I was disappointed by this hit piece. I donāt think it fairly characterized Dr. Carsonās remarks or beliefs. Rather, it seemed as if Dr. Carsonās remarks provided a vehicle for Geoffrey to criticize Seventh-day Adventist Church positions in the context of presidential politics so that he would have a larger readership. Iām no fan of the churchās recent GC actions either, but I donāt see much value in this authorās approach.
I would like to respond specifically to Dr. Brenton Readingās comments. I have tremendous respect for Dr. Reading and his contributions to the Spectrum community, including his many insightful comments and articles, especially in relation to science and the science/faith intersection. That I disagree with his comments here doesnāt diminish my respect for him.
On vaccinations, Carsonās remarks have been misconstrued and lifted from context by many in the press. The transcript can be found here: https://www.washingtonpost.com/news/the-fix/wp/2015/09/16/annotated-transcript-september-16-gop-debate/. Dr. Reading said, āHe started off by correctly stating that there is no scientific evidence that vaccinations cause autism (the one article that made the connection has been refuted). But, then he suggested there might still be a connection with autism by saying that we should delay and space out vaccinations.ā I donāt understand how Dr. Reading drew that conclusion from Dr. Carsonās actual remarks, which were, āwe have extremely well-documented proof that thereās no autism associated with vaccinations. But it is true that we are probably giving way too many in too short a period of time.ā The fact that these sentences were sequential doesnāt mean that Dr. Carson was suggesting there might be a connection between immunization schedule and autism; that would contradict what he had just said. I suspect he had in mind other possible complications of intensive immunization schedules that are described in the medical literature, such as febrile seizures (e.g., MMR vs. MMRV; see Gkampeta A, Pavlidou E, Pavlou E. Vaccination and neurological disorders. Journal of Pediatric Sciences. 2015;7:e237).
Gkampeta et al. note that Dravet syndrome is associated with vaccinations. While vaccinations are not the cause of Dravet syndrome, āthere is some evidence that earlier onset of these syndromes can be triggered by vaccination, especially in children with a SCN1A mutation.ā There seems to be a significant association between febrile seizures and vaccinations. There may be an association between fever (from the vaccination) and the onset, but the syndrome would have manifested anyway later. There isnāt an established causal relationship between vaccinations and the disease itself. Donald Trump related an observation of an employeeās baby; I saw the same thing happen to a colleagueās baby within days of immunization. But, lack of an established causal relationship leads to the suggestion that these observations are merely coincidental (i.e., these diseases first manifest in infancy, and that is also when immunizations are administered).
Despite the Wakefield scandal and the lack of any subsequent demonstration of a causal relationship between immunizations and ASD, the challenge remains that parents (and Trump) observe temporal proximity. There are also still epidemiological hints, as noted by Gkampeta et al.: āA more recent [2014] study by Hooker provides new epidemiologic evidence showing that African American males receiving the MMR vaccine prior to 24 months of age or 36 months of age are more likely to be diagnosed with ASD.ā (Who knows how that will play out; my point is simply that Wakefieldās demise wasnāt the last word on this in the scientific literature).
There is much remaining to be studied. Is there, for example, a specific study comparing the outcomes of a compressed vs. extended immunization schedule? Advocates suggest that reducing aluminum concentration may be one justification for extending immunization schedules. One review of aluminum adjuvants suggests that there are many questions yet to be answered regarding its potential effects, and criticized the confounding presence of aluminum in placebos. http://www.meerwetenoverfreek.nl/images/stories/Tomljenovic_Shaw-CMC-published.pdf
It isnāt clear that all immunizations are necessary either. For example, influenza vaccinations are increasingly given to young children (the CDC recommends starting at 6 months, http://www.cdc.gov/vaccines/parents/downloads/parent-ver-sch-0-6yrs.pdf), yet their effectiveness was questioned in a recent Cochran review (http://www.ncbi.nlm.nih.gov/pubmed/22895945). A more recent review found no adverse effects, but concluded for adults, āInfluenza vaccines have a very modest effect in reducing influenza symptoms and working days lost in the general population, including pregnant women.ā (http://www.cochrane.org/CD001269/ARI_vaccines-to-prevent-influenza-in-healthy-adults). When one considers the massive efforts of the medical industry via drugstores, supermarkets, workplaces, etc., to drive everyone to get an annual flu shot, studies like this lead critical members of the public to question the motives of the industry and its government counterparts. Without public trust, scientists, including doctors, have little chance of persuading the public to accept their claims.
As Dr. Reading knows, science canāt prove a negative. It is impossible to prove that immunizations do not cause ASD. On the other hand, science can establish a causal relationship if one exists (i.e., proveāin a statistical senseāa positive). The big problem for the medical industry with respect to ASD and immunizations is that no comprehensive scientific understanding exists for the cause(s) of ASD or the explosion in number of cases (other than the suggestion that diagnosis has improved). In the absence of a āpositiveā, the ānegativeā retains significance for parents. Thus, medicineās communication problem is rooted in the lack of a satisfactory understanding for ASD.
It is true, as Carson said, that more pediatricians are shifting to extended immunization schedules. One survey suggested that this is not in response to science, but in response to parental demands, and most respondents agreed to extend vaccination schedules but 40% reported decreased job satisfaction as a result (http://pediatrics.aappublications.org/content/early/2015/02/24/peds.2014-3474.short). Many feared losing their patients if they didnāt agree to the extension; this itself indicates that trust has broken down. The fact that a majority of doctors do this, however, indicates that either they are unethical or else they donāt believe there is a significant risk of harm to their patientās health by spreading out immunizations. If Dr. Reading is correct that delays put infants at risk of life-threatening illness, he is implicating a majority of pediatricians as complicit in a scheme to endanger infant lives for financial gain. Or, maybe the enhanced risk is too small to worry about, at least in the United States.
If you examine the transcript, youāll see that Dr. Carson was trying to avoid the CNN ādebateā moderatorsā attempts to start verbal wars between candidates. He responded factually and scientifically to the question, then segued into (somewhat disjointed) remarks about the size of government. In the second response, he repeated his scientifically accurate statement, and then made the statement on extending immunization schedules. There wasnāt time in this format to get into the details of the extensive scientific literature on the subject, and I think it is unfair to judge Dr. Carson as having misled the public or missed an opportunity to advocate for childhood immunizations.
Regarding Dr. Carsonās statements on Islam, I think it is clear from the totality of Dr. Carsonās remarks that he was not suggesting that the U.S. Constitution would tolerate religious discrimination or that this was his position either. Rather, he was pointing out a contradiction between the beliefs of some Muslims and the Constitution, and that for such Muslims, it would not be possible to honestly swear to uphold the Constitution of the United States without violating their conscience. As he later clarified, āI donāt care what religion or faith someone belongs to, if theyāre willing to subjugate that to the American way and to our Constitution, then I have no problem with that.ā (On Hannity, according to CNN.com).
Dr. Carson is well-read; maybe he was simply getting his cues from Spectrum! In an essay by Malcolm Russell (Spectrum, Vol. 30(1), 2002, 17-23), the author āattempts to consider the dissonance faithful Muslims find between the religious and philosophical teachings of traditional Islam and modern practices of international relations.ā Russell continues, āPious (and not necessarily fundamentalist) Muslims suffer this dissonance because Western ideas about the nature of government dominate the world. At the most basic level, the West conceives a secular government, based on the nation-state, seeking its goals from the desires of its citizens, creating its own laws, and operating its foreign policy in its own self-interest. In such realms, the important criteria are human choices and well-being. In contrast, Islam calls believers to live in a community of the faithful, subject to Godās precepts.ā An American president, following the U.S. Constitution, would need to adhere to the secular concept of government. I think that was Carsonās point, yet somehow this has been twisted to suggest the opposite, that Carson believes the government should be sectarian!