As I mentioned recently, as hard as it is to believe, this blog is rapidly approaching the end of its fifth year of existence. Our first post was delivered to the anxiously waiting world on January 1, 2008; so thus upcoming January 1 will represent our fifth anniversary. In the blogging world, that’s almost the equivalent of a fiftieth anniversary, given how fast most blogs turn over. Something that is even more satisfying than mere longevity is that we really have found a niche in the medical blogosphere to the point where we’ve become quite influential. People notice us. Our targets notice it when we discuss them. Sometimes even the press notices us. This is all a very good thing.
Unfortunately, even though we’ve been at this for just shy of five years, there are still topics we haven’t covered, or at least haven’t covered in sufficient depth. The topic of my post today is one of the latter topics. We’ve mentioned it before; we’ve alluded to it before (for instance when discussing the antivaccine website Medical Voices and the Ayn Rand-worshiping Association of American Physicians and Surgeons; but there hasn’t been a post dedicated to this particular topic. I find this particularly odd because it was one a piece of misinformation promoted by elements of the antivaccine movement that truly shocked and disgusted me. Before I learned of this particular myth, I was surprised to learn that there are really people who think that vaccines are dangerous and cause autism, but I viewed it as being of a piece of a lot of other quackery I was discovering at the time.
Way back in the day, when I first encountered antivaccine views in that wretched Usenet swamp of pseudoscience, antiscience, and quackery known as misc.health.alternative (m.h.a.), there was one particular antivaccine lie that disturbed me more than just about any other. As I mentioned, it wasn’t the claim that vaccines cause autism, which is more or less the central dogma of the antivaccine movement. Even ten years ago, before the series of studies that have been released since then that fail to find a hint of a whiff of causation between vaccines and autism, that wasn’t a particularly difficult myth to refute. Indeed, given newer studies, refuting that myth has only gotten easier over the years. Emblematic of how far into the depths that particular myth has been pummeled, I know it’s gotten pretty easy when even the mainstream media start to accept that the claim that vaccines cause autism is a myth and report matter-of-factly on issues such as Andrew Wakefield’s fraud and don’t give nearly as much copious and prominent media time to the likes of Jenny McCarthy. Let’s just put it this way. When the hosts of a “morning zoo”-type radio show in Salt Lake City pummel the latest antivaccine celebrity to make a fool of himself, Rob Schneider, you know that, from an informational standpoint at least, the tide appears to have turned from several years ago, when the media took this myth a lot more seriously. That’s not to say that we don’t still have a problem. After all, “philosophical” exemption rates are going up based on a lot of this sort of misinformation, but at least the media are less insistent on “telling both sides” of a science story that doesn’t really have two sides.
No, what I’ve found to be one of the most disturbing antivaccine claims of all is the assertion that shaken baby syndrome (SBS) is a “misdiagnosis for vaccine injury.” SBS is the name originally given to a triad of findings consisting of subdural hemorrhage, retinal hemorrhage, and encephalopathy. More recently, because the syndrome is more complex than the original description suggested, these days the syndrome is more properly referred to as non-accidental head injury or abusive head trauma. This particularly vile antivaccine lie has popped up again with a story I recently became aware of, that of Amanda Sadwosky, whose father Elwood Sadowsky is currently in prison for killing her and whose mother Tonya Sadowsky is trying to win him a new trial and thereby free him by claiming, in addition to a bunch of contradictory and dubious arguments, that vaccine injury was a major cause of Amanda’s death. She even maintains a web page she calls the Amanda Truth Project, which reminds me very much of the case that first showed me just how low antivaccine activists can go. Let’s go back in time more than a decade and examine the case of Alan Yurko. Then we’ll fast forward and compare it to the case of Amanda Sadowsky. Finally, we’ll wrap things up by discussing why this particular “theory” (more like wild speculation) is so scientifically and intellectually bankrupt.
Free Alan Yurko
I first learned of the vile concept that somehow SBS when I learned of the case of Alan Yurko. Yurko gained “fame” (if you can call it that) when he was sentenced to life in prison without parole in 1999 for the murder of his 10-week-old son, who was shaken to death. Somehow, Yurko became the centerpiece of a campaign (Free Yurko) that featured as the centerpiece of its argument for Yurko’s innocence the claim that shaken baby syndrome (SBS) is in realty “vaccine injury.” Unfortunately, ultimately Yurko was released early, not because the courts agreed with the lie that it was vaccine injury, not SBS, that killed Yurko’s son. Rather, it was because apparently the coroner’s office where the autopsy was done on the dead baby was, as Australian skeptic Peter Bowditch put it, the most shoddily run morgue ever and incompetent coroner ever.
If you ever wanted to know how low antivaccine zealots can sink, let Bowditch describe it:
I want you to think about a dead baby. This baby was ten weeks old when he died. The autopsy revealed bleeding around the brain, in the eyes and in the spinal column. There were bruises on the sides of his head. Another thing that the autopsy showed was four broken ribs. These fractures had started to heal, and therefore indicated a pattern of physical abuse prior to the date of death. The father admitted to holding the baby by his feet and hitting him shortly before he died. I now want to you to form an opinion of the father. If you are the sort of person who opposes vaccination, you would see this man as a hero. You would see him as a martyr to the cause and would try to get him released from prison. In a breathtaking demonstration of what it can mean to believe that the end justifies the means, the anti-vaccination liars have adopted Alan Yurko as a symbol that they can use to frighten parents into refusing vaccination for their children. You can read a loathsome justification for this murderer at http://www.woodmed.com/ShakenBabyAlan.htm.
Alan Yurko’s story is basically as follows. A month before the death of Alan Ream, the baby Yurko was convicted of killing, Alan Yurko was in jail for aggravated burglary. He was paroled and then somehow managed to get away with violating that parole by moving to florida with his girlfriend and her infant son. Not long after the couple arrived in Florida, Alan Ream was rushed to the hospital with massive head injuries, including a subdural hematoma. The baby died from his injuries. Not surprisingly, given his previous convictions and propensity for violence, suspicion rapidly fell on Yurko, the baby’s stepfather, after investigation revealed the baby’s pattern of injuries to be consistent with SBS. Yurko was tried and convicted of first degree murder and sentenced to life in prison plus ten years.
It was at this point that somehow the antivaccine movement latched on to the Yurko case, turning him into a martyr for the cause. Why they would do this, I have no idea. If you’re looking for scientific credibility to persuade people to believe your contention that vaccines cause autism, I can’t think of a worse way to achieve that credibility than to defend a baby killer using pure pseudoscience and outright nonsense. But, then, I’m not an antivaccinationist. Apparently to some elements of the antivaccine movement, it seemed like a good idea at the time (and, sadly, still does to some of the same people today). Basically, these people set up the Free Yurko webpage and a Free Yurko mailing list. Prison officials, judges, and doctors were bombarded with letters arguing that Yurko was innocent of killing his child. The group assisted with Yurko’s appeal, basing it on conspiracy theories and antivaccine pseudoscience. An old “friend” that I’ve written about before in the context of the death of HIV/AIDS denialist Christine Maggiore’s daughter Eliza Jane Scovill provided a long report on Alan’s death that was every bit as much a stinking turd as the report he provided to try to “prove” that Eliza Jane didn’t die of AIDS.
Yes, I’m referring to Mohammed Ali Al-Bayati, PhD, DABT, DABVT, who runs a company known as Toxi-Health International. Basically, Dr. Al-Bayati is not a physician and therefore not a human pathologist; rather, he has a PhD in comparative pathology and is apparently also a toxicologist. Perusing his website leads me to believe that Dr. Al-Bayati specializes in churning out reports for the defense that basically say whatever the defense wants them to say. One particularly despicable area of subspecialization that he appears to engage in is—you guessed it—blaming cases of SBS on vaccine injury combined with a whole host of other medical conditions that he plucked about his nether regions, much the way he did the same when he tried to claim that a girl with HIV in her brain and Pneumocystis carinii pneumonia didn’t die of HIV encephalitis and her pneumonia but rather died of—I kid you not—an allergic reaction to amoxicillin.
In the case of Alan Ream, Dr. Al-Bayati tried to blame the infant’s death on a whole host of factors besides the obvious (trauma), including reactions to vaccines administered two weeks before Alan was rushed to the hospital, where, if you believe Dr. Al-Bayati, Alan was killed by a combination of vaccine injury, massive infection, and overdose of sodium bicarbonate, and an overdose of heparin, as well as from complications due to Francine Ream’s (his mother’s) oligohydramnios, gestational diabetes, anemia, loss of appetite, spastic colon, urinary tract and vaginal bacterial infections, and hemorrhoids, as well as Alan’s five week premature birth. Al-Bayati also tried to tie Alan’s neonatal jaundice to his death four months later and even dismissed a healing rib fracture as having occurred during Alan’s birth and somehow having been missed by the medical staff. Of course, there’s one glaring problem, namely that Alan developed respiratory distress syndrome after birth; I’d be shocked if there weren’t multiple chest X-rays taken during his initial hospitalization after birth. Basically, it’s a veritable Gish Gallop of cherry picked bits of Alan’s clinical history. These bits were then thrown against the wall to see if any of it would stick—very much like Al-Bayati’s report on Eliza Jane Scovill.
It should be noted that Yurko did have grounds for a new trial, but not because there was any credibility to the notion that SBS is a misdiagnosis for vaccine injury. I was rather because of some very shoddy work by the medical examiner who apparently had a history of carelessness. The errors were not directly related to the diagnosis of SBS but were pretty bad nonetheless. For instance, there were typographical errors, such as referring to the child as African American when he was Caucasian and commenting on organs that couldn’t be there because they were donated after the baby was declared brain dead. The judge ruled that these screwups warranted a new trial, after which Yurko’s defense team reached a deal with the prosecution. Yurko pled no contest to manslaughter and was sentenced to time served, six years and 125 days. It didn’t take long for Yurko to wind up back in jail again. He was picked up for a parole violation in his aggravated burglary charge and will be in prison until 2014.
Yurko was the prototype for a defense against SBS that fused antivaccine conspiracy mongering with copious pseudoscience to try to exonerate parents and caregivers accused of SBS. Indeed, if you peruse Toxi-Health’s website, you’ll see many examples. Al-Bayati appears to do a lot of this sort of work, with several reports trying to prove that babies thought to have died due to SBS were in fact killed by something else. Many of them were published in that antivaccine bastion Medical Veritas, and all of them follow what I like to call the “Gish gallop” method of argument, generally blaming a combination of various medical problems and vitamin deficiencies ± vaccines (usually plus vaccines) as the “real cause” of death. Then, “luminaries” such as Harold Buttram (who is also known for claiming that childhood vaccines can result in genetic hybridization from alien human and alien animal DNA contents and is a regular contributor to the antivaccine blog International Medical Council on Vaccination); Veira Scheibner, F. Edward Yazbak, and Michael Innis took up the cause. Then, an Ayn Rand-loving crank medical organization, the Association of American Physicians and Surgeons (AAPS). Indeed, a former president of the AAPS, Jane M. Orient, even wrote a sympathetic portrayal of Alan Yurko right in the Journal of American Physicians and Surgeons (JPANDS), the official journal of the AAPS. To see how many contortions are necessary to blame vaccines, just check out what Dr. Orient writes:
One possible mechanism of a vaccine reaction is vitamin C depletion, which can occur in a variety of conditions including acute illness, strenuous exertion, or catabolic conditions. Ascorbate depletion is accompanied by elevated blood histamine levels and increased capillary fragility.
Her citation to support this statement? An article in the Journal of Orthomolecular Medicine. Not exactly a reliable source.
The death of Amanda Sadowsky
Last week, I came across a story that, although it’s a couple of months old and I somehow missed it, is disturbingly familiar:
Just a few years ago Tonya and Elwood Sadowsky believed that life could not get any better after Tonya gave birth to a beautiful baby girl Amanda. For the first time ever the couple were happier than they ever thought possible. Sadly, their happiness was cut short when aged just four months old Amanda died unexpectedly. Elwood was immediately arrested and charged for his daughter’s murder because he was caring for his daughter at the time she was taken ill.
Amazingly, in June 2007, without ever having a trial, Elwood Sadowsky was jailed for life for Shaken Baby Syndrome. According to wife Tonya, Elwood was forced into taking a guilty plea a few days before the trial was due to have started. He was threatened by the prosecution and emotionally blackmailed by his own lawyers. This was due to the fact that his lawyers did not know how to defend him! Tonya says:
“They literally didn’t know anything about ‘Shaken Baby Syndrome’ and believed the doctors’ diagnosis which was: homicidal blunt force trauma.”
Amanda died from multiple skull fractures and the triad of injuries associated with Shaken Baby Syndrome (SBS) which are Retinal haemorrhages (bleeding into the linings of the eyes); subdural haemorrhages (bleeding beneath the dural membrane); Encephalopathy (damage to the brain affecting function).
Anyone familiar with the case of Alan Yurko can see where this is going, and that is indeed exactly where it went. The next part of Tonya’s story consists of a citation of one John D. Lloyd, Ph.D., M.Erg.S., CPE, CBIS, who seems to have some legitimacy in that he has some peer-reviewed publications, eighteen on PubMed. None of them, as far as I can tell, are related to SBS. He does, however, appear on a directory of expert witnesses, which suggests to me that part of his “professional activity” is to testify on behalf of whoever pays him. None of that means he’s a bad guy or not a decent scientist, but when it comes to SBS, I do find it rather odd that he has several publications on other topics related to ergonomics and brain injury but nothing other than abstracts listed as submitted to various conferences on his CV. Let’s put it this way. Although it’s not uncommon for people to list publications they have “in preparation” or “submitted” to journals, I’ve never seen a CV listing abstracts submitted to conferences. Why? Because abstracts are the lowest form of scientific publication. I could easily whip off a list of abstracts submitted to various conferences, having submitted the abstracts. I might even get them accepted, too, because the bar for acceptance for abstracts is much lower than it is for getting a manuscript published in a peer-reviewed journal. Indeed, some conferences basically accept every abstract submitted for at least a poster presentation, barring obvious problems with them. I also find it rather curious that Dr. Lloyd doesn’t actually mention which conference he’s submitted his three abstracts to.
Now, I realize that we don’t know everything there is to know about SBS. Nor do I normally have a problem with research that questions the prevailing hypothesis, if the research is well done. However, when I see someone like Dr. Lloyd argue against the concept of SBS and lend aid and comfort to a defense team that is using the claim that vaccines are the cause of SBS, then I have a problem:
Examining the timeline of this case an extremely important fact emerges. It is obvious to even the untrained eye that this baby suffered adverse reactions after each vaccination. Her first possible reaction was noted within 24 hours of the Hepatitis B vaccine which she received at birth. Tonya said:
“When she got the Hep B, I wasn’t told. She was wheeled into my room SCREAMING her full head off, thrust into my arms with the comment, “She’s upsetting the other (inmates) babies in the nursery”.
“She was jaundiced by the next day.”
In his report Dr Buttram wrote:
“On the next day, Feb. 17th, according to mother’s notes, Amanda was brought in to her from the nursery screaming, as “she was bothering the other babies in the nursery,” suggestive of an encephalalitic reaction to the hepatitis B vaccine, something rarely recognized for its true nature.”
Leading to this speculation:
Did Amanda suffer from this reaction and was this the reason that baby Amanda was so distressed? If so the injuries found just weeks later may have been caused by the Hepatitis B vaccine, however, this possibility this was never investigated.
Perhaps it wasn’t investigated because the contention that the Hepatitis B vaccine caused multiple skull fractures, much less the injury pattern consistent with traumatic injuries of the sort caused by shaking and trauma seen in abusive head trauma is ridiculous on its very face. Does Dr. Lloyd really want to hitch his wagon to a group that tries to argue that vaccines can somehow cause fractures, retinal hemorrhages, and the like? Those must be some magical vaccines! I know, I know, Elwood admits that he dropped Amanda, but in general his story as described in this article doesn’t add up. Dr. Lloyd’s argument seems to be somewhat contradictory as well. He points out that falls from as low as two and a half feet can produce fatal head injuries, but then claims that it’s not possible to shake a baby hard enough to cause the constellation of injuries seen in SBS. He bases his argument on a series of studies that he’s carried out, including a comparison of shaking with activities of daily living (in which he argues that the head angular acceleration of a baby playing in a Jumparoo is similar to what can be achieved by an adult shaking a baby—I kid you not); a study claiming that vigorous shaking can only be maintained for 20 seconds before adults become exhausted; and a bit of a straw man argument that retinal hemorrhages are “no longer generally accepted by medical doctors to be caused by vigorous shaking of an infant” (no one ever said that retinal hemorrhages alone were necessary for the diagnosis of SBS). Unfortunately, he uses a rather simplistic model that has been found to be wanting; indeed, their results tend to be contrary to the pathological evidence. (Dr. Lloyd even concludes this in one of his studies.) More complex models are now state of the art. SBS is a difficult entity to model, because the primary injury tends to be what is known as diffuse axonal injury or shearing. Basically, the axons (the protruberances from neurons that carry the nerve impulses) can, with repeated strong acceleration and deceleration, shear. Such injuries are often much more severe than they appear on imaging studies.
The defense builds on that argument by claiming that Elwood suffered from a condition that caused him to black out and pass out periodically (which, if true, tells me that he should never be carrying a baby alone). Perhaps the most ludicrous is another defense claim that somehow the use of oxytocin to induce Tonya’s labor resulted in brain damage in Amanda of the sort seen in the postmortem. Taken as a whole, the defense case sounds a lot like Alan Yurko’s defense: Throw out all sorts of pseudoscientific and quacky nonsense and see if any of it sticks. He dropped the baby! But he has a disease that causes him to black out. But the baby was “vaccine-injured” and her mom’s labor was induced with oxytocin, which caused brain injury! It’s an “everything but the kitchen sink” defense that sounds very much like Yurko’s Gish gallop and even involves some of the same people, as you will see. This sort of defense takes advantage of the controversies around SBS and how the triad originally described as pathognomonic of SBS can be mimicked by other conditions (one of which, I might add, is not vaccine injury).
Where you will see these other people, besides seeing Harold Buttram in the news article above, Amanda’s mother, Tonya Sadowski, has gone so far as to publish a website, Amanda Truth Project. Before I delve into that website, let me just say: I understand. Mrs. Sadowski lost her baby. She doesn’t think her husband did it, at least not intentionally. She might even have a valid argument; it’s hard to know, although Elwood Sadowski does have a criminal background not unlike that of Alan Yurko. Be that as it may, and no matter how much sympathy I might have for her, Tonya Sadowski is doing great harm by using the Alan Yurko defense (“vaccines and other nasty stuff done it”). You’ll see what I mean if you peruse the reports on her website prepared by Michael Innis and Harold Buttram. They’re recycling the same sorts of arguments used to try to get Alan Yurko off.
Unfortunately, there are things there like this CT scan report from the hospital to which Amanda was first taken (Fairview Hospital), which found:
- Bilateral temporoparietal and right occipital skull fractures.
- Hemorrhage is seen adjacent to the falx, in the dependent portions of the occipital horns, and in a subtle area of parenchymal hemorrhage in the left parietal lobe.
- There is an area of decreased attenuation in the left posterior parietal region compatible with a remote injury and focal encephalomalacia.
Note that Amanda presented to Fairview Hospital in full arrest, was resuscitated, and then was flown to Rainbow Babies & Children’s Hospital in Cleveland, where from Buttram’s report it is not clear whether the following represent a new head CT or an interpretation of the head CT done at Fairview:
Multiple skull fractures. Bilateral cephalhematoma. intraparenchymal, subdural, subarachnoid, and intraventricular hemorrhage.
Diffuse loss of sulci and cisterns as well as gray-white differentiation consistent with global edema. Downward herniation cannot be excluded.
This is some major trauma. It is not subtle. The most likely explanation for such massive trauma is, well, trauma. What do Buttram and Innis claim? Dr. Innis claims:
I conclude that Amanda suffered from undiagnosed Neonatal Hepatitis as shown by the abnormal Liver function Tests and as a consequence developed Vitamin K Deficiency Disease which caused her death. An Adverse Vaccine Reaction resulting in a fall in the level of Vitamin C cannot be excluded.
Which is a common theme among conspiracy theorists who think that SBS is in reality some combination of vaccine injury and nutritional deficiencies. Buttram, in particular, likes the idea that vitamin C deficiency is a cause of SBS and that vitamin C deficiency is caused by—you guessed it!—vaccines:
Returning to the importance of vitamin C in relation to vaccines, one of the prime roles of vitamin C in the body is its action as an antioxidant in donating electrons to quench free-radical and inflammatory damage from toxins and/or infections, with our consideration here being vaccine toxins. In the process of donating electrons, vitamin C necessarily becomes depleted. Once the level is reduced to the point that it can no longer protect the brain, which is unduly susceptible to toxic and infectious damage, it (the brain) may become subject to free-radical damage.
This is, of course, utter nonsense. It’s also utter nonsense that vaccines commonly cause encephalopathy so severe that it can be mistaken for SBS/abusive head trauma. With this as a way of background, it’s not surprising that Buttram does what he does best in his report for the Sadowskis. He Gish gallops. It’s vitamin K deficiency that caused bleeding! It’s a vaccine reaction! It’s rickets making the baby’s bones brittle! It’s birth trauma! It’s liver dysfunction! It’s nutrient deficiencies caused by Amanda’s mother having been given ampicillin:
The mother did attempt breast-feedings supplemented with formula but ultimately abandoned breast feedings, primarily because of the infant’s difficulty in sucking. Under normal circumstances, breast-feeding establishes a prevalence of highly beneficial and protective Lactobacillus bifidis in the infant’s intestinal flora, but the mother was administered 2 grams of ampicillin intravenously during her labor with Amanda, which would have largely eliminated the L. bifidis. This in turn would have opened the way for yeast infestations, later manifesting as cradle cap, “yeasty” neck folds, and intestinal yeast overgrowth, the true source of the intractable colic and reflux problems. These in turn in all likelihood would have led to unrecognized nutrient mineral and vitamin deficiencies including calcium, magnesium, zinc, and vitamins A, C, and D.
The ridiculousness of this claim speaks for itself. Such are the sorts of arguments used by antivaccinationists who have drunk the Kool Aid that vaccines somehow contribute to a syndrome that is frequently mistaken for SBS/abusive head trauma. I don’t know if Elwood Sadowski really did kill his daughter. Maybe he did fall accidentally while carrying her, resulting in fatal injuries. I suppose it’s possible (although the story given is not convincing). However it happened, Tonya Sadowski’s grief at the death of her daughter does not excuse her abuse of science and embrace of the worst kind of antivaccine pseudoscience in order to exonerate her husband.
One last claim.
Finally, I can’t help but point out one last favored distortion that antivaccinationists use to argue that vaccines cause SBS/abusive head trauma. I learned of this particular canard several months ago, when I came across an article by someone named Catherine Frompovich on the Orwellian-named International Medical Council on Vaccination (formerly Medical Voices) with the even more Orwellian-named subtext “critical thinking for a critical dilemma” entitled Bone Density Test Can Disprove Shaken Baby Syndrome. Frompovich starts out by touting her antivaccine cred by kissing up to—who else?—Harold Buttram:
Before I delve into the topic I want to discuss, perhaps you may want to know that I have co-authored several papers with Dr. Harold E. Buttram, MD, regarding topics such as Brain Inflammation, Basics of the Human Immune System Prior to Vaccines, and Shaken Baby Syndrome, which can be accessed at the International Medical Council on Vaccination website starting with Vaccines and Brain Inflammation at http://lawreview.byu.edu/articles/1325789487_13Seeley.FIN.pdf. In order to access the other papers, you will have to scroll through IMCV’s archives. Dr. Buttram’s name appears first on all articles.
Frompovich’s credulity, which leads her to suck up to Buttram, also leads her to exult over a paper published in a law journal by someone named Matthew B. Seeley entitled Unexplained Fractures in Infants and Child Abuse: The Case for Requiring Bone-Density Testing Before Convicting Caretakers. The basic thrust of the article is that not all cases of unexplained fractures in infants are due to abuse. In other words, it’s rather a massive straw man argument. Here’s why. First, unexplained long bone fractures are not pathognomonic for child abuse. What’s far more suspicious are injuries that are not consistent with the history given. Second, as I mentioned earlier, the term SBS is falling out of favor; the preferred term is now “abusive head trauma,” which doesn’t limit the potential cause of injury to shaking. Third, recent reviews have been very clear in emphasizing that the diagnosis of abusive head trauma is not a trivial matter and can be at times difficult. Indeed, they emphasize other conditions that can cause the usual triad (subdural haemorrhage, retinal haemorrhage and encephalopathy) that characterize the diagnosis. A review from just last year, for example, provides what it characterizes as the “exhaustive” list of conditions that can result in this triad:
- Chronic subdural haemorrhage
- Accidental falls
- Resuscitated SIDS
- Cortical vein and sinus thrombosis
- Inflicted injury
- Vitamin D deficiency
- Second impact syndrome (a second head injury, often very mild, occurring days or weeks after a first)
- Aneurysm rupture
- Rare genetic conditions
Notice that none of the conditions listed above includes “vaccine injury.” There is no evidence that vaccine injury can cause the triad associated with SBS/abusive head trauma. Indeed, this particular review is also notable for its emphasizing a “pragmatic” approach to diagnosing SBS/abusive head trauma. Another review describes the process of diagnosing SBS/abusive head trauma:
SBS is known to be difficult to detect and diagnose. Clinicians should use their own clinical judgment as each individual case is different and needs to be considered carefully on its own evidence…The diagnosis of SBS must be considered in any infant or young child who collapses with no obvious causes. Clinicians must maintain a low threshold of suspicion for considering this diagnosis.16 The diagnosis of SBS is usually made following a careful medical and social history taking. This ought to be supplemented by appropriate investigations.
The authors conclude that the clinical diagnosis is usually based on a patient history that does not explain the clinical features and list the laboratory investigations that should be undertaken.
The paper that Frompovich touts advocates the use of single photon absorptiometers to measure bone density in children. While this might well be a valid tool to estimate bone density in infants, but this argument does not in any way support the idea promoted by antivaccine loons that the SBS/abusive head injury triad can be caused by vaccines. In fact, Frompovich even admits that Seeley would likely “bristle at the thought that vaccines can contribute to SBS.” I have no idea what Seeley would think. For one thing, he’s not a pediatrician, and he published no primary studies on this issue, nor is he a neuroscientist. Rather, he is an exercise scientist wrote a medical-legal review that is basically designed to suggest to other lawyers what sorts of techniques can be used to sow reasonable doubt in a jury considering cases of child abuse of babies who present with the SBS triad, and, quite frankly, I don’t know whether he’s pandering to a law audience or being incredibly simplistic when he argues that there’s a huge degree of doubt because it’s impossible to do a randomized trial to determine whether shaking can cause the SBS triad.
I kid you not. That’s really what he writes, which is one reason why I was underwhelmed. Frompovich, not surprisingly, eats this up, so much so that she starts advocating subjecting children to bone density tests as routinely as Apgar scores and, in a triumph of speculation over evidence, suggests that the birth dose of hepatitis B vacine should not be given before a serum vitamin D test is done. In essence, Frompovich’s invocation of Seeley’s review article is designed to sow fear and doubt about the very existence of SBS and then to imply, not so subtly, that if SBS is difficult to diagnose then it could well be vaccine injury. Never mind that, again, there is no credible evidence that SBS is in any way related to vaccine injury, and never mind further that the intricacies and controversies in diagnosing SBS do not in any way demonstrate that vaccines cause the triad of findings that characterize SBS. By publishing this sort of nonsense, the IMCV has demonstrated that there are no depths to which it would not go in trying to discredit vaccines.
The bottom line is that the claim that SBS is in reality due to “vaccine injury” ignores the wealth of clinical data indicating that SBS (now more frequently and formally referred to as “abusive head trauma”) is a distinct clinical entity that has been well-studied and is probably underdiagnosed. Although there is controversy over the pathophysiology of SBS, how much force is necessary to produce it (hence the additional term to describe it), whether it’s underdiagnosed, what clinical entities can be confused with SBS, and whether it’s sometimes over-prosecuted, there is no controversy that SBS is not “vaccine injury.” When antivaccinationists insist that it is, they abuse science, reason, and morality by by proving themselves willing to use such a myth to exonerate baby killers. They also demonstrate that they are about hatred of vaccines, not clarifying the science and evidence behind abusive head trauma, SBS, or whatever the entity might be called in the future.