Saturday, February 14, 2009

Vaccination, Autism and Hasting-Cedillo: A Lesson from Kitzmiller

As many readers are likely aware, a decision was made in last week in the Hastings-Cedillo case. This case was the test case for claims that vaccines, especially the MMR vaccine caused autism and could thus get compensation under the federal Vaccine Injury Compensation Program. To many people watching the case, the issue of whether vaccines contribute to autism was more important than any issues of legal redress. For a long time, the scientific consensus has been that there is zero evidence that vaccines contribute to autism and if anything the evidence strongly suggests that they are not related. The court's decision came down strongly on the side of the scientific consensus:

The petitioners in this case have advanced a causation theory that has several parts, including contentions (1) that thimerosal-containing vaccines can cause immune dysfunction, (2) that the MMR vaccine can cause autism, and (3) that the MMR vaccine can cause chronic gastrointestina dysfunction. However, as to each of those issues, I concluded that the evidence was overwhelmingly contrary to the petitioners’ contentions. The expert witnesses presented by the respondent were far better qualified, far more experienced, and far more persuasive than the petitioners’ experts, concerning most of the key points. The numerous medical studies concerning these issues, performed by medical scientists worldwide, have come down strongly against the petitioners’ contentions. Considering all of the evidence, I found that the petitioners have failed to demonstrate that thimerosal-containing vaccines can contribute to causing immune dysfunction, or that the MMR vaccine can contribute to causing either autism or gastrointestinal dysfunction. I further conclude that while Michelle Cedillo has tragically suffered from autism and other severe conditions, the petitioners have also failed to demonstrate that her vaccinations played any role at all in causing those problems.
The conclusion is even more blunt:
This case, however, is not a close case. The overall weight of the evidence is overwhelmingly contrary to the petitioners’ causation theories. The result of this case would be the same even if I totally ignored the epidemiologic evidence, declined to consider the video evidence, and/or excluded the testimony of Dr. Bustin. The result would be the same if I restricted my consideration to the evidence originally filed into the record of this Cedillo case, disregarding the general causation evidence from the Hazlehurst and Snyder cases. The petitioners’ evidence has been unpersuasive on many different points, concerning virtually all aspects of their causation theories, each such deficiency having been discussed in detail above. The petitioners have failed to persuade me that there is validity to any of their general causation arguments, and have also failed to persuade me that there is any substantial likelihood that Michelle’s MMR vaccination contributed in any way to the causation of any of Michelle’s own disorders. To the contrary, based upon all the evidence that I have reviewed, I find that it is extremely unlikely that any of Michelle’s disorders were in any way causally connected to her MMR vaccination, or any other vaccination.

In short, this is a case in which the evidence is so one-sided that any nuances in the
interpretation of the causation case law would make no difference to the outcome of the case.
In reading the opinion, I could not help but compare it to Kitzmiller v. Dover in which intelligent design was found by a federal court to simply be repackaged creationism. The circumstances are similar; the existence of an issue in which the scientific consensus went one way and popular opinion often went another. A court looked at the issue and agreed with the scientists. The decision is not as well-written as the Kitzmiller decision but the result is similar.

We can learn from the impact of Kitzmiller to hypothesize what this decision will have. After Kitzmilker, intelligent design is still going strong, and many people still believe that ID is distinct from creationism and that ID is a scientific theory that should be taught in our public schools. The Cedillo decision will almost certainly not have a substantial impact on popular opinion. If anything, Cedillo will likely have even less impact than Kitzmiller had. With intelligent design, the main conflict occurs from proponents attempting to add ID into our public school biology classes. Kitzmiller set a precedent that teaching ID is unconstitutional and that trying to do so makes a school board lose time and money. Such a precedent has real weight when communities consider adding ID to the school curriculum. However, with vaccination, the issue of monetary compensation for families with autistic children has always been a side issue. The direct conflict occurs primarily with new parents debating whether they should have their children vaccinated. A legal decision such as Cedillo will not have as much impact on peoples' behavior. If the general public is to be convinced that vaccines are safe, they must be convinced through education, not legal decisions.

12 comments:

treehouses said...

"If the general public is to be convinced that vaccines are safe, they must be convinced through education, not legal decisions."

Or, unfortunately, through the resurgence of measles, mumps, and rubella.

Lautreamont said...

Josh,

So true to compare these cases, as both would require only the viewing of facts to stem them; in once case sets of statistics professionally run since the inception of MMR vaccines, and in another the literal mountains of genetic, anthropological, and paleontological evidence that supports evolution. The Kitzmiller decision brings a smile to my face each time I think about it, NOT because it is a victory for atheism or even for evolution, but because it is a victory for the concept that both proved truths and honest scientific scrutiny matter.

Joshua said...

Kurt, yes. Measles is once again endemic in Great Britain (or at least England). This is due to the reduced vaccination rate which is now low enough that herd immunity no longer applies. Mumps is also on the rise. (I don't know about the situation with regard to rubella but it wouldn't surprise me if it were becoming more common as well).

Etienne said...

Sorry, completely off-topic:

5 professors and I were thinking about the following problem for 2 hours tonight.

Is the set of bijections N -> N countable?

5/6 of us think "obviously" no but we've gotten nowhere trying to prove it, though we have plenty of fallacious proofs that instead prove the injections are uncountable. Got any ideas?

Joshua said...

Think this works but not completely sure.

We will show that Let f(n) be the identity function from N to N. Consider strings the set A of strings of 0s and 1s (which is clearly uncountable. For any such string S in A, defined f_S(n) to be f with the 2kth and 2k+1 digit swapped iff S has a 1 in the kth slot and otherwise left alone. This is an injection from A into the set of bijections from N to N. So N is uncountable. Does that work?

sniffnoy said...

Here's an even simpler way: Pair up the elements of N ({0,1}, {2,3}, ...), then for each set of pairs, we can make a permutation of N by, for each pair, if it's one of the selected pairs, swap its elements, and if it's unselected, don't swap them. Then this gives an injection 2^NN!. Hell, combined with other facts from cardinal arithmetic, this shows λ!=2^λ for any infinite cardinal λ.

Lautreamont said...

I wish i understood math...I am getting a masters at Columbia now and even all my literary fellows are quite good with numbers. Oh well

lambdadelta said...

To say that ID is still "going strong" is a misstatement. It's dead, and the creationists are still floundering around trying to create a new bridgehead under academic freedom or some such.

The same will happen to the antivax people. Opposition to vaccines has reached its high watermark. It's losing mind-share just as surely as the creationist movement long ago lost mindshare.

Joshua said...

ID is not as strong as it was before Kitzmiller but the general idea is still going strong. It is true that in terms of direct legislation there is less of ID but among the general populace ID is almost as popular now as it was in 2003 or so before Kitzmiller. The only people who have really changed their opinions are people like me who started off with some minimal sympathy with ID and lost it completely during Kitzmiller and during the surrounding years in which the ID proponents failed to do anything resembling scientific research. The fraction of the population who has had their opinions change is small.

The move towards "teaching the controversy" and such is a move by the leadership that wants creationism in schools, not a common belief among actual people.

Brian said...

I like your post and I want to know if autism is dangerous and I need to know if Generic Viagra is the best drug against ED.

Young Women Older Men said...

Nice post but I want to know why this sick is so common and how I can prevent it.

Studio Design said...

Excellent post I want learn more about this kind of disease and I think that the vaccination is excellent to all the problems but I don't know if this is effective to autism.