Olmsted on Autism: The CDC's Point-Three Problem
By Dan Olmsted
WASHINGTON, Oct. 1 -- If I were a rich man, and I wanted to downplay my wealth to someone who was hitting me up for money, I could say, "I'm only worth a tiny fraction of Bill Gates -- I've got a measly three dollars for every thousand he has, to tell you the painful truth." Of course, 0.3 percentage points of Bill Gates' $50 billion is big money -- $150 million. The point: Small fractions can add up to large numbers.
I've been trying to work out that kind of math in my head since the CDC conference call last week -- the one that flogged the new HMO-based study "reassuring" parents that organic mercury in vaccines is harmless. The one where I asked: Why not use never-vaccinated kids as a control group if you really want to reassure parents that mercury is just fine to inject in infants and pregnant women?
Here's the quote that got me thinking:
DR. ANNE SCHUCHAT, DIRECTOR, NATIONAL CENTER FOR IMMUNIZATION AND RESPIRATORY DISEASES, CDC: "In the United States we′re very fortunate to have immunization coverage and (in) our national surveys of two year olds, 0.3 percent of children have no vaccines – have received no vaccines at all. So one of the reasons that we have such low rates of vaccine-preventable diseases in this country is because we have high acceptance of vaccines and usage by parents and providers."
Dr. Schuchat was responding to a Forbes reporter who followed up on my question. The reporter clearly thought a never-vaccinated control group was a logical idea and was pressing for an explanation for why that wasn't done; Dr. Schuchat's argument was that the immunization rate in the United States is so high that a study comparing never-vaccinated kids is just not practical.
Well, let's do the math. There are four million or so children born in the U.S. every year. At a rate of 0.3 percentage points, that leaves about 12,000 American kids unvaccinated at age 2, year after year after year. Gosh, I'd love to know how many of that 12,000 grow up autistic -- it's 66 per 10,000 kids overall, according to the latest CDC numbers.
Yes, some of those two-year-olds will go on to get vaccinated later, but because autism typically manifests between a child's first and second birthday, there clearly are enough kids reaching age 2 without being vaccinated to tell us something important. What's more, postponing vaccinations till after a child's second birthday is an element of many alternative vaccine schedules proposed by parents and experts who fear neurological damage from shots given any earlier. So there's plenty to look for in a population that reaches age 2 without ever being vaccinated.
And I suspect the CDC's never-vaccinated numbers are low, because when Generation Rescue did its phone survey of children ages 4 to 17 -- well past their second birthday -- hundreds of never-vaccinated kids popped right up: "From 11,817 households, data on 17,674 children was gathered. Of the 17,674 children inventoried, 991 were described as being completely unvaccinated."
Come on now. One small group can spend $200,000 and come up with nearly a thousand ages 4 and up who'd never been vaccinated? But the CDC can't. Right.
My own research -- among the Amish, the home-schooled and a large practice in Chicago -- long ago led me to conclude there are tens of thousands of never-vaccinated kids of all ages in this country. And as Generation Rescue showed, they're not that hard to find, unless you're in the business of not looking. (Maybe the CDC could contract with Generation Rescue to identify a sufficient cohort of never-vaccinated kids to study.)
One reason I'm so suspicious about this is because every time the subject comes up, the CDC is loaded for bear. It's not enough to say the study is impossible; they have to add that it wouldn't be useful, even if it could be done. They bring up the Amish (I don't) to suggest that the difference could be genetic. They talk about how kids who aren't vaccinated could be different in some other way. It's hard for me to believe that every single argument in the universe just so happens to fall perfectly into place against the simple idea of testing the autism rate in never-vaccinated kids.
In other words, they protest too much. That's why Rep. Carolyn Maloney, D-N.Y., recently reintroduced her bill to force the federal government to study these kids. She doesn't buy their arguments, either.
Part of the establishment spiel is to point out not just the "fact" that nearly everyone is vaccinated, but to filibuster about how fabulous that is -- "one of the reasons we have such low levels of vaccine-preventable diseases in this country." That's great, but it's irrelevant. We're talking about an unexplained epidemic of neuro-developmental problems here, not a polio outbreak. Polio is bad, and so is autism. We can attack both without being dragooned into the "war on disease" every time we want to talk about autism.
Unfortunately, tactics like that -- and the "0.3 percent" number -- can be quite effective. The Forbes reporter on the conference call -- who I commend for simply asking the question -- seems to have been satisfied by the CDC answer: "Researchers couldn't compare kids who got vaccines with those who didn't, because almost all children are vaccinated," he subsequently wrote. "Only three kids out of every thousand in the United States don't get at least some vaccinations."
And only three dollars out of every thousand in Bill Gates' wallet would make me a very rich man.
I am in the healthcare IT field and have followed quite closely the debate between autism and vaccines as I am expecting a baby boy in a couple of weeks. We chose to vaccinate our 2 1/2 year old daughter but will most likely not be doing the same for our son.
The reason that I am writing is because I am in the Healthcare IT field. I sell an EHR (electronic health record) to the ambulatory physician practice. As these systems are becoming more widely used in the US I wonder what if any attempts to gather information from these systems has been done.
The power of gathering data from these systems is very remarkable. I know for example that in the system I sell a report can be run such as, "give me a list of de-identified patients that are between the ages of 4-8 that have the diagnosis of autism (ICD 9 code 299.0) without an immunization of MMR (CPT code 90707)". This is obviously a "vanilla" example but it speaks to the ability of these systems. I work for a smaller company that is just starting to make a name in this industry thus the patient population in our system is fairly small. However, the other big names in our industry such as surely have millions of electronic charts waiting to be tapped.
Just curious if anyone has gone this route to date.
Posted by: Keith | October 29, 2007 at 03:19 PM
Hi Elucidatus:
Reference your comment:
"I just don't understand why you think that we should stop trying to get to the bottom of why children are coming down with Autism and focus more on the cause of Bipolar Disorder."
I was trying to say that the CDC desperately needs to find the unvaccinated kids because it isn't just autism that is on the increase, bipolar disorder is too. And looking at the complaints of the mom in the story it seems that the child was portraying some symptoms that we have seen in autism. Broadly speaking, there is a whole section of kids coming down with a bunch of different diseases with many varied names and the story each time is - "we don't know why there is an increase in xyz."
For me personally it isn't just about autism but a whole lot more. A lot of kids who look neurologically different from a child on the autism spectrum are having a lot of drugs thrown at them with disastrous consequences. I am not saying we should stop with the autism part of it. On the other hand focussing on all kids with problems and adding up the numbers might help to make the case for the vaccine connection stronger.
Gayatri
Posted by: Gayatri | October 03, 2007 at 05:33 PM
Dear Dan:
I am a new mom, and have plenty concerns with vaccinations, and agree with your testimony 100%. I am lucky enough to have found a pediatrician who supports his patients/parents 100% on our decision to CHOSE to vaccinate or not. To date my son has received all of his shots up to his 4 month appointment. After spending countless days and hours researching this topic, I regret my decisions, to just GO WITH THE FLOW AND FOLLOW THE LEADER on getting these.
I do believe that there are links between children that have Autism and other health problems, asthma, eczema, ADD, ADHD, etc. I personally feel like these are caused from all of them toxins in the vaccines that we are putting into our children, and from the rate in which the CDC recommends vaccinating. It is time that people not only look into what they are putting into their children’s bodies via food, but also look into the toxicity of these vaccinations that is dangerous to our society. I feel that the rising percentages of children with developmental disorders is a huge problem and is slowly growing out of control.
It has long been past due for our UNITED STATES government to look into this issue, and start study groups. Why is it that everything in this country comes down to the mighty dollar?? How bad does it have to get before we do something about it? It is time for all parents to take a stand, and stand united on this issue.
While I have plenty more to learn, and have just begun my digging on this topic; I appreciate people like you who continue to fight and bring this issue into the limelight!
Sincerely,
Michelle Weber
Posted by: Michelle Weber | October 03, 2007 at 10:50 AM
Professor Lucarelli, I have passed your comment along to JB Handley and Dan Olsted. Grazie.
Kim Rossi Stagliano (Rescue Post Editor)
Posted by: EDITOR | October 03, 2007 at 07:36 AM
Dan and J.B.
(sorry for my bad english, I'm italian and I'm living in Turin, Italy)
do you remember the statement by Melinda Wharton (NIPC, CDC) before the Subcommittee on Wellness and Human Rights (September 8, 2004)?
http://www.hhs.gov/asl/testify/t040908.html
Wharton also disclosed that:
'CDC is also funding a follow-up study of a group of Italian children who had participated in a prior DTaP trial in the 1990's in which thimerosal exposure was randomly allocated. A pilot study has determined the feasibility of recruiting these participants for a follow-up study of neurodevelopmental outcomes. The children will be evaluated using a similar test battery as in the Thimerosal and NDD Follow-Up Study. Testing of children for the main study will begin this fall.'
But where are the results of that study?
I've monitored
http://clinicaltrials.gov/ct/show/NCT00004800;jsessionid=831D537ED7464F1A610B28C82F5E491C?order=9
(formerly, the vaccine efficacy trial ended in 1998)
Last Updated: October 13, 2004
Last Updated: July 25, 2005
Last Updated: December 8, 2005
Last Updated (today): June 23, 2005 (?!)
What's happened?
Posted by: Francesco Lucarelli | October 03, 2007 at 06:46 AM
Also of note Dan, the CDC identified the mothers of children who aren't vaccinated as most often being highly educated, upper middle class white women. How that makes us hard to find or too genetically different to compare to is beyond me.
Posted by: Julie | October 02, 2007 at 03:16 PM
Gayatri,
I am glad to see that you are reading the Rescue Post and that you are Raising Awareness just by commenting, but what does Katie Couric on 60 minutes have to do with The CDC's Point-Three Problem? Please help me understand where Katie fits in to all of this. Please understand that I am not being a knuckle head or being disrespectful. I just don't understand why you think that we should stop trying to get to the bottom of why children are coming down with Autism and focus more on the cause of Bipolar Disorder. Please explain.
Posted by: Elucidatus | October 02, 2007 at 01:13 PM
>>"From 11,817 households, data on 17,674 children was gathered. Of the 17,674 children inventoried, 991 were described as being completely unvaccinated."
Meet "selection bias" Mr. Olmsted.
Posted by: Do'C | October 02, 2007 at 01:04 AM
I really wish they would start to find the unvaccinated kids because it isn't just autism that is on the increase. See Katie Couric on 60 minutes yesterday "What killed Rebecca Riley." Bipolar disorder is on the increase, one million children, and they say the numbers are more than autism and diabetes combined?
http://www.cbsnews.com/stories/2007/09/28/60minutes/main3308525.shtml
To me it just looks like Rebecca was another child on the spectrum, same sleep issues, same hyperactivity, non-compliance problems.
Posted by: Gayatri | October 01, 2007 at 02:31 PM
http://www.generationrescue.org/pdf/unvaccinated.pdf
Dan:
The link above is to a CDC-Funded study called:
Children Who Have Received No Vaccines: Who Are They and Where Do They Live?
In this study, they use the 0.3% number, whcih they say equals 19,000 children per year who are 100% unvaccinated.
Of ocurse, our survey would tell you this number is menaingfully low.
Further, if one reads the CDC study, it actually provides a great roadmap for finding unvaccinated kids, because it lists the counties (and states) with hte highest and lowest levels of unvaccinated children.
Remarkable, even though they created their own roadmap, these kids are too hard to find?!!
JB
Posted by: JB Handley | October 01, 2007 at 01:47 PM