Dr. Andrew Wakefield is one of the most vilified medical practitioners of recent times, and now he carries the extremely rare dishonor of a retraction in The Lancet, on the paper he coauthored in 1998 suggesting a potential link between autism, bowel disease and Measles-Mumps-Rubella (MMR) vaccine.
I believe that the public lynching and shaming of Dr. Wakefield is unwarranted and overwrought, and that history will ultimately judge who was right and who was wrong about proposing a possible association between vaccination and regressive autistic spectrum disorder (ASD).
Wakefield's critics can condemn, retract, decry and de-license all they want, but that does nothing to stop or alter the march of science, which has come a long way over the past 12 years, and especially in the last year or two. The evidence that autism is increasing at alarming rates, and that some thing (or things) in our environment is wreaking havoc on a vulnerable one-percent of all US children is now so irrefutable that, finally, the federal government is climbing aboard the environmental research bandwagon - way late, but better than never.
This long-overdue paradigm shift will leave many in the scientific community with some proverbial but nonetheless uncomfortable egg on their increasingly irrelevant faces: Those who have protested with shrill certainty that autism is almost purely genetic, and not environmental in nature, and therefore not really increasing at all, will hopefully recede from the debate.
And that begs a nagging question: If those people were dead wrong about environmental factors in autism, could they also be mistaken in their equally heated denials about a possible vaccine-autism link? More bluntly, why should we heed them any longer?
We need to examine a host of environmental factors (air, water, food, medicine, household products and social factors) and how they might interact with vulnerable genes to create the varying collection of symptoms we call "autism." But these triggers almost have to be found in every town of every county of every state in the land - from Maine to Maui.
Are vaccines the only contributing factors to autism? Of course not. Other pharmaceutical products like thalidomide and valporic acid, as well as live mumps virus, have been associated with increased autism risk in prenatal exposures, so we already know that a variety of drugs and bugs can likely make a child autistic.
But, there are now at least six published legal or scientific cases of children regressing into ASD following vaccination - and many more will be revealed in due time.
There was the case of Hannah Poling, in federal vaccine court, in which the government conceded that Hannah's autism was caused by vaccine-induced fever and overstimulation of the immune system that aggravated an asymptomatic and previously undetected dysfunction of her mitochondria. Hannah received nine vaccines in one day, including MMR.
Then there was the Bailey Banks case, in which the court ruled that Petitioners had proven that MMR had directly caused a brain inflammation illness called "acute disseminated encephalomyelitis" (ADEM) which, in turn, had caused PDD-NOS, an autism spectrum disorder, in Bailey.
And last September, a chart review of children with autism and mitochondrial disease, published in the Journal of Child Neurology, looked at 28 children with ASD and mitochondrial disease and found that 17 of them (60.7%) had gone through autistic regression, and 12 of the regressive cases had followed a fever. Among the 12 children who regressed after fever, a third (4) had fever associated with vaccination, just like Hannah Poling.
The authors reported that "recommended vaccination schedules are appropriate in mitochondrial disease," although "fever management appears important for decreasing regression risk."
That conclusion, however, is not supported by some of the world's leading experts on mitochondrial disease, including Dr. Douglas Wallace, a professor of pediatrics and biological chemistry at UC Irvine, and director of its Center for Molecular & Mitochondrial Medicine and Genetics. "We have always advocated spreading the immunizations out as much as possible because every time you vaccinate, you are creating a challenge for the system" in people with mito disorders, Dr. Wallace, who was recently named to the National Academies of Science, testified at a federal vaccine safety meeting.
The possibility that vaccines and mitochondrial disease might be related to autism was also supported in another chart review published in PLoS Online. The authors wrote that mitochondrial autism is not at all rare, and said that, "there might be no difference between the inflammatory or catabolic stress of vaccinations and that of common childhood diseases, which are known precipitants of mitochondrial regression."
In fact, they added, "Large population-based studies will be needed to identify a possible relationship of vaccination with autistic regression in persons with mitochondrial cytopathies."
Another fact that gets little attention in this never-ending debate is that more than 1,300 cases of vaccine injuries have been paid out in vaccine court, in which the court ruled that childhood immunizations caused encephalopathy (brain disease), encephalitis (brain swelling) and/or seizure disorders. Encephalopathy/encephalitis is found in most if not all ASD cases, and seizure disorders in about a third of them.
If we know that vaccines can cause these injuries, is it not reasonable to ask if they can cause similar injuries that lead to autism? (Stay tuned as those 1,300 cases come under closer scrutiny).
Fortunately, the federal government seems to be getting serious about identifying ALL potnetial environmental factors that could contribute to autism, including a few studies that take in vaccines and the mercury-containing preservative thimerosal. And President Obama's brand-new budget includes increased spending for autism research at NIH, including money to help identify environmental factors that contribute to ASD.
Meanwhile, the National Vaccine Advisory Committee has unanimously endorsed a CDC proposal to study autism as a possible "clinical outcome" of vaccination, and has recommended several more studies pertaining to vaccines and autism, including a feasability study on analyzing vaccinated vs. unvaccinated populations.
And over at the government's leading autism research panel, the Inter-Agency Autism Coordinating Committee (IACC), the Chairman, National Institute of Mental Health Director Dr. Thomas Insel, recently told me that that better diagnosis and reporting could not "explain away this huge increase" in ASD cases.
"There is no question that there has got to be an environmental component here," Insel said.
I asked him if the IACC would ever support direct research into vaccines and autism, now that CDC has rasied the estimated ASD rate from 1-in-150 to 1-in-110, in just two years. "I think what you are going to see with this update is that there is a recognition that we need to look at subgroups who might be particularly responsive to environmental factors," he answered.
So what might those factors include? Well, it turns out that the IACC has unanimously recommend research to determine if certain sub-populations are more susceptible to environmental exposures such as "immune challenges related to naturally occurring infections, vaccines or underlying immune problems."
Nobody seriously thinks that the retraction of The Lancet article, and the international flogging of Dr. Andrew Wakefield, will do anything to make this debate go away. And they are right.
David Kirby's new book, "Animal Factory - The Looming Threat of Industrial Pork, Dairy and Poultry Farms to Humans and the Environment," will be released on March 2, 2010 by St. Martin's Press. It is currently available for pre-order at several online outlets, including here.