In an op-ed piece in the Washington Post last month, New England pediatrician Daniel Summers effectively wrote that the so-called vaccines cause autism debate was over. He wrote, “not merely one study or two, but study after study after study confirms that vaccines are safe, and that there is no connection with autism.” In fact, there are 100s of studies, many of them with a huge number of data points, that have shown no correlation, let alone causation, between vaccines and autism. None.
Other than stating that I objectively support Dr. Summers’ statements and conclusions, I don’t have much else to say. But you and I know that an op-ed piece by a real doctor will be noticed by someone in the vaccine denier world, and they will pull out every single trope, myth, and conspiracy theory to claim that Dr. Summers is wrong and that there really is a “vaccines cause autism debate.”
I came across an article by Jeremy R Hammond in the right wing alternative news website, Personal Liberty, which attacked Dr. Summers with those aforementioned tropes, myths, and conspiracy theories. The same ones you’d see from any of your standard, run-of-the-mill vaccine denier.
Let’s take a look at Hammond’s article. Generally, I can only get through about half of an anti-vaccine article when I have to stop because I’m banging my head against the desk too much. I need to protect the neurons in my brain from further damage. But I will try to persevere in the name of science.
Inventing a vaccines cause autism debate
Dr. Summers wrote one statement that seemed to cause Hammond great distress:
If vaccines genuinely cause autism like their opponents claim, one of two things must be true of pediatricians like me who administer them. Either we are too incompetent to discern the relationship between the two, or we are too monstrous to care. One cannot believe that autism is related to vaccination without simultaneously indicting the overwhelming majority of physicians, nurses and other medical providers in this country.
This is a factual statement. If all of those 100s of peer-reviewed articles, published in respected peer-reviewed journals, are wrong, then there must be some huge conspiracy between every single pediatrician, nurse, researcher, CDC, and vaccine manufacturer across the world to hide that. Or these same people so lack critical thinking skills that every one of these healthcare professionals are so utterly incompetent, that they should have their licenses revoked.
Since the evidence is overwhelming, and anyone with two functioning neurons can ascertain the quality of this evidence, the only conclusion one can make is that all of these pediatricians, nurses, researchers, public health institutions, and vaccine manufacturers are in line with the overwhelming evidence of no link between vaccines and autism. Simply put, there is no vaccines cause autism debate.
But Hammond begs to differ. He states that,
Dr. Summers actually answers this question for us with some comments that explain his own demonstrable confirmation bias (the tendency to accept facts that support his own position while ignoring facts that contradict it)…So there you have it. If his view was shown to be wrong, it would demonstrate that either he’s incompetent or he’s evil. It’s only natural that we can expect Summers, then, to be accepting of science that supports his view while dismissive of science that contradicts it.
First of all, Hammond does not quite understand confirmation bias. In fact, most of us who support vaccines use the scientific method – the evidence leads us to a conclusion. Hammond uses pseudoscience – establish a conclusion, like vaccines cause autism, and ignore all evidence that does not support his beliefs. And frankly, as I’ve written about a million times regarding the vaccines cause autism debate, the evidence supports Dr. Summers’ conclusions.
Frankly, Hammond is projecting the problems with his own arguments onto Dr. Simmons. It kind of invalidates much of what Hammond is writing, but we will continue.
Hammond then rejects Simmons’ assertion that the “vaccines cause autism” hypothesis has been “thoroughly debunked.” It has, over and over and over and over. Again, I’m not just pulling this evidence out of thin air (and neither is Dr. Simmons), there are hundreds of studies that have debunked Hammond’s belief.
Next, Hammond claims that the “government has actually acknowledged that vaccines can cause brain damage, and that this vaccine-caused brain damage can result in developmental regression in genetically susceptible individuals.” He then uses an answer that then CDC Director Julie Gerberding gave to a question in a CNN interview in 2008:
Now, we all know that vaccines can occasionally cause fevers in kids. So if a child was immunized, got a fever, had other complications from the vaccines. And if you’re predisposed with a mitochondrial disorder, it can certainly set off some damage. Some of the symptoms can be symptoms that have characteristics of autism.
Sure, that’s an admission that vaccines can cause brain damage – in a child with an extremely rare disorder. In the USA, only about 1,000-4,000 children are diagnosed with this disease every year, and even in that small of a group, vaccine related effects are extraordinarily rare. Moreover, some diseases, like the flu, can worsen the symptoms of a mitochondrial disorder, so vaccines are actually protecting these children from worsening symptoms. Hammond, in the purest sense of pseudoscience, grasps onto a very rare adverse effect, and uses it to “prove” vaccines cause autism. It most certainly does not.
Now we move on to the cancer preventing HPV vaccine
Dr. Simmons’ op-ed wasn’t just about vaccines and autism. His article was about how Donald Trump and Robert F. Kennedy Jr was making his life tougher, by creating this so-called vaccine safety commission. Dr. Summers writes that:
Despite ample evidence of its safety and efficacy, many parents choose not to give their children the vaccination against the carcinogenic human papillomavirus, leaving their sons and daughters at increased risk of several different cancers.
The evidence, despite ridiculous myths about the HPV vaccine, regarding the safety and effectiveness of the HPV vaccine is not just ample, it nearly borders on irrefutable. But once again, Hammond, relying upon all of the tenets of pseudoscience and science denialism, attempts to trash Gardasil by claiming that:
Can Dr. Summers point to any studies in the medical literature that have shown that the HPV vaccine reduces the risk of developing cervical cancer (or anal or mouth/throat cancers in men)? When the FDA approved its use allowing the vaccine manufacturers to advertise it on the grounds that it can prevent cancer, had this been proven in clinical trials?
I don’t know about Dr. Summers, but I can point to several, but because Hammond has his preconceived conclusion, he won’t care. But here goes:
- The HPV vaccine has shown to reduce the risk of cervical neoplasms by nearly 40% in large population of Danish women.
- Even one dose of the HPV vaccine is sufficient to prevent cancer.
- The Gardasil cancer prevention vaccine reduces the rate of oropharyngeal cancer in men.
- Gardasil cancer prevention vaccines prevents pre-cancerous lesions (cervical dysplasia) in girls 3-4 years after vaccination.
- HPV vaccine effectiveness – cervical cancer rate halved in 10 years.
Those are just my reviews of few of the peer reviewed articles of epidemiological studies that show the cancer preventing HPV vaccine reduces the risk of cancers. But remember, Hammond just looks for evidence that supports his own conclusions – he seems reluctant to let the evidence lead him to a conclusion.
Next up, the MMR vaccine
I’m rapidly becoming impatient with Hammond’s arguments. But I must continue because a feathery dinosaur never quits.
Dr. Simmons tried to make a point about the MMR vaccine – it saves lives:
Preventing measles isn’t a matter of avoiding some minor ailment. The disease killed over 100,000 people in 2015. Even in patients who recover there is a risk of severe brain damage years after getting over measles. Why on earth would parents opt for that risk when there’s a safe way of protecting their children?
This is a factual statement. Measles is a dangerous disease that too many vaccine deniers think is just some minor disease, not much different than a common cold. Let’s disabuse anyone who might embrace that assumption.
According to the CDC, some of the many measles complications are:
- About 30% of measles cases develop one or more complications.
- Pneumonia, which is the complication that is most often the cause of death in young children.
- Ear infections occur in about 1 in 10 measles cases and permanent loss of hearing can result.
- Diarrhea is reported in about 8% of cases.
These measles complications are more common among children under 5 years of age and adults over 20 years old (usually those with lapsed immunity).
Even in previously healthy children, measles can be a serious illness requiring hospitalization. As many as 1 out of every 20 children with measles gets pneumonia, and about 1 child in every 1,000 who get measles will develop encephalitis. (This is an inflammation of the brain that can lead to convulsions, and can leave the child deaf or mentally retarded.) For every 1,000 children who get measles, 1 or 2 will die from it. Measles also can make a pregnant woman have a miscarriage, give birth prematurely, or have a low-birth-weight baby.
Hammond doesn’t get this, and attacked Simmons thusly:
Readers would have to be forgiven for taking away from this that the MMR (measles, mumps and rubella) vaccine is 100 percent safe. Dr. Summers surely knows better. Surely, he is not incompetent (much less evil)! He has argued so himself, after all. So surely he has taken the time to read the manufacturers’ product insert, which lists encephalitis as one of the possible adverse reactions to the MMR (manufactured, by the way, by Merck).
Summers notes the deaths of over 100,000 people in 2015 as a result of measles infection as though the mortality rate in the U.S., absent mass vaccination, would be no different than in third-world countries in Africa.
So much to criticize here. First, Dr. Simmons, myself, or anyone with any knowledge of biomedical sciences would never claim any vaccine, or any medical procedure ever, is 100% safe. To vaccine deniers, there is a false dichotomy – either a vaccine is 100% safe or it’s unsafe. Medicine works because benefits outweigh risks – so unless you completely dismiss the consequences of measles or completely overstate the adverse effects, you could safely conclude that the benefits of the MMR vaccine far exceeds the risks. But that works only if you embrace science.
Then Hammond moves on to the age old Argument by Vaccine Package Inserts – he thinks that package inserts are some sort of infallible document, a document that is brought down from the mountain to impart knowledge on humanity. Actually, package inserts, except for a few important sections, are more informational and legalese than it is science. The list of “adverse events” in a package insert is never evidence of correlation or causality – unless you’re looking for evidence to support your pre-conceived conclusions.
In the section Post-Marketing Reports, encephalitis (infection of the brain) was added to reflect the receipt of reports following ProQuad vaccination. Previously, this adverse reaction was listed under adverse events seen after MMR or varicella vaccination. Encephalitis has been reported approximately once for every 3 million doses of MMR vaccine. Post-marketing surveillance of more than 400 million doses distributed worldwide (1978 to 2003) indicates that encephalitis is rarely reported after MMR vaccination. In no case has it been shown conclusively that encephalitis was caused by a vaccine virus infection of the central nervous system. There was no proven causal relationship between ProQuad and any of the reported cases that prompted the change in the label.
Even if the once in 3 million dosage risk could be attributed to the MMR vaccine, and it can’t, then the risk of encephalitis from measles is still substantially higher than the vaccine. I’m wondering if Hammond actually understands the basic mathematics of risk vs. benefit, because he seems to think that kids getting measles is significantly better than getting the MMR vaccine.
Finally, one of the last points Hammond makes is just plain wrong. Dr. Simmons wasn’t trying to imply that 100,000 children would die in the USA, he’s speaking worldwide. Of course, Hammond’s point sounds vaguely offensive that somehow only Africans will die of measles, and not privileged white Americans. Sigh.
Hammond moves forward with his cherry picking a few articles, one a case study (one of the least impressive forms of scientific evidence) and another published in a predatory journal, which has no value from a scientific evidence point of view.
And I’ve reached the limit of reading Hammond’s criticisms of Dr. Simmons – tropes, myths, conspiracy theories, cherry picking and, need I mention this, outright misinformation.
The TL;DR version
Dr. Daniel Summers is right:
- The MMR vaccine is unrelated to autism. The debate IS over – honestly, there never was a debate.
- The HPV vaccine prevents cancer.
To quote Dr. Summers again,
In the words of my colleagues at the American Academy of Pediatrics in a statement released shortly after Trump’s meeting with Kennedy, “Vaccines are safe. Vaccines are effective. Vaccines save lives.”
But if you want to believe the ramblings of a right wing science denier, go right ahead.