diluted out in the larger population (improperly powered study due to inability to calculate effect size with unknown susceptible subpopulation). I think former NIH Director, Dr. Bernadine Healey explained it best in that population epidemiology studies are not granular enough to rule-out a susceptible subgroup.
Furthermore, science has not systematically studied the children who fell ill following vaccination to determine what the cause(s) for their adverse reaction was. It would follow that if you never tried to understand why a single child developed encephalopathy following vaccinationyou wouldnt have the first clue as to what aspects of vaccination you could alter which could increase the relative risk of that adverse event (whether it be thimerosal, live virus, or too many). Could the susceptibility be a mitochondrial genetic haplogroup similar to Chloramphenicol toxicitysure it could! Why did a few Alzheimers patients die of fatal encephalitis following administration of the failed AN-1792 vaccine, but the majority had no ill effects (vaccine didnt work though)?
Definition: Autism is a heterogeneous systemic disorder with primary neuropsychiatric manifestations due to complex genetic and gene-environmental interactions likely affecting synaptic plasticity early in childhood development. This new theory of Autism is rapidly replacing the old guard dictum that Autism is a genetically predetermined developmental brain disorder of synaptic formation/pruning that is set in motion prenatally. By the 10 year rule of science, your time is about up!
Until the biological basis of ASD subgroups are better understood, further epidemiological and genetic studies regarding Autism causation will be relatively meaningless. We need good science to be able to address these complex issues which parallel nicely the emerging story of genetic and environmental influences in Parkinsons disease. Perhaps some Parkinsons researchers want to take a crack at Autism?
Recommended SCIENCE reading for the evening:
Altered calcium homeostasis in autism-spectrum disorders: evidence from biochemical and genetic studies of the mitochondrial aspartate/glutamate carrier AGC1. Mol Psychiatry 2008 Jul 8. (The discussion includes thimerosal as a potential toxin that could trigger further perturbations of calcium homeostasis leading to neuronal injuryand in a mainstream Nature publication no less)
Thank-you Dr. Novella and his band of skeptics for continuing the debate.
Dr. Jon Poling
Jon S. Poling MD PhD
Managing Partner, Athens Neurological Associates
Clinical Assistant Professor, Department of Neurology, Medical College of Georgia
Diplomate, American Association of Neuromuscular and Electrodiagnostic Medicine
ASN Certified in MRI and CT Neuroimaging
Posted by Age of Autism at July 22, 2008
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Nikki Haley HPV Bill Veto: Bakari Sellers' SC Vaccination Measure For Middle Schoolers Fails [View all]
onehandle
Jun 2012
OP
"doctors I know believe this vaccine is very important in outright preventing cancer"
FiveGoodMen
Jun 2012
#3
Yes they should. And the Dem Party should spend some money making sure that message gets out.
FiveGoodMen
Jun 2012
#10
CBS News: Gardasil Researcher Speaks Out (aka, don't let the facts get in your way).
proverbialwisdom
Jun 2012
#11
It's the summary of a CBS interview with one of Gardasil's chief developers at Merck.
proverbialwisdom
Jun 2012
#19
Censorship, really? I think your assessment of AoA is wrong and that name-calling should be banned.
proverbialwisdom
Jun 2012
#23
It's only easy to defend if you think that science is the same thing as bullshit.
TheWraith
Jun 2012
#26
You are misinformed. The field is highly dynamic and you are not up-to-date.
proverbialwisdom
Jun 2012
#27
You are misinformed, but don't bother reading. You might learn something you don't want to hear.
proverbialwisdom
Jun 2012
#35
I predict your views will one day inhabit the dustbin of medical history.
proverbialwisdom
Jun 2012
#40
That's totally ludicrous, AoA is precisely the opposite of what you describe.
proverbialwisdom
Jun 2012
#28
Upper right-hand corner editor's posts not archived, as far as I can tell, so here's today's.
proverbialwisdom
Jun 2012
#46