April 20th, 2011 → 11:22 am @ Seth Mnookin // No Comments
As you might have heard, PBS’s Newshour is in the midst of a six-part series on autism. It’s being hosted by Robert MacNeil, who returned to the show for the first time in 16 years to work on a special that he says is the first time in his career that he used his family’s personal stories to inform his reporting.
As I said on Monday, he shouldn’t have come out of retirement. The series has been an embarrassment. (For my take on the series’s first episode, see my post titled “An embarrassing, reckless, and irresponsible coda to Robert MacNeil’s career.” For my thoughts on the ineffective counter-tactics of the AAP, see “[Abstracts] vs. anecdotes: What we have here is a failure to communicate.” And for an example of how the series will be used by anti-vaccine activists to legitimize their efforts, see “The first of many statements yoking Robert MacNeil to the vaccine-autism canard.“)
Tonight’s episode is titled “Autism’s causes: How close are we to solving the puzzle?” After PBS was criticized for giving MacNeil’s daughter free rein to make her claims that the MMR vaccine led to her son’s autism, network officials had assured people in the public health and medical communities that the episode on causality would deal with the science in a sober and responsible way.
Guess what? It didn’t. Here’s how MacNeil introduces the vaccine controversy in tonight’s show:
One issue science considered settled for years won’t go away: the parental belief that vaccines cause autism. Public health officials have steadily maintained there is no valid, scientific evidence of such a connection; all epidemiological studies have proved negative. But now, bowing to public opinion, the body that sets priorities in autism research, The Inter Agency Coordinating Committee, has recommended studies to determine whether small subgroups might be more susceptible to environmental exposures, including vaccines.
Here’s my interpretation:
The media has seized on this story about vaccines and autism because it makes good copy. Emotional anecdotes from caring parents draws in readers, listeners, and viewers; details about reams of data showing vaccines do not cause autism do not. This has created a vicious circle: We report on “parental beliefs,” parents point to our coverage when trying to convince federal agencies that “public opinion” is calling for more investigation, those agencies accede to public and media pressure, we point to those agencies’ actions as justification for still more coverage…and on and on and on.
In order to bolster the contention that even after studies involving millions of children, we still don’t know whether vaccines cause autism, MacNeil looks to Martha Herbert, whom he introduces as “professor of neurology at Harvard Medical School.” (Herbert is actually an assistant professor, which means she has not been granted tenure.) Herbert fires off a number terms that all sound impressive — endocrine disruption, neurotransmitters, energy factories in our cells — and then alights on two of Andrew Wakefield’s favorite argument of the past several years: 1. The number of children “vulnerable” to vaccines might be so small that it’s literally impossible to study, and 2. The brain, the immune system, and the GI system operate in unison and when you “disregulate” one, all of the others fall out of whack.
DR. MARTHA HERBERT: I think it’s possible that you could have a genetic subgroup. You also might have an immune subgroup. There are a variety of subgroups. But the problem with the population studies is they don’t they aren’t necessarily designed to have the statistical power to find subgroups like that if the subgroups are small.
DR. MARTHA HERBERT: The brain and the immune system and the gut are intimately related. The cells in those systems have common features. They work together seamlessly, and when you disregulate one, you disregulate all the others. And systems biology is a way of looking at how we work as an integrated whole. I think that’s 21st century biology. Is the brain miswired, or is it misregulated? And I’ve come to think the brain is misregulated. And there are several reasons for that. Short-term, dramatic changes in the functional level of people with autism. One of them is the improvements you see with fever. A child who gets a fever will start to make eye contact, be interactive, will relate. A child who would have been really out of touch will become connected, and then it will go away.
Not surprisingly, outside of his incorrect identification of Herbert’s position at Harvard, MacNeil doesn’t give his viewers any context with which to consider Herbert’s claims…and there’s plenty of context to give. She’s a regular presence at antivaccine conferences.* The last time I saw her was at a conference sponsored by AutismOne, a group whose mission statement reads, “The great majority of children suffering from autism regressed into autism after routine vaccination. … Autism is caused by too many vaccines given too soon.” Here’s my description of that gathering from my book:
Included among the 150 presentations at the 2009 conference was a four-hour long “vaccine education” seminar, a lecture on “autism and vaccines in the US [legal system],” an environmental symposium on “the toxic assault on our children,” and a presentation on “Down syndrome, vaccinations, and genetic susceptibility to injury.” During her talk, Barbara Loe Fisher, the grande dame of the American anti-vaccine movement, explained how vaccines are a “de facto selection of the genetically vulnerable for sacrifice” and said that doctors who administer vaccines are the moral equivalent of “the doctors tried at Nuremberg.” (That parallel, she said, had been pointed out to her by “Andy” Wakefield, in whose honor the 2009 conference was held.) One night, there was the premier of a documentary called Shots In The Dark, which examined “current large-scale vaccination policies” in light of the “onset of side effects such as autism or multiple sclerosis.”
MacNeil also could have told his viewers that Herbert’s theories about autism have been ruled inadmissable by a Massachusetts Superior Court judge, who wrote:
Dr. Herbert’s method is not generally accepted in the scientific community. Dr. Herbert’s theory of environmental triggers of autism may some day prove true. It has not yet. Her proffered testimony does not meet the standard of reliability required by the case law, and cannot be admitted in evidence at trial.
After tonight’s show, there are three more episodes in the Newshour special. Tomorrow night’s is on “autism treatment.” I hope MacNeil doesn’t give airtime to Mark and David Geier, a father-son team that claim that Lupron, an injectable drug used to chemically castrate sex offenders, can cure autism. (The Geiers’ “Lupron protocol” can cost upwards of $80,000 a year. I learned about it at the same AutismOne conference at which Herbert lectured about “environmental impacts.”)
* Herbert seems to be quite sensitive to being linked to alternative autism treatments in the press. In a series on alternative autism treatments in the Chicago Tribune by Trine Tsouderos and Patricia Callahan that ran during the 2009 AutismOne conference, Herbert was quoted writing an email that said she would sue the Tribune if she was portrayed as “an uncritical booster and fan of potentially dangerous unorthodox treatments.” In a separate interview, she said, “I’m not defending chelation. I will sue you if you say that.”
Post Categories: Blog post
Tags: autism, AutismOne, Lupron, Mark Geier, Martha Herbert, media, PBS, Robert MacNeil, vaccines
MarshallDog
13 years ago
Just got my pertussis vaccination. But my doctor balked when I asked to schedule a chelation treatment.
Jake Crosby
13 years ago
Oh, but a researcher who made “several disparaging statements” and those that “were were unsubstantiated and/or false” not to mention “did not disclose his financial relationships with Merck” or for that matter “the entire profile of his professional financial relationships with pharmaceutical companies”…
http://www.ocregister.com/articles/correction-296910-dated-entitled.html
…is apparently good enough for public radio’s Ira Flatow:
http://www.sciencefriday.com/program/archives/200808292
…who shares a studio with your “personal yoda,” Kurt Andersen:
http://www.wnyc.org/shows/
Correct me if I’m mistaken, but Flatow’s first interview with Offit was roughly the same time you say you started working on your latest book, Seth, mid-2008. Perhaps you have some idea as to why public television has finally come around, but public radio hasn’t (yet).
And Bob’s your uncle:
http://www.ageofautism.com/2011/03/seth-mnookin-bobs-your-uncle.html
Andrew
13 years ago
Thanks for the link to the Flatow interview – the discussion with the antivax caller (Chantelle) in which she admitted that she wasn’t interested in evidence was very illuminating. Reminded me of JB Handley’s admission that his blog “protects” people from hearing facts that disagree with his opinions.
jre
13 years ago
Conspicuous by their absence in PBS’ reporting — and, alas, in much reporting of science — are context and a sense of proportion.
Scientists are used to hearing wacky ideas; indeed, they thrive on them. But when someone says that “[t]he brain and the immune system and the gut are intimately related” a neurologist or an immunologist or a gastroenterologist would have the context to understand that this is the introduction to an airy conjecture. Nothing wrong with that. Airy conjectures are the ore from which testable hypotheses and, ultimately, established facts are smelted. But reporters all too often fail to understand that this is low-grade ore, and report it instead as 24-karat specie.
The other problem I see is an inherent difficulty in communicating proportional relationships among large numbers. Could a vaccine safety trial detect a rare adverse event? Sure, in principle — but it depends on just how rare it is. For example, the Rotashield vaccine against rotavirus was suspended after CDC found a probable causal link between the virus and 15 cases of intussusception (a bowel obstruction typically affecting between 1 infant in every 2,000 to 3,000). How much did receiving the vaccine increase the risk that a given infant would develop intussusception? By CDC’s estimate, the vaccine might lead to one or two extra cases of intussusception among each 10,000 infants vaccinated. Think about that for a second. The rate of adverse events from Rotashield was only 1/3 to 1/5 the background rate — and it was still severe enough to suspend the vaccine! To detect that rare an adverse event, a trial has to be very sensitive indeed, and vaccine trials typically are that sensitive. The incidence of autism is estimated by various groups to be as high as 1 in 110 children in the US, a number used to support theories of an autism “epidemic.” Yet proponents of a vaccine-autism link also claim that clinical studies lack the statistical power to detect that link because of its rarity. You really can’t have it both ways, but the way this story is reported, um, yeah, you do after all.
jre
13 years ago
I posted a comment after being away for a while, and see that Jake Crosby has also commented in the meantime. It bears mentioning that the Rotateq virus, which replaced Rotashield, was co-invented by Crosby’s bête noire, Paul Offit. Saving the lives of thousands of infants is something to be proud of, and Offit is clearly on the side of the angels here.
Twyla
13 years ago
I find her credentials impressive, and her work extremely interesting.
MARTHA HERBERT, Ph.D., M.D. (Program Director; MRI and Biomarkers)
Dr. Martha Herbert, is an Assistant Professor of Neurology at Harvard Medical School, a Pediatric Neurologist with subspecialty certification in Neurodevelopmental Disabilities at the Massachusetts General Hospital in Boston, a Principal Investigator and a member of the MGH Center for Morphometric Analysis, and an affiliate of the Harvard-MIT-MGH Martinos Center for Biomedical Imaging.
She earned her medical degree at the Columbia University College of Physicians and Surgeons. She trained in Pediatrics at Cornell University Medical Center and in Neurology and Child Neurology at the Massachusetts General Hospital, where she has remained.
Prior to her medical training she obtained a doctoral degree at the University of California, Santa Cruz, studying evolution and development of learning processes in biology and culture in the History of Consciousness program, and then did postdoctoral work in the philosophy and history of science. This work has influenced her current orientation toward systems biology, brain connectivity and brain-body interrelationships.
In 2004 she received the first Cure Autism Now Innovator Award; she directs the Cure Autism Now Foundation’s Brain Development Initiative. She is the Co-Chair of the Environmental Health Advisory Board of the Autism Society of America. Her research program includes studying what makes some autistic brains unusually large, how the parts of the brain are connected and coordinated with each other, and how we can develop measure sensitive to changes in brain and body function that could result from treatment interventions.
http://www.massgeneral.org/research/researchlab.aspx?id=1260
Also see her website http://www.marthaherbert.com/
Leila
13 years ago
I was not impressed with Martha Herbert interview on the program. I am not a scientist, just an autism parent. But I noticed her use of some new-agy terms with nothing to back up her assertions.
Dr. Gerald Fishbach of the Simons Foundation seemed to be the most substantial expert interviewed. He made me want to go look into that Foundation’s work and research.
jay blue
9 years ago
Some people can have a fatal reaction to peanut or bee sting. There is no law of nature that says someone cannot possibly be allergic to something. What Dr. Herbert is saying that it is possible that some percentage of kids could have adverse reactions to vaccines. Why is that so strange or unbelievable, when some people are actually allergic to sunshine of all things (google it if you believe it), or pollen, or milk?
Thalidomide caused 20,000 kids to be born without arms or legs, and the drug manufacturer would not admit it for decades. Why? Surveys show that more educated parents are less like to vaccinate their kids. Why? Parents who out of absolutely good intention vaccinated their kids cannot possibly admit that vaccines could have side effects. No parents can believe that what they did out of pure love might possibly end up harming their kids. Humans are not machine. Emotions trump everything. Therefore, no matter what Dr. Herbert or Science has to say, it will fall on deaf ears. And now, people who made that choice for their own kids want all other kids to face the same risk by making vaccines mandatory. It’s understandable why they want to do that.