IT MUST HAVE BEEN THE SPEECH THERAPIST: DAY NINETEEN AUTISM OMNIBUS PROCEEDING
It Must Have Been the Speech Therapist – Day Nineteen of the Autism Omnibus Proceeding – Snyder v. the Secretary of Health and Human Services
By Kent Heckenlively, Esq.
I keep expecting the defense to come up with convincing evidence that autism has nothing to do with vaccines.
I keep expecting them to provide information which would convince a reasonable person that they understand what’s gone wrong in the brains and bodies of our children. Maybe it’s because after all this time my mind still subconsciously rebels against the thought that this profession which I’ve long respected has been responsible for such a great tragedy.
But like a well-connected pillar of the community who can’t explain where he was on the night of his wife’s murder, if this day’s medical testimony from the defense is the best they have, the government’s case is in serious trouble.
Direct Examination of Dr. Burton Zweiman by Mr. Voris Johnson – Attorney for the Government (Respondent)
Since 1963 Dr. Zweiman has been on the faculty of the University of Pennsylvania School Of Medicine. He is currently an emeritus professor. For 24 years he was Chief of the Division of Allergy/Immunology at the school. Dr. Zweiman is board-certified in internal medicine, as well as allergy and immunology. Until recently he treated patients, but still consults with colleagues on cases. He has received awards for his work from the American Academy of Allergy, Asthma, and Immunology.
Dr. Zweiman was presented as an expert witness regarding the auto-antibodies to myelin basic protein, otherwise known as anti-MBP.
Dr. Zweiman began by explaining that myelin is a fatty material which coats the axons of neurons, preventing the electrical charge from leaking into the surrounding tissue. Myelin basic protein is a protein within myelin which is very alkaline (as opposed to acidic) and has a very strong, positive charge. It’s important to understand this point because the protein is so highly charged that a number of non-immunologic factors may interfere with the charge.
There’s good evidence that T-cells play an important role in the production of anti-bodies against myelin basic protein. Myelin damage can often be seen in the MRI scans of people with multiple sclerosis, but demyelination is not generally observed in those with autism. Testing for antibodies to myelin protein is often difficult.
Zweiman is aware of reports that find antibodies to myelin basic protein in the blood serum of approximately 50-60% of autism patients. Similar numbers have been reported with other neurodegenerative conditions like epilepsy, multiple sclerosis (62%), and those with rheumatoid arthritis (50%). However, the discovery of anti-MBP antibodies is not always an indication of neurological dysfunction. Evidence about what the finding of anti-MBP antibodies means is unclear. For example, injecting anti-MBP antibodies into experimental animals doesn’t cause neurological disease in those animals. It’s been suggested that the presence of anti-MBP antibodies may actually be a part of the healing process.
Dr. Zweiman believes the only possible ways there might be a connection between the production of anti-MBP antibodies and the MMR vaccine is through contamination, or some molecular mimicry between the inactivated measles virus proteins and myelin basic protein. However, an Institute of Medicine study did not find any such link.
He is aware Colten had an elevated anti-MBP level of 46 from his test of January 2000, and that such a reading was extremely high. However, two months later his anti-MBP level was undetectable. Colten’s cerebral spinal fluid was tested in 2002 for anti-MBP antibodies and was found to be negative. In Dr. Zweiman’s opinion, a finding of an elevated anti-MBP level in the cerebral spinal fluid would be more direct evidence of damage to the brain.
In the absence of other evidence, an elevated anti-MBP level is not a reliable marker for a measles infection in the brain.
Dr. Zweiman did acknowledge Colten showed evidence of a decreased IgA level, but believed it was only moderately decreased, and did not rise to the level of a true deficiency. Further testing showed Colten’s IgA levels had returned to normal levels.
Dr. Zweiman does not believe Colten had significant immuno-suppression before or after the MMR shot, and further, that Colten’s symptoms were not similar to the reactions to MMR vaccines as documented by Dr. Weible in his article.
Cross-Examination of Dr. Zweiman by Mr. Tom Powers – Attorney for the Family (Petitioners)
In the cross-examination, Dr. Zweiman claimed that anti-MBP antibodies can be found in people without any clinical symptoms of immune-mediated diseases, and that one usually needs to look at the findings in combination with other symptoms.
While Dr. Zweiman acknowledged that damage to the myelin sheath is the most common reason for the presence of anti-MBP antibodies, it is not the only possible reason. In his words, the clinical relevance was “uncertain.”
It was true, Dr. Zweiman said, that anti-MBP antibodies were higher in epileptics, but declined to answer whether epilepsy was higher in autistics. He did acknowledge that seizures were more common in autistics as they entered into adolescence, but declined to otherwise offer an opinion.
The suggestion that elevated levels of anti-MBP antibodies were part of a healing process is only a hypothesis at this point, according to Dr. Zweiman.
Dr. Zweiman did not answer the question of, if the presence of anti-MBP antibodies were part of a healing process, what was the injury? The only real response he gave is that they might have been caused by some cross-reactivity with milk proteins. (Anybody want to comment on the possible gluten/casein connection?)
Questions from Special Master Denise Vowell
Special Master Vowell first asked about Colten’s high reading of 46 for anti-MBP antibodies in January of 2000.
Dr. Zweiman replied that the finding was of “uncertain significance.”
Vowell next asked whether the IVIG treatments, secretin, or nutritional supplements might have had an effect on Colten’s anti-MBP antibodies level.
Zweiman replied he didn’t think any of those treatments would have had an effect on his anti-MBP antibodies levels.
Zweiman testified that while high anti-MBP levels are not a marker for treatment, the New England Journal of Medicine recently claimed they might be a marker for multiple sclerosis.
While Colten’s severely elevated IgE levels were a matter of concern, they were apparently not followed up with further testing. Dr. Zweiman thought the level might be an indication of parasitic infection, or eosinophilic gastroenteritis.
Redirect Examination of Dr. Zweiman by Mr. Johnson – Attorney for Government (Respondents)
Dr. Zweiman appeared to amend his testimony by stating that IVIG treatments might affect anti-MBP levels, but the levels would need to be closely monitored.
Recross Examination of Dr. Zweiman by Mr. Powers – Attorney for Family (Petitioners)
Mr. Powers simply wanted to nail down the timeline suggested by Dr. Zweiman, that if IVIG treatments were to have an effect on a person, it would take about two to three weeks for the body to respond, and another two to three weeks for that change to show up on medical testing.
Direct Examination of Dr. Max Wiznitzer by Mr. Voris Johnson – Attorney for the Government (Respondents)
Dr. Wiznitzer is staff neurologist at Rainbow Babies and Children’s Hospital in Cleveland, Ohio and associate professor of pediatric neurology at International Health Education at Case Western University in Cleveland, Ohio. About twenty-five percent of his patients have autistic spectrum disorders.
In this proceeding he has heard nothing to change his opinion that autism is not caused by vaccines. Colten’s reported symptoms did not resemble a measles infection and he disagrees that Colten had clinical lethargy over the Memorial Day Weekend of 1998. His lethargic behavior was probably the result of a viral infection as shown by the clinical evidence of dehydration.
Dr. Wiznitzer went onto say Colten would probably have been excluded from the Weible group of kids (referring to those kids who had reactions to the MMR shot and were described in an article in “Pediatrics”) because there was an alternative explanation for his symptoms. The alternate explanation was acute viral infection with fever with pharyngitis and dehydration, which improved when treated.
In preparation for his testimony Dr. Wiznitzer reviewed family videos of Colten. He noted a decrease in expected language up to 13 months, noting that Colten only used nonspecific noises, had no interpersonal babbling he could see on the videos, and had an inconsistent response to voices. In his experience he’s seen a similar pattern with his patients.
According to Dr. Wiznitzer, Colten really started to show improvements after he began speech therapy around mid-July of 1999. Intervention helps children with speech problems as they will tend to improve to their own intellectual and cognitive potential. Colten’s improvement is consistent with what he describes as the “natural history of autism”, namely that things are at their worst during the second to third year of life, but begin to improve with intervention.
However, none of his patients has ever improved enough to lead a normal life.
(Author’s note – In her testimony, speech therapist Katherine Timlin said she only worked with Colten twice a week for thirty minutes. At the beginning of treatment when Colten was 26 months old he displayed the communicative abilities of a 9 month old. Because of his remarkable progress which the speech therapist credited to the work of Dr. Bradstreet, he stopped regular speech therapy when he was six years old. As of the date of the hearing Colten was a normal ten-year-old.)
Cross-Examination of Dr. Wiznitzer by Mr. Thomas Powers – Attorney for Family (Petitioners)
Mr. Powers first questioned Dr. Wiznitzer about what he believed to be the biological underpinnings of autism. He explained they ranged from chromosome 15 syndrome, Fragile X, tuberous sclerosis, PKU, and mitochondrial disorders. These conditions have no environmental contribution.
However, there are environmental contributions which can raise the risk of autism, such as pre-natal exposure to thalidomide, as well as the rubella and cytomegalovirus. This list is not exhaustive, but rather illustrative. The number of causes has gone up over time as more research has identified them. Dr. Wiznitzer does not believe in any post-natal contributions to autistic spectrum disorders.
Dr. Wiznitzer had no opinion on the theory that there may be genetic vulnerabilities which act in concert with environmental factors.
Dr. Wiznitzer also acknowledged there was a lack of data about what percentage of regressive autism cases may be caused by biologic agents.
Turning to Colten Snyder, Dr. Wiznitzer identified three domains which are abnormal in children with autism; language, social interactions, and obsessive interests. From the videos Dr. Wiznitzer claimed he saw soft signs in language. However, the testimony of the aunt and the videos showed a socially active child who did not have obsessive interests. Dr. Wiznitzer still claimed there were subtle signs.
In contradiction to Dr. Wiznitzer’s claim of abnormal language use, Colten’s parents claimed word usage at 15 months was around 15-20 words and his referral for speech was made post MMR shot.
Dr. Wiznitzer agreed that Colten’s improvement also coincided with the institution of the gluten/casein free diet, secretin injections, nutritional supplements, and IVIG therapy. He did remember the testimony of Katherine Timlin in which she claimed Colten’s improvements wee “unusual and striking.”
Dr. Wiznitzer protested that none of there therapies have been shown to have any effect on the core symptoms of autism.
Mr. Powers next turned to the subject of Dr. Kinsbourne’s report and Dr. Wiznitzer’s criticisms of that report.
Dr. Wiznitzer agreed with Kinsbourne that glutamate is the predominant excitatory neurotransmitter in the brain and the chief inhibitory neurotransmitter is GABA, and the balance between these two is the main factor of neurological health.
He doesn’t know whether the pyramidal cells of the hippocampus are particularly vulnerable targets of cytotoxic damage due to glutamate excess. However, he does agree that any neuron exposed to excess glutamate is at risk.
He agrees that there is a decrease in the number of Purkinje cells in the cerebellum of autistics, but doesn’t know whether that was caused pre or post-natal.
Dr. Wiznitzer doesn’t have enough information to have an opinion as to whether a lower
amount of glutamate excess could change the number of synaptic connections, decrease dendridic growth, and change the brain in other predictable ways. Generally, he believes excess glutamate leads to cell death, he does believe an acute stressor might allow those brain cells to survive.
Dr. Wiznitzer agrees that excess glutamate leads to epileptic discharges, but notes that most of the epilepsy associated with autism takes place in adolescence or early adulthood, although the majority have subclinical discharges on their EEG reports.
He is in agreement with Dr. Kinsbourne’s report that astrocytes are responsible for controlling glutamate and turning it into GABA. If the astrocytes die then the balance between glutamate and GABA is upset. However, Dr. Wiznitzer doesn’t agree with Kinsbourne that astrocytes can release glutamate on their own.
Dr. Wiznitzer concurs with Dr. Kinsbourne that excess glutamate can cause adjacent circuitry to become activated in a manner which escalates over time and can lead to clinically significant neurological symptoms and cell death.
However, he does not believe that excess glutamate would cause a child to become inward focused. He believes the social problems of autism are not due to an avoidance of contact, but a lack of interest.
Dr. Wiznitzer has done no original research on the potential causes of autism.
Questions from Special Master Denise Vowell for Dr. Wiznitzer
Dr. Wiznitzer began by saying that about 25-30% of children with autism have some identified biological underpinning such as Fragile X, Retts Syndrome, rubella, or thalidomide exposure, but then immediately began to undercut his assertion by noting that the Rett syndrome girls are very social, unlike autistics.
Encephalitis in adults can often produce some autistic-like symptoms, but then again, these vary substantially from autism.
Dr. Wiznitzer had no real explanation with convincing data about the cause of autism, noting the theory that brain development is based on a number of signals being sent to the brain at the right time. However, he could provide no clinical or biological evidence to support his belief.
Direct Examination of Dr. Michael McCabe, Jr. by Mr. Vincent Matanoski – Attorney for the Government (Respondents)
Dr. McCabe is an associate professor in the Department of Environmental Medicine at the University of Rochester, School of Medicine and Dentistry. His specialty is immunotoxicology. He runs his own lab and is an associate editor of “Toxicology and Applied Pharmacology” as well as serving on the editorial board of the “Journal of
Immunotoxicology.” In 2000 he received the award for “Young Outstanding Immunotoxicologist.”
The first topic covered was the earlier assertion by Dr. Byers that he was surprised by the number of papers relating to mercury and the immune system. Dr. McCabe was not at all surprised that there were many papers on this subject.
Dr. McCabe thought Dr. Byers made a provocative statement when he asserted that mercury targets the T-regulatory cells of the body. According to Dr. McCabe, there are no papers showing mercury influences auto-immunity or auto-T-reactivity in humans.
However, there are a sizeable number of papers showing mercury modulates the immune response in animals. Mercury is often used as a tool to cause immune modulation to study immune modulation. Dr. Byers cautioned that results from animal studies can’t be readily translated to humans, especially since they were using relatively high amounts of mercury.
It’s also known and generally accepted that thimerosal can provoke changes in intracellular calcium. However, Dr. Byers thinks the assertion by Dr. Isaac Pessah of UC Davis in which he linked changes in intracellular calcium to changes in signal transduction in dendridic cells was making too great of an intellectual leap.
Dr. McCabe is not aware of any evidence mercury would inhibit the immune response to a measles vaccine.
In preparation for his testimony Dr. McCabe reviewed the medical records of Colten Snyder. He noted Colten’s mercury levels in blood and hair were low, and that his urine mercury levels were high only after a provocative challenge.
While Colten’s urinary porphyrin test results were high (testing which reveals the byproducts caused by retained mercury in the body) were high, they didn’t change over time, which would be expected in a child undergoing chelation.
Cross-Examination of Dr. McCabe by Mr. Thomas Powers – Attorney for Family (Petitioners)
Dr. McCabe was unable to answer the question of at what level of mercury exposure one would expect to start seeing immune dysregulation. He said it was difficult to answer because those studies which have looked at occupational exposures have not been very sophisticated. He is not aware of any which have done more than examine mercury exposure and as he described it “count cells” (lymphocytes).
He agreed that when thimerosal is injected it breaks down into ethyl mercury. Dr. McCabe is familiar with the University of Washington study by Dr. Burbacher which showed ethyl mercury has a greater chance of being deposited in the brain than methyl mercury. Once in the brain the ethyl mercury breaks down into mercury plus 2, the most toxic form of mercury. Additionally, once in the brain the mercury will not be expected to come out through hair, blood, or urine.
Dr. McCabe conceded there was no non-invasive way to directly test for mercury in the brain. However, the urinary porphyrins test pioneered by Dr. Wood does show the byproducts of mercury, even from mercury which may remain in the brain. He actually believes the evidence used by Dr. Wood to establish body mercury burden for urinary porphyrin levels is quite convincing.
He is familiar with Dr. Woods work showing approximately 13% of dental workers showed evidence of mercury retention in their bodies, but was not particularly interested in the subject.
Dr. McCabe agrees the blood, urine, and hair tests performed on Colten Snyder all took place at least two years after his MMR shot.
Questions from Special Master Denise Vowell for Dr. McCabe
Dr. McCabe was unable to provide the Special Master with any formula for translating the mercury in vaccinations with what one would expect to see in a blood, urine, or hair test.
Dr. McCabe didn’t know whether ethyl mercury had more of an affinity for the kidney than other organs.
According to Dr. McCabe, methyl mercury has a half-life in the body of about 65 days, while the half-life for thimerosal is about 7 days.
Dr. McCabe had no opinion as to whether there is such a condition as a “mercury efflux disorder” in which certain individuals are theorized to have difficulty ridding their body of mercury.
The Special Master drew Dr. McCabe’s attention to an article by Dr. Woods in which dentists with known exposure to mercury through dental fillings were given urinary porphyrin tests. About 13% of the subjects showed elevated urinary porphyrin levels, leading Dr. Woods to conclude they had been retaining mercury. Further investigation by Dr. Woods revealed that those individuals with elevated porphyrins had a CPOX-4 polymorphism. Dr. McCabe felt unable to express an opinion on this subject.
Special Master Vowell then asked if the CPOX-4 polymorphism might provide a partial explanation for the reported 1 in 500 number of children who suffered from acrodynia (Pink’s disease) from ingesting teething powders containing mercury. Again, Dr. McCabe did not have an opinion on this subject.
The Special Master then asked if Dr. McCabe had considered this in his review of Colten’s files. Dr. McCabe said Colten’s profile didn’t resemble those in Dr. Wood’s
study.
The Special Master said that from her review of Dr. McCabe’s report it didn’t seem as if he had considered the question.
Thoughts on this Day of Testimony
The government’s expert witness on anti-myelin basic protein antibodies said the finding of these antibodies in Colten Snyder were of “uncertain significance” despite the fact they’re found in 62% of those suffering from multiple sclerosis, 50-60% of epileptics, 50% of sufferers of rheumatoid arthritis, and 50-60% of those with autism spectrum disorders. (Forgive him, folks, he’s only been a professor since 1963! I’m sure he just needs a few more years to figure out what they mean! Oh yeah, he’s retired, so I guess he got through his entire career without knowing what they mean!)
The government’s expert witness on neurology credited Colten’s miraculous recovery to the two sessions a week of thirty minutes he spent with a speech therapist. (Never mind that the speech therapist herself is the one who suggested Colten see Dr. Bradstreet, a doctor who specializes in bio-medical treatments and credits Dr. Bradstreet’s work for Colten’s recovery.) However, none of his patients have ever made such a dramatic recovery.
The government’s expert witness on the toxicity of mercury had no opinion as to whether some people might have a CPOX-4 polymorphism which results in them having a difficulty in excreting mercury from the body.
Let me state that again.
THE GOVERNMENT’S OWN WITNESS HAS NO OPINION AS TO WHETHER SOME PEOPLE HAVE DIFFICULTY RIDDING THEIR BODIES OF MERCURY. (Remember, this was the “Young Outstanding Immunotoxicologist of 2000! Maybe one can have a bright future in medicine without having any opinions or knowing anything of significance about your subect!)
Today’s testimony was a little like having a murder suspect say he has no idea how the victim’s blood ended up all over his clothes and asks for us to believe him.
I wouldn’t bet on an acquittal.
Kent Heckenlively is Lega Editor for Age of Autism.
Right on Kelli!
Posted by: Jeanne | February 22, 2008 at 04:01 PM
Sandy, If any official body/ies could be bothered to carry out proper taking of family medical histories, then it would be found that many mothers with an autistic child have diabetes/thyroid conditions/rheumatoid arthritis/other autoimmune disorders themselves and, additionally, both parents have strong family medical histories of autoimmune disorders/allergies/gastrointestinal disorders. We know this to be true by talking to each other - why, why, why, don't the medical profession start the clinical examination of autistic children then, in a few years' time it just might be possible to work out which children should not (underlined) receive triple/multiple vaccines. In the UK we've been asking for this for more than ten years but all we get given is yet another pointless epidemiological study.
Posted by: Elizabeth | February 22, 2008 at 01:37 PM
Wow, Kent no wonder many of the previous vaccine omnibus cases had their records sealed.It is embarrassing to watch what little evidence and argument the government has.
Posted by: Richard | February 22, 2008 at 01:22 PM
“Dr. Byers cautioned that results from animal studies can’t be readily translated to humans, especially since they were using relatively high amounts of mercury.”
Huh?
So, what are we supposed to do doc? Use “real humans” to conduct the experiments in order to get “legitimate” results when it comes to determining a safe level for mercury? And if we don’t, nothing else counts?
Unfortunately, as crazy as that sounds – the experiment IS being conducted – just not in a closed laboratory.
Posted by: Kelli Ann Davis | February 22, 2008 at 12:46 PM
Thanks, Kent, as usual.
One thing that struck me is that one of the government's witnesses mentioned that pre-natal exposure to rubella can result in autism. I wrote a column on this. (Anyone who wants to be able to access the supporting documentation should use the link below, otherwise you can read it in its entirety below the link):
http://www.vaccinationnews.com/Scandals/2003/Dec_2/Scandal67.htm
Scandals - 12/2/03
Is Rubella Vaccination Playing A Role In The Rise In Autism?
by Sandy Mintz (aka Gottstein)
Much has been written about the declining use of the MMR vaccine in the UK due to concerns about its possible connection to autism. Ironically, in spite of this, the BBC recently reported, “New mothers and women hoping to become pregnant are to be offered the MMR jab because supplies of the single rubella vaccine have run out.”
In a stunningly irresponsible fit of pro-vaccine enthusiasm, Dr Elizabeth Miller, of the Health Protection Agency, reportedly remarked to the BBC that "There are no potential adverse effects as a result of receiving the MMR vaccination when women are planning to become pregnant, or after childbirth."
"NO POTENTIAL ADVERSE EFFECTS"? Aside from the fact that one can never reasonably say there is NO potential for side effects, among the things that are known about MMR and its component vaccines, the following can be stated:
1) Merck itself has warned about potential adverse effects from administration during pregnancy and nursing.
2) The Institute of Medicine found that MMR and/or its component vaccines can cause arthritis, thrombocytopenia, and anaphylaxis. (1,2)
3) There have been thousands of adverse MMR vaccine-associated reactions among those 18 and over reported to VAERS.
Given that the vaccine was designed specifically for childhood use, it is not clear that much testing of adults has ever been conducted. Certainly, since MMR has not long been used by adults, little can be known of its long-term effects in that population.
Beyond the more obvious question whether or not MMR is safe and if it should be recommended for adult women of child-bearing age, however, lies a more provocative and critical series of questions: Has congenital rubella syndrome actually declined? If so, how much has it declined? How much of that decline is rubella vaccination responsible for?
Vaccination against rubella is known to result in a subclinical or mild case of the disease.
Rubella (German measles) is a disease for which there is a widely used vaccine. (It is generally administered via the MMR vaccine.) It is, in itself, a mild, often even subclinical disease. The reason it is recommended/mandated is to protect the developing fetus, which, if exposed to the virus during a critical period while still in the womb, can develop a serious condition called congenital rubella syndrome.
There is evidence that the rubella vaccinated, including pregnant women, are getting subclinical cases of rubella, just as is the rest of the population. What does vaccination accomplish if all it does is result in a subclinical case of an already mild or subclinical disease?
Moreover, what does vaccination accomplish if previously vaccinated pregnant women not only can get subclinical cases of rubella, but that such cases can result in congenital rubella syndrome (CRS)?
Unfortunately rubella vaccine immunity also appears to wane over time. On the other hand, natural immunity to rubella is thought to generally be life-long.
Would it not be better to expose children, particularly non-immune teenage girls, to rubella in order to increase the likelihood that one would be immune during pregnancy, rather than to risk the possibility of getting rubella while pregnant? As Dr. Hugh Paul stated in "The Control of Diseases", which was written in 1964, before formulation of the rubella vaccine, "The disease (rubella) cannot be prevented, and in view of its very mild character, and the possibility that it may have catastrophic effects if contracted by an expectant mother, it is questionable if it should be prevented in childhood and adolescence even if this were possible. It has been suggested that female children should be deliberately exposed to infection in order to achieve a life-long immunity from the disease and possibly from malformation in the offspring in later life. This idea is not an unreasonable one... Rubella does not kill, and even complications are uncommon."
And if rubella during pregnancy is often subclinical among the vaccinated, how diligent are we being in evaluating newborns for congenital rubella syndrome since serological testing is necessary to confirm CRS and often even rubella itself?
There are a number of symptoms associated with the condition. Two of the possible symptoms are "developmental delay" and hearing loss, both of which might not be noticed immediately. Are we assuming something isn't congenital rubella syndrome simply because the mother was vaccinated? Are we testing every infant or child who shows "developmental delay" or hearing loss for congenital rubella syndrome?
The textbook "Vaccines" lists a group of "prominent clinical findings in congenital rubella syndrome". Among them are autism and diabetes. Are we testing every infant and child with autism or diabetes for CRS?
Some of these conditions, including autism and diabetes, are thought to be on the rise.
Could these increases be occurring not only because rubella vaccine is causing more women of child-bearing age to be vulnerable to the disease, now that they no longer achieve natural immunity during childhood, but also because the vaccine is causing subclinical rubella?
Prior to rubella vaccination, often the only sign that a woman had been infected by rubella was the birth of a CRS baby. Might widespread rubella vaccination have merely resulted in more undetected rubella and CRS than has previously been the case? Might there now be among the signs of CRS, conditions like autism and diabetes? Might we be overlooking the possible connection between conditions like autism and diabetes, precisely because we assume, but don't really test for it, that rubella vaccination results in the prevention of congenital rubella syndrome?
Are we conducting laboratory testing of every infant or child who shows one or more of the numerous symptoms associated with CRS? If not, isn't it possible that we have been overestimating rubella vaccine's success in eliminating congenital rubella syndrome? Of even more concern, might rubella vaccine be at least partly responsible for the rising incidence of some CRS-associated conditions, including autism?
Posted by: Sandy Gottstein | February 22, 2008 at 11:34 AM
Excellent summary as usual. Thank you so much, Ken, for following the trials and explaining them to parents and others.
FWIW, two names were misspelled -- Dr. Isaac Pessah, and Special Master Denise Vowell.
I am impressed with the level of questioning from Special Master Vowell. She quickly spots the DOJ's omissions and obfuscations.
Posted by: nhokkanen | February 22, 2008 at 10:58 AM
I would be hesitant about comparing what happened in the Wyeth case to what is likely to happen in the Autism Omnibus Proceeding.
First, the Vaccine Court was established with the assumption that some people wold be harmed by vaccines. It is difficult to read the legislative history and come to any other conclusion.
Second, the standard of proof is significantly different. As you can see from Wyeth, the expert witnesses for the plaintiff were not even allowed to testify. It's kind of hard to put on a case in such a situation. By contrast, the experts were allowed to testify in this action.
Third, while from my read of the Wyeth case the court seemed to base its decision on what is generally accepted in the scientific community, the Special Masters have struck me as aware that this case is pushing the envelope of known medical science and feel comfortable doing it.
Last, when you prevent expert witnesses from testifying you don't have to comment on their evidence. In the Autism Omnibus Proceeding the Special Masters will need to comment on the evidence which has been provided, as well, in my opinion, of how the plaintiffs have challenged the government's witnesses.
If I was to make a guess, the Autism Omnibus Proceeding will more likely end up looking like the Congressional Report headed by Representative Dan Burton than the Wyeth case.
All the best,
Kent Heckenlively
Posted by: Kent Heckenlively | February 22, 2008 at 10:06 AM
"Today’s testimony was a little like having a murder suspect say he has no idea how the victim’s blood ended up all over his clothes and asks for us to believe him.
I wouldn’t bet on an acquittal."
Guess what Kent, there was an acquittal in a similar case (I would think). However acquittal does not imply lack of guilt in the minds of the greater public.
http://biz.yahoo.com/prnews/080219/nytu096.html?.v=10
Posted by: Mark | February 22, 2008 at 09:26 AM
The blow by blow of the government experts' testimony reads like the lost chapter of "Slaughterhouse Five". Horrifying and banal and kind of silly.
And can someone tell me again why there are attorneys hired by the government to ward off claims against pharmaceutical manufacturers in the first place? I can't wrap my mind around it.
Posted by: Gatogorra | February 22, 2008 at 08:50 AM
Kent, excellent summary. I love the way you wrap it all up at the end.
The Special Masters are asking good questions.
Posted by: Anne S | February 22, 2008 at 07:52 AM