By John StoneFollowing two articles on the organization Voices for Vaccine and its two leading advocates Dorit Reiss and Karen Ernst . John Stone (UK Editor of Age of Autism) had the opportunity for a detailed exchange of views with Reiss on Examiner.com in its blog ‘Anti Jenny McCarthy petition authored by pharmaceutical industry cronies’. The position, however, is much as before.The legal and historical status of Voices for Vaccines
Dorit tried to make light of the association with ‘Task Force for Global’ a sizeable non-profit which claims to be a partner of the Centers for Disease control which takes money from the pharmaceutical industry. In fact, VFV were started by ‘Task Force’ in 2008 which stated its intention of recruiting members of the public to act as advocates for the vaccination program. When I originally wrote about Dorit on these Karen was on in minutes stating:Voices for Vaccines has as its fiscal agent The Task Force for Global Health. They take in our donations and cut checks for us. Many non-profits who are too small to handle their own 501(c)3 status use fiscal agents in this way; it's quite common. We have absolutely no access to their money, nor do we benefit from their money. Voices for Vaccines is not tied to any pharmaceutical corporation or to any government organization. Thus far, all of our donations have been small and have come from individuals.
However, the Task Force website states that VFV is a project of Task Force (and it subdivision Vaccine Equity) and CDC veteran Alan Hinman is named as both director of Vaccine Equity (funded by Bill Melinda Gates Foundation, Merck and Novartis) and VFV. When finally cornered on this we had the following exchange:Dorit: The problem is that she [Karen] cannot show you a negative: how is she supposed to show you that Hinman is not controlling? I point out that if you look at what VFV does, it is very clearly Karen and Ashley's voice you hear and no one else. If you want to demonstrate links to the Task Force, I'd appreciate some evidence of control.Me: It would be a trifle unusual for the director of an organization not to have any say in its running. BTW does VFV have an independent report and accounts - I can't see anything displayed on the website? Dorit: Note that Hinman is not listed as director on VFV. I don't know why he is on the Task Force. And I don't know about the accounts - you'd have to ask Karen Ernst.Me: Karen can comment here if she wants.
I do not know whether Karen is grateful to Dorit but so far she has not shown up to clarify matters. Earlier on in the exchange Dorit had seemed to have more knowledge of VFV’s financial arrangements:Many non-profits that are small make use of a financial agent. The global task force serves in that role for Voices for Vaccines. They pay the Global Task Force for it.Agency or Regulator Capture
Here Dorit maintains the level of obfuscation we might expect following her article on the benefits of agency capture, only surprise she does not recognise any instance of capture and all the points where the CDC and industry meet – either through Task Force or the CDC Foundation – are ineffably benign and beneficent.Dorit: … Reading the Task Force's annual report, I see some ex-CDC among its people, and some projects in which the CDC is a funder. http://www.taskforce.org/sites.... The fact that the Task Force gets funding from CDC seems to suggest that if anything the CDC has input into their projects, not that pharma influences the CDC covertly through the Task Force. That's not good evidence of pharmaceutical control (or even influence) on the CDC. To remind you, the CDC's operations are funded by CongressMe: Surely, it is a matter of culture. Julie Gerberding was appointed head of Merck vaccine division within a year of leaving the directorship of the CDC - that is scarcely reassuring. You may be comfortable with such things, but I am not.It's a long time ago but Task Force according to Wiki was founded by three ex CDC execs who could thus form partnerships with both industry and the CDC.
Another commenter “Ember” intervenes:Your article arguing the benefits of (regulatory) capture is not confusing. The term regulatory capture was originated by Woodrow Wilson to signify the phenomenon of state regulatory agencies which were created to act in the public interest but which instead advance the commercial or special interests that dominate the industries the agencies are charged with regulating. There's really nothing confusing about trying to rectify the term or the practice as a "good thing."
Dorit responds to neither point. This is a later exchange:Me: Actually, when it comes to the issue of regulatory capture the CDC Foundation is a very interesting topic. Here is a list of the foundations corporate partners with the rubric:"Our diverse partners understand that linking with CDC through the CDC Foundation can significantly advance public health in this country and worldwide. Often, partners become engaged early on in a project to clearly understand its objectives or participate in the program design. Several partners may jointly fund a program to ensure its successful completion."Corporations whose goals or philanthropic interests align with CDC’s work often partner with the CDC Foundation to advance CDC's work on a specific health threat, such as protecting patients from healthcare-associated infections, reducing tobacco use and increasing screening and treatment for chronic and infectious disease." (http://www.cdcfoundation.org/what/partners#category-299)Of course, all the major pharmaceutical manufacturers are there (and none of them are really philanthropic organizations)Dorit: The foundation is actually set up as a good example of the…kind of collaboration that we want to encourage and that does not really raise concerns about capture. The foundation operates outside the CDC, with a dedicated team; it does things that do not require direct regulation of companies - most of the projects are focused either on research or on activism abroad; it does not give funding partners direct access to decision making inside the CDC; it allows the CDC to do things that it would not be able to do on its regular budget to prevent health threat; and in case you noticed, funding partners include The Mayo Clinic, the World Health Organization, and others.
Me: An alternative reading is that the agency simply becomes the instrument of various industrial (and other) interests, which as I understand it you welcome. That, after all, was where we came in.Dorit: I'm not sure where you read that I welcome an agency becoming the instrument of industrial interests - that's some serious misunderstanding of my article. But the CDC foundation certainly does not show that the CDC is an instrument of the companies. It does projects related to public health beyond the core responsibilities of the CDC, separate functionally from decision making, and I'm not sure how you can say any of the specific projects makes it the instruments of companies.Me: It certainly does not show careful distance - it makes the CDC a conduit for trade.
To which Dorit does not respond.Banning Jenny McCarthy from public broadcasting and whether vaccines cause autism
These two issues sit together, with Dorit’s attempt to de-legitimize and marginalize Jenny’s experience. I wrote:Me: When I wrote an article about you a couple of weeks ago…I was disturbed at your attitude to agency capture, combined with your very hard line on vaccine compliance and an aggressive strategy to shut people out and…down who disagree - Jenny McCarthy would be a case in point.Dorit: …I always do my best - time permitting - to respond to comments from the other sides on articles in journals, though I rarely engage on your home base, which seems needlessly provocative. I certainly do have a strong view on vaccine compliance: while I do not support mandatory laws (laws imposing fines and penalties on those not vaccinating), I support tight school attendance requirements and other mechanisms for encouraging compliance. But it is unfair to characterize this as shutting down people: nobody is preventing McCarthy - or anyone else - from voicing an opinion, and she - and you - do so in many forums. The opposition to her role on The View is because of the apparent legitimacy it confers on her opinions - not as an attempt to shut her up. She still has multiple forums to express her opinions, and I would certainly not deny her her right to free speech. On the other hand, I too can exercise my right to free speech and mobilize to get a private network not to hire her.Me: No, that's doubletalk. Her opinions are perfectly legitimate - she speaks from experience, and she asks for the vaccine program to be made safer - what could possibly be more moderate or reasonable? The basic point is that you want a say on what is legitimate. People who don't jump into line must be excluded from public life, shoved to the margins.It's perfectly reasonable to debate the pros and cons of vaccines in a blog and it ought to be on TV too…Dorit:.. It's not double talk: free speech does not entitle one to a public, televised platform. Jenny McCarthy provides unfounded, problematic health advice - on vaccine and other things. I won't support shutting her up, but I do protest against putting her on the show.Me: No, you say it is unfounded, and you want to say it is unfounded in the case of every single parent who speaks up, but you weren't there - and frankly it is a bit of a nerve. The reality is that vaccines cause brain damage and they cause autism:After the Hannah Poling case Julie Gerberding, at the time head of the CDC but now of Merck's vaccine division was forced to admit:“….. if you’re predisposed with the mitochondrial disorder, it [vaccination] can certainly set off some damage. Some of the symptoms can be symptoms that have characteristics of autism.”.While Vaccine Injury Compensation Program officials told Sharyl Attkisson:
"The government has never compensated, nor has it ever been ordered to compensate, any case based on a determination that autism was actually caused by vaccines. We have compensated cases in which children exhibited an encephalopathy, or general brain disease. Encephalopathy may be accompanied by a medical progression of an array of symptoms including autistic behavior, autism, or seizures."But apparently you know better, and you know better in every single case.Dorit: As to the cases: encephalopathy is not autism (nor is encephalitis) (see question 6 here: http://www.neuro.jhmi.edu/neuroimmunopath/autism_faqs.htm) A mitochondrial disorder is not autism, even if some of the symptoms are similar. As these studies show, it is not clearly connected to autism: http://www.biomedcentral.com/content/pdf/1471-2350-12-50.pdf http://www.ncbi.nlm.nih.gov/pubmed/21404085 The fact that a child has both encephalitis and autism does not negate this. And to remind you, vaccine preventable diseases also cause encephalitis - at much higher rates than vaccines - and can also be horrible to children with mitochondrial disorders. So if those conditions translate to autism, the absence of vaccines would increase rates. But they're not autism, nor contribute to it.Liquidambar: Dorit;Autism is just the psych term of what you got left after a vaccine injury.Me: No one said encephalopathy is autism - straw man argument. 'Liquidambar' is right too: autism may not be the exclusive cause of autism but it is matter of the brain injury resulting in autism (which is a non-specific group of neurological impairments), and the officials admit that it happens.Of course, now we have an autism rate of about 1 in 50 so the issue of vaccinated vs unvaccinated is very pressing.Dorit: I wasn't there. But frankly, being there means the parent can offer excellent testimony on…what happened (allowing for the natural limitations of perception and memory that apply to every eyewitness account, especially something this charged). They are less able to address the why, because they don't have the perspective of background rates and other potential causes: those things are invisible. And I've no doubt saying this hurts the parents, and if there's one thing I regret here is that pain: it can't be pleasant to hear, again and again, you are wrong about something this important to your heart. But I will still say it, for two reasons: A. Parents who believe vaccines caused their child's autism feel guilt for allow the child to be vaccinated and bitterness at others. I think it's important to remind parents that there is no evidence for that link because it's not fair to the parents to leave them with those emotions, when it's contrary to the evidence. B. Not vaccinating leaves children at risk of vaccine preventable diseases. That's dangerous. Leaving children at that risk without evidence of a link, and with evidence to the contrary is worse. I think it's important to point out the flaws and provide the information to correct that. But I do understand that it hits a nerve, and wish there was a way to make the argument without that.Liquidambar: Nope you were not there, as I kept vaccinating and kept seeing reactions that even the vaccine inserts says to talk to your doctor about. But something is wrong with the doctors - they did not listen untill a stroke like event I think that is called rechallenged isn't it?Me: Almost immediately above I have posted statements by US government official[s] admitting that vaccination can give rise to autisms - it is certainly possible and certainly happens. I guess you don't like being told your wrong or having possible guilt foisted on you either, but relevance?Dorit: Neither statement admits that vaccine cause autism, and both point out that compensation was not for autism.Me: In bureaucrat-speak fairyland: autism is the effect of the injury. If there was no significant effect from the injury there would be no serious compensation. Dorit: "Symptoms that can have characteristics of autism" and "autism-like" symptoms are not autism. Symptoms cross over between conditions. The fact that I can have nausea after I broke my arm and nausea because of morning sickness does not mean a broken arm is a pregnancy.Me: This is completely wrong. - autism is entirely defined by it symptoms. If there were any difference between "autistic behaviour" and "autism" - only possibly a matter of degree - the HHS HRSA statement resolves it by naming both (as the result of vaccine induced brain injury) and also mentioning seizures, which alas often accompany autism. But as I have also pointed out the case for a brain injury would be hard to make out if there was no resulting impairment, so in principle the impairment is acknowledged too - has to be. What Dorit does here is demonstrate her total ignorance of autism diagnosis (which doesn't stop her pontificating).Dorit: Autism is defined by its symptoms, but it has requirement - just having some of the symptoms, or something like the symptoms is not enough. http://www.autreat.com/dsm4-autism.html Me: And your point is?Dorit: Encephalopathy is not autism; encephalitis is not autism; a mitochondrial disorder is not autism; the government officials did not concede vaccines cause autism, in fact they said they did not. They did point out that some of the injuries cause by vaccines can have some of the symptoms of autism. In no case did the NVICP or another court in the U.S. compensate a child on the theory vaccines caused her autism. There is no credible evidence for such a link.Me: Dorit, if you want to argue like that its up to you, and people can draw their own conclusions about your motives, but this is what they said:"The government has never compensated, nor has it ever been ordered to compensate, any case based on a determination that autism was actually caused by vaccines. We have compensated cases in which children exhibited an encephalopathy, or general brain disease. Encephalopathy may be accompanied by a medical progression of an array of symptoms including autistic behavior, autism, or seizures."Now, there is more than a touch of distinctions without differences about this (as Sharyl Attkisson was pointing out) but in so far as one can make sense of it the point is there is a mechanism (encephalopathy) which results in impairment (autistic behaviour, autism, seizures) and what you have to show is brain damage occurred as a result of the vaccine. But if there was no impairment it would be hard to argue that a case needed compensating, so they are forcing a point while admitting that autism is sometimes involved.Also, it is worth noting that in the statement "autism" and "autistic behavior" are symptoms of encephalopathy ("encephalopathy may be accompanied by a medical progression of an array of symptoms including...") and there is no mention of "symptoms of autism", which is erroneously interpolated by you in order suggest it is not proper autism. But not only is this technically silly - another distinction without a difference - what concerns parents is not whether there is some Platonic ideal of autism to which their child's disability corresponds, but their often reasonable belief that their child has been damaged.
This conversation goes round in circles a few more times with Dorit splitting the same hairs. The government did not compensate the autism, they compensated the encephalopathy which caused the autism (but then if encephalopathy didn’t cause anything why compensate it?) And at the end of it is simply not clear why Jenny McCarthy would be unreasonable in believing that her child’s autism was caused by a vaccine, or why Dorit – who says she believes in free speech – is reasonable in wanting to ban Jenny from speaking in the mainstream media. Some might call it humbug, and who would I be to disagree?The safety and effectiveness of vaccines, the case of Andrew Wakefield etc.Me: There are lots of things which ought to be debated here - and now you are making a show of welcoming discussion but this has not been the pattern until this point.My own contention over vaccines is not that they don't have benefits but they are neither as effective or as safe as you or the propaganda would have everyone believe: in fact the truth is decidedly messy and we don't have proper accountability. I suspect if you had your way it would be reduced to zero. But this is done by silencing people and that is not a scientific project.Dorit: Obviously I also disagree with your claim that vaccines are not safe and effective and I think the evidence on this is very clear cut. I'm willing to discuss specific points with you.Me: Well, there are a great many specific points to discuss and one is aggressive campaigns against parents or professionals who have spoken up about vaccine damage - that in itself is a way of distorting the evidence base. The problem with Andrew Wakefield was not the quality of his research but the fact that he listened to parents - that was what was intolerable. But as was shown in the English High Court last year - in the appeal of his senior colleague John Walker-Smith - there was nothing wrong with the Lancet paper which the UK General Medical Council skewered all three doctors on. Of course, it was a warning to everyone else who stepped out of line.I was particularly sickened at the beginning of the year when GAVI/Bill and Melinda Gates Foundation successfully lobbied the UN to continue the use of thimerosal in vaccines on completely spurious arguments.I sent Dr Larson 90 abstracts of pubmed studies condemning thimerosal to no avail. It is very easy to conduct studies which don't find anything but these were 90 which did.That's two points. It's very late at night here.Dorit: The last point about thimerosal - as pointed out, thimerosal in vaccines has actually been studied in relation to autism, and no harm actually found. Your studies seem to be a combination of animal studies and tissue studies, and the human studies examining the issue - and examining it in the context of vaccines - are stronger. I would also add that I'm not sure why you think it's possible to fake a negative result but not a positive one. Seems that either result could be arrived at in a valid or flawed manner, depending on the methodology.Me: No, you can fake both positive and negative but it is easy to design studies poorly to obtain indeterminate results. This critique by Brian Hooker of two recent CDC studies is very telling, and nobody of any sense came to defend them.
Dorit fails to respond to the Hooker question and moves on to Andrew Wakefield (with something of a concession):Dorit: I think your description of the Walker-Smith decision is incomplete. It is true that the judge found the council did not have evidence that the procedures performed on the children were clinically unjustified, and that may affect Wakefield's case; but the judge's overturning of the guilt for misrepresenting the ethic's committee approval was based on Wakefield changing the article after the last draft Walker-Smith saw - basically, on Wakefield misrepresenting the facts behind his co-authors back, and that is not an exoneration of Wakefield, quite the contrary. Similarly, the Walker-Smith decision does not address Wakefield hiding conflicts of interest and the other problems.However, silence reigns again when I demonstrate that there is nothing in the ethical approval issue to incriminate Wakefield either:Me: I think John Walker-Smith missed it because there wasn't much to see:"Ethical approval and consent"Investigations were approved by the Ethical Practices Committee of the Royal Free Hospital NHS Trust, and parents gave informed consent."The investigations needed ethical approval and had them and the paper did not have ethical approval and did not need it. The statement does not say the paper had ethical approval. Nor was it commissioned by the Legal Aid Board or based on their protocol, so no conflict there. Nor was it the convention in that period to declare court work as a competing interest.
Perhaps Dorit might like to consider how people’s lives can be unfairly and erroneously trashed when they stand up against governments or industry, and wonder whether this is really the nice side to be on.Paul Offit and rotavirus vaccine
I did not raise this but of course Offit is one of the four professional advisors of VFV. It was, of course, a VFV predecessor of Karen Ernst (and fellow St Paul citizen) Lisa Randall who in 2008 went after Sharyl Attkisson of CBS News because of her report on Offit, through Orange County Record
who, finally – in 2011 – published a retraction
:An OC Register article dated Aug. 4, 2008 entitled “Dr. Paul Offit Responds” contained several disparaging statements that Dr. Offit of Children’s Hospital of Philadelphia made about CBS News Investigative Correspondent Sharyl Attkisson and her report. Upon further review, it appears that a number of Dr. Offit’s statements, as quoted in the OC Register article, were unsubstantiated and/or false. Attkisson had previously reported on the vaccine industry ties of Dr. Offit and others in a CBS Evening News report “How Independent Are Vaccine Defenders?”
July 25, 2008. Unsubstantiated statements include: Offit’s claim that Attkisson “lied”; and Offit’s claim that CBS News sent a “mean spirited and vituperative” email “over the signature of Sharyl Attkisson” stating “You’re clearly hiding something.” In fact, the OC Register has no evidence to support those claims. Further, Offit told the OC Register that he provided CBS News “the details of his relationship, and Children’s Hospital of Philadelphia’s relationship, with pharmaceutical company Merck.” However, documents provided by CBS News indicate Offit did not disclose his financial relationships with Merck, including a $1.5 million Hilleman chair he sits in that is co-sponsored by Merck. According to the CBS News’ documentation recently reviewed by the OC Register, the network requested (but Offit did not disclose) the entire profile of his professional financial relationships with pharmaceutical companies including: The amount of compensation he’d received from which companies in speaking fees; and pharmaceutical consulting relationships and fees. The CBS News documentation indicates Offit also did not disclose his share of past and future royalties for the Merck vaccine he co-invented. To the extent that unsubstantiated and/or false claims appeared in the OC Register and have been repeated by other organizations and individuals, the OC Register wishes to express this clarification for their reference and for the record"
Anyway Liquidambar raised the issue of Offit’s rotavirus vaccine conflict:Liquidambar: Get paid for your work - is fine, but how often is it that you get to actually vote on your own work and force it upon everyone because it is made mandatory. He got a hefty some for his work too - 6 million I do believe.Dorit: How can they vote to make their work mandatory?Me: "Unlike most other patented products, the market for mandated childhood vaccines is created not by consumer demand, but by the recommendation of an appointed body called the Advisory Committee on Immunization Practices (ACIP). In a single vote, ACIP can create a commercial market for a new vaccine that is worth hundreds of millions of dollars in a matter of months. For example, after ACIP approved the addition of Merck’s (and Offit’s) Rotateq vaccine to the childhood vaccination schedule, Merck’s Rotateq revenue rose from zero in the beginning of 2006 to $655 million in fiscal year 2008. When one multiplies a price of close to $200 per three dose series of Rotateq by a mandated market of four million children per year, it’s not hard to see the commercial value to Merck of favorable ACIP votes."From 1998 to 2003, Offit served as a member of ACIP. Before and during his ACIP term, Offit was involved in rotavirus vaccine development activities, the value of which ACIP influenced. Shortly before his term began in October 1998, Offit’s first two rotavirus patents were granted by the U.S. Patent and Trademark Office, the first on May 6, 1997 and the second on May 12, 1998. During his ACIP term, Offit received two additional patents in 2000 and 2001"Dorit: It's a little unclear whether your insinuations about Dr. Offit stem from your feeling that he voted on his personal interests or because you see him as representing Merck. At any case, they are incorrect:A. Dr. Offit does not hold the patent for Rotateq - CHOP does. After the initial payment, he does not get royalties (and I am sure you don't begrudge a man payment for 25 years work, work that resulted in a vaccine with the potential to save hundreds of thousands of lives), so he does not have a financial stake in the success of the vaccine. B. As you yourself point out, Dr. Offit stopped serving on ACIP in 2003 and the Rotateq vaccine was voted in later. He was not involved. C. Dr. Offit does not work for Merck - as is pretty easy to find, he works in the Children's Hospital of Philadelphia and for Penn Medical School. He does not depend on Merck for his salary.Me: I should have included the next paragraph:"Four months before Offit was appointed to ACIP in October 1998, the committee had voted to give the rotavirus category a “Routine Vaccination” status, in anticipation of an FDA approval of RotaShield (oddly, ACIP made this vote before the FDA approved Wyeth’s RotaShield vaccine on October 1, 1998). Shortly after Offit’s term began, there were several additional votes involved in establishing the rotavirus vaccine market and Offit voted yes in every case. In May of 1999, the CDC published its revised childhood vaccination schedule and rotavirus vaccine was included. This series of favorable votes clearly enhanced the monetary value of Offit’s stake in Merck’s rotavirus vaccine, which was five years into clinical trials."Dorit: So the vaccine was added to the schedule before Offit joined, and he had to decide on specific issues after the facts, issues related to a vaccine that was not his - was, in fact, a competitor - while his vaccine was still in trials, behind in market entry. Sorry, not very good evidence of a conspiracy or capture.Dorit: It is true that the CDC's ACIP approves - and removes approval - from vaccines. For example, after concerns about intussusception arose from Rotashield, that vaccine was removed from the market - and removal from the market (like in this case), and non-recommendations - for example, not recommending meningococcal C for infants - is good evidence that ACIP does not blindly stamp industry recommendations and is not captured.Me: Even better for Paul O. His product also has a big record with intussusception.Found 914 events where Vaccine is RV5 and Symptom is IntussusceptionFound 7 events where Vaccine is RV5 and Symptom is Intussusception and Patient DiedFound 266 events where Vaccine is RV5 and Patient DiedOf course, VAERS is only passive surveillance and is likely only to record a small percentage of incidents. Dorit: Actually, to remind you, Rotateq tested for intussusception in the clinical trials, and the rate was lower for the vaccine group than the placebo group. The CDC examined the VAERS incidence, and it was found no higher than the background rate - remember, intussusception does happen naturally - which leads to the conclusion that rotateq does not cause intussusception, that we're just seeing the regular rate. http://www.cdc.gov/vaccinesafe.... And again, this whole incidence is evidence of how seriously real problems with vaccines are treated: a serious adverse event was discovered in one out of 10,000 children with Rotashield; the vaccine was removed from market; the new vaccines were tested to make sure they don't cause the same problem. http://www.cdc.gov/vaccines/vp.... This is pretty good evidence that there is no capture and the system works.Me: And post-marketing monitoring? The spirit of the three wise monkey reigns!In the UK we are just about to get rotavirus vaccine (the GSK version) so it is quite interesting to look at our Health Protection Agency charts - it seems to be fairly consistently around 15,000 lab confirmed cases a year (connected with hospital admissions). That's a lot, but what I don't see are any associated deaths (unlike the vaccines).
I should have said post-market monitoring seemed to have worked better in the case of Rotashield than Offit’s Rotateq but raising the issue that the vaccine seemed more associated with death than disease was once again met with Dorit’s silence.
I have not reported every aspect of the discussion: for instance Dorit’s hobby horse about suing parents who do not vaccinate for infection, as against the problem of vaccines that shed and spread infection (for instance the nasal flu vaccine Flumist/Fluenz), nor our exchanges about genetic research. But it was an interesting and ultimately revealing dialogue, which perhaps I enjoyed more than she did.
John Stone is UK Editor for Age of Autism.