Part two of my series of posts on Dr Richard Halvorsen’s book focuses on the chapter on vaccines and autism (subtitled “Autism, Allergy, and Auto-immune Diseases“).
Was Hannah Poling’s Autism Caused By Vaccination?
Halvorsen raises the case of Hannah Poling. The failure of Dr Poling to declare a conflict of interest when submitting his paper titled Developmental Regression and Mitochondrial Dysfunction in a Child with Autism has been discussed elsewhere. Conflicts of interest do not overly concern me when they are openly declared and readers are able to take them into account, but when a COI exists and is not mentioned I find it worrying. (Note: there is also a line in a letter from Dr Poling to the journal that printed his paper, that Left Brain/Right Brain reads as an admission that it was actually conceded that vaccination caused encephalitis rather than autism.) There is more discussion of the case here at NeuroLogica. Referring to a blog post by Orac, Steven Novella points out that:
the government only conceded that “compensation is appropriate.” That is all – they conceded nothing about the larger question of vaccines and autism.
Halvorsen seems to rely on (a) a court judgement that conceded only that compensation was appropriate (i.e. it did not concede that vaccination had caused the symptoms of autism noted in Hannah Poling) and (b) a single academic paper, submitted by an author who failed to declare a significant competing interest. It is also worth reading this post on Patrick Holford’s views. It seems that Halvorsen is not alone in misinterpreting legal findings. I would also argue that relying on a single paper to provide substance to an argument is undesirable, whether there are other concerns (e.g., undeclared competing interests) or not. Halvorsen does not even acknowledge the undesirability of reliance upon one or two papers picked out from all those available. It is disappointing to see someone rely upon a single paper (or to rely upon an abstract rather than the full text of a paper, which is something I admit that I have done) – a failure to acknowledge the issues around doing so is doubly disappointing. We should be honest about the limitations of what we write and the evidence our writings rely on.
Hannah Poling was found to have mitochondrial dysfunction (MD), which is very rare. Halvorsen claims that MD is not actually as rare as was once thought:
a recent study in the UK has discovered that 0.54% (over 1 in 200) children are born with mitochondrial abnormalities – in the form of pathogenic mitochondrial DNA mutations – which may cause some degree of mitochondrial dysfunction or even outright disease.
The emphasis is mine – and it is important. This research tells us that mitochondrial abnormalities are not particularly rare. It does not tell us that mitochondrial dysfunction is more common than previously thought. The article is here and the term “mitochondrial dysfunction” does not appear once. The authors conclude that “at least one in 200 healthy humans harbors a pathogenic mtDNA mutation that potentially causes disease in the offspring of female carriers” – they are looking at mitochondrial DNA mutations in healthy humans, not at mitochondrial dysfunction. It appears that Halvorsen is relying upon a paper that cannot be used to support his argument that MD is more common than previously believed.
Halvorsen then claims that autism “is one of several immune system disorders, such as diabetes and asthma, that have been linked to vaccines.” Halvorsen cites two studies to support his claim that autism is (“at least in some children”) an auto-immune disorder. The first is this paper. The same authors also wrote this paper later the same year. They state in the latter paper that their earlier findings:
support the view that neuroimmune abnormalities occur in the brain of autistic patients and may contribute to the diversity of the autistic phenotypes
Which seems to me to fall short of saying that autism is an auto-immune disorder.
The second paper Halvorsen cites is this one: link; in which the authors state that:
Our results indicate excessive innate immune responses in a number of ASD children that may be most evident in TNF-alpha production.
It is not clear to me whether this means that the authors found that autism is an auto-immune disease. Do some children with autism have excessive immune responses? It appears so. Does this mean that autism is an auto-immune disease? I don’t know, and reading Halvorsen’s book is not something I found helpful. Halvorsen simply states that autism is an auto-immune disease and provides two citations to papers that may or may not support his contention. He fails to make clear how these papers provide evidence supportive of his opinion.
So, having taken a quick look at the abstracts of the two papers Halvorsen cites, are we satisfied that autism is an auto-immune disorder that has been linked to vaccines? I’m not. Two papers that point out apparent differences in immune responses of autistic and non-autistic individuals – and do not seem to even mention vaccines – are not evidence that autism “is one of several immune system disorders, such as diabetes and asthma, that have been linked to vaccines.” Apart from anything else, I would like to see what other literature is out there that has not been cited by Halvorsen.
There’s this from Paul Offit and Jeffrey Gerber:
Autism is not an immune‐mediated disease. Unlike auto-immune diseases such as multiple sclerosis, there is no evidence of immune activation or inflammatory lesions in the CNS of people with autism. In fact, current data suggest that genetic variation in neuronal circuitry that affects synaptic development might in part account for autistic behavior. Thus, speculation that an exaggerated or inappropriate immune response to vaccination precipitates autism is at variance with current scientific data that address the pathogenesis of autism.
This seems to completely contradict Halvorsen’s assertion regarding autism being an auto-immune disorder caused by vaccines.
I have only ‘scratched the surface’ of this book, and already noted misinterpretations of findings, selective referencing of scientific papers, and the citing of evidence that it seems cannot possibly support contentions made. A worrying start.
Unfortunately, I have not yet been able to track down the full text of each of the papers cited in this post and in some cases have had to rely on an abstract – which is clearly undesirable. It is important to note that the full text of a paper might not always be accurately represented by an abstract.
I have only commented on the first three pages of the eight which make up this chapter of The Truth About Vaccines. Commenting on Halvorsen’s book is taking up rather a lot of space and is also proving to be time-consuming.
I have previously written blog posts about Richard Halvorsen here and here on the Lay Science website (the former is regarding an article on vaccination written by Halvorsen and published in the Daily Mail, the latter is regarding an appearance on the Today programme on Radio 4). I also have a category on this blog for posts about Halvorsen here – including a post I wrote about a Halvorsen article in The Times (on swine flu vaccination) and one I wrote fairly recently about a terrible article (on HPV vaccination) in the Sunday Express that relied heavily on Halvorsen.