Anti-vaccine paper retracted again – like a zombie, it keeps coming back

Anti-vaccine paper

Late last year, I spent a couple of thousand words critiquing an awful anti-vaccine paper that attempted to claim that vaccinated kids were sicker than unvaccinated kids. Soon after the paper was published, a huge kerfuffle arose on Twitter, which pointed out the false conclusions, bad experimental design, and high levels of bias made by the authors. Within days of publishing the article, the journal retracted it (see Note 1).

Tell me if you’ve heard this before.

Not two days ago, I spent a couple of thousand words taking down an anti-vaccine paper that tried to claim that vaccinated kids were sicker than unvaccinated kids. Soon after the paper was published, the journal retracted it (see Note 2).

Oh wait, you had heard it before. The papers were the same one, where the primary author went shopping for journal after journal to get it published. Why so persistent? The primary author, Anthony R Mawson, from Jackson State University, has a long, established background of supporting the Andrew Wakefield along with anti-vaccine research. In 2011, Mawson had actually filed a lawsuit against the Mississippi State Department of Health in which he claims that there is a need for more studies on vaccines (including his own design, apparently), and that the Department of Health interfered with his getting a contract renewal at the University of Mississippi Medical center. The suit was dismissed in 2012.

Mawson actually has a Master’s and Doctorate in Public Health, specializing in epidemiology. You’d think he’d know better about vaccines, but I guess being a sycophant of MrAndrew Wakefield makes him deny his scientific background. Then, he goes out and invents a bad experimental design just to support his nonsense beliefs. And to be more endearing to Wakefield I suppose.

Now, you, my reader, are probably thinking, “OK, got it, let’s talk about GMOs.” Except, I have to drag you back in, and remind you that myths, tropes and memes in the anti-vaccine world are like zombies. They never quite die, biting one anti-vaccine cheerleader after another. Even a dead paper, like Mawson’s, will arise again somewhere.

As the curmudgeonly Orac just wrote,

One of the most frequent topics for posts like this is a pseudoscientific or just plain bad study that, despite being retracted, keeps rising from the grave, like the proverbial zombie. I call them, appropriately enough, zombie studies. Depending on my mood when I write posts like this, I often add imagery featuring zombies (or, if you’re into The Walking Dead, walkers).

I can’t resist a good Walking Dead metaphor.

Let’s look at this zombie/walker anti-vaccine paper. Because you just know, like the end of the zombie movie, the story drops hints for Part II. Or Part II. Or Part XXI.

 

How did an anti-vaccine paper get retracted twice?

The simple answer is that it was published twice in predatory journals, whose standard of publication is not much more than if the author can pay the fees to publish their paper. Mawson’s article was published for the first time in Frontiers in Public Health, a part of the Frontiers Media empire. It was published for the second time in the Journal of Translational Science, a part of OAT. Both Frontiers Media and OAT are predatory publishers according to the definitive Beall’s List of predatory publishers. A predatory publisher is an “exploitative open-access publishing business model that involves charging publication fees to authors without providing the editorial and publishing services associated with legitimate journals.”

In case you missed my articles about this before, let’s look at Frontiers Media and OAT:

  • Frontiers in Public Health (FPH) is not indexed in PubMed. The Journal of Translational Science (JTS) is not indexed in PubMed. PubMed is one of the most valued resources in searching for biomedical articles, even in obscure journals. Without PubMed, it is extraordinarily difficult to find the article. Of course, there’s no reason given for it’s exclusion from PubMed, but we can speculate that possibly the science is bad.
  • Both FPH and JTS lack an impact factor. The impact factor gives us a relative understanding of the quality of a journal – generally, the impact factor tells us approximately how many times an average article published in a journal is cited per year. A journal like Nature has an impact factor of 36, which means the average article is cited 36 times a year. Why is this important? We know that more pivotal and valuable research is cited many times and often repeated by other scientists, especially in new publications. This is how science develops solid evidence, by examining and repeating the findings of others.
  • As we mentioned above, both FPH and JTS are published by predatory publishers (one of the possible reasons that the journals are not indexed).
  • Low impact factor, predatory journals are generally dismissed by scientific researchers because the peer-review is weak. These journals are often abused by researchers whose data has been rejected by one or more of the respected journals, so they settle for these low quality versions. In the academic community, publications such as these often cannot be used as evidence of qualification for tenure.

Clearly, neither FPH or JTS were actually interested in what Mawson had written. If they were, either or both of them would have rejected the articles in the first place. But here we are, both articles were “published” (or whatever verbiage they use), and both were retracted (or scrubbed from the internet).

 

Remember, this anti-vaccine paper was garbage

Just in case you’re anti-vaccine, and you think that there’s some conspiracy against “evidence” that vaccines are dangerous, get over yourself. These two journals are awful, and it’s entertaining that Mawson’s article was so bad that it fell beneath the journal’s miserable standards.

Let me remind you of how terrible this article was (before being retracted twice).

  1. This study intended to “compare vaccinated and unvaccinated children on a broad range of health outcomes, and to determine whether an association found between vaccination and neurodevelopmental disorders (NDD), if any, remains significant after adjustment for other measured factors.” This is a good start, and if done well, it could provide us with more information about any potential links between vaccines and NDDs such as autism spectrum disorder. But this is not a well-designed study to answer that question.
  2. The study surveyed 415 mothers of 666 children educated at home. And the paper goes downhill quickly. First of all, we are relying on data from a group, which may or may not be biased versus a random sampling, that home schools children. There are lot of reasons why parents do this, but are they representative of the population at large? Second, it relies upon the memories and, frankly, biases of the mother being surveyed – it doesn’t rely upon data in actual medical files of each of these children, which can be considered to be somewhat “scientific.”
  3. Parents who do vaccinate may be less reluctant to visit their physician to get diagnosed for diseases, while a non-vaccinating parent may choose to ignore any health issues as minor. Thus, there may be an unintentional bias towards health care issues for vaccinated children.
  4. The groups (vaccinated vs. unvaccinated) are not randomized which will lead to observational and confirmation bias.
  5. The population for the study is quite small to tease out data on very rare conditions. A meta-review that included nearly 1.3 million children, using real medical records to establish both vaccination status and ASD status, found that there was no difference between vaccinated and unvaccinated groups with respect to incidence of autism.
  6. Questionnaires are not the best way to gather data about medical issues – in fact, the use of questionnaires for epidemiological studies is frowned upon by many researchers. The reasons for this are many, but they include a reliance upon the memory of the participant for events that may be not be recalled correctly. In addition, there might be intentional or unintentional bias of the survey participants towards relating a condition to vaccines or ignoring one in unvaccinated kids. Better done, and frankly, more expensive, epidemiological studies rely upon medical records to reduce errors in memory and bias. This is a critical point – the best studies that show no link between vaccines and autism rely upon actual medical data for each child, not on a questionnaire which may or may not be tracking accurate information.
  7. At best, this is observational data, which are not the type of data used to reject or accept an hypothesis. The CDC uses surveys to determine vaccination uptake, for example, but they used a non-biased methodology to gather data. They surveyed nearly 15,000 children, and were given permission to contact the health care provider to get more information.
  8. Mawson’s study found that 39% of children surveyed were not vaccinated. Now if we accepted this data without analysis, we’d think that the vaccination rate has dropped. However, that’s not what we’ve seen in other, better-designed surveys, such as the CDC’s massive ones, which showed that vaccine uptake was between 85 and 95% depending on the vaccine and the area. With such a difference between this study and better designed ones, one would have to believe that the study with a much smaller number and an apparently biased population would be the outlier.
  9. There was a lack of analysis of potential cofounders which might bias the results. Were there other differences between he vaccinated and non-vaccinated groups that could have biased the results one way or another?
  10. The use of odds ratio by the researchers is curious and may have biased the results. The only reason to use OR is to inflate the difference between both groups. Real epidemiologists prefer relative risk (RR) which provides us with a much more sensitive understanding of the incidence of a condition in a vaccinated group vs. an unvaccinated group. For example, the RR for ASD from this study (if the data actually were useful, which it isn’t) is 3.1, whereas the OR is 4.2.
  11. The over reliance on p-values is always a red flag to researchers. With so many p-values, the probability of false positives is fairly large. Because the population for the study was so small, it’s also worth nothing that the OR had relatively large error brackets, most of which crossed near unity, that is, 1.0, indicating no difference between the groups.
  12. The authors seem to overlook or ignore the point that the vaccinated children had much lower risk of diseases like chickenpox and measles, which we know bring with them significant risks of long-term health issues. Even if we accept this poorly designed study as providing us with evidence of harm from vaccines, one would have to balance it against the benefits of avoiding vaccine preventable diseases. Of course, this study is so bad, it’s hard to accept anything useful from it.

There’s more, I’m sure. I just get tired of tearing apart these bogus articles, when it’s really hard to get over the fact that it’s been retracted twice by awful predatory publishers. Seriously, that should be the end of the story.

 

Summary

As the crotchety Orac wrote recently about Mawson’s article,

I’ll conclude by pointing out yet again that it is a myth that there are no studies comparing the health of vaccinated children compared to unvaccinated children. In fact, there have been several. It turns out that they don’t show what antivaxers think a vaxed/unvaxed study will show. Basically, all of the vaxed/unvaxed studies not done by antivaccine-friendly scientists or quacks have shown either no differences in the prevalence of neurodevelopmental or chronic diseases between vaccinated children and unvaccinated children or have actually found better health outcomes in the vaccinated population. Mawson concludes by arguing that further “research involving larger, independent samples and stronger research designs is needed to verify and understand these unexpected findings in order to optimize the impact of vaccines on children’s health.” Mawson’s study is so biased, flawed, and incompetently carried out and analyzed that its results can be discounted as almost certainly worthless. It doesn’t provide the rationale for “more studies.” Quite the contrary.

Yet, that’s how antivaxers are spinning it, as they always do.

Same as it ever was.

There really are plenty of good articles, published in real, indexed, high impact factor journals that show that there is little or no difference between the health of vaccinated versus unvaccinated children. We should also include that nagging point that vaccinated children don’t generally catch deadly, disabling vaccine preventable diseases.

We also have boatloads of evidence, again, published in major journals, that dismiss any link between vaccines and autism, which feels like the basis of Mawson’s junk article. So, if you want to use that rubbish anti-vaccine article as the basis of your “evidence” that vaccines are dangerous – well, you really need something more convincing. Mawson’s article was retracted twice by the detritus of predatory publishers, so it would be laughable to use it as real evidence.

But we all know that this zombie article will rise again. They eat brains, and apparently they’re looking for nutritious anti-vaxxer brains. But zombies aren’t real, except on TV and movies. So the anti-vaccine world keeps pushing zombie tales – because they think that by Part XXI, we will be bored with the zombie myth and not try to take it down. Don’t count on it.

 

Notes

  1. Actually Frontiers Media noted that the study was only “provisionally accepted but not published.” That might be what they think, but the article appeared on their website, then disappeared.
  2. Technically, we can’t tell that the article was retracted. It’s just been scrubbed from JTS’ website, as if it never existed. But the internet never forgets.

 

 

Vaccinated children sicker – another anti-vaccine trope

vaccinated kids sicker

One of the enduring zombie myths pushed by the anti-vaccine side is that their children are healthier than vaccinated children. But are vaccinated children sicker? Not based on any real, scientific evidence. But that never stops the science denying anti-vaccine crowd.

The vaccine myth website, vaccines.news, published an article recently pointed to two poorly designed studies to make the outlandish claim that vaccinated kids are sicker. One the studies, a German one, which used internet surveys (yeah, think about that) to get data,  was pushed by several anti-vaccine groups, including the propaganda blog, Age of Autism, as “proof” vaccines are dangerous. But as the silver-tongued Orac concluded:

In any case, I take some comfort in the hilarious result of this survey that demonstrates that autism prevalence in the unvaccinated is similar to autism prevalence among the vaccinated, no matter how much anti-vaccine activists try to spin it otherwise. I realize that this survey is in fact so poorly designed that it really doesn’t tell us much of anything, but it is fun watching anti-vaxer brains explode trying to spin this result as supporting the vaccine/autism hypothesis.

Remember, there is no scientific evidence supporting the vaccine/autism hypothesis.

Now we have a new study that barely rises to the same abhorrent quality level of the aforementioned German study. Of course, we have to look at it.

 

Vaccinated children sicker – the research behind the myth

The claims that are circulating across the anti-vaccine blogosphere are based on a recent article published in the Journal of Translational Science. Before we get into the article, you might be wondering what is “translational science,” because it sounds a bit woo-based. Translational medicine or science is an interdisciplinary approach which combines resources, expertise, and techniques within basic sciences to discover enhancements in prevention, diagnosis and therapies for various diseases. It’s actually pulling medicine back to basic sciences to better understand everything going on in the body.

For example, they may discover a mutated gene that produces a dysfunctional protein that has a profound effect on the body. They then target that gene and its protein production to treat the disease, rather than target the symptoms that are caused by the bad protein. Translational medicine is an exciting field of biomedical research, on which has shown much promise. However, some “translational medicine” has moved into the world of woo.

Here’s what the Journal of Translational Science (JTS) says its goals are:

JTS is a novel journal that will focus upon the translation of cellular, molecular, and genetic pathways into clinical strategies for multiple medical disciplines that can impact a broad spectrum of disorders that involve stem cells, degenerative diseases, aging, immune function, tumorigenesis, epigenetics, musculoskeletal function, cognition, behavior, neuronal, cardiac, pulmonary, gastrointestinal, and vascular targets, and metabolic function overseeing all aspects of translational research and medicine.  JTS will provide a platform in today’s scientific and medical literature to serve as an international forum for the healthcare and scientific communities worldwide to translate novel “bench to bedside” science into clinical therapies as well as report upon prognostics, novel therapeutic strategies, and biomarker development.

That’s all well and good, but the study from JTS that we’re discussing in this post doesn’t fit in any of those. And a review of much of the research they publish is laughably woo-based. In the same issue of JTS as the article we’re discussing, they had published an article examining traditional Chinese medicine, which is neither traditional nor medicine.

So, let’s take a closer look at the “vaccinated children sicker” paper.

 

A 10,000 meter meta critique of the paper.

There’s a lot to dislike about this paper and journal. But I think it’s important to take a meta-approach to this paper to make sure you have a good grasp of the quality of what we’re critiquing.

  1. The Journal of Translational Science is not indexed in PubMed. It’s been over two years since the journal was first published, and it is rare for a journal to not be indexed there. Without PubMed, it is extraordinarily difficult to cites one of the articles published in JTS. Of course, there’s no reason given for it’s exclusion from PubMed, but we can speculate that possibly the science is bad.
  2. JTS lacks an impact factor. The impact factor gives us a relative understanding of the quality of a journal – generally, the impact factor tells us approximately how many times an average article published in a journal is cited per year. A journal like Nature has an impact factor of 36, which means the average article is cited 36 times a year. Why is this important? We know that more pivotal and valuable research is cited many times and often repeated by other scientists, especially in new publications. This is how science develops solid evidence, by examining and repeating the findings of others.
  3. The publisher of JTS, OAT, is a predatory publisher according to the definitive Beall’s List of predatory publishers. A predatory publisher is “exploitative open-access publishing business model that involves charging publication fees to authors without providing the editorial and publishing services associated with legitimate journals.”
  4. Low impact factor, predatory journals are generally dismissed by scientific researchers because the peer-review is weak. These journals are often abused by researchers whose data has been rejected by one or more of the respected journals, so they settle for these low quality versions. In the academic community, publications such as these often cannot be used as evidence of qualification for tenure.

None of these issues alone should lead one to dismiss the data outright. However, if one had real data that leads to a conclusion that “vaccinated kids sicker – watch out,” it would have been accepted by any of the journals that have focus on vaccines. But if the research was not well-designed, and well-analyzed, then the better journals would move away, and quickly, from adding it to their publication.

 

Critique of the “vaccinated children sicker” paper

The authors, Anthony R Mawson et al., hypothesized that there was an association between vaccines and neurodevelopmental disorders (NDD) of 6- to 12-year old biological children. The study was of home schooled children in Florida, Louisiana, Mississippi and Oregon. The mothers were asked to complete an anonymous online questionnaire on their children with respect to pregnancy-related factors, birth history, vaccinations, physician-diagnosed illnesses, medications used, and health services utilized. The NDD was defined as having one or more of these diagnoses – learning disability, attention deficient hyperactivity disorder (ADHD), and autism spectrum disorder (ASD).

The study found the following conditions were more prevalent in vaccination children:

  • Allergic rhinitis (odds ratio = 30.1). We’re going to take a look at odds ratio down below.
  • Other allergies (OR= 3.9)
  • Eczema/atopic dermatitis (OR=2.9)
  • Learning disability (OR=5.2)
  • ADHD (OR=4.2)
  • ASD (OR=4.2)
  • Any chronic illness (OR=2.4)

Well, all that sounds like vaccines are worse for our children. Except it really doesn’t.

How about we jump in with a harsh critique of these kinds of studies:

  1. It uses an internet questionnaire to determine each of the data points for this study. The use of questionnaires for epidemiological studies is frowned upon by many researchers. The reasons for this are many, but they include a reliance upon the memory of the participant for events that may be not be recalled correctly. In addition, there might be intentional or unintentional bias of the survey participants towards relating a condition to vaccines or ignoring one in unvaccinated kids. Better done, and frankly, more expensive, epidemiological studies rely upon medical records to reduce errors in memory and bias. This is a critical point – the best studies that show no link between vaccines and autism rely upon actual medical data for each child, not on a questionnaire which may or may not be tracking accurate information.
  2. Home schooled groups are unrepresentative of the school age children at large. Many children are homeschooled because of parents dislike of vaccinations, so this forms a biased group. Now, maybe the home schooled group mirrors a traditionally schooled group – if you want to make that case, then you need actual data published in an actual journal.
  3. Parents who do vaccinate may be less reluctant to visit their physician to get diagnosed for diseases, while a non vaccinating parent may choose to ignore any health issues as minor. Thus, there may be an unintentional bias towards health care issues for vaccinated children.
  4. The groups (vaccinated vs. unvaccinated) are not randomized which will lead to observational and confirmation bias.
  5. The population for the study is quite small to tease out data on very rare conditions. A meta-review that included nearly 1.3 million children, using real medical records to establish both vaccination status and ASD status, found that there was no difference between vaccinated and unvaccinated groups with respect to incidence of autism.
  6. There was a lack of analysis of potential cofounders which might bias the results. Were there other differences between he vaccinated and non-vaccinated groups that could have biased the results one way or another?
  7. The use of odds ratio by the researchers is curious and may have biased the results. The only reason to use OR is to inflate the difference between both groups. Real epidemiologists prefer relative risk (RR) which provides us with a much more sensitive understanding of the incidence of a condition in a vaccinated group vs. an unvaccinated group. For example, the RR for ASD from this study (if the data actually were useful, which it isn’t) is 3.1, whereas the OR is 4.2.
  8. The over reliance on p-values is always a red flag to researchers. With so many p-values, the probability of false positives is fairly large. Because the population for the study was so small, it’s also worth nothing that the OR had relatively large error brackets, most of which crossed near unity, that is, 1.0, indicating no difference between the groups.
  9. The authors seem to overlook or ignore the point that the vaccinated children had much lower risk of diseases like chickenpox and measles, which we know bring with them significant risks of long-term health issues. Even if we accept this poorly designed study as providing us with evidence of harm from vaccines, one would have to balance it against the benefits of avoiding vaccine preventable diseases. Of course, this study is so bad, it’s hard to accept anything useful from it.

Predictably, the authors conclude that:

First, additional research is needed to replicate the findings in studies with larger samples and stronger research designs. Second, subject to replication, potentially detrimental factors associated with the vaccination schedule should be identified and addressed and underlying mechanisms better understood.

Maybe because their paper was published in a journal that is not indexed in PubMed, they didn’t search there. If they had, they would have found find 100s of articles, with much better, unbiased studies that conclude that there is no link between vaccines and neurodevelopmental disorders. I’ll simplify for Mawson et al., I reviewed and wrote an article that include the most important real science articles that they are wrong about vaccines and neurodevelopmental disorders.

 

Conclusion

Are vaccinated children sicker? Well, if you listen to the anti-vaccine crowd, who have cherry picked Mawson et al. to support their pre-conceived faith that vaccines and autism are linked, you’ll buy into the anti-vaccine conclusions:

This pilot study shows us that if mainstream medicine and our public health agencies are really interested in children’s health, not just vaccine profits or defending vaccine religion against blasphemy, what is needed is not the will to make everyone believe, but the courage to find out.

But real science says that the study used by this anti-vaccination believer is poorly designed, and it does not show what they claim it shows. It’s biased, poorly analyzed, and comes to conclusions that are not supported by the vast mountains of real science published in real (read, non predatory journals). No real scientist would accept the findings of this paper, other than to laugh heartily. I don’t laugh, because I know some crackpot will use it to “prove” that vaccines are dangerous, when there’s no robust evidence to support that belief.

Vaccines are safe. Vaccines are effective. A badly designed, irresponsibly published article does not change the vast consensus of scientists that vaccines are safe and effective.

 

Citation

Another anti-vaccine article – bad journal, bad data

anti-vaccine article

Here we go again. An anti-vaccine article was published in a journal, and now every vaccine denier will use it as absolute “proof” that vaccines are evil, bad, and useless. And that means one of the pro-science community has to provide a critical analysis so that those on the fence know what is supported and not supported by real science.

The article, “New Quality-Control Investigations on Vaccines: Micro- and Nanocontamination,” published in the International Journal of Vaccines and Vaccination on 23 January 2017. I want to examine this from the meta level, discussing the quality of the journal, down to the actual data. Spoiler alert – it’s bad. Continue reading “Another anti-vaccine article – bad journal, bad data”

Another antivaccination cult “peer-reviewed” paper–SIDS and vaccines

SIDS-vaccine-2Since I just wrote an article about the pathetic “peer-reviewed” paper being pushed by the antivaccination cult, I was almost reluctant (not really) to take down another so-called peer reviewed paper. But this one is actually worse than the B Hooker et al. travesty. It’s much much worse.

In an article recently published in Current Medicinal Chemistry, Matturi et al. attempted to claim that the hexavalent vaccine (a combination of DTaPHibIPVHepB, used in Europe) was associated with (or even caused) sudden infant death syndrome (SIDS). This is one of those antivaccine tropes that has more zombie resurrections than an episode of the Walking Dead. Continue reading “Another antivaccination cult “peer-reviewed” paper–SIDS and vaccines”