A more thorough look,,,I call bullsh*t, if the shoe fits (Pt 2)

 
That aside for the moment, my personal favorite anti-vaxx trope by Maher, centers around this statement:

[C]an you do too much of a good thing,,,But in 1983 they gave a third of what they give now.  Is it limitless?  Are there no amount that is too much?

In other words, Maher is asking if the vaccine schedule is "too much, too fast" or "too much, too soon."   Also hidden within that screed is this - antibiotic resistance - which he erroneously conflates to vaccines, as though the consequences of vaccines are horribly resistant bugs (like, oh,,, my MRSA).  Vaccines are not the same as anti-biotics, "smallpox vaccination didn’t result in resistant strains of smallpox. It resulted in the eradication of smallpox!"

But back to Maher and his "too much, too soon" screed.  Here's a bit of background,,,

Initially [An] early complaint among the anti-vaxx crowd blamed autism rates on the vaccine preservative thimerosal, when it was removed from vaccines in or about 2001 (see here for list of Thimerosal Content in Some US Licensed Vaccines) and autism rates continued to rise (cf. Autism and thimerosal-containing vaccines: lack of consistent evidence for an association); affected parents shifted the goal post and decided that it is the vaccine schedule that was the problem.

This "too much, too soon" hypothesis (TMTS) gained a lot of ground in 2008 with the Green our Vaccines (GoV) rally that included Robert F Kennedy, Jr., Jim Carrey and Jenny McCarthy.

,,,the number of vaccines given and the ingredients - like the frickin mercury, the ether, the aluminum the antifreeze - need to be removed immediately,,, (starting at the 1:11 mark)

"Green our Vaccines" is in essence a two-point attack.  There is the "toxin gambit" which deals with the specific ingredients of vaccines (cf. thimerosal and now aluminum) or the actual antigens (the bacterial or viral proteins designed to evoke the protective immune response).  Then there is the flip side, which deals with the number of shots and/or the timing of (at what age and how spaced out) the shots are received.  McCarthy, for example, attacks the ingredients.  "From a scientific standpoint, they were horribly wrong, but from a propaganda standpoint they were brilliant, not the least of which because 'too many, too soon' was [is] much more difficult to falsify than other antivaccine tropes,,,."

So this "toxin gambit" is a tried and tested trope of the anti-vaxx movement used by the likes of Mike Adams, Jay Gordon, Kent Heckenlively, and McCarthy.  (Another name that pops up is Bob Sears.)  Basically, "it consists of listing all sorts of scary-sounding ingredients that are found in vaccines and then trying to argue that vaccines are horrific cesspits of toxins because they contain trace amounts of formaldehyde, for example. It’s a truly stupid, brain dead gambit, but no matter how many times it’s slapped down, there will always be some ignorant antivaccinationist who will resurrect it."

What it is very important to understand when dealing with this gambit is the concept of dose-response relationship; something that is completely ignored.  In other words, as Scott Gavura writing for Skeptic North explains:

What is really bizarre, Jenny McCarthy has to be aware of this concept, why else would she inject herself with one of the most toxic substance currently known.  She campaigns against vaccines because of the "poisons" contained in them, but she has used botox repeatedly.

In a different posting on Facebook concerning dose-response relationship, I used this horrific example Social media mom accused of poisoning son with salt charged with murder; the Spears' trial is still continuing.  Another prime example, albeit a slightly satirical one, DHMO.

But let's take a closer look at TMTS from a science-based outlook,,,

In his article The death of "Too many too soon”: Not a moment too soon, Dr. David Gorski gives an excellent example of why the TMTS/Toxin Gambit is so difficult to defend.  In questioning the experience of anti-vaxxers in regards to the basics of epidemiology, statistical method and the nature of a case control study, Gorski refers to Heidi Stevenson writing at Gaia Health.  (Gorski also takes on Bob Sears and others as well.)  [Note::Gorski's article is referring to this study here by DeStephano et al.  Stevenson's article is no longer available on Gaia Health, but I did find a copy here.]

Quoting Stevenson, Gorski attacks her understanding of why the study was done in the first place. "Why would you want to investigate whether the degree of exposure affects a condition, unless you've already found that it actually causes it?

Gorski's answer: "This study was done to see if there was a connection between vaccine and autism detectable as a difference in vaccine antigen exposure between cases and controls."

Stevenson, again on the same point, "This study, even if well done, would be meaningless simply because it jumps the gun. It makes no sense to do a study on the relative degree of a potential toxin’s effect on autism when no study has yet been done to determine that there is one. Since no such study has been done that officially implicates vaccines as the cause of autism, as explained earlier, what’s the point in doing a study focused on the relative degree of harm?"

In other words Stevenson has no clue as to what a case control study is or what merits its use, "Case-control studies are often used to identify factors that may contribute to a medical condition by comparing subjects who have that condition/disease (the "cases") with patients who do not have the condition/disease but are otherwise similar (the "controls").  They require fewer resources but provide less evidence for causal inference than a randomized controlled trial (RCT)."

Which is exactly what the anti-vaxxers want "a type of scientific (often medical) experiment, where the people being studied are randomly allocated one or other of the different treatments under study."  In essence, the vaccinated versus unvaccinated trope.

But,,,

Gorski actually goes a different route in his discussion concerning the methodology used - case control study versus a cohort study,

After all, case control studies starts with the outcome (presence or absence of disease or condition) and then work back to exposure, while cohort studies start with exposure and work towards outcomes. Each study type has its advantages and disadvantages, but I get no sense that Dr. Bob has any clue about when it is best to use one versus the other.

In questioning both Sears' and Stevenson's cry for a different study other than the DeStephano study, he notes:

,,,case control and cohort studies are different methodologies that each have advantages and disadvantages compared to the other. However, if a case control study as well done as DeStefano et al is so completely negative, there is no scientific justification for proceeding to do a cohort study. Yet that’s exactly what Dr. Sears and a homeopath [Stevenson] are demanding because they think that a different study methodology will show them what this methodology didn’t. No doubt if someone did a cohort study of the type they want and it was negative, they’d proceed to demand a case control study.

But here is where it gets idiotic and why these anti-vaxxers should not be taken seriously.  Not only do they not understand the science or the methodology, they don't even know what the hell it is they are asking for.  As Goski said,  TMTS "is much more difficult to falsify than other antivaccine tropes" and this is why.  Again from Stevenson's article:

They looked at the number of antigens given to each child, both overall for their first two years and the number given on single days. This presumes that the number of antigens, rather than the number of vaccinations is the issue. It completely ignores adjuvants and other vaccine ingredients, including known toxins such as formaldehyde, mercury, and sorbitol 80, among others.

Talk about moving the goalpost!!

While I see a means of getting their "vaccinated versus unvaccinated" studies Gorski rightly asks:  "So which is it? “Too many too soon" or “the toxins"?  I can’t tell. I guess it’s whatever argument happens to be convenient that day for the antivaccinationist making it."

So in 20 or so years, "we" have moved from Andrew Wakfield's MMR causes autism to specifically that it was thimerosal. Then came the “toxin gambit," which led into the “too many too soon” canard.  All have been falsified.  Makes me wonder what they will come up with next, because all that is left as noted by Gorski "are calls for “vaxed versus unvaxed” studies and pharma shill ranting."