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Comment by robotrout | Hacker News Reader

Staying away from the global cooling stuff for now, I'll comment on this.

     McCarthy has a long history of dismissing epidemiology, 
     statistics, and all the other evidence-based tools we use 
     to make public health decisions

That's not really true. The problem is that there have been no studies made regarding vaccine and autism. McCarthy believes they are linked and asks to be shown a study proving they are not. (A study that takes populations of vaccinated children and unvaccinated children and compares their autism rates) No studies are available, and years later, that remains true.

Given that this is pretty easy to find out, I think this author has their own little axe to grind.

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The problem is that there have been no studies made regarding vaccine and autism...(A study that takes populations of vaccinated children and unvaccinated children and compares their autism rates) No studies are available, and years later, that remains true.

Simply false. Here are studies which compare children given MMR to control children given no MMR vaccines. Both find no statistically significant correlation between MMR vaccine and autism:

http://journals.lww.com/pidj/Abstract/publishahead/Lack_of_A...

http://www.plosone.org/article/info:doi/10.1371/journal.pone...

There are also temporal studies comparing autism rates over time after the reduction/removal of thimerosal from vaccines (disproving a narrower hypothesis, that thimerosal causes autism):

Hviid A, M Stellfeld, J. Wohlfahrt, and M Melbye (2003). Association between thimerosal-containing vaccines and autism. JAMA 290:1763-1766.

Madsen KM, MB Lauritsen, CB Pedersen, P Thorsen, AM Plesner, PH Andersen, PB Mortensen (2003). Thimerosal and the Occurrence of Autism: Negative Ecological Evidence From Danish Population-Based Data. Pediatrics 112:604-6.

Fombonne E, R Zakarian, A Bennett, L Meng, D. McLean-Heywood (2006). Pervasive Developmental Disorders in Montreal, Quebec, Canada: Prevalence and Links With Immunizations. Pediatrics 118:e139-50.

Fombonne E (2008). Thimerosal disappears but autism remains. Arch. Gen. Psychiatry 65: 15-6.

At the risk of hemoraging more karma, let me make the following observations.

1) The MMR study consists of 288 children, 192 of which were hand-picked to match 96 autistic children. It strikes me that for a condition that is diagnosed in 1 out of 120 children, a population of 300 children is a bit sparse. Is that blasphemy?

2) The MMR study (which the other high karma poster is also quoting, it's the same study) is, after all, an MMR study. That means that of the 30 or so shots http://www.cdc.gov/vaccines/recs/schedules/downloads/child/2... that a child is forced to undergo in the US by age 6, the Measles-Mumps-Rubella shot has been shown apparently (with a sample size of 288 kids) not to correlate with autism. I'm not sure why MMR was singled out, but for many of us, it's not any one vaccine that's the issue, nor is it thimerosal (although I'm glad it's out of there), it's the sheer number of them and how fast they are imposed on young bodies. Many more of them, I may add, than when you were a kid.

I feel that you are not going to be swayed from your position that all is well in vaccination land. I wonder if you have children. When you have a new son (boys are diagnosed at a rate of 1 in 70) we'll see if you aren't more willing to be critical of one or two studies that are quoted so often it seems like there are 50.

My original point still stands. Fund a study of non-vaccinated children. They exist. I have two of them. Compare their autism rate against the general population. Use a sample size that is actually meaningful, and you'll shut up Jenny McCarthy, and you'll let me sleep easier as well.

http://www.sciencebasedmedicine.org/?p=2962

It's the same study guys. Same study mentioned four times now. It's got 288 people in it, and it's specific to MMR.

STUDY POPULATION: The 96 cases with childhood or atypical autism, aged 2 to 15, were included into the study group. Controls consisted of 192 children individually matched to cases by year of birth, sex, and general practitioners.

This downvoting crap is starting to piss me off. How about this?

echo "127.0.0.1 ycombinator.com" >> /etc/hosts

Fuck you guys. I'm going home.

1.) It's not blasphemy, but it is statistically irrelevant since the study was a case control study.

2.) MMR and thimerosal were singled out because anti-vaccine activists made the claim that they caused autism.

Now that those claims have been disproven, Jenny McCarthy and other anti-vaccine activists are making different claims.

Incidentally, I will be swayed from my position when I see some repeated, statistically significant evidence that vaccines are correlated with autism. At the moment, most of the evidence indicates no correlation.

When you have a new son (boys are diagnosed at a rate of 1 in 70) we'll see if you aren't more willing to be critical of one or two studies that are quoted so often it seems like there are 50.

It's human nature. Kids get vaccines every 6 months (or so it feels). If/when they develop autism, as a parent you are bound to wonder what happened. You look back, and the first thing that you can think of is the needle in your son 6 months prior. Nothing else comes to mind.

But that's because we don't have a clue what causes autism. So it's easy to associate any kind of needle, something we don't understand, with the shock. It helps cope.

Back on rational grounds, vaccines definitely have +++++++ effect, and you are trying to argue that there might be a tiny (-) somewhere, which is still very much completely hypothetical. Do the math: vaccines still end up way positive.

It strikes me that for a condition that is diagnosed in 1 out of 120 children, a population of 300 children is a bit sparse. Is that blasphemy?

In fact, you don't need large samples to get significant results. If there is a strong effect, even a very small sample will show it. If the effect is small, you will need a larger sample.

300 is, in fact, a pretty large sample. I haven't read the full study, but if its a simple random sample, the an effect would have to be quite weak indeed to not show up (in all probability).

It is indeed easy to find out. If you go to pubmed and search for vaccines and autism, you'll quickly find papers like this:

http://www.ncbi.nlm.nih.gov/pubmed/19614825?itool=EntrezSyst...

Which show that it has indeed been studied and that there is no known link. Rather, it is our detection capability that is improving.

There is plenty of information:

http://www.ncbi.nlm.nih.gov/pubmed/19896907?itool=EntrezSyst...

http://www.ncbi.nlm.nih.gov/pubmed/19522237?itool=EntrezSyst...

Jenny McCarthy is a well known anti-vaccine proponent who refuses to accept the huge number of studies in the area.

Who funded the studies? Money skews the findings, I think we can all agree...

There are multiple studies, all in prestigious peer-reviewed medical journals, that show that there is no link. In 2010, the peak of advancement in our species, you cannot get closer to fact than that.

We in the medical community find it unethical to conduct randomized, placebo-controlled trials when a preponderance of evidence already favors treatment (or nontreatment). Vaccines provide a clear benefit to society; the epidemiology does not suggest that vaccines are linked to autism. There is no clinical equipoise here.

This is why the parents of affected kids don't trust the medical community to address their concerns. They see the impact immediately after the kids get vaccines, but your mind is made up unfortunately.

Someone comes to me without any credible evidence and states "I think statins cause cancer. Let us randomize people with high LDL to statins or placebo." I will reject this study, not because my mind is "made up" and I am stubborn, but because the prior probability is low (due to lack of credible evidence) that statins truly lead to an excess of cancer, whereas the evidence supporting the use of statins to reduce death in those with high LDL is of gargantuan proportions.

So while I am sorry that we as a medical community have not succeeded in making it clear why no randomized trial should be conducted for vaccines given the current evidence, I reject the assertion that this is simply because "my mind is made up."

There's plenty of parents of kids with autism who accept the science and e.g. get their younger kids vaccinated so it can't be as obvious a link as you'd suggest.

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