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Notes -
Impact of Childhood Vaccination on Short and Long-Term Chronic Health Outcomes in Children: A Birth Cohort Study
Table of results
This testimony by Aaron Siri provides a useful contextualization and lay explanation of the study's methodology and findings. I've personally been skeptical of most anti-vax claims for awhile (sans the harms of COVID vaccines being used in young populations). It mostly seemed like a haze of memes with a high noise to signal ratio, but this study has changed my mind, at least for now. I'm not terribly familiar with this topic, so I looked for critiques of this study.
I found this guy's 2 minute critique. Here's the key points he makes:
For point 1, the study already answers this, and it seems convincing enough to me:
I would like to see how big the effect is from the "previous studies" as well
Point 2 seems weak to me. First, because almost all of the population receives childhood vaccinations, if vaccinations were causing ADHD, this is exactly what you would see. Second, this is one metric on which it makes sense that anti-vax parents would be less likely to bother with a diagnosis due to skepticism. ADHD is a very squishy diagnosis. The popular critique is that it is overdiagnosed, and that the expectations are at fault, not the child, because it is absurd to expect children to sit in a classroom for hours every day filling out paperwork without lashing out or being bored. This thinking would likely be popular among anti-vax parents. But, as the study itself notes, it's hard to see how this same logic would apply to something more clear-cut like asthma. On the other hand, I do have a hard time interpreting the apparently low incidence rate even among the vaccinated group. 262 cases/16,511 vaccinated = 1.6%. Perhaps this is due to a large portion of the study group being younger than 8 years old? This might be the main answer to the critique. The study claims to control for age when calculating hazard ratios so younger-bias this shouldn't affect the results (?)
Point 3 seems stronger to me, though it has some limitations. First, that study focused mostly on using aluminum content of the vaccine as a dependent variable. The various vaccines in the Denmark schedule can have a 2 to 10 fold difference in aluminum content, so if you're doing a regression, it would bias it towards being flat if aluminum is not doing anything, but something else about vaccination is (such as pure number of vaccines). A minor nitpick is that the MMR vaccine has 0 mg of aluminum per their supplementary table 2, so "children not vaccinated with any aluminum-adsorbed vaccines" is not quite the same as unvaccinated children. Denmark also only appears to have 5 vaccines in their schedule (just based on that supplement table), but the theory from RFK and friends seems to be something like vaccine overload. The Henry Ford study, by contrast says the median number of vaccinations in the exposed group is 18.
Does anyone know of any high quality deep dives into this or other similar studies which do not have any institutional bias? Is it vaporware, or is there something to this?
The general problem here is that parenting attitude is a massive confounder. It is not like the study authors had randomly flipped coins to decide which kids would get vaccines and which ones would get saline solution instead.
There is a certain type of helicopter parent who will drag their kids to the doctor whenever it is coughing. Their kids will generally get all the recommended vaccines, but also get any diagnosis under the sun that might be vaguely applicable. If little Timmy is late (e.g. 90ths percentile) learning to speak, he will get diagnosed with a Speech Disorder, Development Disorder and ADHD. For autoimmune diseases, I think that it is much more likely that the unvaccinated kids are allowed to play in the dirt where they get exposed to pathogens. Generally, anti-vaxxers are probably more rural, e.g. somewhat closer to the ancestral environment, which might have all kinds of neurological benefits for brain development.
These two effects (diagnostic bias, systematic lifestyle differences) seem enough to explain the observed factor 6 in relative risk.
From a mathematics perspective, the table on page 17 looks a bit shoddy. If they have 8 cases of "Brain Dysfunction" in group A and none in group B, that seems to be the kind of thing you could calculate a p-value for (e.g. "What is the probability that given there is no effect, the result will be more skewed by random chance"). They do not. But then again, this may be a general shoddiness of medical research.
I would not dignify anything he says with the word "theory". "Narrative" might be the better word.
At the risk of going all Bulverist on the authors, I think that his health department creates a huge demand for studies which show how dangerous vaccines are. Any professional who is willing to go on a p-fishing trip in publicly available data to bolster his narrative can possibly hope to be hired in his department.
Up until COVID, the two strongest predictors of having an unvaccinated child were high income and living in California, Washington, or Oregon.
Depending on the dates of the studies, this might actually confound things in the other direction.
Every single antivaxxer I can think of here in Finland is either part of some specific religious subgroups, a new age hippie or a "bro you need to watch this youtuber to get The Real Truth"-pseudo conspiracy theorist. The religious groups are mostly concentrated in specific parts of the country (which presents a real local problem with herd immunity for some dangerous diseases). Hippies are obviously much more urban.
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This is true in my experience. I know anti-vaxxers pre-covid. They were largely new-age types, very liberal before woke was a thing, and hypochondriacs/against letting their children play outside much. I will say they were anti-doctor visits/checkups though. But like the OP said maybe not if there was something really serious like asthma.
The new post-covid antivaxxers are conservative folk that probably do let their kids play outside/in the dirt more than the average "pro"-vaxxer, but I don't think these are in any studies yet.
IIRC alternative medicine is almost never a first second and final solution; alties basically always go to the doctor if their ailment is serious and doesn't improve.
Makes sense
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But isn’t the opposite true? That is, for years there was a huge demand for vaccine friendly studies. Are you sure you aren’t falling to an isolated demand for rigor?
In my world model, there is a wagon fort mentality in the respectable medical community. They know that the crazies will eventually get their hands on every paper they write and thus try to proactively avoid anything which can be used as an argument-as-soldier by the anti-vaxxers.
This is of course bad for truth-seeking. It will also erode what little trust there is between the anti-vaxxers and the medical establishment. It is a bit of a catch-22: research and publish without bias and your papers will be quoted prominently by a crazy influencer with millions of views, or have some bias and get accused of hiding The Truth from an unsuspecting public.
Personally, I trust the medical establishment to eventually find the correct answer, even if hampered by these considerations. But yes, I would price in that papers which show genuine problems with specific vaccines are probably less published than they would be in Dath Ilan.
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