The Wakefield paper, purporting to show a connection between MMR vaccination and autism, was found to be fraudulent and was retracted.
Last week I commented on a breakthrough study that put Autism Spectrum Disorder (ASD) on a solid biochemical base. Finally, the multiple genetic strands that had been associated with ASD were pulled together by the discovery that they all feed into a key cellular regulator, mTOR. When this protein is hyperactive in certain regions of the brain, the neurological basis for autism ensues.
So, it is particularly dismaying that a cohort of anti-vaccine activists that have joined forces with professional conspiracy theorists haven’t heard the news yet.
The Wakefield Paper: The Autism-Vaccine Fraud
Remember the Wakefield paper, purporting to show a connection between MMR vaccination and autism? That paper was found to be fraudulent and was retracted. Wakefield was censured by medical organizations in the U.K. and was barred from practicing medicine. Pretty damning, and you’d expect that any self-respecting scientist would avoid any association with the fraudster, or his data, like the plague. However, never underestimate the resilience of true believers.
Brian Hooker recently published a paper in Translational Neurodegeneration, a Chinese open-access journal (I must admit to never hearing of this journal before) claiming that a re-analysis of a paper published by CDC investigators (Distefano et al. Pediatrics, 2004) that showed no relationship of MMR vaccination to ASD, actually did show that “when comparing cases and controls receiving their first MMR vaccine before and after 36 months of age, there was a statistically significant increase in autism cases specifically among African American males who received the first MMR prior to 36 months of age.”
What’s wrong with this paper?
Statistics, for starters. Post-hoc subgroup analysis is fraught with risks too numerous to detail here. Suffice it to say that confounding factors fall into the “known unknowns” and “unknown unknowns” categories. Multiple logistic regression analysis can ferret some, but not all, such problems. It is puzzling then that Hooker chose to use extremely simplified contingency statistics (chi square) that are far more prone to false positives, since they’re less capable of isolating out confounding factors than the multiple logistic regression.
Distefano and his colleagues noted no significant correlation in various groups based on race, maternal age, maternal education, and birth weight. They did find that “Vaccination before 36 months was more common among case children than control children, especially among children 3 to 5 years of age, likely reflecting immunization requirements for enrollment in early intervention programs”. In plain English, it is likely not due to an actual effect, but due to confounding factors.
And what could those factors be in this particular study?
We know that many African Americans are disadvantaged economically, and their children’s medical care was (pre-ACA) spotty at best, especially in the Atlanta metropolitan area, where this study was conducted. The Atlanta School Board issued a ruling that in order to enter public school children had to be vaccinated with the MMR vaccine. So what is a poor African American mother to do? She gets her 5 year-old vaccinated, of course. Now, since odds are that she hasn’t seen a pediatrician on a regular basis before she was compelled to do it, the diagnosis of autism was likely to be made late. From here to the apparent correlation of vaccination and autism is a skip and hop.
There are other statistical sins committed. For instance, the original study had a case-control design, and was analyzed as such. The “re-analysis” tampered with the control group to make it a cohort study. This is not only chutzpah, it is un-kosher statistical trickery, with intent to deceive.
Who is Brian Hooker?
I intentionally concentrated on the substance of the paper rather then on personalities. But looking at who is behind this study would add some color to the story.
According to Sciencebasedmedicine.org, Hooker is a chemical engineer who has now taken a faculty position as an associate professor of biology at Simpson University. He has managed a systems biology research program at Batelle/Pacific Northwest National Laboratory and continues to operate his own consulting agency. He also has an autistic child, whom he describes as “vaccine injured” and is on the board of directors of Focus Autism, an organization that describes itself as “born out of the desire to put an end to the needless harm of children by vaccination and other environmental factors” and runs the anti-vaccine campaign A Shot of Truth. He has been known for making numerous Freedom of Information Act requests for data and information from the CDC and for having (possibly) persuaded Darrell Issa to hold hearings on the link between vaccines and autism, although it’s not clear that a large campaign contribution from a prominent member of the anti-vaccine group Canary Party didn’t have more influence.
Who are these people?
Starting from fundamental psychological evolutionary principles, it is pretty well established that our brains crave order and abhor uncertainty. This is why people invented supranatural explanations (gods of various persuasions and capabilities) to bring order to a chaotic and menacing universe. But what about the modern age and its advanced physics and evolution and genomics? These advances were brought about by skeptics – scientists who questioned prevailing theories and dogmas, proposed alternative theories that are testable and falsifiable. If they were falsified -they were ditched and replaced by alternative testable and falsifiable theories. So what’s the difference between the skeptical scientist and the conspiracy theorist?
The answer is that people who suspect conspiracies aren’t really skeptics. Like the rest of us, they’re selective doubters. They favor a worldview, which they uncritically defend. But their worldview isn’t about God, values, freedom, or equality. It’s about the omnipotence of elites. Cutting through the psychological lingo, William Saletan of Salon magazine summarized it best:
“The common thread between distrust and cynicism…is a perception of bad character. More broadly, it’s a tendency to focus on intention and agency, rather than randomness or causal complexity. In extreme form, it can become paranoia. In mild form, it’s a common weakness known as the fundamental attribution error—ascribing others’ behavior to personality traits and objectives, forgetting the importance of situational factors and chance. Suspicion, imagination, and fantasy are closely related”.
The difference between scientific skepticism and suspicion, imagination, and fantasy revealed itself in bold relief when I had lunch with a Palestinian scientist working at the Hadassah Medical Center in Jerusalem. Unavoidably, the conversation about genetic research slipped into politics. I was dumbfounded to hear this scientist telling me in a conspiratorial sotto voce that Israeli doctors, some of them his colleagues, were vaccinating Arab children with MMR laced with the HIV virus.
Alas, this doctor is not an oddball, there are many like him. Brian Hooker is of the same ilk.