Critiques of Holland et al., Unanswered Questions From The Vaccine Injury Compensation Program

The "Revealing Link Between Vaccine Settlements and Autism" law review paper

On "Probe to Reveal Link Between Vaccine Settlements and Autism" referring to Holland M, Conte L, Krakow R and Colin L, (2011) Unanswered Questions From The Vaccine Injury Compensation Program: A Review of Compensated Cases of Vaccine- Induced Brain Injury 28 Pace Environmental Law Review pages 480-543 [ Download Unanswered Questions from the Vaccine Injury Compensation Program]. 

This paper in the Pace University Environmental Law Review (a law student journal) is being referred to by various nicknames,  the Holland study, "the Pace study", the EBCALA study (for Elizabeth Birt Center for Autism Law and Advocacy).

Critiques of the study:

• David Gorski MD at Science-Based Medicine: When You Can't Win on Science, Invoke the Law
• Robert Lowes at Medscape: Anti-vaccine Activists Claim that Court Paid for Autism Cases
• Kevin Leitch at LeftBrain/RightBrain: When The Science Fails You, Turn to the Law
• Seth Mnookin at the Panic Virus: The Latest Claims of 'Proof' That Vaccines Cause Autism: Will the Media Take the Bait?
• Seth Mnookin at The Panic Virus: And the Winner Is...Fox News
• Lisa Jo Rudy at About.Autism.com Update on Vaccine Court Publication Raises Questions ("I have no further information about why the press release was rewritten to suggest the involvement of Pace Law School investigators, nor why the investigation was published, not in a major law journal, but in a student-run publication.")
• Orac Knows at Respectful Insolence Another Swing for the Fences and A Miss by the Anti-Vaccine Movement
• Ken Reibel at Autism News Beat: Unanswered Questions frm the Pace Law Journal Study: Ethical Standards for Research on Human Subjects
• Sullivan at LeftBrain/RightBrain Study by NYU and Pace: Another Failure in Obtaining Ethical Approval?
• Prometheus at Photon in the Darkness: 2 1/2 Studies: Autism Prevalence and "The Hidden Horde"

 

Summary of critiques:

The core of the argument in Holland et al appears to boil down to the following claims.

• Autism, "autism-like" symptoms, and encephalphathy are all the same thing. "Because autistic disorder is defined only by an aggregation of symptoms, there is no meaningful distinction between the terms “autism” and “autism-like symptoms.” and on page 495, an even further distortion of the DSM-IV definition of autism, One must note that the DSM-­IV definition of “autistic disorder” is similar on its face to the VICP’s definitions of “encephalopathy, seizures and sequela.”

This is an astonishing and counter-factual claim. A diagnosis of autism is made using the DSM-IV criteria; a person must exhibit  enough of the criteria to recieve an autism diagnosis. I like Orac's two examples:" This is akin to arguing that anyone who has a belly ache or diarrhea must have irritable bowel syndrome or that someone who experiences a headache must have migraines."

• Of the more than 2,500 individuals who have been compensated for vaccine injury, 83 have autism (using the authors unique understanding of autism)

This too is an astonishing and counter-factual claim. The method they used was to comb through the all  cases of vaccine injury compensated through March 3, 2011 (according to the footnote on page 522), in the years 1989 to 2011.  Of those cases (which the authors estimate as ”… approximately two thousand five hundred; the actual number as of May is 2,664). 

From that search  identify
  Using their unique understanding of "autism", Holland et al. claim that 83 individuals have been compensated for vaccine injury that includes autism (see table on pp combed through all  cases of vaccine injury compensated through March 3, 2011 (according to the footnote on page 522), in the years 1989 to 2011.  Of those cases (which the authors estimate as ”… approximately two thousand five hundred; the actual number as of May is 2,664).  From that search  identify  83 individuals where compensation  cases, stretching from 1,. During this time, according to the authors, the VICP had  compensated vaccine injury claims.” The footnote mentions that this number was checked on 3 Mar 2011. When I checked (17 May 2011), there were 2,664 compensated claims. According to the VICP, at the end of 2010, there had been 2,524 compensated claims. The authors’ figure lacks the precision available. Second, because they base this estimate primarily on children for whom there are reports of “autistic-like” symptoms or who ultimately developed autism, they argue that there is no difference between autism and having been noted to exhibit “autism-like” behaviors or symptoms.

• Finally, they claim that this means that autism is three times more prevalent in VICP-compensated children than in the general population. Let’s look at these one at a time.

The "83 cases"

The article’s authors are:

Mary Holland, a lawyer who wrote the chapter defending Andrew Wakefield in the recent book Vaccine Epidemic; Louis Conte, the father of two boys he believes are vaccine injured and the former director of something called the “Vaccine Injury Compensation Program Justice Project”; Robert Krakow, who is an attorney who represents clients who have filed Vaccine Court claims and who has filed his own claim on behalf of his son; and Lisa Colin, one of Krakow’s colleagues.

About the Pace Environmental Law Review:

Established in 1982, the Pace Environmental Law Review (PELR) was one of the first scholarly journals in the then-new field of environmental law. It is run and edited by Pace Law School JD candidates.