Debate on Vaccine Damage (SIDS)
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|Thu, 05-08-2008 - 11:14am|
Response to Harris Coulter, Ph.D.
In 1996 Harris Coulter made one or more postings to Usenet group(s) asserting a connection between pertussis immunization and the incidence of SIDS (sudden infant death syndrome). I responded to him on Usenet with a critique of his methods and interpretations and the lack of scientific support for his position.
Coulter chose not to engage in actual direct debate, but chose instead to reply from a website. Since H. Coulter will not respond any other way, I will answerin kind.
My reply to Coulter regarding the Walker study. (1)
Dr. Morgan accepts the raw data on SIDS. I do not: very many deaths were excluded from the survey without the reader being told the reason.
The study states very clearly:
"These infants remained under surveillance, and therefore in the study population, for the duration of their families' membership in GHC."
". . . all deaths which on the basis of death certificate diagnosis, hospital discharge data, and pharmacy use taken together could be clearly ascribed to causes not related to immunization were excluded."
In other words, children may die from many causes. If the cause was clearly from other sources, i.e., birth defects, etc., then they clearly would be unrelated to any potential vaccine association and are appropriately excluded. Further follow-up of unrelated deaths are neither appropriate nor necessary.
It is a matter of common knowledge that only 10% of vaccine reactions are reported by physicians. And it is ludicrous to think that the authors of the study could get a true picture of SIDS by scrutinizing death certificates, hospital discharge data, and pharmacy use. The article does not state that the families of the babies concerned were interviewed.
Coulter fails to explain how this supposed 'common knowledge' has any application to this study. This study did not rely on the reporting of vaccine reactions at all. Instead, the actual complete health records, including the vaccine history and the cause of death, were examined for correlation. Coulter fails to appreciate that the actual health records are the very best sources of data available. Records linkage has become the preferred method for examining for rare events because it allows coverage of large populations, thus improving accuracy. (10,11)
In fact these types of record registries are considered ". . . the new gold standard measure of immunization status." These records ". . . will enhance the ability to conduct studies of barriers to timely vaccination, interventions to improve coverage, vaccine safety, and vaccine efficacy.(12)
It is further unlikely that family interviews would be of significant use. The average parent can do little more than call an ambulance when a SIDS death occurs. Parents are not in a position to provide a diagnosis, or to do an autopsy to determine cause of death, or to do a systematic records comparison. These latter steps are absolutely essential in evaluating any vaccine role.
But even with these defects and exclusions, the SIDS incidence after vaccination was uncomfortably high, as the authors admit.
Walker notes an "apparent" elevation in the risk of SIDS in the first four days following immunization, but then also notes that children without DTP immunization had a SIDS incidence six times higher that those who had been immunized. Coulter continues to ignore that clearly stated fact.
In my initial Usenet posting I stated:
What does this mean? The study itself noted: "Delay in immunization of high-risk infants might lead both to an elevated risk in the never-immunized and to a foreshortening of the interval between immunization and SIDS in the immunized. Both phenomenon could operate in the absence of any causal connection between immunization and risk of SIDS death . . ."
Coulter responded with:
This paragraph is unintelligible. Dr. Morgan seems to be discussing an English study, but his reference is to a study conducted in Los Angeles, California.
My quote above is NOT from an English study, and is NOT from Baraff's Los Angeles study, as Coulter asserts. It is taken directly from the Walker study, page 947, 2nd column, 2nd paragraph. Coulter fails to recognize the very study he is supposed to be discussing!
The paragraph simply says that delaying immunization:
a) increases risk in high-risk infants who are not immunized, and
b)decreases the time interval between time of immunization and any occurrence of SIDS in those who are immunized.
In my Usenet posting I quoted from a British study wherein the risk of SIDS was 2.4 times GREATER in NON-IMMUNIZED children.(3)
This 1981 British study is too old and too obscure to be cited as a reference for anything. And it is inappropriate to try to disprove my conclusions by citing references which suffer from the same defects as those being criticized.
It is most incredible that Coulter would consider a nationwide study from the prestigious British Medical Journal (BMJ) to be too "obscure"! Perhaps his real wish for trying to dismiss it is that it refutes his position.
Harris Coulter has no training in the health sciences, no health research experience, and has never published any health research. Is he qualified to judge the attributes of ANY health study?
Furthermore, the scientific community has not been ignoring me at all. DPT: A Shot in the Dark sparked passage of the "National Childhood Vaccine Injury Act" of 1986
Coulter confuses science with politics. The NCVIA was a political (not scientific) response to the hysteria Coulter and others created. It is acknowledged that the NVCIA has assisted in positive ways Coulter may not have anticipated:
a) without the threat of unfounded lawsuits vaccine supplies are now
more stable and plentiful than ever,
b) numerous new vaccines have been developed and introduced
c) vaccine coverage is steadily increasing and is now at all-time record highs
d) in the extreme rare instances where vaccine injury does occur prompt
compensation is available.
Since the NCVIA was passed an abundance of additional studies have emphatically refuted many of the assumptions upon which it was based. The above benefits, however, will guarantee that it will stay in place.
Dr. Morgan quotes against me the conclusions of the very study I have criticized as
methodologically defective. A little elementary logic is called for: before he can cite the article in his favor, he must deal with my criticism of it.
Quite to the contrary. A little elementary logic demands that Coulter demonstrate that he is qualified to render a worthwhile criticism to any study. Scientists who are qualified consider both the Walker and Griffin studies to be supportive of immunization and refute any real world connection with SIDS. (4)
Coulter's primary objection is to the use of records to track adverse events. The scientific community has long gone to records linkage approaches because of the superior results they produce. (10)
It would appear that Coulter's attitude is unsupported and unsupportable and demonstrates his lack of familitarity with basic research techniques.
His reference to the National Childhood Encephalopathy Study is also tendentious (ref. 6). The contribution made by this study and its follow-ups has been to demonstrate that vaccinations do cause acute reactions and long-term neurologic sequelae. The authors suggested a low figure of 1:100,000 for the incidence of these conditions, but does anyone really believe that figure? Maybe Dr. Morgan does, but everyone else knows the figure is going to go up. My own estimate is 1:5-1:10.
Unfortunately, Coulter cannot support his claim that "everyone else knows the figure is going to go up". That simply has not happened.
Coulter did not cite evidence to support his estimate of a 1:5-1:10 sequelae incidence, nor does he have any to cite. Coulter's statement is pure, unsubstantiated wishful thinking.
Research does not occur in a vacuum nor is it static. Every year new information becomes available. Early on the data said this:
"From 1975-1980, when DTP was used, of 19.8 million doses, there were 8 severe adverse reactions with sequelae, including 3 deaths, a rate of 0.4/million doses. (5)
By 1994 when Gale studied 218,000 children in Washington and Oregon aged 1 to 24 months it was found that: "This study did not find any statistically significant increased risk of onset of serious neurological illness in the 7 days after DTP vaccine exposure for young children."(6)
Further, in 1996 a ten year follow-up to the NCES study in Great Britain was conducted. The results of the NCES update ". . . do not establish a causal relationship between pertussis vaccination and chronic neurologic abnormalities." (7)
Another 1996 study flat out states:
". . . several large epidemiologic studies indicate that whole cell vaccines (pertussis) do not cause infant deaths or neurologic disease." (4)
Thus, it appears that the recognized incidence of serious sequelae actually caused by vaccine, DTP in particular, is steadily and continually decreasing.
I do a lot of other things besides criticizing vaccinations. And Dr. Morgan, with his usual silliness, doesn’t even understand the concept of conflict of interest. If Barbara Fisher went on the Oprah Winfrey show to promote sales of DPT: A Shot in the Dark, would she be in "conflict of interest?"
Promoting a book on a talk show is not conflict of interest, nor did I make such a statement. Talk shows are not at issue. What is at issue is this: Harris Coulter makes statements like:
"Pediatricians make about half their income from giving shots; hence they
will defend shots to their dying day (may it come soon!)".
If Coulter is going to make statements like the above then he leaves himself open to being evaluated under similar criteria.
Coulter continues selling like DPT - A shot in the dark, and AIDS and syphilis-the hidden connection in which he makes claims that AIDS is just syphilis and is treatable with a typhoid vaccine and penicillin!
We have to wonder what his motives are. Why would he continue to sell books making such claims considering the mountains of refuting evidence Like the old saying goes: "When they say it's not the money - IT'S THE MONEY!"
And that IS conflict of interest!
In conclusion, let me note that Dr. Morgan uses the common, although not admirable, technique of misquoting the specialized literature on the assumption that no one will check up on him. But I check up on everyone and everything.
Coulter has failed to document a single incidence of where I misquoted anything. On the other hand I feel I have demonstrated quite clearly that Coulter not only systematically misrepresents the professional literature but carefully ignores and avoids anything that might refute his claims.
There have been -many- studies that individually and collectively question Coulter's claims.
There is Mitchell's New Zealand SIDS study that examined 78% of live births in the entire country over a three year period and found that immunized children had a lower incidence of SIDS than non-immunized children.(8) Then we could look at the JAMA article that declares pertussis vaccine encephalopathy to be a MYTH! (9) Then we could discuss how the incidence of SIDS has dropped dramatically, despite greatly increased immunization coverage, by just putting infants on their backs to sleep.
1. A Walker, et.at., Diptheria-tetanus-pertussis immunization and sudden infant death syndrome. AJPH Aug 1987, 77:8; 945-950
2. Possible temporal association. . ., Ped. Infect Dis, 1983; 2:7-11.
3. Effect of low pertussis vaccination uptake on a large community. BMJ, 1981;282:23-26.
4. J Cherry. Historical review of pertussis and the classical vaccine. J Infec Dis, Nov 1996; Vol 174, Supp 3, S259-263.
5. T Aoyama. Acellular pertussis vaccines developed in Japan the their application for disease control. J Inf Dis 1996:174, Supp 3; S264-9.
6. J Gale. Risk of serious acute neurological illness after immunization with Diptheria-Tetanus-Pertussis vaccine: a population based study. JAMA 1994; 271(1):37-41.
7. The relationship between pertussis vaccine and central nervous system sequelae: continuing assessment. Amer Acad of Ped Comm on Infec Dis. Pediatrics 1996; 97(2):279-281.
8. E. Mitchell. Immunisation and the sudden infant death syndrome. Arch Dis Child; 73:6, 498-501.
9. J Cherry. 'Pertussis Vaccine Encephalopathy': It Is Time to Recognize It as the Myth That It Is. JAMA, 263:12; 1679-80
10. RT Chen. Vaccine Safety Datalink project: a new tool for improving vaccine safety monitoring in the United States. The Vaccine Safety Datalink Team. Pediatrics. June, 1997; 99:6; 765-73
11. T Fujita. . Nippon Koshu Eisei Zassh. 41:2; 114-25.
12. L Rodewald, et al.. Immunization performance measurement in a changing immunization environment. Pediatrics. April 1999,103:4; 889-897.