Evaluating Transition Research

Uncertainty is a major theme of The Politics of Autism.  In the concluding section, I write:

A key question in autism policy evaluation is simple to pose, hard to answer: How do autistic people benefit? How much better off are they as a result of government action? While there are studies of the short-term impact of various therapies, there is surprisingly little research about the long term, which is really what autistic people and their families care about. As we saw in chapter 4, few studies have focused on the educational attainment of autistic youths. For instance, we do not know much about what happens to them in high school, apart from the kinds of classes that they take. One study searched the autism literature from 1950 through 2011 and found just 13 rigorous peer reviewed studies evaluating psychosocial interventions for autistic adults. The effects of were largely positive, though the main finding of the review is that there is a need for further development and evaluation of treatments for adults.

Kristen Bottema-Beutel and colleagues have an article at Autism titled  "An evaluation of intervention research for transition-age autistic youth."  The lay abstract:

In this study, we assess the quality of intervention research that focuses on autistic youth who are 14–22 years old. We found 193 different studies on this topic, and carefully reviewed them. Most of these studies tested strategies that were behavioral. This means that they used procedures like prompting and rewards to change participants’ behavior. We found that the majority of studies had problems that make it hard to determine whether or not the intervention worked. The problems related to how researchers designed their studies, and how they measured the study outcomes. We also found that researchers rarely tried to find out if the strategies they studied had unintended negative effects for participants. Because of these issues, we make suggestions for how researchers might design better studies that will let people know how well the strategies worked.

Vaccine Polarization

 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.

Unfortunately, Republican politicians and conservative media figures are increasingly joining up with the anti-vaxxers.   Even before COVID, they were fighting vaccine mandates and other public health measures.

A decade ago, there was significant vaccine resistance in liberal enclaves. California's wealthy Marin County was once an example of left-wing antivax sentiment.At NYT, Soumya Karlamangla reports that things have changed.

In the pandemic age, getting a Covid-19 shot has become the defining “vax” or “anti-vax” litmus test, and on that account, Marin County has embraced vaccines at rates that surpass the vast majority of communities in the nation. It comes after public health efforts to change parents’ opinions, as well as a strict state mandate that students get vaccinated for childhood diseases.

And as the nation has grown more polarized, Marin residents are less comfortable wearing the “anti-vax” label increasingly associated with conservatives. Americans who identify as Democrats are more than twice as likely to be vaccinated and boosted against Covid — and Marin County is one of the bluest enclaves in America.

...

Dr. [Matt] Willis left the C.D.C. and in 2013 took over as Marin County’s health officer, and he was intent on figuring out why relatively few parents were vaccinating their children.

He surveyed the parents of thousands of kindergartners to understand what their vaccine concerns were. On the list were autism, ingredients in vaccines and the speed at which babies are administered dozens of shots. A 1998 study that purported to connect the measles, mumps and rubella vaccine with autism was debunked and retracted — but only after propelling the anti-vaccine movement, particularly among parents skeptical of traditional medicine and pharmaceutical companies.

Dr. Willis began public health campaigns to specifically address those fears and primed local pediatricians to have those conversations too. His efforts got a boost when, in late 2014, a measles outbreak erupted at Disneyland, drawing greater attention to unvaccinated children. When cases spread to Marin County, its low vaccination rates became a glaring example in California.

...

The anti-vaccine movement used to be a place where the left met the right, but increased polarization during the pandemic has made such a combination difficult to sustain, said Jennifer Reich, sociology professor at the University of Colorado Denver and the author of “Calling the Shots: Why Parents Reject Vaccines.”

“When we start to see such vastly different sources of information about what the risks of infection of Covid are, you start to see people making wildly different decisions in their life,” Ms. Reich said. “The vaccine and scientific expertise has become politicized.”

Jacob Wallace, Paul Goldsmith-Pinkham & Jason L. Schwartz, "Excess Death Rates for Republicans and Democrats During the COVID-19 Pandemic," NBER Working Paper 30512 ttp://www.nber.org/papers/w30512

Political affiliation has emerged as a potential risk factor for COVID-19, amid evidence that Republican-leaning counties have had higher COVID-19 death rates than Democrat- leaning counties and evidence of a link between political party affiliation and vaccination views. This study constructs an individual-level dataset with political affiliation and excess death rates during the COVID-19 pandemic via a linkage of 2017 voter registration in Ohio and Florida to mortality data from 2018 to 2021. We estimate substantially higher excess death rates for registered Republicans when compared to registered Democrats, with almost all of the difference concentrated in the period after vaccines were widely available in our study states. Overall, the excess death rate for Republicans was 5.4 percentage points (pp), or 76%, higher than the excess death rate for Democrats. Post- vaccines, the excess death rate gap between Republicans and Democrats widened from 1.6 pp (22% of the Democrat excess death rate) to 10.4 pp (153% of the Democrat excess death rate). The gap in excess death rates between Republicans and Democrats is concentrated in counties with low vaccination rates and only materializes after vaccines became widely available.

Traffic-Stop Practice in Connecticut

In The Politics of Autism, I discuss interactions between police and autistic people.  Sometimes they occur on the road.  A number of ASD people drive cars.

In New London, CT, Erica Moser at The Day:

First in a line of several cars in the Fitch High School parking lot on a rainy morning, a driver was in what would otherwise be an odd circumstance: He was waiting for a cop to pull him over.

But he and about a dozen others showed up Saturday specifically for that reason.

Southern Connecticut State University’s Center of Excellence on Autism Spectrum Disorders teamed up with police departments to hold mock traffic stops for autistic people.

“We know our individuals with autism benefit not just to see something happen but to actually practice, and of course traffic stops make us all nervous,” said Kari Sassu, director of strategic initiatives for the center. But on top of that, she noted that people on the spectrum may have sensory issues associated with lights or sirens, or fear having broken a rule.

Southern held this kind of event on campus last fall and this spring, but Saturday was the first time the center held it elsewhere in Connecticut.

After going through a mock stop and pulling over again to complete a brief survey, Derek Regenauer, 25, said he thought it went well, and that he came because he wanted to have a better understanding of what to do if he got pulled over. His mother, Kara Regenauer, said they had gone to one of the events at Southern but “repetition is good.”

Disability Employment Awareness Month

In The Politics of Autism, I discuss the employment of people on the autism spectrum.

From President Biden:

During National Disability Employment Awareness Month, we celebrate the essential contributions to our workplaces, economy, and Nation made by disabled Americans and recommit to promoting equal opportunity for all people.

For far too long in this country, employers could refuse to hire you if you were disabled. Stores could turn you away. If you used a wheelchair, there was no real way to take a bus or train to work or school. America simply was not built for all Americans. In 1945, President Truman established National Disability Employment Awareness Month and issued the first national call for disabled people to access all the opportunities and rewards of work. Forty-five years later, in 1990, the Congress came together to pass the Americans with Disabilities Act (ADA), which helps to ensure our workforce is more productive, prosperous, and inclusive by banning disability discrimination, including in the workplace. Courageous activists of all backgrounds had fought for decades to lay the groundwork and change public consciousness, and I was proud to cosponsor this groundbreaking civil rights law. Since then, the ADA has not only transformed lives, but it has also inspired over 180 other countries to pass similar laws and brought us closer to realizing the full promise of our Nation.

Still, we have a long way to go. Studies have found that Americans with disabilities are especially productive and motivated workers — but they still have a harder time getting jobs, promotions, and fair pay. They are three times less likely than others to be employed and often earn sub-minimum wages for their work. That is wrong. We have an obligation to change that, and as the Nation’s largest employer, the Federal Government has a responsibility to set an example as a model workplace where everyone is valued and treated with respect. Last year, I issued an Executive Order putting diversity, equity, inclusion, and accessibility front and center across the entire Federal Government. To ensure our Federal workforce actually looks like America, the Executive Order directs agencies to find and remove barriers to hiring and promotion and to recruit more recent graduates with disabilities.

Meanwhile, my Administration’s Labor Department is protecting the rights of workers with disabilities in the private sector, cracking down on employers who discriminate, and ending the unfair use of sub-minimum wages. The Departments of Education, Labor, Health and Human Services, and the Social Security Administration, are helping State and local governments, employers, and nonprofits that hire people with disabilities to access funding for competitive integrated employment opportunities. My Administration’s Bipartisan Infrastructure Law is expanding access to transit, updating old train stations and airports so more people with disabilities can travel and work. We are working to ease the added threat the pandemic has posed to the disabled community and its support networks. Where long COVID has now risen to the level of a disability, we are helping people understand their rights and get the workplace accommodations they need.

This month, let us acknowledge workers with disabilities who make our communities, our economy, and our Nation stronger. Let us continue the legacy of generations of disability rights activists who have fought for equal employment opportunities, integrated workplaces, and equal pay for equal work. Let us deliver the promise of America to all Americans.

NOW, THEREFORE, I, JOSEPH R. BIDEN JR., President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim October 2022 as National Disability Employment Awareness Month. I urge all Americans to embrace the talents and skills that workers with disabilities bring and to promote the right to equal employment opportunity for all.

IN WITNESS WHEREOF, I have hereunto set my hand this
thirtieth day of September, in the year of our Lord two thousand twenty-two, and of the Independence of the United States of America the two hundred and forty-seventh.

Mercola Sues Google

 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.  

Brendan Pierson at Reuters:

A Florida doctor known for spreading false claims about vaccines has sued Google LLC and its parent company Alphabet Inc for removing all of his content from their YouTube video-sharing platform with no advance notice, saying the move breached its terms of service.

In the lawsuit, filed Thursday in federal court in San Francisco, Joseph Mercola asked the court to order Google to reinstate his YouTube account and to award unspecified money damages.

Acetaminophen Litigation

In The Politics of Autism, I discuss various ideas about what causes the condition. 

If you listen to Sirius XM, you may have heard radio ads about a class action lawsuit alleging that acetaminophen causes it.

But there is a very long and growing list of other correlates, risk factors, and possible causes that have been the subject of serious studies:

Reuters:

The Judicial Panel on Multidistrict Litigation will meet today in St. Louis to consider creating nationwide MDLs for three fast-growing areas of product-liability litigation: social media addiction lawsuits, primarily against Facebook and Instagram’s parent Meta Platforms Inc; claims that acetaminophen use during pregnancy increases the child’s risk of autism-spectrum disorders and ADHD; and cases spurred by Exactech Inc’s recent recalls of many of its knee, ankle and hip-replacement products.

...

MDL No. 3043 − IN RE: ACETAMINOPHEN − ASD/ADHD PRODUCTS LIABILITY LITIGATION Dozens of lawsuits have been filed in the past year, quoting recent studies that link pregnant women’s use of acetaminophen to an increased risk of autism spectrum disorders (ASD) and ADHD in their children. In June, plaintiff Aujenai Thompson sought to consolidate 19 actions against the sellers of “store-brand” acetaminophen products for pretrial coordination or consolidation. Since then, more than 30 related actions have been filed, naming Costco Wholesale Corp, CVS Pharmacy Inc, Rite Aid Corp, Safeway, Target Corp, Walgreen Co and Walmart Inc as defendants.

Shocks Continue

In The Politics of Autism, I write:

For those who remain at larger residential institutions, the horrors of yesteryear have generally ended. In 2012, however, a ten-year-old video surfaced, showing disturbing image of an electric shock device at the Judge Rotenberg Center in Canton Massachusetts. Staffers tied one student to a restraint board and shocked him 31 times over seven hours, ignoring his screamed pleas to stop. The Rotenberg Center is the only one in the nation that admits to using electric shocks on people with developmental disabilities, including autism. Center officials said that they had stopped using restraint boards but insisted that shocks were necessary in extreme cases to prevent officials insist the shock program is a last resort that prevents people with severe disorders from hurting themselves or others.

Earlier this year, a federal appeals court overturned an FDA ban on the use of electric shock devices to correct aggressive or self-harming behavior. The Center said it will continue using them.

 From the Arc:

 Medical and disability leaders have worked for years to ban the use of electric shock devices for behavior modification on people with intellectual and developmental disabilities (IDD). The brutal treatment is widely recognized as cruel, harmful, and ineffective. Yet the Judge Rotenberg Center (JRC), an institution in Massachusetts for people with IDD, still subjects its residents to this extreme practice. We prevailed in 2020, but the Food and Drug Administration’s ban of the use of the device was overturned on a technicality just one year later. The Arc and our advocates have been asking Congress to put an end to this barbaric treatment in the 2022 FDA User Fee Package – and they have failed to stand up for the basic human rights of people with disabilities.

Today, Senate and House leaders announced they are moving a bill forward to fund the FDA for another five years without the ban. Initial versions of this bill that passed the House and the Senate HELP Committee with bipartisan support included the ban on the shock device. The Arc of the United States, its 600+ chapter network, and people with IDD and their families are devastated by this omission.

“This practice is torturous and a violation of basic civil rights. We will continue fighting for justice for JRC’s residents by working with our partners to get a ban into the end-of-year spending package and ensuring every single representative prioritizes the health and safety of people with intellectual and developmental disabilities,” said Peter Berns, CEO, The Arc.

Polio Vaccination Rates

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.    Examples include measles, COVID, flu, and polio.

Prof. Jennifer Girotto at The Conversation:

Throughout the U.S., vaccination rates for polio vary significantly.

The CDC recommends that infants and young children receive a four-dose schedule of the inactivated poliovirus vaccine at 2 months, 4 months, 6 to 18 months and 4 to 6 years. For those who begin vaccination later – as older children, teens or adults – three doses is considered to be complete vaccination. This is because three doses of inactivated poliovirus vaccination have been shown to provide between 99% and 100% protection against severe disease.

Although all U.S. states are currently above the 80% herd immunity threshold for poliovirus, there are areas within the country that include many pockets of unvaccinated or undervaccinated individuals – those who have not received a total of three lifetime doses of the inactivated vaccine.

New York state, for example, holds one of the highest kindergarten polio vaccination rates in the country, with 97.9% of kindergartners vaccinated in the 2020-2021 school year. But current estimates by the New York State Department of Public Health suggest that only 79% of 2-year-olds in that state have received three doses of the polio vaccine.

Further, in certain pockets and counties of New York, such as Rockland, Orange and Sullivan, three-dose vaccination rates may be far lower based on the 2-year-old age group, which is the only data that is available by county: Rockland 60%, Orange 59% and Sullivan 62%. In fact, 46% of counties in New York are below the three-dose poliovirus vaccination herd immunity threshold for 2-years-olds

.

Senate Votes to Reauthorize Kevin and Avonte's Law

The Politics of Autism discusses the problem of wandering, which has been the topic of legislation before Congress.

From Sen. Chuck Grassley:

Just four days after it was introduced, legislation to help families locate missing loved ones with Autism, Alzheimer’s disease and related conditions unanimously cleared the Senate Thursday. The bill to extend Kevin and Avonte’s Law, was introduced Monday by Judiciary Committee Ranking Member Chuck Grassley (R-Iowa) and Senator Amy Klobuchar (D-Minn.).

The original law, authored by Grassley and passed in 2018, is named in honor of two boys with autism who perished after going missing. The extension that passed Thursday continues programs established under the law to support training for caregivers to prevent and respond to instances of wandering.

“The Senate’s swift adoption of our bill honors the legacies of young Kevin and Avonte, and demonstrates our commitment to helping communities locate loved ones whose conditions cause them to wander. It’s a commonsense, time-tested bill that’s been instrumental in reuniting families – exactly the kind of policy that Congress should pass without delay,” Grassley said.

“We must do everything we can to support people who are diagnosed with Alzheimer’s, autism, and other developmental disabilities,” said Klobuchar. “Our bipartisan legislation will ensure that caregivers and law enforcement have the tools and training they need to act when these Americans go missing. Reauthorizing this bill will help families locate their loved ones, prevent tragedies and save lives. Now that it has passed the Senate, I look forward to seeing this legislation signed into law.”

The bill is named in honor of two young boys diagnosed with autism who wandered away from supervised settings and drowned. One of the two, nine year-old Kevin Curtis Wills, died in 2008 in the Raccoon River near his home town of Jefferson, Iowa. The other, high school student Avonte Oquendo of Queens, New York, drowned in NYC’s East River in 2014. Six year-old Hamza Elmi of St. Cloud, Minnesota, who was also diagnosed with autism, drowned in the Mississippi River near his home in 2015.

The bill reauthorizes an alert program to help notify communities about missing individuals with Alzheimer’s Disease, autism and other developmental disabilities. It also allows Justice Department grants to be used for state and local education and training programs to help prevent wandering and reunite caregivers with missing family members who have a condition linked to wandering. Along with Grassley and Klobuchar, the bill is also cosponsored by Sen. Thom Tillis (R-N.C.) and Senate Majority Leader Chuck Schumer (D-N.Y.). It must now be passed by the U.S. House of Representatives before it can be signed into law.

“The Autism Society of Iowa strongly supports the reauthorization of Kevin and Avonte’s Law and we thank Senator Grassley for his leadership on this important issue,” said Kris Steinmetz, Executive Director of the Autism Society of Iowa.

“The Autism Society of America applauds the introduction of a bill to reauthorize Kevin and Avonte’s Law. The law honors the memory of Kevin Willis and Avonte Oquendo, two boys with Autism who drowned after wandering from a supervised setting. This law has resulted in increased training of first responders and helped reduce the number of injuries and deaths of people with Autism due to wandering. These trainings are extremely important and must continue and be increased. The Autism Society supports Senator Grassley's leadership on this issue and stands ready to help move this bill quickly through Congress,” said Christopher Banks, President and CEO of the Autism Society of America.

“Autism Speaks strongly supports the reauthorization of Kevin and Avonte’s Law, and we are grateful to Senators Grassley and Klobuchar for their leadership in bringing this bill forward. Since its passage, Kevin and Avonte’s Law has resulted in local communities across the country receiving $10 million in critical funding for programs to reduce the dangers associated with wandering, a common behavior among autistic individuals that puts tremendous stress on families and tragically has resulted in far too many injuries and deaths. We applaud the sponsors of this legislation for their efforts on behalf of the autism community and urge swift passage,” said Keith Wargo, President and CEO of Autism Speaks.

The bill is also supported by the National Center for Missing and Exploited Children.

Read more about the original Kevin and Avonte’s Law HERE.

Autism Centers for Excellence

In The Politics of Autism, I discuss the National Institutes of Health.

 From NIH:

The National Institutes of Health has awarded a total of $100 million over the next five years to support nine Autism Centers of Excellence (ACEs). This endeavor funds large research projects to understand and develop interventions for autism spectrum disorder (ASD). Created in 2007, the ACE program is renewed every five years.

ASD is a complex developmental disorder affecting how a person behaves, interacts with others, communicates, and learns. The U.S. Centers for Disease Control and Prevention estimates that ASD affects nearly 2% of 8-year-olds in the United States.

The ACE program supports research on the diagnosis, causes of, and interventions for ASD. It also seeks to facilitate innovative and cost-effective services for people with ASD throughout the lifespan. The awards support research at individual centers, which feature collaboration between teams of experts, and at research networks, which involve multiple institutions, dedicated to the study of ASD. Each center and network focus on a specific research topic.

Each ACE will adopt a specific Plan for Enhancing Diverse Perspectives (PEDP) as part of its proposed research project. The PEDP will outline strategies to increase participation of women and individuals from traditionally underrepresented groups in the ACE biomedical, behavioral, and clinical workforce. Additionally, the PEDP is intended to increase the participation of underrepresented and underserved populations in research.

Community engagement is also a core feature of the ACE program. Each ACE will have an external advisory board that includes individuals with ASD and/or parents of individuals with ASD as members. In addition, ACE investigators will engage with the ASD community to learn about their needs and research concerns and to inform them about research findings and plans for future studies.

The ACE program is supported by NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institute of Mental Health, National Institute on Deafness and Other Communication Disorders, National Institute of Neurological Disorders and Stroke, and National Institute of Environmental Health Sciences.

"Evidence-Based"

Uncertainty is a major theme of The Politics of Autism.  In the concluding section, I write:

A key question in autism policy evaluation is simple to pose, hard to answer: How do autistic people benefit? How much better off are they as a result of government action? While there are studies of the short-term impact of various therapies, there is surprisingly little research about the long term, which is really what autistic people and their families care about. As we saw in chapter 4, few studies have focused on the educational attainment of autistic youths. For instance, we do not know much about what happens to them in high school, apart from the kinds of classes that they take. One study searched the autism literature from 1950 through 2011 and found just 13 rigorous peer reviewed studies evaluating psychosocial interventions for autistic adults. The effects of were largely positive, though the main finding of the review is that there is a need for further development and evaluation of treatments for adults.

 Giacomo Vivanti has a commentary at Autism Research titled, "What does it mean for an autism intervention to be evidence-based?"

Abstract:

Although there is consensus in the field that individuals on the autism spectrum should receive interventions that are evidence-based, the concept of “evidence-based” is multifaceted and subject to ongoing development and debate. In this commentary, we review historical developments, methodological approaches, as well as areas of controversies and research directions in the establishment of an evidence base for autism intervention.

From the commentary:

A relevant dimension of what is tested in a trial is the distinction between efficacy trials and effectiveness trials. Efficacy studies are designed to determine whether an intervention produces beneficial effects under optimal circumstances, that is, well-controlled settings in which a variety of potential confounds are controlled for. For example, in an efficacy trial the intervention might be delivered by highly trained clinicians, with frequent fidelity checks and corrective feedback/re-training in case of low adherence to intervention protocols, often supported by University-based research grants. Additionally, participants might be selected to be homogenous across multiple dimensions, such as age, IQ, absence of specific comorbidities, availability to receive intervention at home or in a clinic for multiple hours per week, and the intervention might be delivered in research settings on top of the usual care that is normally available through community services. By maximizing homogeneity in standards of intervention delivery, participant features, and intervention features (e.g., duration, intensity), efficacy trials allow for causal inference on the internal validity of an intervention (i.e., they address the question “can the intervention work under ideal circumstances?”). The inherent limitation of efficacy trials is that participants, resources, settings, and interventionists might not resemble those in real-world settings, limiting generalizability of the results.

To address this issue, efficacious interventions should then be subject to tests of effectiveness, which measure the degree to which the beneficial effects documented in efficacy trials are obtained when the same intervention is delivered by non-University-based practitioners within normative “usual care” contexts, for example, community clinical or educational settings, and across the populations that those settings have the mandate to serve, for example, individuals who have multiple diagnoses in addition to autism. In these contexts, it is often unfeasible to assign participants to intervention conditions at random without interfering with regulatory constraints, mandates, and performance standards by which agencies are held accountable. Therefore, especially for interventions previously shown to be efficacious in tightly controlled RCT, effectiveness trials might use a quasi-experimental design (Handley et al., 2018), whereby participants are not randomly assigned to different conditions (e.g., a study comparing outcomes of two preschool programs, using children who have previously enrolled in those programs as participants; Boyd et al., 2014; Vivanti, Prior, et al., 2014; Vivanti, Paynter, et al., 2014). Although the lack of randomization in this type of studies increases the risk of bias (for example, one setting might be only accessible to more resourceful families, introducing a systematic bias), the combination of efficacy and effectiveness trials has the potential to accomplish both indication of internal validity and impact of the intervention in real world settings. Importantly, despite the previously mentioned challenges, there is a small but growing literature of effectiveness studies that use RCT designs (e.g., Kaale et al., 2012; Vivanti et al., 2019).

An Incident in Kansas

In The Politics of Autism, I discuss interactions between police and autistic people.  Police officers need training to respond appropriately.  When they do not, things get out of hand. 

Tim Hrenchir at the Topeka Capital-Journal

A Jackson County sheriff's deputy used his Taser on a 12-year-old autistic boy without warning as the youth sat handcuffed, shackled and hogtied in the deputy's vehicle.

The state's law enforcement oversight body says Matthew Honas on Feb. 23 used excessive force multiple times on the boy, including tying him up in a manner that threatened "his ability to breathe properly."

The Kansas Commission on Peace Officers' Standards and Training on Aug. 22 issued an order of reprimand to Honas. While Honas was discharged March 3 from his deputy's job in Jackson County, the commission chose not to revoke his certification as a law enforcement officer.

The encounter was captured on Honas' in-car camera, KSCPOST said.

Jackson County counselor Lee Hendricks rejected The Topeka Capital-Journal's open records request for the video.

Polarization and Vaccination

 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.

Unfortunately, Republican politicians and conservative media figures are increasingly joining up with the anti-vaxxers.   Even before COVID, they were fighting vaccine mandates and other public health measures.

At The American Journal of Public Health, Kevin Estep and colleagues have an article titled "Partisan Polarization of Childhood Vaccination Policies, 1995‒2020."

Abstract

Objectives. To examine trends in partisan polarization of childhood vaccine bills and the impact of polarization on bill passage in the United States.

Methods. We performed content analysis on 1497 US state bills (1995–2020) and obtained voting returns for 228 legislative votes (2011‒2020). We performed descriptive and statistical analyses using 2 measures of polarization.

Results. Vote polarization rose more rapidly for immunization than abortion or veterans’ affairs bills. Bills in 2019–2020 were more than 7 times more likely to be polarized than in 1995–1996 (odds ratio [OR] = 7.04; 95% confidence interval [CI] = 3.54, 13.99). Bills related to public health emergencies were more polarized (OR = 1.76; 95% CI = 1.13, 2.75). Sponsor polarization was associated with 34% lower odds of passage (OR = 0.66; 95% CI = 0.42, 1.03).

Conclusions. State lawmakers were more divided on vaccine policy, but partisan bills were less likely to pass. Bill characteristics associated with lower polarization could signal opportunities for future bipartisanship.

Public Health Implications. Increasing partisan polarization could alter state-level vaccine policies in ways that jeopardize childhood immunization rates or weaken responsiveness during public health emergencies. Authorities should look for areas of bipartisan agreement on how to maintain vaccination rates. (Am J Public Health. 2022;112(10):1471–1479. https://doi.org/10.2105/AJPH.2022.306964)

From the article:

The trends we have identified can be explained, in part, by the rise and fall of controversies during this timeframe. Beginning in 1998, Democratic and Republican lawmakers alike were focused on the possibility that the mercury-containing vaccine preservative thimerosal could be linked to autism. The high frequency of bills to prohibit mercury in vaccines and to expand access to exemptions in the early 2000s were almost certainly motivated by these safety concerns.13 However, a 2004 Institute of Medicine report established the scientific consensus against the autism‒mercury hypotheses, the Lancet retracted the study that first proposed a vaccine‒autism link because of ethical and scientific concerns, and the study’s lead author, Andrew Wakefield, was removed from the United Kingdom’s registry of physicians in 2010.13,14,28

Faced with the loss of legitimate scientific arguments, leaders of vaccine-critical organizations were compelled to innovate new narratives that might resonate with blocks of potential supporters.28 In their analysis of antivaccine Facebook pages from 2009 to 2019, Broniatowski et al.17 found a decreasing prevalence of safety or efficacy concerns and an increasing emphasis on protecting individual liberty from government intrusion. This shift in emphasis from safety to parental freedom would certainly have been felt by policymakers. Legislators might strongly disagree about whether certain vaccines are safe for children, but such disagreements are not inherently partisan. By contrast, as vaccine policies became increasingly framed in terms of individual liberty versus the state, legislators might have faced mounting pressure to choose their side based on adherence to conservative or progressive views on the appropriate role of government.

 Olafimihan Oshin at The Hill:

Anthony Fauci, the nation’s top infectious disease expert, said in a new interview that the “anti-vaxxer attitude” of some Americans risks causing non-COVID virus outbreaks in the U.S.

“I’m concerned the acceleration of an anti-vaxxer attitude in certain segments of the population . . . might spill over into that kind of a negative attitude towards childhood vaccinations,” Fauci told The Financial Times in an interview published Sunday.