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Sunday, Nov 8, 2009
Robert F. Kennedy Jr. responds:
Dr. Fineberg charges that I fabricated quotations by the participants of the January 2001 IOM meeting, but offers no evidence of "fabricated" quotes. I took all the statements from transcripts created by the IOM. Dr. Fineberg complains that I took Dr. Marie McCormick's words at the January 2001 organizational meeting out of context. He suggests McCormick wasn't trying to influence the study results when she said "the CDC wants us to declare, well, these things are pretty safe." But the context he adds does not contradict the way I used her quote.
Furthermore, additional statements made by McCormick ("We are not ever going to come down that [autism] is a true side effect of [thimerosal exposure]") and other meeting participants, including IOM study director Kathleen Stratton ("The evidence [will be] inadequate to accept or reject a causal relation") and Dr. Michael Kaback ("How we work our way out of the trap, I think is the charge"), make it clear that the panel members felt they were under pressure to exonerate thimerosal.
Dr. Fineberg complains that I didn't cite a 2001 report by the IOM that found a biologically plausible link between thimerosal and neurological disorders including autism, recommended removal of thimerosal from vaccines and advised that the links between thimerosal and the wide range of neurological disorders should be further researched. Dr. Fineberg argues that "this would hardly seem to be a conclusion that would be reached by a committee that was instructed to produce a report debunking the link." I did cite the 2001 IOM report in an early draft of "Deadly Immunity"; it was moved to a sidebar. But in 2004, the IOM contracted with the CDC to study the link between thimerosal and autism, and to look at studies that had appeared subsequent to the 2001 report. It was that committee's findings I wrote about in "Deadly Immunity."
Instead of conducting further studies of the possible causal links between thimerosal and a range of neurological disorders including speech delay, attention deficit disorder, hyperactivity, mental retardation and autism, as the 2001 IOM Immunization Safety Review Committee had recommended, the IOM narrowed its focus, at the request of the CDC, to study autism only. Although Dr. Fineberg says the committee cited 215 studies on links between thimerosal and autism, the report placed heavy emphasis on the four epidemiological studies I called flawed in "Deadly Immunity": studies of European countries where children had been exposed to only a fraction of the thimerosal concentrations administered to American children, and where they often undercounted the number of autistics.
The IOM's narrow focus on autism also allowed the committee to avoid the larger number of studies linking thimerosal to the wider spectrum of neurodevelopmental injuries. IOM chief staffer Kathleen Stratton effectively acknowledged that when she told me in an interview, "Clearly, mercury is very toxic. Clearly, ethyl mercury is neurotoxic. Clearly, ethyl mercury affects cell systems -- animals, human cells -- all those sorts of things, and clearly, when it was injected into newborn mice they had weird behavior. The point is, mercury is not good for you. Granted, thimerosal ... I mean it can't be good for you, right? And certainly, at some doses it's very bad for you. But the [only] question [we were charged with answering] is whether any of those animal or in vitro studies make a connection to autism."
I also question Dr. Fineberg's assurance that the IOM follows stringent policies for reviewing the potential conflict of interest of its panel members. Surely he is well aware of the many journalists and public officials who have raised questions about the web of ties among the CDC, the pharmaceutical industry and the research community. Fineberg's claims that the members selected for the Immunization Safety Review Committee had no links to the CDC and received no money from funding sponsors (the NIH and the CDC) are wrong. Committee member Dr. Rebecca Parkin is a former CDC epidemiologist. Dr. Gerald Medoff has a long history with NIH, having served on a Research Advisory Board for the National Institute of Allergy and Infectious Diseases, which along with the CDC contracted the IOM report. Additionally, his former employer, Washington University, receives significant funding from vaccine manufacturers. Dr. Steve Goodman received more than a dozen grants from NIH since 1993. Dr. McCormick's Harvard School of Public Health receives NIH funding as well as funding from pharmaceutical companies, and Dr. Bennett Shaywitz has received more than 50 NIH grants since 1988.
On the question of further research, Dr. Fineberg's own letter makes clear that the 2004 committee report recommended that research be funneled "to the most promising areas," which was almost universally understood to mean areas unrelated to the thimerosal-autism link. In fact, committee chairwoman Marie McCormick was explicit in a press conference after the report was issued: "The overwhelming evidence from several well-designed studies indicates that childhood vaccines are not associated with autism. We strongly support ongoing research to discover the cause or causes of this devastating disorder. Resources would be used most effectively if they were directed toward those avenues of inquiry that offer the greatest promise for answers. Without supporting evidence, the vaccine hypothesis does not hold such promise."
On the question of conflating two panels, my article described the February 2005 findings as the work of a "new" panel, but wrongly stated that it had been established to review the earlier committee's work. Instead, the new panel was convened to address continuing concerns about the Vaccine Safety Datalink data-sharing program. Its February 2005 findings were critical of the way the VSD had been used to study vaccine safety, which was central to the work of the Immunization Safety Review Committee's 2004 findings on thimerosal.
Dr. Fineberg claims that the IOM came under no pressure from the CDC to debunk the autism-vaccine link, despite the concerns voiced at the January 2001 meeting. But the CDC has failed to fully release the details of the contract (Task Order No. 74) that laid out the CDC's specifications to the IOM for the thimerosal-autism study, despite Freedom of Information Act requests. I challenge Dr. Fineberg to release the documents to support his claim, and further release all meeting notes, memorandums, e-mails, documents and transcripts from its Immunization Safety Review Committee from 2001 to 2004, including all closed-door meetings, which have been previously unavailable to the public. I also ask that Dr. Fineberg and the IOM join with other scientists, policymakers, legislators and advocates to demand that the CDC allow independent scientists to study the Vaccine Safety Datalink (which contains the vaccine and medical records of 6 million children). Instead, the CDC has closed the VSD to outside scientists, and has persistently defied federal law, congressional demands and appeals from the scientific community to open it.
