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The Vaccine Debate, II

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The Straight Dope response by Cecil Adams regarding autism and vaccines [June 8] is filled with false statements that reflect a basic ignorance of the truth and moreover, the product of a journalist who failed to investigate both sides of the story.

First, thimerosal is such a poor preservative that the FDA banned its use in 1982 from over-the-counter medications because of toxicity (including deaths) and product contamination. In 1985 two large outbreaks of staph-abscess were reported in children resulting from contamination of a thimerosal-preserved, multiple-dose vial of diptheria vaccine. Had these cases occurred in 1928 they would likely have been fatal. Thimerosal is a very ineffective preservative. In 2004 Chiron's flu vaccine supply was contaminated with bacteria in spite of thimerosal's presence. This resulted in the largest biological contamination in U.S. history and widespread flu vaccine shortages. So why are we using a preservative that does not work? Shouldn't Adams be asking that question?

Adams states that thimerosal is "mostly gone." His answer is "mostly wrong." Thanks to an expanded flu vaccine supply, children in Chicago can get over 50 percent of the total mercury load prior to thimerosal removal from other childhood vaccines. A good investigative reporter might ask why Illinois health officials like Julie Morita and Eric Whitaker or pediatrician "leaders" like Ed Pont have lobbied hard against even informing parents that their kid's flu shot has enough mercury for a 550-pound adult.

Adams also reviewed "major studies" that refuted a link but again never critically discusses or even addresses legitimate and widespread claims of research fraud that many journalists and scientists have reported.

The Denmark studies (3) have been discredited because of a shaky, altered psychiatric database (where is Tom Cruise when you need him?) that increased the size of the sample population by 13-fold without adjusting the denominator. As FOIA documents (which I am sending your editor) as well as critical reviews of these papers show, thimerosal removal resulted in dramatic declines in autism rates in Denmark.

As far as Canadian research, Dr. [Eric] Fombonne's work is near and dear to my heart since I obtained a copy of his epidemiological database and am publishing a more accurate version. In a word--fraud. Dr. Fombonne's claim that thimerosal was removed in 1996 from Quebec is blatantly false. That MMR coverage rates declined while PDD rates increased was true . . . when you compare MMR coverage rates from Quebec City (256 kilometers away from Montreal) to PDD rates in Montreal--a fact undisclosed in his publication. PDD rates actually increased in Montreal in stride with increased MMR vaccine coverage rates and number of MMR shots administered.

The true and honest assessment of the link between vaccines and autism will never be disclosed by governing agencies, mainstream media, medical society journals that rely on drug company dollars. Apparently you can add "independent" journalism to that list.

D Ayoub, MD

Springfield

Cecil Adams replies:

I recognize that parents of children with autism desperately want an explanation for this baffling condition. However, there's little indication thimerosal is it. To address your complaints:

1. I make no claims regarding thimerosal's effectiveness as a preservative. The column was about whether it causes autism, not whether it ought to continue to be used in flu vaccine.

2. Thimerosal is "mostly gone" from the list of vaccines routinely administered to children. If you get enough flu shots, sure, you'll increase your exposure to the stuff.

3. Regarding the "discredited" Denmark study, presumably you're referring to the assertion by Sallie Bernard, executive director of an autism advocacy group, that methodological flaws invalidated the study's conclusions. Ms. Bernard summarized her objections in a 2004 letter to the Journal of the American Medical Association--basically she claimed some Danish autism cases were dropped from the research database, skewing the analysis. The study's authors explained why they felt Ms. Bernard's objections were ill founded. You may not find their reply persuasive (it seemed reasonable enough to me), but that hardly means the study has been discredited.

4. As for your suggestion that Dr. Fombonne's work amounts to fraud--that's not likely to foster useful debate. Perhaps it explains why Pediatrics declined to publish your letters describing the study's alleged defects. Or perhaps, as the press release you sent along indicates, the journal's editor simply has his mind made up and doesn't care to hear contrary argument. All I know is that articles by advocates of a thimerosal/autism link (the Geiers, for example) continue to appear in the medical journals. While their views are in the minority, I see no evidence of a broad conspiracy to suppress unpopular opinions.

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