Opponents of legislation to tighten school immunization requirements have been promoting a movie called Trace Amounts to legislators and others. They seem to think this movie proves a link between thimerosal – a mercury-based preservative in vaccines – and autism. It shows, in their view, that our vaccine program is corrupt and harmful through and through, and hence is an argument against vaccine mandates. The movie, however, shows nothing of the sort. There is no new evidence in it, and it simply repeats old and disproven claims.
Trace Amounts – old news in a new package
The movie, Trace Amounts, opens with the story of Eric Gladen, one of the directors, whose health suddenly and unexplainably deteriorated. Distressed by his very serious symptoms, Mr. Gladen took to the Internet and researched them, finally arriving at the conclusion that he was poisoned by mercury. He also created a timeline and arrived at the conclusion that his symptoms started immediately after he received a tetanus vaccination that contained thimerosal (also known as thiomersal outside of the USA or, generically, ethyl mercury).
A search on the Internet convinced him that thimerosal in vaccines can cause his symptoms. He chose to follow a specific chelation protocol and apparently found a doctor willing to cooperate. His symptoms improved temporarily, and he believed chelation worked.
When his health deteriorated again, his doctor suggested thinking about other sources of exposure to mercury (there is no indication the doctor reconsidered that maybe the diagnosis of mercury poisoning was in error). Gladen concluded the return of his symptoms came from being exposed to mercury fumes from a broken lightbulb. Although further chelation did not seem to work, Mr. Gladen remained convinced that his symptoms are due to mercury poisoning, and he also concluded that his symptoms resemble autism.
The evidence that Mr. Gladen’s problems did, in fact, stem from the vaccine or mercury in any shape or form seems confined to his internet research and support from a doctor obviously willing to chelate for this “autism” in spite of the FDA warnings against that and the lack of a scientific basis for the treatment. But this belief led him to conclude thimerosal in vaccines is harmful, and from there he somehow arrived at the belief that it caused the autism epidemic and set out to make a movie.
Trace Amounts is a well-made movie. It is well paced, hits all the right notes to cause fear and doubt, and weaves arguments commonly made by groups who believe vaccines cause autism into a plausible-sounding story. But each of the building blocks used to construct the story is problematic – and the story itself ignores abundant data to the contrary. In other words, this movie does a good job at presenting a misleading, inaccurate picture, and may trick people into believing something that isn’t true – and to leave their children at risk of disease based on that inaccurate information. That makes it dangerous.
Why thimerosal in vaccines?
The movie starts by claiming that the only reason to use thimerosal in vaccines is greed. But that’s not accurate. Thimerosal is added to multi-dose vaccines because reinserting a needle into a vial that has several doses can contaminate the vaccine with bacteria or other organisms – which can be dangerous to those receiving the vaccine.
A move to single dose vials can prevent cross-contamination, which led to removal of thimerosal from childhood vaccines in the United States. But that comes at a cost: more packaging, more expensive shipment and more storage is needed, and that can be really expensive. For-profit companies will naturally roll that cost onto the consumer – driving up the cost of the vaccines. This can mean that a third world country already strapped for cash will not be able to afford the vaccine – and hence that children or adults won’t get vaccinated and protected against these diseases. It means a small medical practice may have problems with storing the vaccines.
“Costs don’t matter” is an approach that’s only possible for the privileged. If my fellow privileged westerners behind this movie want to make buying, shipping and storing vaccines to protect children from diseases much more expensive – meaning that other countries and small practices will have to choose if to spend more money there or on other important health and safety measures – they should have good evidence that the change is warranted. Trace Amounts doesn’t.
Trace Amounts faces the same problem as other organizations or individuals that want to claim thimerosal in vaccines is dangerous face: there is no good support for that, and plenty of evidence against it. To overcome that problem, Trace Amounts does what other anti-vaccine sources do.
First, it uncritically accepts evidence that cannot stand to claim thimerosal in vaccine is harmful. Second, it ignores many of the studies that show it’s not – and dismisses others for reasons that don’t hold water, in part, by using implausible conspiracy theories.
It’s not practical to cover every point in the movie in a blog post. But addressing at least some of the evidence it alleges shows the dangers of thimerosal – drawing on the extensive work of dedicated science bloggers and writers such as Dr. Paul Offit – should caution readers of how misleading the analysis is and how carefully any claim made in the movie should be examined. To the best of my knowledge, each point it makes was addressed elsewhere.
The movie claims that the symptoms of mercury poisoning are similar to autism – based on an article written by four non-scientist parents who believed their children’s autism was caused by mercury in vaccines, which was published by Medical Hypotheses – a predatory journal for speculative ideas which at the time did not use peer review (with an incredibly low impact factor of 1.152, indicative of very poor scientific source).
Scientists have since pointed out that the symptoms are not actually similar. The movie ignores that.
The movie refers to a range of animal studies and cell studies. Not all of them are identifiable, because the movie doesn’t provide references, but many animal studies on the topic have been examined by science bloggers in the past, and mostly were found deeply flawed – and not just because neither mice nor hamsters are people.
To mention one example, the movie refers to a murine study by Dr. Hornig which has substantial limitations – among other things, that the dosage was too high (and that it’s a little hard to evaluate autism in mice).
The movie also addresses a problematic monkey study to claim that thimerosal is more toxic than methyl mercury, the kind found in fish. The study is too flawed to be able to conclude that; all that it shows is that guidelines based on methylmercury cannot be used to assess the safety of an amount of ethylmercury, the type found in thimerosal.
Among the main speakers in the movie are Dr. Mark Geier and his son David Geier, both of whom did studies suggesting thimerosal in vaccines causes autism. The movie describes them as “controversial”. That’s very much an understatement. The Geiers are known for their very, very bad science. Yet they are the primary speakers in the movie, presented as experts – although their work has been thoroughly debunked (for more about the Geiers, see the next section).
In addition to bad studies of animals the movie tries to base the claim that thimerosal in vaccines causes harm on a set of hypotheses (that are, by the way, not internally consistent), none of which is well supported.
The mechanisms proposed here include:
- A connection between testosterone and mercury, previously used to come up with the idea of chemically castrating autistic children – an idea with no real basis.
- Blaming a mutation in the MTHFR gene for making children unable to manage the alleged toxins in vaccines and become autistic – again, with no real basis.
- Blaming “synergetic toxicity” – aluminum salts in vaccines combining with thimerosal and making it a lot more toxic. Again, this idea has no good basis. Furthermore, if that’s the issue, the movie’s attempt to claim that influenza vaccines are a problem because they are the only one children get that still contain thimerosal doesn’t work: inactivated influenza vaccines – the kind that might contain thimerosal, if they’re of the multi-dose variety – don’t contain aluminum adjuvants (pdf).
A set of unsupported hypotheses thrown together does not create good support for the argument that thimerosal in vaccines is harmful. Especially in the face of the many studies to the contrary.
The movie attacks using influenza vaccines that may contain thimerosal in pregnancy (implying that the CDC was intentionally trying to poison fetuses by deciding to vaccinate pregnant women against influenza. Why it would do that isn’t quite clear). Again, this claim is extremely problematic.
The movie ignores the fact that a few states – for example, California – have laws prohibiting use of thimerosal containing vaccines for pregnant women and children under two. Rates of autism diagnoses in California have been rising in spite of that. That’s pretty strong epidemiological evidence that thimerosal is not the culprit. The movie also ignores studies that examined thimerosal in pregnancy (see also here) or methylmercury in pregnancy generally and found no link to autism.
As one more side note, the movie quotes the inserts to say that no studies of the safety of influenza vaccines in pregnancy were done. The inserts do say that. But that does not reflect the reality. The influenza vaccine was studied in pregnancy. My friend COVRAC created a list of such studies.
More recent studies include this, this, and this review. I’m not going to go in detail into the writing and reading of inserts and why they do not include that information– on that, see here. But saying influenza vaccines have not been studied in pregnant women is simply incorrect. And the studies show them to be safe in pregnancy.
A last point is that the movie goes on to claim that mercury exposure from other sources adds to mercury in vaccines to cause autism. Aside from the fact that, as already mentioned, the claim that autism and mercury poisoning have similar symptoms doesn’t withstand scrutiny, the study used to make that claim is, itself, deeply flawed. So here, too, there is a problem.
Based on this compilation of bad science, Trace Amounts supports and recommends chelation as a way to cure autism. Not only is there no basis for thinking chelation does anything for autism, it can be harmful – to remind readers, in 2005 a five-year-old autistic boy died from it.
Using conspiracy theories to dismiss science
To compensate for the lack of evidence, the movie suggests that evidence of the harms of thimerosal exists – but the CDC is hiding it. It’s a conspiracy. It addresses three conspiracy theories, none of which really supports what the movie is trying to draw from them.
The first is the Verstraeten study – a large-scale study that examined what thimerosal could do and found it not harmful. An analysis of this study – and other studies showing lack of connection between thimerosal and autism – can be found here. The movie repeats claims that center on the study’s preliminary findings, that suggested there may be a link between thimerosal and neuropsychological developments, including autism.
As highlighted by Dr. Emily Willingham, these preliminary findings have been, appropriately, reexamined and refined – and as has been highlighted by Orac, early preliminary results that do not hold up to closer examination is hardly unusual.
The movie claims that the CDC then convened the Simpsonwood conference to try and hide the results – and as many anti-vaccine sites have done in the past, they draw on carefully selected quotes to do so. This claim has been examined by bloggers in the past –see here and here. Examining the transcripts in full does not support the claims of a conspiracy to hide data. It does show the scientists discussed the limitations of Verstraeten’s initial analysis and pointed out flaws that needed fixing – but that’s hardly sinister.
In other words, completely contrary to the presentation in the movie, Verstraeten’s study, after going through a process of examining and improving its methods, did not show a link between thimerosal and neurological problems. Simpsonwood was not a coverup. There is no real support to the claims of conspiracy that would lead us to dismiss this result. And you can see how not new this unfounded claim is, and further deconstruction, here and here.
Since the movie draws heavily on Congressman’s Dan Burton hearings trying to show a link between vaccines and autism, maybe it should have paid attention to another Congressional investigation, discussed here. As reported by Leftbrainrightbrain:
Allegation #2: The Centers for Disease Control (CDC) convened the Simpsonwood Conference to cover up the finding that thimerosal causes autism.
–Findings: The allegation is not substantiated.” ….
Allegation #3: Dr. Thomas Verstraeten, MD, MSc, was pressured into changing his research position regarding a causal link between thimerosal and autism.
–Finding: The allegation is not substantiated.”
Congress, apparently, agrees with science bloggers about the lack of cover up. All that’s left is a paper finding no harm from thimerosal in vaccines.
The second conspiracy theory was an attempt to dismiss a study from Denmark that also found no link between thimerosal and vaccines in autism. That theory had two parts. First, the movie argues that the Danish team manipulated the data of who should be included, and that the real numbers would show that autism rates decreased after the removal of thimerosal from vaccines. But that’s not actually correct – as demonstrated by Matt Carey, rates of autism in Denmark did, in fact, go up after the removal of thimerosal from vaccines.
The other part of this claim focuses on Poul Thorsen. Thorsen was involved in a number of studies of vaccines and autism. There is reason to believe Thorsen embezzled money from the CDC. Anti-vaccine activists seem to think that negates the studies.
As pointed out by Emily Willingham, that’s not the case – Thorsen was one of several authors, and not a lead one, and there’s not only no evidence of any misbehavior by any other authors, there’s nothing to suggest any data manipulation. This claim, too, does not support the argument. It’s also internally inconsistent: if Thorsen is accused of stealing from the CDC, how can he at the same time be an accomplice of the CDC in hiding data?
Again, since the conspiracy theory does not hold, all that’s left is a paper that shows no link between thimerosal in vaccines and autism.
The last conspiracy theory used to try and dismiss data is the CDC Whistleblower manufactroversy. In this, a CDC scientist – Dr. William Thompson – in a series of conversations with Brian Hooker suggested the CDC hid results showing a link between vaccines and autism.
This conspiracy has been debunked in detail elsewhere, but for the purposes of the Trace Amounts, the problem they run into is that Thompson’s study of thimerosal did not find a connection between neurodevelopmental problems and thimerosal – with one exception, tics, and even there, evidence is that the connection is not supported (as the paper itself said). In fact, Thompson’s original study also found a connection to tics in boys – and to better performance on several of the tests by girls. If Thompson’s study is to be used as evidence that thimerosal causes tics in boys, shouldn’t it be use to suggest better performance by girls? Both findings are equally badly supported by the evidence overall.
As evidence that thimerosal is dangerous, this conspiracy theory is even less convincing than as evidence that the MMR vaccine causes autism (and it’s not convincing on that).
And again, we are left with a paper that does not support claims of harm from thimerosal in vaccines.
None of these conspiracy theories hold water, and none can support the view that thimerosal in the tiny amounts in vaccines is harmful.
In addition to trying to dismiss some of the data contradicting its point of view, the misleading picture it makes is compounded by glaring omissions. The movie completely ignores the many other studies from all around the world that examined the link between thimerosal and autism and found none. If we accept that the CDC is engaged in a conspiracy to hide a link between thimerosal and autism, would we say that:
Iceland is part of the conspiracy, since although thimerosal was removed from the vaccines in 1991, ASD rates have continued to increase since then (and administration of influenza vaccines, which may contain thimerosal, is not recommended to children or pregnant women?):
Double Standard, Inaccuracies and Omissions
Let’s discuss for a moment how the movie depicts the experts presented in it (I am grateful to Liz Ditz for providing much of this information). The movie includes comments by Dr. Paul Offit, MD – an actual pediatrician and vaccine expert; co-developer of a rotavirus vaccine; director of the Vaccine Education Center in the Children’s Hospital of Philadelphia, one of the editors of a professional textbook on vaccines and author of several books on vaccines directed at lay people.
Dr. Offit is routinely and viciously attacked verbally along with other tactics by the anti-vaccine movement. This is probably because they cannot attack his expertise and he is a frequent speaker in the media for the need for vaccines – in a real sense, the public face of pro-vaccine advocacy. Trace Amounts includes comments from him (although he was not interviewed for it – they use footage from other sources) – and then does it best to undermine Dr. Offit’s credibility with a series of problematic tactics.
First, the movie attacks Dr. Offit for alleged conflicts of interests. It follows journalist Sharyl Attkisson and suggests that Dr. Offit’s holding of a chair endowed in part by Merck (and in another part, something not mentioned, by CHOP) is a conflict of interests.
But an endowed chair is not a salary – it’s not something the donor has control of once it’s in place, besides setting the terms for the initial endowment. Holding the chair does not make Dr. Offit beholden to Merck in any way. The movie then reminds us that CHOP’s share in the rotavirus vaccine Dr. Offit was involved in creating was sold, and Dr. Offit received a share of that. Of course, selling the patent actually removes a conflict of interests – it means CHOP or Dr. Offit no longer have a financial interest in the vaccine.
In other words, the movie presents two non-conflicts of interests as if they were serious points against Dr. Offit. It then goes a step further by juxtaposing Dr. Offit’s comments about vaccine safety side to side with comments by a representative of the tobacco industry claiming vaccines are safe.
If someone doesn’t know how false the comparison is, maybe it could work to undermine the speaker. It is, however, false through and through: Dr. Offit isn’t a representative of industry – he works for a non-profit hospital and a university; there was never a scientific consensus that tobacco was safe (in fact, the scientific and medical consensus, since the late 1940s, has clearly stated that tobacco is dangerous) – and there is such a consensus about vaccines; the same kind of studies on which Dr. Offit bases his comments about vaccine safety are those that showed the link between tobacco and lung cancer. In other word, it’s a baseless and base trick aimed to undermine a legitimate expert.
Let’s compare that to the treatment of some of the other people represented as experts in the movie – focusing on what was not said about them.
The Geiers probably speak most in the movie. They are described as controversial, and one shot shows a blog post entry saying:
That’s an understatement; by mid 2013, Dr. Mark Geier lost his license in all 12 states where he was licensed to practice medicine. His son, David, was sanctioned for practicing medicine without a license.
Both actions were based on misdiagnosis and mistreatement of autistic children subjected to their Lupron protocol – chemical castration. The Lupron protocol was based on the unfounded claim that testosterone increases mercury toxicity. And it was sold to parents of children with autism as a way to “cure” their children. To justify it, Dr. Geier falsely diagnosed autistic children with precocious puberty.
Do I need to say that chemically castrating a child using a treatment that was never approved for that purpose and has no real basis is simply wrong? Even without the need to apply a false diagnosis?
In addition, Mark Geier also made a living as a professional expert witness in vaccine injury cases. On this, “Geier’s credibility as an expert witness has been questioned in 10 court cases.” In 2003, a judge ruled that Geier presented himself as an expert witness in “areas for which he has no training, expertise and experience.” In other cases in which Geier has testified, judges have labeled his testimony “intellectually dishonest,” “not reliable” and “wholly unqualified.”
The Geiers directly profited from claiming that thimerosal in vaccines caused autism and claiming vaccines are harmful. Their expertise and science is, at best, suspect. But the movie mentions neither fact.
Similarly, Andrew Cutler (author of the 1999 book Amalgam Illness, Diagnosis and Treatment : What You Can Do to Get Better, How Your Doctor Can Help Paperback, the self-published book Hair Test Interpretation: Finding Hidden Toxicities) makes his living advising parents how to keep their children on chelation chemicals for years. He has a direct and current stake in claiming thimerosal in vaccines causes autism.
Brian Hooker is the father of an autistic child. He has a graduate degree in chemical engineering, but has no formal training in statistics or epidemiology, nor is he trained in any field pertinent to the study of vaccines or autism (e.g., immunology, vaccinology, childhood development, developmental psychology, etc.). Hooker has an open case claiming vaccine injury for his son before the Vaccine Court, claiming, among other things, that thimerosal in vaccines caused his son’s autism. He, too, has a direct stake in the theory and no relevant expertise.
Professor Boyd Haley is a retired professor of chemistry. At some point late in his career, Haley became convinced that dental amalgams caused all manner of ills. There is no evidence for this belief. Later, Haley became convinced that thimerosal in vaccines caused autism. Again, there is no evidence for such beliefs. In about 2008, Haley started marketing an industrial mine-cleaning product, as a “dietary supplement” for autistic children. The FDA made him stop. In other words, Haley too, for a long time, earned money from the claim that thimerosal in vaccines caused autism.
So Trace Amounts presents a legitimate expert in ways designed to undermine his claims by claiming conflicts of interests where there are none – and contrasts him with a set of people without expertise in the relevant fields, several of whom have or had real conflicts of interests, a fact that is not mentioned, and whose claims are presented as facts, even when very problematic.
This approach further reflects on the movie’s credibility.
The movie opens by claiming it is not anti-vaccine – a common tactic among people who are, in fact, anti-vaccine. But the whole premise of the movie is that the CDC acted underhandedly to poison a generation of children – via vaccines – and that children were seriously harmed by vaccines. If that’s not anti-vaccine, I don’t know what is. It also hits all the usual tactics used by those who attack vaccines:
- Present anecdotes of children and adults allegedly harmed by vaccines – regardless of the fact that there’s no evidence it was the vaccines in the cases presented, and the science suggests otherwise. Check.
- Also: Claim untested and potentially dangerous treatments with no biological basis – in this case, chelation and hyperbaric oxygen therapy. Check.
- Dismiss epidemiological studies – partly just by attacking them, partly by using conspiracy theories (repeating theories routinely used by anti-vaccine activists). Check.
- Uncritically accept bad science. Check
- Claim corruption and nefarious motives on the part of vaccine advocates and health officials – both individual experts and organizations. Base the claims on weak and spurious evidence, again, uncritically accepted. Check.
- Also: Attack Dr. Offit. Seems to be a tradition among anti-vaccine organizations these days. So, check.
The movie makers may believe in the harms they claim and may sincerely believe they are not anti-vaccine. But their actions speak for them. This movie is misleading anti-vaccine propaganda. It has no value as a source of information, and can only do harm.
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