[Editor’s note: I realize this post might look familiar to some, although it has been tweaked and updated. Grant deadline Tuesday, meaning no time to produce original content up to the standards of SBM that you have come to expect. At the same time, I figured I had to contribute something this week. Hopefully this update on a certain bit of antivaccine posturing will do. Fear not, though. Harriet will take my Monday slot, and we have a very special guest post for you on Tuesday. I’ll be back at it, same day and time, same Bat channel, next week.]
The antivaccine movement and conspiracy theories go together like beer and Buffalo wings, except that neither are as good as, yes, beer and Buffalo wings. (Maybe it’s more like manure and compost.) In any case, the antivaccine movement is rife with conspiracy theories. I’ve heard and written about more than I can remember right now, and I’m under no illusion that I’ve heard anywhere near all of them. Indeed, it seems that every month I see a new one.
There is, however, a granddaddy of conspiracy theories among antivaccinationists, or, as it’s been called, the central conspiracy theory of the antivaccine movement. That conspiracy theory postulates that “they” (in the U.S, the CDC) have known for a long time that vaccines cause autism, but “they” are covering it up. In other words, the CDC has, according to this conspiracy theory, been intentionally hiding and suppressing evidence that antivaccinationists were right all along and vaccines do cause autism. Never mind what the science really says (that vaccines do work don’t cause autism)! To the antivaccine contingent, that science is “fraudulent” and the CDC knew it! Why do you think that the antivaccine movement, in particular Robert F. Kennedy, Jr., went full mental jacket when Poul Thorsen was accused of financial shenanigans (i.e., fraud) with grant money from the federal government? It was a perfect story to distract from the inconvenient lack of science supporting the antivaccine view that vaccines cause autism. More importantly, from the antivaccine standpoint, it was seen as “validation” that the CDC studies failing to find a link between autism and vaccines were either fraudulent or incompetently performed. Why? Because Thorsen was co-investigator on a couple of the key studies that failed to find a link between the MMR and autism, antivaccinationists thought that his apparent financial fraud must mean that he committed scientific fraud. They’re the same thing, right? Well, not really. There were a lot of co-investigators, and Thorsen was only a middle author on those studies.
Enter William Thompson, a.k.a. the “CDC whistleblower,” or, if you’re on Twitter, the #CDCwhistleblower. There has been a new development sufficiently bizarre as to catch my attention, but first, since it’s been a while, here’s the mandatory recap.
Recall, back in August, that biochemical engineer turned antivaccine activist and epidemiologist wannabe, published a study, recently retracted, that basically provided strong evidence that Andrew Wakefield was wrong about the MMR vaccine being associated with autism. When I first saw Hooker’s study, even I recognized how utterly incompetently it was carried out, and I’m not even an epidemiologist or statistician. After all, it’s pretty obvious that data collected for a case control study should not be analyzed as a cohort study, but that’s just what Hooker did. When I first read the study, I was actually not as hard on it as I should have been. The more I’ve read, and the more I’ve found out, the more I’ve realized just how badly done it was. Contrary to what Hooker apparently believes, simplicity is not beauty in statistics, particularly when you fail to control for obvious confounders and analyze data incorrectly. The result was a “finding” that there was a 3.4-fold increased risk of autism associated with MMR in African-American boys. Never mind that the numbers of this subgroup were tiny and the data incorrectly analyzed. Never mind that the rest of the data were negative as negative could be for even a whiff of a hint of a correlation between vaccines and autism for any other subgroup and that the vast majority of the leaders of the antivaccine movement are your basic affluent white people who never showed much in the way of an interest in the problems of African-American children before. Suddenly, this finding was being likened to the Tuskegee syphilis experiment by Andrew Wakefield himself!
This incompetent study was the result, allegedly, of discussions between Hooker and a senior psychologist at the CDC named William Thompson. For reasons that are still not clear, Thompson, a co-author on an important study by DeStefano et al, confided in Hooker, who, betraying his confidences, recorded much of what he said, an action whose legality is unclear given that it’s unclear where all of these recordings were made (one party or two party consent states). Hooker then teamed up with Andrew Wakefield to cherry pick bits to make it sound as though Thompson were confessing to some horrible crime of data manipulation to hide this “bombshell” result reported by Wakefield. Thus was born the “CDC whistleblower,” who featured prominently in the video likening DeStefano et al and the “coverup” to the Tuskegee syphilis experiment. Later, Thompson released as statement through his lawyer characterizing the whole problem over DeStefano et al as being a scientific disagreement. Nonetheless, a new conspiracy theory was born: The “CDC whistleblower,” complete with its own hashtag on Twitter, #CDCwhistleblower. Thompson has said nothing publicly since then, and the mainstream media has basically ignored the story other than an interview with Ronan Farrow of MSNBC that basically trashed the claims of the antivaccine movement.
So, after two months of relentlessly trying to get the mainstream media to pay attention and utterly failing, Andrew Wakefield and Brian Hooker had to try something new. Last Wednesday, that something new dropped into the antivaccine blogosphere with a massive plop that no one heard outside of the echo chamber confines of sites like the antivaccine crank blog Age of Autism. For instance, everyone’s favorite hysterical antivaccine blogger Kent Heckenlively proclaims it as “The Hammer Falls!”:
Dr. Brian Hooker, Dr. Andrew Wakefield, and attorney James Moody announced today they have sent a complaint by Federal Express to Dr. Harold Jaffe, Associate Director for Science at the Centers for Disease Control and Prevention, as well as Dr. Don Wright, Acting Director of the Office of Research Integrity at the Department of Health and Human Services, claiming research misconduct in the 2004 paper, “Age at First Measles-Mumps-Rubella Vaccination in Children with Autism and School-Matched Control Subjects: A Population-Based Study in Metropolitan Atlanta,” which was subsequently published in the journal, Pediatrics.
The allegations are horrifying, not just for the millions of families who deal with autism on a daily basis, but for the picture it paints of a government agency, the Centers for Disease Control and Prevention (CDC), devoid of any shred of scientific integrity or what we once used to call “honor” in this country.
If these claims are shown to be true, we will be looking at nothing less than the greatest crime committed in the history of our republic, and a dark page in science which will be remembered for centuries to come.
Let’s just say that Heckenlively is prone to a little…hyperbole. I mean, seriously. For the sake of argument, as a thought experiment, let’s imagine for the moment that every allegation flowing from the fever dream conspiracy theory that is the #CDCwhistleblower is true. In that case, does Heckenlively really believe that this “crime” was worse than, say, slavery? The internment of Japanese-Americans in the early days of World War II after the bombing of Pearl Harbor? The real Tuskegee syphilis experiment? This is worse? It just goes to show how out of touch with reality these people are. But, then, this is Kent Heckenlively we’re talking about here. Reality and Mr. Heckenlively haven’t been on the same planet for at least a decade, not to mention that this is Brian Hooker and Andrew Wakefield making an accusation of scientific fraud. In what bizarro world does Andrew Wakefield, the ultimate scientific fraudster himself, accuse anyone, much less CDC scientists, of scientific fraud? Then there’s Hooker, who is the most incompetent epidemiologist wannabe I’ve seen aside from his young Padawan Jake Crosby and whose big foray into epidemiology broke records in speed of retraction. Even more hilariously, his article was retracted from a new journal. It was so toxically bad that even a new journal, scrambling to establish itself and attract quality submissions, couldn’t afford not to retract it. Pot, kettle, black, anyone?
The result of these delusional accusations is a 34-page letter to the Dr. Harold Jaffe, CDC Associate Director for Science, and Dr. Don Wright, Acting Director, ORI, along with an appendix. It’s a painful slog to read through, particularly given that it doesn’t discuss much that I haven’t already covered in detail before here and here (not to mention on my not-so-super-secret other blog). That’s not to say that there aren’t any new revelations, but most of them have little or nothing to do with the attacks on the science based on methodology, which have been covered, discussed, and dissected here and on other blogs until it was quite clear that Hooker had no clue how to do an epidemiological study and went into his “study” with a preconceived notion of what it should show.
The core of this complaint is found in this early paragraph:
We write to report apparent research misconduct by senior investigators within the National Immunization Program (NIP), Battelle Memorial Institute at the Centers for Public Health Evaluation (CPHE), and the National Center on Birth Defects and Developmental Disabilities (NCBDDD), and to request an immediate investigation.
The Analysis Plan dated September 5, 2001 [Exhibit 2] set forth the objective of the research reported in the above-titled article, to compare ages at first MMR vaccination between children with autism and children who did not have autism, and to test the hypothesis that age of first MMR vaccination is associated with autism risk.
The research team, headed by Dr. Frank DeStefano, MD., (NIP) including Dr. William Thompson Ph.D., (NIP) Dr. Marshalyn Yeargin-Allsopp, MD (NCBDDD), Dr. Tanya Karapurkar Bashin (CPHE), and Dr. Coleen Boyle, Ph.D., (NCBDDD) (collectively referred to by Dr. Thompson as “The Group”) found statistically significant associations between the age of first MMR and autism in (a) the entire autism cohort, (b) African-American children, and (c) children with ‘isolated’ autism, a subset defined by The Group as those with autism and without comorbid developmental disabilities.
We’ve heard this before, albeit not exactly in this way. The central charge is that the investigators altered the research plan after the study was under way. The charge basically goes this way. The CDC planned a case control study examining the age of receiving the MMR vaccine and whether it correlated with an increased risk of autism using data from the Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP). Seeing a result they didn’t like, they allegedly altered the plan in order not to report the “inconvenient” result that the MMR resulted in a 3-fold increased risk of autism among African-American boys. Explaining from scratch why this is BS would take a post of truly Gorski length in and of itself. Fortunately, Wakefield and Hooker couldn’t keep their mouths shut. Wakefield had to go and make a video outlining the charges before he sent this letter to the CDC:
The video came out about two weeks days ago, and I actually thought of blogging it at the time, but I was a bit burned out on the whole #CDCwhistleblower thing. So I let this antivaccine cup pass for a change. Fortunately, Matt Carey took it on more than a week ago, and that makes my job easier. Matt’s post is worth reading in its entirety, but the Cliffs Notes version is as follows. In the video, Wakefield zeros in on a single sentence that says “The only variable available to be assessed as a potential confounder using the entire sample is child’s race.” Based on that, and allegedly confirmed by Thompson during conversations with Hooker, Wakefield and Hooker claim that “decisions were made regarding which findings to report after the data was collected,” further claiming, “Thompson’s conversations with Hooker confirmed that it was only after the CDC study coauthors observed results indicating a statistical association between MMR timing and autism among African-Americans boys, that they introduced the Georgia birth certificate criterion as a requirement for participation in the study. This had the effect of reducing the sample size by 41% and eliminating the statistical significance of the finding, which Hooker calls a direct deviation from the agreed upon final study protocol – a serious violation.’”
I discussed this aspect in my original post, namely how doing this was not the scientific fraud claimed, but at the time I didn’t have access to the original research plan. In any case, notice that that one sentence doesn’t even really mean that the investigators deviated from the plan, as race was always planned to be examined as a potential confounder for the whole group. As Carey put it:
There are two interesting points in the above. First, the sentence Mr. Wakefield highlights doesn’t say what he claims. The only variable available to be assessed as a potential confounder using the entire sample is child’s race. The plan doesn’t say that they will test and report race. Consider the context: this is a section of the plan called “statistical analysis”. Put in context with the entire paragraph, this sentence is clear: the full dataset is limited because it only has one variable available.
The CDC didn’t deviate from the plan when they didn’t report on race for the total sample because that was never in the plan.
Exactly. More importantly, Wakefield and Hooker are cherry picking. (So what else is new?) As Carey points out, the analysis plan doesn’t include a call to report on race separately in the total sample (the group without the birth certificates), and the CDC “approved analysis plan” did include analysis of a subset with birth certificate data. Use of birth certificate data to look for confounders was always an option in the plan. For example:
For the children born in Georgia for whom we have birth certificate data, several sub-analyses will be carried out similar to the main analyses to assess the effect of several other potential confounding variables.
3) Analyses examining Gender Effects
Males are at substantially higher risk for autism and may be more vulnerable to the exposure associated with the MMR vaccine. We will analyze males and females separately and replicate the main objectives of the primary analyses as well as examine the potential confounders available from Georgia birth certificates.
In the complaint, Wakefield and Hooker even misquoted the analysis plan, as Carey also points out. The plan states, “The only variable available to be assessed as a potential confounder using the entire sample is child’s race.” The complaint quotes this as, “The only variable that will be assessed as a potential confounder using the entire sample will be the child’s race.” He had also verified that he was examining the same document that Wakefield and Hooker had.
Wakefield also tries to do a bit of statistical prestidigitation by claiming that one of the analyses proposed, analyses of “isolated” versus “non-isolated” autism were not done. “Isolated” autism is autism with no comorbid developmental disabilities, such as mental retardations. As Carey convincingly argues, this subanalysis was done. He even explains how, although the raw, unadjusted analysis appears to show an association between age at MMR vaccination (vaccination prior to 36 months) and autism, the adjusted, final analysis does not. Tellingly, Hooker’s study is praised in the complaint thusly:
Dr. Hooker has approved access to public datasets for the original raw data from the study provided by the CDC. Dr. Hooker was thereby able to repeat the original analyses and confirm The Group’s findings of an excess autism risk in African American children. Dr. Hooker’s reanalysis [Exhibit 4] was rigorously peer reviewed and published.6 Dr. Hooker’s paper was reviewed and approved by Dr. Thompson. Dr. Thompson has also supplied Dr. Hooker with his original data output and subsequent data runs of his analyses.
Funny how Wakefield and Hooker didn’t see fit to mention that Hooker’s study was retracted—and retracted over a week before they sent their letter to the CDC! Wakefield and Hooker owe me a new keyboard again (or I should know better than to drink anything, even water, while reading anything written by these two) for this, as well:
Dr. Hooker is a scientist, Assistant Professor at Redding University, California, an extensively published vaccine safety researcher, and the father of a child with autism. Dr. Wakefield is an academic gastroenterologist by training and a documentary film producer/director with Autism Media Channel. Both have standing to complain. Both have a strong interest in documenting this research misconduct and in securing a remedy for the severe damage it has caused: Dr. Hooker’s son was, as alleged in his petition for compensation to the NVICP, permanently damaged by vaccines. The ethically required and Congressionally – mandated compensation provided by this program has been denied to many children based in part on the misconduct alleged herein. He has also suffered scientific opprobrium for his position on vaccine safety. Dr. Wakefield first proposed a possible link between MMR and autism,7 and specifically, age of exposure to MMR and autism risk.8 Had The Group’s true findings been published as intended,9 well before their actual publication date in 2004, much of the damaged done to Dr. Wakefield’s career and reputation might have been mitigated. Mr. Moody is an attorney with a longstanding interest in the National Vaccine Injury Compensation Program (NVICP) and an expert in Whistleblower law.
Hooker is an “extensively published vaccine safety researcher”? A PubMed search reveals four publications that might have anything to do with autism or “vaccine safety,” including the retracted one. Subtract the retracted paper and a paper dismissing paternal age as a risk factor for autism (clearly it must be the vaccines, then!), and only two publications that have anything to do with vaccines remain (1, 2). That’s hardly “extensively published.” Of course, Wakefield’s standing in this is dubious at best, too, given that his reputation and career were almost entirely destroyed in England, not the US.
So we know that Wakefield and Hooker are dishonestly cherry picking evidence in their letter, but there’s one bombshell that shocked me and goes a long way towards explaining something that’s always bothered me about this affair: Why? Why did Thompson confide in Hooker? What drove him to it? It turns out that, if Hooker and Wakefield are telling the truth about this (and I really take anything they say with an enormous grain of salt), Thompson was (and presumably still is) prone to anxiety issues (at minimum), depression, and what Thompson calls “delusions,” which first manifested themselves in a big way a decade ago, around the time he was preparing to present the results of this study to the Institute of Medicine and was facing the likelihood of being called to testify in front of a Congressional committee whose chair was notorious for his antivaccine views. After citing an e-mail from Thompson to Julie Geberding, the then-director of the CDC (which I discussed), in which Thomspon expressed anxiety about appearing in front of a Congressional committee, Wakefield and Hooker write:
In the end, Dr. Thompson signed off on The Paper that was published in Pediatrics [Exhibit 1]. However, his name was withdrawn from the roster of those due to present to the IOM on February 9, 2004. In reporting a discussion that he had had with his whistleblower lawyer Thompson stated:
Ya know, I’m not proud of that and uh, it’s probably the lowest point in my career that I went along with that paper and I also paid a huge price for it because I became delusional.24
In his recorded call with Dr. Thompson of 5.8.14, Dr. Hooker pressed the Dr. Thompson on whether he raised his concerns about the omission of significant data with The Group in the days leading up to the IOM meeting.
Dr. Hooker: Did you raise that…did you raise that issue at the time?
Dr. Thompson: I will say I raised this issue…I will say I raised this issue, the uh…two days before I became delusional.
This reference is important: three days before the IOM presentation Thompson – faced with either presenting false data or taking responsibility for the vaccine-autism link in front of potentially hostile parents of autistic children25 – stopped sleeping, and became profoundly depressed and “delusional.” Crucially, he reports no prior history of mental disorder.
Dr. Thompson went on to confirm, to Dr. Hooker, that the DeStefano 2004 paper was the reason for these acute psychological problems.
Dr. Thompson: It is one of the reasons I became delusional because I was so paranoid about this being published.
Citation 24 is claimed to be from a phone conversation between Hooker and Thompson dated May 24, 2014. That was the Saturday of Memorial Day weekend this year. Hmmm. That was also during Autism One. Brian Hooker gave a talk at Autism One on May 23. One wonders if he was still there, one does. Why do I wonder that? Because Illinois has one of the most Draconian laws in the country when it comes to being a “two party” consent state with respect to recording conversations. If Hooker recorded a phone call with Thompson while Hooker was in Chicago, that could be big trouble for him, should Thompson wish to pursue it. That’s a minor consideration, though. The major consideration is that, if this conversation occurred as represented, then Hooker just divulged highly personal medical information that Thompson confided to him, namely that Thompson suffered some sort of mental breakdown, complete with paranoia, delusions, and depression, right before IOM conference ten years ago. This, after having bragged about how he was Thompson’s “confessor,” like a priest. How low can you go? In order to imply that the magnitude of the “crime” Thompson was being forced to be party to was so massive that it led him to some sort of mental breakdown in the days leading up to the IOM conference, Hooker betrayed Thompson’s confidences about a very personal health issue issue.
Oh, wait. This is Brian Hooker and Andrew Wakefield we’re talking about.
It’s now clear to me that Thompson appears to be a bit of a fragile soul, easily rattled. From the sketchy description in Wakefield’s and Hooker’s complaint, he sounds as though he suffered a bout of what sounds like a panic attack or severe anxiety disorder, but I don’t know enough to tell. If that’s the case, though, anxiety disorders can be profoundly crippling and lead to the sort of behavior described. Either way, anxiety disorder or no anxiety disorder, depression or no depression, it’s quite clear that, even at his best, Thompson melts under pressure, and that could explain a lot of his behavior, certainly back in 2003 and 2004 and possibly even this year.
In the end, though, Wakefield’s and Hooker’s complaint is nothing more than a publicity stunt. Their first play, the video likening DeStefano et al and the “coverup” of “vaccines causing autism in African American boys” to the Tuskegee syphilis experiment, Hitler, Stalin, and Pol Pot, failed miserably. For all the Twitter bombing of the #CDCwhistleblower hashtag, the mainstream media barely took notice, and rightly so. There was nothing to see there. Also, as I’ve pointed out many times before, Wakefield’s name is, quite correctly, now so toxic that his involvement with this whole affair virtually guaranteed that no one of any consequence in the mainstream media would take it seriously. If Hooker had written this letter, sent it to the CDC, and publicized it out of the blue, he might have fooled a few credulous mainstream media outlets or reporters into doing a story or two about it in a fairly neutral tone. Making this play now, after having been associated with Wakefield and after all the #CDCwhistleblower nonsense, virtually guarantees that nothing will come of this.
But it sure will rile up the antivaccine base. That’s the point, after all.