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Sunday, January 23, 2022

Antivax Rally

In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread  And among those diseases could be COVID-19.

Antivaxxers are sometimes violent, often abusive, and always wrong.  

Peter Jamison and Ellie Silverman at WP:
As anti-vaccine activists from across the country prepare to gather on the steps of the Lincoln Memorial on Sunday, they are hoping their rally will mark a once-fringe movement’s arrival as a lasting force in American society.

That hope, some public health experts fear, is justified. 
Almost two years into the coronavirus pandemic, the movement to challenge vaccines’ safety — and reject vaccine mandates — has never been stronger. An ideology whose most notable adherents were once religious fundamentalists and minor celebrities is now firmly entrenched among tens of millions of Americans.

Baseless fears of vaccines have been a driving force among the approximately 20 percent of U.S. adults who have refused some of the most effective medicines in human history: the mRNA vaccines developed against the coronavirus by Pfizer, with German partner BioNTech, and Moderna. The nation that produced Jonas Salk has exported anti-vaccine propaganda around the globe, wreaking havoc on public health campaigns from Germany to Kenya.

The scientific case for the full range of vaccines recommended by public health authorities in the United States remains as solid as ever. Research has shown that those vaccines — which have all but eliminated diseases that once sickened, debilitated or killed millions every year — to be safe for the vast majority of those who receive them. The 1998 study by Andrew Wakefield that claimed a link between a common childhood vaccine and autism, launching the modern anti-vaccination movement, was exposed as fraudulent.

Jamieson and Silverman also report:

Organizers estimate that 20,000 people will attend the rally, marching from the Washington Monument to the Lincoln Memorial, according to a permit issued by the National Park Service. D.C. police were fully activated from Friday Jan. 21, during the annual March for Life, through today for the anti-vaccine mandate rally, spokesman Dustin Sternbeck said.

The march is billed as a protest of mandates, rather than the medicines themselves. But similar rhetoric — emphasizing individual autonomy rather than untenable scientific ideas — has long characterized the broader anti-vaccine movement, and the march’s speakers include movement veterans such as Robert F. Kennedy Jr. and Del Bigtree, founder of the anti-vaccine group Informed Consent Action Network.

Other speakers include physician Robert Malone, a prominent critic of the coronavirus mRNA vaccines, and former CBS News correspondent Lara Logan, who in a November appearance on Fox News compared White House chief medical adviser Anthony S. Fauci to the Nazi doctor Josef Mengele. Public employee associations that have formed to protest their employers’ vaccine mandates, such as Feds for Medical Freedom and D.C. Firefighters Bodily Autonomy Affirmation Group, are also participating.



Saturday, January 22, 2022

Texas Is a Tough State

In The Politics of Autism, I write about special education and the Individuals with Disabilities Education ActSome states do a reasonably good job with education and social services, but Texas has not been one of them. A 2016 Houston Chronicle investigation revealed that tens of thousands of disabled students  were refused access to services because of a de-facto enrollment cap.

Lauren Castle at The Fort Worth Star-Telegram:

Forty-six percent of Texas children ages 9 months to 35 months received a developmental screening, according to 2018-2019 data from the Annie E. Casey Foundation. The Centers for Disease Control and Prevention recommend that all children should have a developmental screening and formal test even if there are no concerns.
While pediatricians are able to help families with concerns on child development, continuous health care can be a challenge for some families. Dr. Christina Robinson, medical director at the University of North Texas Health Science Center’s pediatric mobile clinic, has noticed patients facing multiple barriers to care.
“We have noticed that there is usually not just one barrier, but layers of barriers our families are struggling with,” Robinson said. “When one barrier may not exist one time, the next time you see them another barrier might be there when the other one hasn’t resolved.”

 The state’s Early Childhood Intervention program underwent a federal investigation that concluded in 2020. The US Department of Education determined that not all of the young children eligible for the agency’s programs were provided services, according to an Oct. 2020 letter sent to the Texas Health and Human Services Commission.

Texans Care for Children, a policy organization, stated in a 2020 report that the state program overall was under-enrolling infants and toddlers across the state, and disparities were seen among children of color. “In 2018, Texas [Early Childhood Intervention] served 2.34 percent of children under age three, compared to the national average of 3.74 percent, ranking the state 46th in the nation,” the Texans Care for Children report stated. “While Texas [Early Childhood Intervention] enrollment is low for children of all backgrounds, it is disproportionately low for Black children.”

Friday, January 21, 2022

Asian Americans with Disabilities

In The Politics of Autism, I write about the experiences of different economicethnic and racial groups.  

At NBC, Victoria Namkung reports on Princeton University undergraduate Jennifer Lee:
These experiences led Lee to found the Asian Americans with Disabilities Initiative, or AADI, in July of 2021 with a goal of amplifying disabled Asian American voices and creating space to explore the intersectional identities of being both disabled and Asian American. The youth-led nonprofit group wants to provide the next generation of disabled Asian American leaders with accessible resources to help combat anti-Asian racism and ableism.

Last week, the advocacy organization published the Asian Americans with Disabilities Resource Guide featuring first-person testimonials, comprehensive peer-reviewed research and sections such as access to disability services, mental illness and intersectionality. The nearly 80-page online guide is designed for Asian Americans with disabilities, as well as their caretakers, family members, allies, businesses and organizations.

Thursday, January 20, 2022

The Antivax Toll

In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread  And among those diseases could be COVID-19.

Antivaxxers are sometimes violent, often abusive, and always wrong.  

At LAT, Dr. Venktesh Ramnath, medical director of critical care and telemedicine outreach at UC San Diego Health:
Incredulous families summarily deny that COVID-19 (and absence of vaccination) could be responsible for the critical illnesses I see every day. Patients and their relatives vehemently claim that healthcare workers and hospitals are “poisoning” and “punishing,” as if part of an Orwellian plot, leading to belligerent, abusive behaviors against staff.

Many providers have become inured to uninformed rebuffs of medical recommendations, including vaccination. Educational efforts have devolved into counterproductive debates.

Far from “heroes” or even compassionate advocates for health, providers are viewed as biased technicians with dubious motives locking loved ones behind hospital doors.

One response to this emotional onslaught is, understandably, attrition. Most veteran ICU nursing staff where I work have left, replaced by temporary assignment nurses from across the country. Some physicians who have become ostracized by the very communities they serve now contemplate nonclinical work or early retirement.

Among those of us still in the trenches, some medical professionals are now breaking traditional practice norms. Providers are resorting to less evidence-based practices, desperate to help and also to avoid another conflict. By opening the door to “try everything,” they have become unwitting supporters of anti-science movements, placing additional stress on others who promote well-established, proven practices.

A 2021 release from USC:

Between 37,000 and 43,000 children in the United States have lost at least one parent to COVID-19, a “staggering” 20% increase in parental loss over a typical year, USC research shows.

The scope of deaths “is forever imprinting the lives of tens of thousands of young Americans,” said study co-author Emily Smith-Greenaway, associate professor of sociology and spatial sciences at the USC Dornsife College of Letters, Arts and Sciences. “It’s a social crisis that merits far greater attention, as well as a collective response to slow the tide of loss that’s washing over children.”

The research appeared this week in JAMA Pediatrics.

Three-fourths of children who lost a parent were adolescents, and 1 in 4 were children younger than 10. Black children have also suffered disproportionately from parental bereavement: Although they comprise only 14% of children in the U.S., they make up 20% of those who’ve lost a parent to COVID-19.


Wednesday, January 19, 2022

Vaccination, Politics and COVID-19

 In The Politics of Autism, I analyze the discredited notion that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread  And among those diseases could be COVID-19.

Antivaxxers are sometimes violent, often abusive, and always wrong.  

UnfortunatelyRepublican politicians and conservative media figures are increasingly joining up with the anti-vaxxers.  There is a great deal of overlap between MAGA World and the antivax movement.

At BMC Public Health, Don Albrecht has an article titled "Vaccination, politics and COVID-19 impacts."  The abstract:

The development of safe and effective COVID-19 vaccines provides a clear path to bring the pandemic to an end. Vaccination rates, however, have been insufficient to prevent disease spread. A critical factor in so many people choosing not to be vaccinated is their political views. In this study, a path model is developed and tested to explore the impacts of political views on vaccination rates and COVID-19 cases and deaths per 100,000 residents in U.S. counties. The data strongly supported the model. In counties with a high percentage of Republican voters, vaccination rates were significantly lower and COVID-19 cases and deaths per 100,000 residents were much higher. Moving forward, it is critical to find ways to overcome political division and rebuild trust in science and health professionals.

From the article:

Despite the obvious fact that vaccines save lives and reduce human suffering [34], there has been opposition to vaccination since the time of Jenner [35]. This opposition has become more organized and vibrant in recent years, with help from the Internet and social media [30, 36]. A critical event was an article published in 1998 that purported a link between the MMR (measles, mumps, and rubella) vaccine and autism. Later it was found that the research was faulty and the article was retracted in 2010. The damage, however, had been done and a strong “anti-vax” movement was growing throughout the world. The movement was greatly enhanced by tweets from Donald Trump both before his election and after he became president [31]. The consequences are profound, and vaccination rates have been declining around the world [37].


Conservative opposition to vaccines was enhanced by the support of Donald Trump. Over the years, Trump has sent many tweets with anti-vax and pro-conspiracy theory themes. For example, in 2014 he tweeted, “Healthy young child goes to doctor, gets pumped with massive shot of many vaccines, doesn’t feel good and changes – AUTISM. Many such cases.” On September 2, 2015 he tweeted, “I am being proven right about massive vaccinations – the doctors lied. Save our children and their futures!” A study by Hornsey et al. [31] found that these statements had an effect and that Trump voters were more likely to express vaccine hesitancy, distrust medical authorities, and believe conspiracy theories about COVID-19 vaccines.

Beyond the president, other political leaders and media outlets sent divergent messages on COVID-19. Again, Republicans and the right-wing media tended to downplay the threat of the disease and express opposition to steps intended to prevent spread [93]. Fridman et al. [94] found a critical factor in vaccine resistance was exposure to right-wing media. With support from Republican leaders and the right-wing media, protests were held throughout the country in opposition to mask mandates, business and school closures, and vaccination mandates. In many communities, wearing a mask or getting a vaccine became a political statement, with many Republicans arguing that these actions violated their individual freedoms and were unnecessary anyway. The consequence was increased levels of virus spread in Republican-dominated counties. A study from early in the pandemic found that counties where Trump received a higher proportion of the vote were initially safer from the virus, but this changed as the pandemic progressed, and these counties then experienced severe impacts [95]. Research shows that a likely reason for the initial safety of Trump-leaning counties from the disease is that they tend to be more rural where people are naturally social distanced and less likely to be reliant on mass transit, conditions which enhance virus spread [61]. This same study found a positive relationship between the percent voting for Trump in a county and the severity of the pandemic in that county. In this study, we expect an inverse relationship between the percent voting for Trump and vaccination rates. Lower vaccination rates are expected to lead to higher rates of COVID-19 cases and deaths.

Monday, January 17, 2022

California Autism Professional Training and Information Network (CAPTAIN)

In The Politics of Autism, I discuss the implementation of public policy toward autism at the federal, state, and local levels, involving education and social services.  Implementation needs far more study.

At Autism, Jessica Suhrheinrich and colleagues have an article titled "Practice-driven research for statewide scale up: Implementation outcomes of the California Autism Professional Training and Information Network."  The lay abstract:

Supporting use of evidence-based practice in public service programs for autistic individuals is critical. The California Autism Professional Training and Information Network (CAPTAIN) brings together best practices from intervention and implementation research to support scale up of autism services. The current study was designed to evaluate the impact of CAPTAIN on provider-level outcomes including attitude toward, knowledge, fidelity, and use of autism EBPs and overall classroom quality. Overall, results indicated variability across measures, with some significant differences between CAPTAIN-trained and non-CAPTAIN-trained providers. These preliminary findings show promise for the efficacy of the CAPTAIN model to increase dissemination and implementation of EBP at the classroom level.

From the article:

The use of research-based practices is mandated by IDEA and ESSA and has been linked to best outcomes for students with autism, which highlights effective implementation and scale up of EBPs in schools as a critical priority. The growing literature on factors that support the implementation process indicates key drivers which can be considered targets of implementation interventions to improve implementation outcomes. In this study, we explored implementation outcomes at the direct service provider level and evaluated differences between CAPTAIN-trained and non-CAPTAIN-trained providers using one of the first large-scale statewide examinations across multiple levels of the special education service system. Overall outcomes indicate CAPTAIN-trained providers and teachers report more favorable attitudes toward EBP, better implementation outcomes related to data collection, and use with students, higher knowledge of their primary EBP, and better ratings of learning environment. These findings show great promise for CAPTAIN as a model to support statewide scale up if EBP for autism and are discussed in more detail below