The British Medical Journal Re: The MMR story is not complete 15 October 2008 John Stone London N22
I am surprised that John Snyder [1] (John Snyder, Chief, Section of General Pediatrics, Dept of Pediatrics, Saint Vincent's Hospital, New York, NY 10011) is allowed to attack me in the terms that he has. This is the essence of ad hominem:
"Nor, does it seem, do people like John Stone understand that science and the null-hypothesis will never be able to prove the MMR doesn't cause autism, or earthquakes, or hurricanes, or financial crises." [1]
This is instead of addressing any of the points I made [2]. It should be pointed out that MMR is a pharmaceutical product, and if the only resort to people who question its safety (like any other product) is to attack their character or intellectual competence, there is something wrong in the terms of the discussion. If witnesses to adverse drug events are treated like this by Snyder, what weight can be placed on his opinion? And what makes MMR different from other products, placing it forever beyond scientific investigation?
Snyder has no answer to the deficiencies in the epidemiology documented in my post, either from Cochrane [3] or former National Institute of Health chief Bernardine Healy [4]. And he has no answer for the fact that the passage in the Hornig study I quoted absolutely does support continuing scientific concern about this matter. Hornig [5] failed to test the Wakefield hypothesis adequately by fudging its data set, unlike Uhlmann [6], which it validates in the discussion. Healy has stated that to test the vaccine/autism hypothesis you would need to study sub- groups (as in fact Wakefield and colleagues were doing in the Uhlmann study). The only sense I can make of the passage in Hornig is that they are saying that if they had had a similar study group to Uhlmann they would likely have replicated its results. As it is we might look at the semantics of the paper's title: not "No Association between Measles Virus Vaccine and Autism with Enteropathy" but "Lack of Association" [5]. What it documents is precisely that Hornig et al have been over-eager to jettison the hypothesis.
John Stone
[1] John Snyder, 'Re: The MMR story is not complete', BMJ Rapid Responses 14 October 2008
[2] John Stone, 'The MMR story is not complete', BMJ Rapid Responses 8 October 2008
[3] V Demicheli, T Jefferson, A Rivetti, D Price,[Review] 'Vaccines for measles, mumps and rubella in children', Cochrane (Wiley 2005)
[4] CBS News, 'Leading doctor: vaccines-autism worth study'
[5] Mady Hornig, Thomas Briese, Timothy Buie, Margaret L. Bauman, Gregory Lauwers, Ulrike Siemetzki, Kimberly Hummel, Paul A. Rota, William J. Bellini, John J. O'Leary, Orla Sheils, Errol Alden, Larry Pickering, W. Ian Lipkin, 'Lack of Association between Measles Virus Vaccine and Autism with Enteropathy: A Case-Control Study', published 4 September 2008
[6] V Uhlmann, C M Martin, O Sheils, L Pilkington, I Silva, A Killalea, S B Murch, J Walker-Smith, M Thomson, A J Wakefield, and J J O'Leary, 'Potential viral pathogenic mechanism for new variant inflammatory bowel disease', Molecular Pathology, Mol Pathol. 2002 April; 55(2): 84–90
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