Il Mercurio and the AAP
The new thimerosal study published in Pediatrics leaves a lot of open questions. So does the response to the study by the Editor-in-Chief of the journal, Dr. Lewis First.
In his blog introducing the study, Dr. First wrote that, "You'll be reassured that the results show essentially no differences between groups who did or did not get thimerosal in their vaccines-and you'll want to know this information when talking with parents of your patients about the safety and benefits of vaccines."
But that made no sense. The study clearly stated that all children received thimerosal in the first year of life - some got 62.5 micrograms and the rest got 137.5 mcg. But there were no children who "did not get thimerosal," as Dr. First urged America's pediatricians to tell parents.
I thought I would write to AAP and clear things up, and see if a correction would be run. Officials there were (and have been) courteous, respectful and professional. So I sent the following email to the press office of the Academy:
As you can see by the study, there were only two groups - lower thimerosal exposure and higher exposure. The lower exposure group had no Hg in their DTaP, but did have it in their HepB and DT. The higher exposure group had Hg in DTaP, HebB and DT. Therefore, the statement by Dr First in Pediatrics is wrong, and somewhat misleading for Pediatricians to now relay to their patients across the country. I would like to ask for official comment from the AAP on a few questions,
1) Why did Dr. First urge pediatricians to tell parents that this study examined children "who did or did not get thimerosal in their vaccines?"
2) Will a statement of correction be sent out to members?
3) Does the AAP feel that this study had an under-ascertainment of ASD cases (1 in 1,700 vs. 1 in 150 in the US) or does the Academy believe that the rate in Italy is actually 1 in 1,700?
4) If there was an under-ascertainment of ASD, could it be due to the fact that study only looked at healthy children, and excluded premies and others? Also, if this study somehow excluded children with ASD (the US rate is 11 times that found in this Italian study) - isn't it possible that some children who developed other NDDs might have been equally excluded?
5) If the actual rate of ASD in Italy is only 1 in 1700 (about
6-per-10,000) - how can you explain the much higher rates in the US and UK? Is it just better reporting?
Many thanks, David Kirby
Shortly after that, to his credit, Dr. First himself wrote back to me:
Dear Mr. Kirby,
Susan Martin referred your email below to me regarding your concern about how I have discussed the findings in the current article in the February issue on thimerosal in my blog. Please understand that the purpose of my blog is to encourage our readers to read the articles in the issue. The blog expresses an opinion and is not meant to be a formal review of the data that has already been peer-reviewed. Thus I have used the information that the authors have shared in their abstract and "what this study adds" section of their article to preview what I hope readers will read for themselves and then interpret as they see fit. I have used the word "essentially" in my blog to express my own opinion/interpretation and to note, by using that phrase "essentially" that the data may still note associations but not ones that I personally feel are meaningful as per the data they have presented. Others such as yourself can and will feel differently, and I would encourage you to share your concerns on the e-letters page of our website where (once it has been received and reviewed by our e-letters editor) your review of the data can be displayed and commented upon by others, including the authors of the study who are best positioned to answer your questions as asked below. Thanks for your ongoing interest and comments on this article. I hope you will consider sharing them on the e-pages for others to comment upon as well.
Lewis R. First, MD
As I said, courteous and professional. But not what I asked. So I wrote back again:
Dear Dr. First,
Many thanks for your reply, it is much appreciated. However, it leaves me a little confused as it did not address the central question I had, which is why did you interpret the study to mean that there was a zero-exposure arm in the data? More importantly, are you going to run a correction, or will you allow your members to relay this inaccurate information in your blog to millions of parents around the country?
Perhaps you could clear that up before I write my own blog?
Also, I was wondering if you or anyone at AAP could provide comment to the following limitations in the study:
1) The cumulative intake of thimerosal was relatively low.
2) The analysis included only healthy children. Some families might have declined to participate because their children had cognitive developmental problems. This might have reduced the prevalence of adverse neuropsychological conditions.
3) Only 1% of children in this study received hepatitis B virus vaccine at birth.
4) Participation by low birth weight children was limited.
5) The study was not powered to detect an association of thimerosal exposure and neuropsychological development in low birth weight infants.
6) There was no comparison group with no exposure to thimerosal, and an absence of any evidence suggesting a threshold dose for observation of an effect.
These statements were taken directly from the authors themselves.
I thought sure that this time the doctor would at least acknowledge his error, but he didn't seem to think he had made one - it was simply his personal opinion and interpretation of the study. Dr. First wrote back:
Dear Mr. Kirby,
Again, I can understand your having a different interpretation of the data and respect that. My blog is not meant to be a critique of the article's limitations but an encouragement for our readers to read the article and form their own opinions of the data that is being presented.
(My use of the word "essentially" was purposeful for just the reasons I have stated before--it allows me to express my own interpretation but also notes that the data is not necessarily perfect to absolutely prove that my opinion is the correct one). I would continue to encourage you to share your points about the limitations of this study that you have identified as an e-letter so that the authors of the article (with whom you should be corresponding with your questions) can be notified and respond to you and the rest of our readers via that area of our website.
I will be sending my questions shortly to the authors. One thing I would really like to ask about is the exclusion of children of low birth weight, who are thought to be more prone to autism and other neurodevelopmental disorders - (among preemies, the risk of autism may
be as high as one in four). If you eliminate all the unhealthy kids from your study, you may be inadvertently eliminating those who are most at risk for injury from vaccine mercury.
Finally, it is astounding how the media has portrayed this as a story about how "vaccines" do not cause "autism," when it showed no such thing. As the lead author said in reply to an email from Lisa Rudley, a New York State activist and mother, "We did not have the objective to specifically study children with autism and the number of subjects included in our study would have been insufficient to make any epidemiological assessment on this subject."
So some people in the media went ahead and made that assessment for him.
PS: The response to my Huffpo piece with RFK, Jr. has been predictable. But this comment really stuck out as emblematic of the hysterical and low-rent quality of the people who oppose vaccine-autism research:
"Mr. Kennedy," the commenter wrote, "I hope that your new friends on the loony-tunes quackery fringe make you feel big and important, lending your name to their campaign of lies and death. And I hope you die from something there's a vaccine
Wishing death on a member of the Kennedy family Such is the caliber of the debate from those on the "other side."
David Kirby is author of www.evidenceofharm.com and a contributor to Age of Autism.
So this study looked at 1403 kids. Were none of these kids on Ritalin, none with ADD or ADHD, no seizures, none taking neuroleptic drugs, no bi-polar, none of the chronic conditions we see in epidemic numbers in US schools. No learning disabilities what-so-ever?? What planet is Italy on?
Posted by: michael framson | February 04, 2009 at 01:42 PM
"You'll be reassured that the results show essentially no differences between groups who did or did not get thimerosal in their vaccines-and you'll want to know this information when talking with parents of your patients about the safety and benefits of vaccines."
“did not get thimerosal” is not up for interpretation. If this guy says water is wet we better run to a faucet and double check.
Posted by: sdtech | January 29, 2009 at 11:22 PM
The following link says it all about the CDC and their foreign studies.............
US Research Fraud, Tax Dollars And Italian Vaccine Mercury Study
Posted by: Raymond Gallup | January 29, 2009 at 06:08 PM
thank you, David. unfortunately it seems that scientists and physicians need reminding that science is indeed in the details.
Posted by: SD | January 29, 2009 at 02:26 PM
"First finally put an addendum up at his blog, acknowledging that both groups got thimerosal, and acknowledging that Italians get even less thimerosal then US kids."
He had to. It was a major error with no gray area whatsoever. I wish he had posted the other five limitations to the study cited by the authors, and not just the one. But it's good step in the right direction.
Thank you David for bringing this to light.
Posted by: dismayed | January 29, 2009 at 11:11 AM
Thank for this post David. You raised some very interesting points. Perhaps the most vital piece of information needed to interpret this study is where did the money originate for this study. If one follows the money trail via emails and internal memos, as I have done for the past 5 years, one will likely find this is no different than the other studies designed to exonerate vaccines and thimerosal. I suggest one follow the PhaRMA, GAVI, WHO, CDC and NHS money trail as it leads to very interesting places...all of which carry the stench of corruption and scientific fraud. According to my forensic accounting research, records clearly show, as did conversations with the late Dr. Frank Engley, a world reknowned microbiologist and member of the FDA committee to ban Thimerosal in OTC products, that it was in fact the Italians that first raised the concerns over Thimerosal that promoted many Europeans countries to begin banning and/or limiting the use of Thimerosal from vaccines.
Lujene G. Clark
Posted by: Lujene G. Clark | January 29, 2009 at 10:22 AM
First finally put an addendum up at his blog, acknowledging that both groups got thimerosal, and acknowledging that Italians get even less thimerosal then US kids.
Posted by: AnneS | January 29, 2009 at 09:37 AM
I see that he has indeed posted a retraction/clarification on his blog.
I do think he needs to be commended for taking this step at least.
Posted by: Nick D. | January 29, 2009 at 09:31 AM
Went to read Dr. First's article this morning and saw that he printed a "retraction" of sorts. He posted a piece this morning indicating that if you read the study, you will note both groups were exposed to Hg. What he did not correct was his suggestion to use this study to convince parents to vaccinate their kids.
Posted by: chrissie | January 29, 2009 at 09:14 AM
@ Maureen Fisher
who asked: "Does anyone know how much it would cost for a study good enough to be published in a major medical journal?"
Maureen, that is a good question. The best place to get an answer is from Big Pharma. They know exactly how much it costs to pay "researchers" and to advertise enough to ensure publication of their desired results in targeted "journals."
Posted by: David Taylor | January 29, 2009 at 08:38 AM
thanks "dismayed" I just sent an email to a doctor Adami at Harvard with my thoughts on the lack of integrity with respect to this matter.
Posted by: jen | January 28, 2009 at 09:02 PM
You are the best.
That is why I always make sure I shake your hand when I meet you. You stick your nose in business that is not your own for the sake of children and parents that cannot do so on their own.
Thank you so much for sticking with us.
(speaking for the non-english speaking MN Somali parents too.....)
Posted by: Tim Kasemodel | January 28, 2009 at 08:12 PM
And it's our children who have been labeled with a "communication disorder"? Dr. First, good job using your words, but you're not making sense! Stay on topic.
Posted by: Alison Davis | January 28, 2009 at 08:10 PM
I went to this blogspot and First is obviously disingenuous on several levels.
He refers to the blog, in his reply to David, as "my blog". One would assume that it is the official blog of Pediatrics as their banner tops the page and the address is pediatricsblog.blogspot.com
If this is First's personal blog no one would make that assumption and it should not be headed by the journal's logo. Either way, as it's editor, I am quite certain that AAP member pediatricians (who are obliviously the intended audience) expect reliable, scientifically based information not his opinion and when he does share an opinion it should be clearly defined as such.
I become more and more convinced that pediatricians are as much the victim of all this propaganda as the general public. Our family pediatrician recently shared with me that doctors are trained not to question the medical establishment. It's high time they start asking some questions and applying some critical thinking to this debate.
Posted by: Pamela | January 28, 2009 at 06:10 PM
On the bright side, thanks to that Huffington Post comment you can now make sure that everytime your name is mentioned in the press the talk about how you need to take precautions becuase of death threats against you.
What the hell, it's probably as credible as the ones Offit hides behind.
Posted by: MadDad | January 28, 2009 at 05:54 PM
First "essentially" reminds me of Vizzini in The Princess Bride: "INCONCEIVABLE!"
I guess that makes David Kirby (and the rest of us) Inigo Montoya: "I do not think that word means what you think it means..."
Posted by: Garbo | January 28, 2009 at 05:15 PM
Thank you David. I believe the only way we will get a vaccinated vs. unvaccinated study in the United States, is if we pay for it ourselves. Does anyone know how much it would cost for a study good enough to be published in a major medical journal?
Posted by: Maureen Fischer | January 28, 2009 at 05:08 PM
"I have used the word "essentially" in my blog to express my own opinion/interpretation and to note, by using that phrase "essentially" that the data may still note associations but not ones that I personally feel are meaningful as per the data they have presented."
So essentially, he lied.
It says on First's blog he received an MS in epidemiology from Harvard. I wonder how the Department of Epidemiology at Harvard's School of Public Health would feel about First's method of interpreting and reporting data.
In case anyone wants to ask...
Posted by: dismayed | January 28, 2009 at 05:00 PM
OOps, I mean essentially.
And how bizarre that his "First Read" article is about how people do not have time to read everything, so he is putting the important things together for our busy society. Good grief. How can this guy be for real?
Posted by: kathleen | January 28, 2009 at 04:56 PM
I applaud Mr.Kirby for continually attempting to bring reason and sanity into the logic-vacuum of the Wackosphere, regardless of their baffling, form-driven responses to his straight-forward, simple questions. He has the patience of Mother Teresa. Don't give up! We love ya!
Posted by: Julie Swenson | January 28, 2009 at 04:31 PM
Our kids are very lucky to have someone like David Kirby, he does not give up.
None of the words that Dr First used were confusing to me. So much double talk.
I used to have a plaque that said..
I know you believe that you understand what you think I said. But I am not sure you realize that what you heard was not what I meant.
Posted by: K Fuller Yuba City | January 28, 2009 at 04:17 PM
I think 'essentially' Dr. First didn't 'essentially' read the study or he hopes no one else will and will just lap up his little soundbyte.
Posted by: Alison MacNeil | January 28, 2009 at 04:12 PM
The more they spin,lie and avoid any meaningful research the more concerned I am about the dark secrets they are hiding!!!!!
Posted by: Richard | January 28, 2009 at 03:08 PM
One thing left unsaid by Dr. First: ...."..and you can be damn well sure no vaxed versus unvaxed study will be done any time soon" : The more deceptive the provaccine folks are, the more we know in our hearts that no study comparing thimerosal and no thimerosal will take place No vaccinated versus non vaccinated. They simply cant afford to be exposed by the truth.
Hey there, folks at CDC and AAP, in case you are reading this, how about a trip to India to see the kids who get about 200 mcg mercury in vaccines by 3 and a half months of age and thats after their mothers get 100 - 200 mcg in tetanus toxoids. Just imagine- YOU could go into the history books as the discoverer of the cause of autism !! Wow !
Posted by: Cherry Sperlin Misra | January 28, 2009 at 02:21 PM
"In his blog introducing the study, Dr. First wrote that, "You'll be reassured that the results show essentially no differences between groups who did or did not get thimerosal in their vaccines-and you'll want to know this information when talking with parents of your patients about the safety and benefits of vaccines."
I do not understand how these people can get away with uttering blatant lies such as this. Is there no accountability for this kind of rhetoric? Are they not ashamed of themselves? Do they not care about what their children might think of them, or their spouses? Or their relatives? Or the world at large, I mean the non-corrupt one that excludes Big Pharma vested interests?
Should these people not be tried in a court of law if the public at large takes their comments at face value, and goes ahead and gets their kids' vaccinated, thinking there is nothing wrong with the vaccines? I mean there should be some sort of ramification for making statements such as this, given that you are putting human life in jeopardy.
Posted by: Criminal Falsehoods | January 28, 2009 at 01:37 PM
We were watching on an OPB station the other night, that in essence, our MEDIA or "freedom of the press", ranks 27th in the world. I was shocked but not surprised. One wonders what yonder sits on editorial boards and upi wires, and who is actually controlling the information americans receive? For the most part, they want to believe our government is going to fix things, when in fact, the ability of the people to fix things has diminished. Somehow I think THEY, whoever THEY are, know this. So, studies like this will be reported over and over, sham science and junk science portrayed as honest and real, and meanwhile, this autism epidemic will continue. This is why I say, is there any dealings or accountability that we can hold them to? I can only say, I have to try, but in the twenty odd years in this autism biz, most of our efforts have been futile. I feel the only approach is to hit them where it hurts, boycott vaccines in total. This means a fair amount of missionary hood on our parts, to make sure our NEIGHBORS are warned, our FAMILIES, etc. If we as an autism population did that, say, 10 families, can you imagine what would happen to the vaccine industrialists?
Where is the objectivity in research, when clearly all of these parties have a vested interest in the outcome?
Posted by: Kathy Blanco | January 28, 2009 at 01:02 PM
I'm no lawyer. But I tend to think that if these people were forced to speak in a court of law in front of a jury of unbiased individuals, this would have been over decades ago.
Posted by: Bad Apple | January 28, 2009 at 12:52 PM
Thank you, David, for holding Dr. First and the AAP accountable. The media coverage of this study has been driving me insane. What a sham!
Kim, you're exactly right. Most of the public doesn't want to face the truth. It's too disconcerting and it puts too much responsibility in their own hands. They want to remain blissfully ignorant. Let's face it -- we who read and post here have wrestled with regret and anger and have become thoroughly disillusioned with the gov't and the mainstream medical establishment. It would be much easier to blindly trust the CDC, AAP, etc.
Posted by: Cindy Keenan | January 28, 2009 at 11:45 AM
In a comment to the initial AoA article on this study, "Garbo" quoted the study as saying, "Nearly 70% of the invited subjects participated in the neuropsychological assessment (N = 1403)." Maybe among the 30% who did not respond were the kids whose parents figured they would not be able to complete all the assessments (e.g. written tests?) due to behavioral issues, mental impairment, ADHD, health issues etc., or whose parents were too busy and stressed to participate due to those same issues in their kids.
Webster's definition of the word "essential": "of, relating to, or constituting essence..." "implies belonging to the very nature of a thing and therefore incabable of removal without destroying the thing itself or it's character".
Dr. First's definition of the word "essential": "Might not be true, but who cares?"
Dr. First reminds me of Cornelius Fudge.
As always, thank you so so much David Kirby.
Posted by: Twyla | January 28, 2009 at 11:33 AM
Al Franken wrote about a ploy he used to respond to rude emails-- he would reply with thanks as if the person had flattered him. It clearly made the recipient boil, probably more to think that their aggression hadn't made impact than that they were being toyed with. I wonder what would happen if someone responded to First as First responded to you-- writing back something unrelated to his email:
Dear Dr. First,
Thank you for your admission that you lied in your blog. That kind of concession is very rare in medicine these days and it clearly takes nerve. Duly noted that when you wrote that "either did or did not" receive thimerosal containing vaccines, you were interpreting the data in the study falsely and in a way that you knew would be pleasantly accepted by the AAP so that they would help disseminate your remarks and as a way to mislead parents into believing the study was definitive so that they would continue to vaccinate without hesitation. I will pass on your honest comments to me to ensure that people understand your contrition for initially perpetrating dangerous disinformation. You deserve credit for having courage.
Posted by: Gatogorra | January 28, 2009 at 11:25 AM
From "DR." Lewis First -
"Dear Mr. Kirby,
Again, I can understand your having a different interpretation of the data and respect that....."
Dr. Lewis First, there is nothing to "interpret" - there is thimerosal or there isn't. We are talking quantity here, NOT quality. These are concrete figures. Yes thimerosal, yes thimerosal.
PS: You are a big fat liar.
PPS: Are you related to that cheat FRIST by any chance?
Posted by: For Lewis First | January 28, 2009 at 11:22 AM
It's amazing that he won't admit the blatant false statement he made "reassuring" his readers.
Posted by: Fielding J. Hurst | January 28, 2009 at 11:08 AM
Sounds like Dr. First is taking his rhetorical cues from Paul Offit's lawyer. Pretend that a little bit of poison is actually NO poison.
Good Lord, I hope that this doctor's patients are aware that he places such little value on the accurate use of chemical measurements.
Posted by: nhokkanen | January 28, 2009 at 10:27 AM
Lewis First should just "take the shame" as one of "Lauren Cooper's" buddies would advise her. Go to you tube and type in Katherine Tate(amazing British comedienne) and watch some of the Lauren Tate videos- especially Katherine Tate and David Tennant (the Shakespeare sketch) and the translator-hilarious. "I'm not bothered."
Posted by: jen | January 28, 2009 at 10:24 AM
way to call them on this joke of a study, David. Watch them just repeat that bullshitty answer that Lewis First gave you even if it did show up on their comment page. That first guy sure couldn't have been first in his class OR he is perpetuating a bold faced lie.
Posted by: jen | January 28, 2009 at 09:49 AM
Doctors like First are so used to having the press fall all over themselves broadcasting any "official study" without questioning the makeup and conclusions of the research, that he's probably stunned that anyone actually looked at the specifics.
Doctors love to wave "studies" at the worried parents, so they’re highly unlikely to look into one in depth.
David's critique is highly unusual. Lots of people at Pediatrics and the AAP are probably scrambling right now to come up with an official response.
I can't imagine how they're going to spin this to justify calling two control groups receiving different level of thimerosal a vax vs unvax study.
Posted by: Anne Dachel | January 28, 2009 at 09:20 AM
How would First testify under oath before Congress? The 'fudged' graphic is polite understatement for what is going on here, as you have documented.
Posted by: anonymous | January 28, 2009 at 08:52 AM
Only to comment that this is a very odd, not to say lame study.
Of course, even on US or UK incidence we would not be talking about a vast number of ASD children, but Tozzi comments that parents of disabled children may not have volunteered them, and you could say with a reasonable degree of certainty that the more disabled they were the less likely it was - and even in cases where the children might have a conceptual understanding of what was asked, in most cases parents would avoid anything which might cause stress.
The point surely is that the study is of absurd bureaucratic design, ensuring the non-participation of any of the sensitive cases. I don't know whether in the US you are familiar with the term "shaggy dog story" but this is a shaggy dog story. After ten years of prevarication the AAP have come up with a study of consumate and transparent silliness - a study which proves that anything goes, providing you can get out the press release, and - as you have pointed out - a professional briefing.
Now (presumably), the study is not definably a "scientific fraud" because the limitations are actually set out within it, but it is misleading. And, of course, that is only where the folly begins, because based on this piece of circumlocutory nonsense, the medical/scientific establisment can institute another round of opinion forming articles.
So now it has been going on for ten years, and I can safely say that of all the tautological nonsensical studies I have ever read this is by far the stupidest, and that time is simply being wasted while guilty men and women fight a futile and damaging rear-guard action as our children suffer.
Well done for calling the AAP's bluff!
Posted by: John Stone | January 28, 2009 at 08:51 AM
Don't forget - the public WANTS the vaccine autism question to go away so it's very easy to swallow any pabulum/tainted fudge AAP and it's cohorts publish. No one wants to think they're jeopardizing their child's future by going to a well visit. It's overwhelmingly frightening. Think of the scantily clad girl talking to her buff boyfriend in a horror movie, as they cower in a mine shaft entrance. "The killer is gone right?" she begs him. "Yes. Yes. The killer is gone." Pan to their heads rolling across the ground.
The power of WANTING TO BELIEVE is in AAP's favor.
Posted by: Stagmom | January 28, 2009 at 08:33 AM
That comment on the Huffpost was swiftly removed. I replied to it and *poof* it was gone and mine never showed.
Now, somebody can claim a death threat was made against him and this time it'll actually be true. Since some of us saw it written at the Huffpost. I didn't read every comment from Paul Offitt's Huffpost piece...but I don't think any death threats were made against him. Alert the media, call Dr. Snyderman somebody threatened a Kennedy over his stance on vaccines... That post you are referring to was only the 5th one posted after your and RFK Jr.'s post went up. The baby poisoners sure move quickly to death threats, don't they?
I wish Dr. First would have just been straight forward with you about the purpose of his blog. The purpose of his blog is just to get people - doctors and their patients to "believe" no matter what. Just keep on vaccinating. I can't believe he refuses to acknowledge his error and says this is only his intrepretation of the study. What a pathetic copout. He apparently doesn't care he is providing misinformation and leading people to the wrong conclusions.
But, as long as the headline made the news worldwide "vaccine study shows no link to autism"...that's all that matters, right?
Now thanks to JB Handley we know these people hardly ever read the studies anwyays, that they claim let vaccines off the hook. It's all about headlines they generate. People don't have the time or attention to look beyond the headline, do they? Even Bernadine Healy confessed to never actually reading the studies and then when she did, look what she happened. She came out and said this needs studied, because their "mountain" of evidence doens't exist, and the medical profession is turning it's back on an unidentified susceptible group. I wonder what she will have to say about the "Italian job" study? I do hope she will comment.
If people only saw the comment you shared with us from the lead author of the study:
"We did not have the objective to specifically study children with autism and the number of subjects included in our study would have been insufficient to make any epidemiological assessment on this subject."
Posted by: Andrea | January 28, 2009 at 08:14 AM
Lewis First is "essentially" full of crap.
Posted by: Jack | January 28, 2009 at 08:13 AM