Lessons From the Autism-Vaccines War
Researchers long ago rejected the theory that vaccines cause autism, yet many parents don't believe them. Can scientists bridge the gap between evidence and doubt?This week, the open-access journal PLoS Biology investigates why the debunked vaccine-autism theory won't go away. Senior science writer/editor Liza Gross talks to medical anthropologists, science historians, vaccine experts, social scientists, and pediatricians to explore the factors keeping the dangerous notion alive - and its proponents so vitriolic.
Pediatrician Paul Offit has made it his mission to set the record straight: vaccines don't cause autism. But he won't go on Larry King Live - where he could reach millions of viewers - or anyplace celebrity anti-vaccine crusaders like Jenny McCarthy appear. ''Every story has a hero, victim, and villain,'' he explains. ''McCarthy is the hero, her child is the victim - and that leaves one role for you.''
When she read that hecklers were issuing death threats to spokespeople who simply reported studies showing that vaccines were safe, anthropologist Sharon Kaufman dropped her life's work on aging to study the theory's grip on public discourse. To Kaufman, a researcher with a keen eye for detecting major cultural shifts, these unsettling events signaled a deeper trend. ''What happens when the facts of bioscience are relayed to the public and there is disbelief, lack of trust?'' Kaufman wondered. ''Where does that lead us?''
Despite overwhelming evidence that vaccines don't cause autism, one in four Americans still think they do. Not surprisingly, the first half of 2008 saw the largest US outbreak of measles - one of the first infectious diseases to reappear after vaccination rates drop - since 2000, when the native disease was declared eliminated. Mumps and whooping cough have also made a comeback. Last year in Minnesota, five children contracted Hib, the most common cause of meningitis in young children before the vaccine was developed in 1993. Three of the children, including a 7-month-old who died, hadn't received Hib vaccines because their parents either refused or delayed vaccination.
Now, more than ten years after unfounded doubts about vaccine safety first emerged, scientists and public health officials are still struggling to get the story out. Their task is made far more difficult by the explosion of misinformation on the Internet, talk shows, and high-profile media outlets, by journalists' tendency to cover the issue as a "debate," and, as Kaufman argues, by an erosion of trust in experts.
Information technology has transformed the way trust and knowledge are produced, Kaufman says: ''Scientists have to consider their role in this changed landscape and how to compete with these other sources of knowledge.'' Simply relating the facts of science isn't enough. No matter that the overwhelming weight of evidence shows that vaccines don't cause autism. When scientists find themselves just one more voice in a sea of ''opinions'' about a complex scientific issue, misinformation takes on a life of its own.
Lessons From the Autism-Vaccines War
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I Challenge Liza Gross To Interview The Side She Demeans
The foundation of Liza Gross' article is that science has long rejected a vaccine- autism connection. .. It hasn't but Liza would not know that because she has failed utterly to speak to those who would actually provide her the other side of the debate instead of the caricature provided by vaccine patent holder Paul Offit.
Dr. Bernadine Healy has twice pointed out that the epidemiological studies cited to refute a vaccine autism connection are not specific enough to account for population subsets that might be more vulnerable to possible vaccine injury. She has called for observational studies comparing autism rates amongst vaccinated and unvaccinated populations and for more lab and clinical studies. Both the Interagency Autism Coordinating Committee and the NVAC, Nationa Vaccine Advisory Committee have accepted her recommendations for more research along these lines of possible vaccine autism connections.
Dr. Julie Geberding and Dr. Duane Alexandre have also called for more such studies. They are joined amongst others by Dr. Jon Poling the neurologist and father of an autistic child who successfully pursued on behalf of his child a vaccine injury complaint.
In 2004 the IOM Report on Autism and Vaccines expressly discouraged the type of research that would actually inform us as to the extent, if any, of the role played by vaccines , vaccine ingredients and vaccine schedules. In 1999 Teresa Binstock wrote an article pointing out the express discouragement of such research in favor of the "its gotta be genetic model" of autism.
Now at long last the medical establishment is JUST beginning to talk about conducting the necessary research into possible vaccine autism connections and the www is awash with one sided articles such as these which demean concerned parents and trivialize these serious issues.
If, and I repeat, IF, Liza Gross is serous about understanding why the vaccine autism issues are still alive she should do more than repeat faithfully after vaccine patent holder Paul Offit. She should do her homework. She should talk to the people, including the serious, credible health and research professionals like Doctors Healy, Gerberding, Alexandre and Poling, if, and again I repeat IF, she truly wants to understand these issues and why they remain so stronly in the public domain.
If not she should stop wasting the public's time with amateurish attacks on concerned parents and respected professionals who do not share the views of vaccine patent holder Paul Offit.
- AutismRealityNB June 8, 2009 6:39PM
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Evidence based arguments, please
Perhaps AutismRealityNB should save their outrage with Liza Gross until after they have read the complete article at PloSBiology.org
Meanwhile, I would be interested to read any peer reviewed publications on the epidemiology of autism or the safety of vaccines that AutismRealityNB's experts have written. I have already seen Poling's case study on his daughter in which he omitted to mention that he was her father or that they were claiming compensation for vaccine damage. And PubMed revealed nothing on autism by Duane Alexandre and only one autism related article by Duane Alexander. Does AutismRealityNB have anything more substantial to support their position?
- mike stanton
June 10, 2009 5:41PM
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And Vaccine Patent Holder Offit's Autism Expertise Is What Exactly?
Mike Stanton somewhat frivolously dismisses the recommendations of former NIH director Dr. Bernadine Healy, former CDC director Dr. Julie Gerberding and Dr. Duane Alexander current Director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), an NIH agency. He fails to address the fact that their recommendations have largely been adopted by the Interagency Autism Coordinating Committee and the National Vaccine Advisory Committee in the US. Perhaps he should demand to see the credentials and the learned publication history of each member of these health advisory bodies.
As for Dr. Jon Poling he is a neurologist in addition to being the parent who not only brought a vaccine injury claim on behalf of his autistic daughter but brought it successfully.
I assume Mike Stanton was joking when he offered his critique of these senior health professionals and ignored the recommendations of the IACC and NVAC. Perhaps when he decides to provide a more serious response he can provide a list of learned publications on the subject of autism disorders by vaccine patent holder Dr. Paul Offit.
- AutismRealityNB June 10, 2009 7:27PM
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What IACC really said.
AutismRealityNB states that recommendations to further investigate a possible link between vaccines and autism have the support of the Intergency Autism Coordinating Committee. The IACC strategic plan (January 2009) does indeed mention vaccines in two paragraphs which I will quote in full.
"Research on environmental risk factors is also underway. An Institute of Medicine workshop held in 2007 summarized what is known and what is needed in this field (Institute of Medicine of the National Academies, 2007). Numerous epidemiological studies have found no relationship between ASD and vaccines containing the mercury based preservative, thimerosal (Immunization Safety Review Committee, 2004). These data, as well as subsequent research, indicate that the link between autism and vaccines is unsupported by the research literature. Some do not agree and remain concerned that ASD is linked or caused by vaccination through exposure to Measles Mumps Rubella (MMR), imposing challenges to a weakened immune system, or possibly due to mitochondrial disorder. Public comment to the Committee reflected opposing views on vaccines as a potential environmental cause. Those who are convinced by current data that vaccines do not play a causal role in autism argue against using a large proportion of limited autism research funding toward vaccine studies when many other scientific avenues remain to be explored. At the same time, those who believe that prior studies of the possible role of vaccines in ASD have been insufficient argue that investigation of a possible vaccine/ASD link should be a high priority for research (e.g., a large-scale study comparing vaccinated and unvaccinated groups). A third view urges shifting focus away from vaccines and onto much-needed attention toward the development of effective treatments, services and supports for those with ASD."
and
"To address public concerns regarding a possible vaccine/ASD link, it will be important over the next year for the IACC to engage the National Vaccine Advisory Committee (NVAC) in mutually informative dialogues. The NVAC is a Federal advisory committee chartered to advise and make recommendations regarding the National Vaccine Program. Communication between the IACC and NVAC will permit each group to be informed by the expertise of the other, enhance coordination and foster more effective use of research resources on topics of mutual interest. Examples of such topics include: studies of the possible role of vaccines, vaccine components, and multiple vaccine administration in ASD causation and severity through a variety of approaches; and assessing the feasibility and design of an epidemiological study to determine whether health outcomes, including ASD, differ among populations with vaccinated, unvaccinated, and alternatively vaccinated groups."
They recommend
"Monitor the scientific literature regarding possible associations of vaccines and other environmental factors (e.g., ultrasound, pesticides, pollutants) with ASD to identify emerging opportunities for research and indicated studies."
I think it is fair to summarize the IACC position thus.
"The data we have does not support a vaccine-autism link. Some parts of the public remain unconvinced so we will keep an open mind on the subject and if new data emerges we will suggest fresh avenues for research."
Meanwhile there are no recommendations for research or funding for vaccine research in the strategic plan.
- mike stanton
June 11, 2009 1:42PM
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I am still waiting for the control group study
It has always amazed me the number of statistical studies that have been done without a control group, i.e. one that measures the rate of autism among the unvaccinated population. Control groups are a normal part of statistical studies, except in the autism studies.
When I suggest that it would be a good thing to take control group measurements I get:
Ridicule - Leave the science to the scientists. You don't know what you are talking about.
It would be too hard - We would have to sort out all of the other factors in the research. There aren't enough people to sample.
It would be unethical - We can't keep children from being vaccinated! (That population already exists.) People might not vaccinate if we did such a study.
The arguments I have heard against doing a control group measurement are specious. This makes it sound like the old addage: Don't ask the question if you cannot stand the answer.
- EdR77203
June 13, 2009 8:36PM
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Abandoning Ethics
Of course in a perfect world we could do all the control group studies we want with no consequences whatsoever. However the reality exists that we are dealing with human health and human lives here, specifically the lives of children .
The simple truth is that, irregardless of weather or not vaccines cause autism in a small percentage of children who recive, what they do do is prevent diseases, that, before the vaccine was invented literally killed hundreds of thousands of children. Measles, Whooping cough and the like are not the harmless ailments of childhood that we often imagine them to be. They can and do kill kids , especially babies, and can cause permenant brain damage due to high fevers. A drop in vaccination rates for a vaccine free control groups means a rise in preventable deaths, not only among those who were not vaccinated, but in immunocomprimized children and people, and in children with uncompleted vaccination scheduals.
If you are killing people to test your hypothesis, that is unethical, no matter how you slice it. If you would like to like in a world where medical researchers are handed a license to maim and kill with no consequence, that's your prerogative. I'd rather that we maintain the strict ethical standards of science we hold to today.
We've had to work around this in medical research for a very, very long time. When numerous studies show a connection does not exist, you have to move on to new avenues of research - ones that may actually produce a result, studies that may actually help children and treat autism. Science cannot be done by committee, and it cannot be bullied into getting a result that you like.
- UrsulaMinor
June 26, 2009 4:32PM
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