After years of struggle, and some truly distressing failures, this is the one and only successful HIV vaccine trial.

It was definitely took an odd approach. Take two failed vaccines, combine them together, and see if they’ll work. The first vaccine stuffed into a tamed Canarypox virus some of the critical functional proteins of the HIV virus. (Canarypox is in the same broad family of viruses that includes Smallpox. Birds are the desired home of Canarypox; it’s capable of getting into human cells, but not properly replicating itself once in. As such, it has the ideal vaccine combination of really pissing off the human immune system while being incapable of causing injury.) The second, booster, vaccine was simply some of the purified and isolated surface protein (gp120) from the HIV virus. (This booster vaccine is a bit like going around the human immune system with a mugshot of the HIV virus. The isolated protein is incapable of causing disease, but gives the whiff of what the real deal is like.) When the study was first proposed, parts of the scientific community were non-plussed. Isn’t zero times zero still zero?

Nope, it’s one third. What do you do with a vaccine that only works sometimes, or only for some? For a vaccine to be considered clinically useful (i.e, after the shots are done, you can feel confident in telling someone they are vaccinated and protected against the infection), you’d hope to have at least 70-80% of those vaccinated to be protected. (Herd immunity takes care of the rest of the risk, eventually.) Further, this vaccine combination (bizarrely) failed to produce neutralizing antibodies even in the successfully vaccinated.

For the next few months and years, the results of this study will be torn into, trying to answer some of these questions. In the meantime, this is an extremely heartening sign–indicating a real potential to salvage other failed vaccines into successful combination therapies.

Autism is not caused by vaccination.

Autism is not caused by vaccination.

Autism is not caused by vaccination.

Autism is not caused by vaccination.

Autism is not caused by vaccination:

…..a special federal court ruled Thursday that the measles-mumps-rubella vaccine and vaccines that contained a mercury-based preservative were not connected to the autism that developed in three children.

Can we please–pretty please, with a cherry on top–please, please, please stop looking for a causal connection between vaccination and autism? Please? Because, after decades of intensive research–I could have found hundreds upon hundreds of published studies looking into this question, each demonstrating a lack of connection, or unconvincing connections or correlations–we have the answer: Vaccines do not cause autism.

Given how little money is available for scientific research in general, and research on pediatric health in particular, this is just simply wasteful. Criminally wasteful. The continuing obsession by some parents–absolutely certain in the existence of a non-existent connection between vaccination and autism–is wasting precious time and money. This money could be used to develop therapies for autism, to look for far more promising causal agents or studying other serious illnesses of childhood.

Please. Please. Vaccines don’t cause autism. Can we stop asking now?

Let’s look at the data, thanks to a recently published article in PLoS Medicine surveying drug usage worldwide. How do we rank, next to the decadent drug-tolerant nations of the world. Hell, let’s make it easy and compare ourselves to the Netherlands. With all we’ve spent and sacrificed, we’ll certainly beat the Dutch, with their hash-bar loving ways.

First the legal drugs:

Ah, we can clearly see the perfidious Dutch are approximately as drunk as we are–up there with such unsavories as the Ukrainians and Germans. We tried prohibition and gave up. See what it did?

At least we show some leadership on the whole tobacco issue. Nothing more American than a Southern farm pumping out the good leaf.

Now on to the illicit.

Ahem. Well, despite pot being illegal in the US, and defacto legalized in the Netherlands, we end up at least trying pot at twice the rate. Certainly our draconian drug policies should at least keep hard drugs away from good and decent Americans.

Ahem. The taste of hard-fought and sweet success.

Snark aside, I think this is a quite good survey. But, we should be cautious before drawing too many causal connections.

The methodology seems quite solid, with the same survey used in each country–keeping comparisons between countries meaningful. Even the structure of the interview was shared between nations. Bilingual supervisors of the study were used for every country that participated. This in contrast to many similar studies that merely aggregate many individual surveys specific to a given nation–surveys that can differ dramatically in the both the questions asked and how the questions were asked. I’d be more apt to believe the comparisons in this study than the prior.

By asking “have you ever used,” the stigma threshold is also probably reduced–leading to more accurate responses. This is mostly speculation on my part, so feel free to disagree. On the converse, the rates of regular drug usage are probably quite different from this most lenient standard.

So far as inferences, there certainly was no correlation between the severity of a country’s drug laws and rates of drug usage. If drug laws did work, we’d at least expect some negative corrolation; while this doesn’t prove drug law are ineffective, it doesn’t really support the notion at all.

Some of the rates went against my expectations–Don’t the French supposedly smoke like chimneys? Neat.

Congratulations on your last day at Microsoft and welcome to the world of biomedical research!

Everyone I know who endured a ‘billg’ review agrees—you’re apparently a bit of an ass. Quick to question and call bullshit, to point out errors or inconsistency, and to demand the best, willing to yell if yelling is needed.

Excellent! We need an ass working in public health right now–right here in the United States. Peter J. Hotez makes the case in PLoS Neglected Tropical Diseases:

In 1962, an estimated 40 million Americans lived in poverty, almost one-quarter of the US population. Today, the poverty rate in the US is roughly half of what it was when The Other America was first published, however, the total number of people living in poverty remains about the same. We now recognize that this group of 36.5 million impoverished Americans is at higher risk for heart disease, cancer, and other chronic diseases compared to the rest of the US population. However, it is not well known that just as the poorest people in the low-income countries of Africa, Asia, and Central and South America have the highest rates of the neglected tropical diseases (NTDs), there is evidence to suggest that large numbers of the poorest Americans living in the US also suffer from some of these unique infections.

Like what? Hookworm–causing malnutrition and severe anemia–is assumed to be eliminated in the South. Why assumed? We stopped looking for it in 1970. The last study completed showed the disease still exists. Why stop looking? “…because they only occur among impoverished people and mostly underrepresented minorities, I believe that there has been a lack of political will to study the problem, so that these diseases of poverty have been allowed to simply remain neglected,” notes Dr. Hotez.

Another?

Imagine this Toxocariasis worm slowly chewing its way through your body–migrating through your skin, causing horrible itching, through your lungs, causing horrible asthma, and even across your eye.

We know that playgrounds in poor cities are full of toxocariasis eggs. In Bridgeport and New Haven Connecticut around 10% of children have evidence of current or past infection with these guys. Ten percent!

Another? Cysticercosis tapeworms are surprisingly common, particularly among Hispanics.

This tapeworm, in the process of smashing the brain, can cause seizures; in certain Los Angeles hospitals about 10% of seizures are caused by cysticercosis.

I’ll let Dr. Hotez finish up for me:

We need to begin erasing these horrific health disparities by stepping up measures to conduct active and national-scale surveillance for soil-transmitted helminth infections, especially toxocariasis, as well as cysticercosis and congenital toxoplasmosis. In addition, based on data suggesting that the NTDs cutaneous leishmaniasis, ratborne leptospirosis and hantavirus infection, dengue fever, brucellosis, tuberculosis caused by Mycobacterium bovis, trichomoniasis, and louse-borne trench fever are emerging among the poor in the US, it is imperative that we address these conditions as well…

The fact that reliable numbers on the actual prevalence of the NTDs are simply not available is reflective of their neglected status, and their disproportionate impact on minorities and poor people. There is an urgent need to support studies that (1) assess the disease burden resulting from the NTDs in the United States and (2) identify the minority populations at greatest risk, and then to (3) identify simple and cost-effective public health solutions. Accordingly, PLoS Neglected Tropical Diseases is pleased to consider and review articles on this vitally important topic. There are no excuses for allowing such glaring health disparities to persist in one of the world’s wealthiest countries.

We don’t like hard realities in the United States. We don’t like thinking of ourselves as in the same category as the poorest nations on the planet. When it comes to horrific diseases, the poor in the United States might be as burdened as the poorest around the world. Human beings with these diseases cannot study, cannot develop fully, cannot reach their full potential. To not even bother looking, to willfully ignore the problem is deeply immoral.

We need an ass to stand up and demand we find out the true extent of this problem, demand we accept reality so that we can start to fix it. BillG, you are just than man for the job. Have at it!

With Sincerity,
Jonathan Golob