This marked up version of the table was not from the Mitkus study in 2011. It was a study by Yokel in 2008 and it's obvious to really anyone that it has been marked up in a way that wouldn't have been published in this form. The date on the table (2008) also gives this away.
The reason I recognized this screenshot is because another antivaxxer, Harold Clarkson aka RGTWINGBLKMAN aka boglethemind, is the one I assume who marked up the original Yokel table with some pretty bad math during the course of a long Twitter discussion regarding vaccine aluminum. Harold, like all antivaxxers, claims that vaccine aluminum is dangerous and a neurotoxin that results in neuroinflammation somehow related to autism. Harold has an issue with an extremely detailed article by a BBB (blood brain barrier) scientist I linked to about vaccine aluminum and how the bioavailability of aluminum is very small even compared to oral aluminum ingestion.
During the course of this discussion, Harold made several factual errors that he has also neglected to acknowledge to date even before this latest math disaster.
(1) He mistakenly believed that the FDA limits for vaccine aluminum is 5 mcg/kg/day.
What Harold never admitted to (instead playing the very Dunning-Kruger-esque "I'm educating you..." card), is that this limit is not the one established for vaccine aluminum. This limit is for parenteral (IV) administration of aluminum - typically in the form of parenteral nutrition (TPN). The actual limits for vaccine aluminum set by the FDA is:
Harold was the one to be educated on this point.
(2) It gets worse. One would assume that anyone arguing about vaccine aluminum would at least know that vaccines are not, in fact, given IV. This fact seemed to have escaped Harold's knowledge when I pointed out to him that, by definition, vaccines cannot have 100% bioavailability because they are not given IV. This explains why he made his error above.
(3) Harold tries to pass off numbers from a study on aluminum by Flarend claiming that the numbers in his homemade table was "real math" from the study but, as it turns out, these were not actual figures from the study. He backpedaled later that the numbers he originally claimed were from the study, were actually what he (incorrectly) "calculated".
(4) Oddly, after pointing out his dishonesty regarding his fabricated numbers from the Flarend study, he starts demanding I "retract" what I said and threatening me for unclear reasons. When asked what I would "regret", he avoided answering.
(5) Harold's latest claim to which he still hasn't acknowledged his basic math and logic errors, is the dissemination of the marked up table referred to above. He continued to tweet this table several times believing himself to be clever in "correcting" Yokel's table and its use in the BBB Scientist's article. Here it is again.
Here's a bigger version to see the wrong calculations he made.
Now, where to start.
In the purple box at the top, he's trying to adjust the table according to the amount of oral feedings that an infant takes on a roughly daily basis at around 6 months of age and average weight of 5.8 kg. These numbers look right to me and can be corroborated in the Children's Hospital of Philadelphia page about vaccine aluminum. (scroll down to "Quantities of aluminum in other substances")
Error #1 - Harold didn't calculate the range of daily Al absorbed for oral intake correctly. The authors used oral intake for adults and took the smallest daily Al exposure divided by an average weight of an adult and then multiplied by the lowest amount of absorption for the low end of the range. Harold should have used the highest daily Al exposure (the amount he inserted for a typical 6 month old) divided by an average weight of a 6 month old and then multiplied by the highest amount of absorption for the high end of the range:
650 mcg divided by 5.8 kg then multiplied by 0.003 = 0.336 mcg/kg/day rather than 0.11 mcg/kg/day - 3 orders of magnitude higher. This is an important error to correct.
Error #2 - in the line for vaccine aluminum amounts, in the column entitled "absorption", it says "100 eventually" which is odd to list this as (1) there is no 100% bioavailability of an IM/SQ injected vaccine (and demonstrates why there's a difference between bioavailability and absorption) and (2) the daily rate is being determined here and we know that aluminum adjuvant (AA) is absorbed very very slowly following injection. In other words, it isn't simply absorbed in one day. The correct absorption should be based on the Flarend study of 0.6%. (BBB scientist explains why he came to this figure in his article). Harold missed this (or ignored it) & at one point, even tried to claim "100% bioavailability".
650 mcg divided by 5.8 kg then multiplied by 0.003 = 0.336 mcg/kg/day rather than 0.11 mcg/kg/day - 3 orders of magnitude higher. This is an important error to correct.
Error #2 - in the line for vaccine aluminum amounts, in the column entitled "absorption", it says "100 eventually" which is odd to list this as (1) there is no 100% bioavailability of an IM/SQ injected vaccine (and demonstrates why there's a difference between bioavailability and absorption) and (2) the daily rate is being determined here and we know that aluminum adjuvant (AA) is absorbed very very slowly following injection. In other words, it isn't simply absorbed in one day. The correct absorption should be based on the Flarend study of 0.6%. (BBB scientist explains why he came to this figure in his article). Harold missed this (or ignored it) & at one point, even tried to claim "100% bioavailability".
Errors #3 and #4 is his calculation of the daily AA absorbed in mcg/kg/day - this one I just can't figure out why Harold chose to do it this way - it makes zero sense. The green box demonstrates his calculation of the amount of AA in mcg/kg/day. The authors took the aluminum concentration and, when calculating the daily aluminum exposure, used 20 injections over 6 years to determine the daily AA exposure. For example, using the higher end for dose:
850 mcg x 20 injections divided by 2160 days (6 years) = about 8 mcg/day. To determine the daily Al exposure in mcg/kg/day, you just divide 8 by 20 kg (the weight of an average 6 year old) = 0.4 mcg/kg/day. (the authors assumed 100% absorption).
Harold wants to substitute vaccines given over 6 months (rather than 6 years) and use the average weight of a 6 month old (instead of a 6 year old). The correct math should be (for the higher end of the range):
8 mcg/day divided by 20 kg (weight the authors used) x 0.006 (the actual daily absorption from Flarend) = 0.0024 mcg/kg/d. This number is quite a bit smaller than the higher end of the range of AA absorbed orally (the one he calculated incorrectly). To find out how much AA that is for a 6 month old, you would multiply this rate (0.0024 mcg/kg/d) by 5.8 kg (average weight of a 6 month old) = 0.01392 mcg/day.
Why Harold multiplied the daily AA absorption by 20 kg and then divided by 5.8 kg is the mystery. That makes no mathematical sense at all as this is a rate already expressed in mcg/kg/day.
But there's a further problem that Harold seemed to ignore entirely....
Error #5 - this error was actually in his favor. I think in his fervor to generate what he thought was a "slam dunk win" in this "corrected" table, he didn't realize that the amount of vaccine given - the AA concentration and daily AA exposure are still for a 6 year old given 20 injections. He should have adjusted these numbers to account for the amount of AA given in the first 6 months of life. This amount increases the calculations significantly but, in the end, given the daily bioavailability of about 0.6%, it's still not as much as what a child can consume on the high range of oral intake.
The correct numbers would be (at least in my office):
Al "concentration" = hep b x 1, pediarix x 3, prev x 3, HiB x 2 = 500 mcg (I'm using the highest possible - it's actually usually 250 mcg) + (850 mcg x 3) + (225 mcg x 2) + (125 mcg x 3) = 3875 mcg
Daily Al exposure = 3875 mcg divided by 180 days = 21.5 mcg.
Using a daily bioavailability of 0.6%, the amount of daily AA absorbed = 21.5 divided by 5.8 kg x 0.006 = 0.022 mcg/kg/day.
Al "concentration" = hep b x 1, pediarix x 3, prev x 3, HiB x 2 = 500 mcg (I'm using the highest possible - it's actually usually 250 mcg) + (850 mcg x 3) + (225 mcg x 2) + (125 mcg x 3) = 3875 mcg
Daily Al exposure = 3875 mcg divided by 180 days = 21.5 mcg.
Using a daily bioavailability of 0.6%, the amount of daily AA absorbed = 21.5 divided by 5.8 kg x 0.006 = 0.022 mcg/kg/day.
Comparing this number to what's absorbed via ingestion, AA exposure is either 3x more via vaccine OR 15 times less than ingestion depending on whether an infant is breastfed or formula (soy) fed. A corrected table would look like this:
Admittedly, you can argue about the use of Flarend's 0.6% daily bioavailability given that some of the vaccine doses are given on the same day, but what I'm really just addressing is the math Harold presented and why both his math and his logic was deeply flawed and frankly in error.
I've waited 3 days for Harold to come forward and admit his math errors and finally just got tired of asking him to do it for himself. I assume that he couldn't reconcile his own math which was clearly wrong. This is just another example of antivaxxers who lack the basic knowledge of pharmacology, immunology, and, well, math but choose to argue against vaccines anyways. Poorly done, at that, and certainly not to their credit.
***edited to add (1 October 2017): Now Harold believes that I am the author of the BBB Scientist article about vaccine aluminum. I just had to throw this in as yet another error that he's made in the course of this long exchange. And because it's just plain funny.
***edited to add (6 October 2017): Now Harold believes I'm a "bot" and has made a "formal request" to have his "rebuttal" added to my blog. He's even resorted to making threats as well. This just keeps getting more entertaining....
Harold is going off the deep end again claiming that aluminum adjuvant is absorbed 100% and suggesting that this translates to 100% bioavailability. Despite redirecting him back to the BBB scientist article that cites both Flarend and Mitkus regarding pharmacokinetics demonstrating that aluminum adjuvant is not 100% bioavailable, he continues to pretend that there are no citations that demonstrate this fact. Antivaxxers also continue to dishonestly suggest 100% bioavailability of vaccine aluminum adjuvant. Harold's latest humorous error (#6 now) is claiming that the BBB scientist said this:
What the BBB scientist actually said was this:
The BBB scientist is referring to the 2015 vaccinepapers.org article that was "recycled" by Jeffrey Roberts at Collective Evolution. He links to the April 2017 Collective Evolution article that resurrected (aka recycled) 2015 article. If I didn't say it before, I'll say it now. Harold's Dunning-Kruger is absolutely stunning.