No, Vaccines Aren't Behind the Rise in Autism

I have hesitated to wade into this acrimonious public debate. Yet my family has gotten forwarded HuffPo columns that hype the supposed link between vaccines and autism. As a public health researcher and as a caregiver, I take umbrage.

I should say at the outset that I have never in any way taken a dime from a vaccine manufacturer. I should also that I accept the need to closely regulate the vaccine industry. Four million children are born in America every year. Most greatly benefit from vaccination. There are a small number of real tragedies in which some vaccine harms specific children.

Sensible regulation isn't easy. Vaccine epidemiology is an imperfect science, and policymakers must consider both the risks and benefits of these products. Autism spectrum disorders are especially mysterious, varied, and frightening. It is not clear that the incidence of these disorders is rising. Whatever the trend, these conditions merit a determined, disciplined, and sustained public health response to help individuals and families who suffer because of these conditions.

Spreading debunked rumors will not help anyone here. Last month, I watched the pilot episode of the ABC series, Eli Stone. This show is funny, well acted, inspiring. It includes a great cameo of George Michael singing "You've got to have faith." Mr. Stone himself is a heroic, Grisham-style litigator who sees heavenly visions brought about by divine intervention, a brain aneurysm, or some combination of these things.

Driven by these visions to forsake the usual corporate law road, Eli bravely represented a stunning young mom who is suing a vaccine manufacturer. The drug company makes vaccines which include an ingredient "mercuritol," a compound which the show clearly presents as the likely cause of her son's autism.

The show powerfully illustrates the dangers of corporate greed -- not the greed of the fictitious drug company, but of ABC itself for spreading damaging and unfounded myths.

Except when George Michael is singing, the whole episode is a thinly-veiled allusion to the thimerosal controversy. Despite all evidence, this faux debate has persisted because of the sincere but harmful actions of Congressman Dan Burton and a misguided segment of the autism advocacy community.

As reported in an excellent New York Times story by Edward Wyatt, there is no scientific debate over the alleged link between vaccines and autism. I know that many good people believe that vaccines have harmed their children, but there is just no evidence that vaccines lay behind the concerning rise in diagnosed autism cases in recent years.

Among the reasons not to believe it:

• The effective removal of thimerosal from vaccines brought no observable impact on autism rates.
• Unvaccinated autistic children show the same age of onset as do vaccinated autistic children.
• Major studies and several expert panel reports in the United States and around the world have investigated this issue exhaustively, and found no reason for worry.

For the real information, I encourage readers to check out the websites of the Institute of Medicine here, and the American Academy of Pediatrics here.

I'll simply say that the scientific controversy has been put to bed long ago, even if many people angrily respond to this post.

Unfortunately, the same social currents that lead people to fear vaccines lead people to dismiss the messengers and messages that might assuage these fears. Elaine Showalter's Hystories: Hysterical Epidemics and Modern Culture appeared 10 years ago. Too bad, because the vaccine-autism controversy provides a great illustration of how hysterical epidemics are spread through an interaction of families in pain, underlying cultural anxieties, issue advocates, and the modern media.

The vaccine-autism controversy features heart-wrenching testimony from parents who faithfully took their child to the pediatrician for shots, only to witness the onset of autism soon after. On the other side, it features pharmaceutical companies, often poster boys for corporate greed. It taps into public distrust of the influence and social authority of scientific medicine. It taps into public fears about strange chemicals that penetrate our bodies in novel combinations to do strange things.

The controversy also reflects complacency about infectious disease. The early Salk vaccine brought real danger. Early manufacturing errors infected hundreds of children with polio. Fifty years ago, Americans tolerated the risk, because my parents' generation had very recently lived in fear that their kids would become paralyzed after swimming in the local swimming pool.

When enough people are vaccinated in a given community, an infectious disease such as measles is unable to gain a foothold. The public health community calls this herd immunity. This is what tamed polio. That's also what we too much for granted these days.

Many people chafe at mandatory vaccination, for religious, political, and other reasons. Ron Paul raises this issue in his campaign litter. Whatever you think of the competing Democratic health plans, here is a real issue of individual mandates on which we should all agree. Especially if vaccination brings minor inconveniences, discomfort, and either imaginary tiny risks, it's very tempting to let someone else, let someone else's child, assume these burdens.

Public health practitioners fear that television shows such as Eli Stone and recent appearances by celebrities on Oprah spreading similar rumors will discourage people from getting flu shorts or immunizing their kids. Practitioners' fears are reasonable. They are rooted in long experience. Flu kills a surprising number of Americans every year. According to the American Academy of Pediatrics, failure to immunize toddlers was a major cause of a U.S. measles epidemic which resulted in 11,000 hospitalizations and 120 deaths. Fanciful TV shows should not influence peoples' attitudes and behavior regarding important matters in the real world. A trainload of medical and public health studies indicate that they do.

More to the point, a later-retracted 1998 study that alleged an autism link convinced many British parents not to vaccinate their kids. The study was discredited, but not before it stoked needless measles outbreaks in which hundreds of children were hospitalized and a few died. A 2006 story in the British paper, the Guardian, starts out:

England is experiencing its biggest measles outbreak in 20 years, fuelled by the reluctance of some parents to have their children immunised because of now-discredited claims of a link between the MMR jab and autism. There have been 449 reported cases of measles since the beginning of the year,... That, in less than six months, is more than double the 438 for the whole of 2003. Last year there were only 77 cases.

The article, which can be linked here makes sobering reading,

My own displeasure is personal. My wife and I are caregivers for an intellectually disabled man. I know only too well that families are drawn to quackery and hokum. I have also seen how hard it is for medical science to compete for airtime with unfounded theories and worthless products and therapies. I suspect that false rumors are hard to debunk through straight information. Many parents in difficult cirumstances have bad experiences with the schools, social services, and medical providers to whom they turn for help. When these systems and providers fail to show a competent and caring human face, parents themselves turn away. They easily fall prey to all sorts of mischief.

Given these realities, it is especially irresponsible to falsely blame vaccines for health difficulties. And there is something heartless for major television networks to coyly spread myth in this area. We are used to politicians who doubt global warming and evolution, the cranks who claim that Jewish doctors are spreading AIDS. Of course, the problem goes deeper, and crosses every ecumenical and political line. My friend Mark Kleiman spearheads one of the best blogs in the web: the reality-based community. Out in the real world, the reality-based community is always embattled because reality so often fails to provide the answers or the consolation that people seek. Hence the permanent lure of scapegoating and magical thinking.

And there is always someone willing to make a buck on it. ABC's misleading story line stacked the deck in the usual storybook TV way. The network was shamed into running the usual "this fictional account" disclaimer, together with links to an earnest CDC website that few viewers will ever frequent. The network claims that the episode showed both sides -- a statement that could apply with equal merit to airing a debate over whether mosquitos spread AIDS.

In the end, Eli takes down the drug company for $5.2 million when its CEO is forced to admit that he refused to vaccinate his own child with the company's product. The show's sole connection to reality was ironic: A handsome trial lawyer swayed a pliable jury and TV audience to believe something that isn't true.

ABC got good ratings. Some unknown and unknowable number of people will surely avoid useful vaccines. It is depressing how low the penalties are for unethical corporate behavior. John Grisham, I have an idea for your next book.

Comments

[HeevenSteven]

Pyrum,

You may be right about new cases of polio being caused by the vaccine. The fact remains, however that 1000 or so new cases a year pales in comparison to many many thousands before 1954. I stated in response to your death statistics that deaths and new infections are not the same thing to which you replied "whatever". Well what of it?

You've stated that the reduction of polio and outright irradication of smallpox are not because of the vaccines. I asked what you base that on. I really don't know were you're coming from.You haven't made your case. Are you saying that all vaccines are a hoax?

[HAP]

I appreciate the many thoughtful responses to my post. Many of you concerned about the potential bias of American sources might want to examine the experience of other wealthy democracies. The accumulated data again militate against a link between vaccine practices and increases in autism. These are well-summarized in
http://www.nature.com/clpt/journal/v82/n6/pdf/6100407a.pdf

[avicenna]

Meta-analysis are useful if the studies they base their findings on were all designed independently and without bias. This, of course, is almost always impossible when it comes to looking at the effect of vaccines. Dilution of any possible immune connection to vaccination protocols in general (not necessarily to one particular type of vaccine or its contents) would, I think, yield a better understanding of the change in the immune system's repertoire following vaccination - including the number of vaccinations, age, and history of antigen exposure. I think we just have to admit we don't know enough, and health care practitioners are trying their best. Most are working in the interest of the public, however, it is unfortunate that their education comes from pharmaceutical industries and their clinical studies. That is a fact. I am also aware of the difficulty of publishing unpopular results - which results in another angle of bias of the stack of available information. A very recent study found that there is a relationship possibly between the mother's antibodies that make their way to the fetal brain - this was to explain why so many autistic children have higher concentrations of antibodies. The plot thickens if the vaccine conundrum goes back to the mother's vaccine history - especially considering this overzealous HPV vaccine trajectory we've found ourselves in. Perhaps less threatening or controversial would be first to determine if autism is related to having an altered or defected immune response or sensitivity. If that is true - then the logical thing would be to look at everything that can contribute to such a phenomenon - and vaccinations are certainly a part of the first manipulations the immune system of infants are subjected to these days.

[CraigWilloughby]

Mr. Pollack, you happen to be one of the few people on here who I would like to debate this subject with. You treat the matter with respect and a great deal of thought, and you also don't come out with guns blazing, immediately saying that all of us parents who believe that vaccines are connected to autism are nuts. I truly appreciate that, I and hold you in both high esteem and with a great deal of respect, even if we are on opposite sides of the debate.

However, and I have stated this on previous posts, there are so many parents who can pinpoint when their child began showing symptoms of autism, and in so many cases, they can pinpoint it to within a few days after receiving a vaccine. With such a large group of people, can we safely discount the connection? If there was no link between mercury and autism, then wouldn't it have been safe to leave thermirisol in the vaccines? If vaccines were safe, then would there have needed to be a clause in the Homeland Security Act that protects vaccine companies from lawsuits pertaining to injuries resulting from vaccinations? And shouldn't we treat the reports released by the IOM, an organization that has in the past been known to accept money to doctor reports in the favor of companies that knowingly poison their consumers (i.e. Big Tobacco), shouldn't we treat these reports with the same skepticism as so many people treat the vaccine-autism connection?

Again, I thank you for the respect you've shown in your article, and I look forward to discussing this more with you.

[HAP]

Thank you. I will read the link you gave.

What are you referring to with the IOM? They are currently extremely anti-tobacco, as their recent reports make clear.

[CraigWilloughby]

Oh, I forgot the link.

http://www.washingtonindependent.com/view/independence-of-cdc

I apologize for the multiple posts...my browser is acting weird. It seems to post previous posts that I've done today for some reason. Not trying to spam you guys. Again, apologies.

[CraigWilloughby]

Oh, and here is an article for you guys to peruse. One quote that stands out for me states that, "Some departing scientists and outside experts have charged that senior CDC officials are failing to give the office the independence it requires to investigate possible harm from vaccines."

Uh oh.

[CraigWilloughby]

Yes, I agree with you, vaccination is important. However, I also believe that our vaccination schedules are way too stringent. Why in the world would you give a baby with an immature immune system 36 live viruses in the space of a few months?

I believe in a more relaxed vaccine schedule. Don't get the cocktails (the 3-in-1's like the DPT and MMR). Spread them out over a few weeks to allow the child's immune system to catch up. This makes far more since to me. posted 03/03/2008 at 12:04:29
People automatically assume that we are looking for someone to blame. We aren't. We are looking for answers. As any scientist will tell you, the way to solve a problem is to first find out what caused the problem.

And the government does nothing to help my son. I am a Network Administrator, middle class, and they say I make too much money to receive SSI and Medicaid benefits for my son. My insurance company refuses to pay because they say he has a pre-existing condition. So, I pay for his medication, his occupational and speech therapy, and his psychiatric visits all out of pocket. This adds up to more than my rent and utilities combined. I have no savings, no 401k, and I barely live from paycheck to paycheck, all so I can give my son as normal of a life as possible. And you tell me that the Government and the Medical Industry wants to help him?

Here's a little tidbit, and please don't take this as disrespect. Your post was quite thoughtful and respectful, and I appreciate that. So was Mr. Pollack's. The Government and the Medical Industry do not want my son to be healthy. Why? There is no money in healthy people. Sick people buy their products, and as everyone knows, the more we spend, the more the economy prospers.

[ccdaddy57]

DR. Pollack

This is actually on the MSDS sheet ( (pregnant women
should not be exposed to the product ) ) wonder if the
CDC has seen this? The CDC is currently recommending
pregnant women to receive two flu vaccines containing
25 micrograms of mercury each.. Armed with the simpson wood meeting knowledge from DR Weil
stated ( There are just a host of neurodevelopmental data that would
suggest that we've got a serious problem. The earlier we go, the more
serious the problem ) and two studies that state children 6 mos to 2 years old get no benefit except that of a placebo effect.. So what was their reason for putting it back in ?
When you are poisoning a population by accident
then you pull the poison out of product the numbers
would fall so rapidly it would be very apparent what happened to a generation of children. So you taper
it down and then is not so Crystal clear what
happened to the population­...We even said if you
want ban thimerosal then please state a preference
for pregnant women with thimerosal free they said NO!
we will not and that goes along with what that guy
said the day David Kirby was on the radio that
worked for the pharma co. he said they the CDC
was not interested in removing the thimerosal

This is also on the MSDS
sensitization with allergic manifestations in predisposed
persons AKA maybe peanut allergies, ect . . .

[CraigWilloughby]

Repost:
The 2 studies you mention in your article, Mr. Pollack, were both sponsored and funded by the Institute of Medicine. Since it is their integrity, and dare I say their butts on the line, then they have a vested interest in keeping any possible injuries that may occur from their products under wraps. This is called a conflict of interest, and as any scientist will tell you, it does NOT make for a valid study.

Remember not too long ago all of the "studies" released that showed that Tobacco wasn't addictive? These were released by the same IOM that is releasing these vaccine reports. And then after the lawsuits were filed, we found out that Big Tobacco had bought these reports, doctoring them in their favor. Who is to say this isn't happening again?

Until a report is released by an Independant Research firm that is in NO WAY linked to the IOM, The Pharma Corps, the FDA and the CDC that proves that there is not link then parents will continue to try to prove what we've known all along; that vaccine cocktails are poisoning our children.

[CraigWilloughby]

The 2 studies you mention in your article, Mr. Pollack, were both sponsored and funded by the Institute of Medicine. Since it is their integrity, and dare I say their butts on the line, then they have a vested interest in keeping any possible injuries that may occur from their products under wraps. This is called a conflict of interest, and as any scientist will tell you, it does NOT make for a valid study.

Remember not too long ago all of the "studies" released that showed that Tobacco wasn't addictive? These were released by the same IOM that is releasing these vaccine reports. And then after the lawsuits were filed, we found out that Big Tobacco had bought these reports, doctoring them in their favor. Who is to say this isn't happening again?

Until a report is released by an Independant Research firm that is in NO WAY linked to the IOM, The Pharma Corps, the FDA and the CDC that proves that there is not link then parents will continue to try to prove what we've known all along; that vaccine cocktails are poisoning our children.

[middleofnowhere]

thank you for writing this. I hope more people, that responded to the previous article on Autism, read your unbiased take.

[Pyrum]

Vaccinations should not be federally mandated. Parents deserve to know the full information on vaccines, both pro and con, and decide for themselves if the benefits outweigh the risks.

Your bullet points are misleading. Thimerasol has not been effectively removed from vaccines, because it has not been banned. It's being removed on a voluntary basis only, and the new thimerasol free formulas are not even close to making up the bulk of vaccines being currently administered.

In populations of children who typically aren't vaccinated, such as the Amish, autism is virtually unheard of. You'd be hard pressed to find a child in America with autism who has not been vaccinated.

The studies you are referring to are funded by the pharmaceutical companies who manufacture vaccinations, so they can't be trusted to be unbiased.

Also, measles outbreaks have been known to occur in populations vaccinated against measles. Getting a measles shot is no guarantee you won't get measles.

[avicenna]

I think the vaccine-autism debate should be one that is pursued further scientifically - but on a different tangent. I don't think that particular heavy metals or preservatives in vaccines, per se, are the causative factor in susceptible infants to get autism. I do think that an altered immune system is implicated in the disorder as many autistic children have higher rates of certain food allergies and they have been found to have higher titers of antibodies - especially directed to the brain/CNS. As an immunologist, I do think that we should reconsider the cost/benefit and science of vaccines with less laisez faire. We are stimulating the immune system to expand their adaptive immune cells - in a manner that it isn't designed to do. Does this have the potential of expanding "by stander" immune cells that have the ability to damage or attack either self-antigens or get overexcited in the presence of noninfecti­ous/non-da­ngerous antigens? Is that why we are seeing higher levels of allergies, increased rates of autoimmune disorders, and disorders that implicate disorders like autism? Are we overzealous in our vaccine protocols? We already know from vets that there are many questions regarding this issue in regards to "over vaccination" of pets and the negative health effects this seems to be inducing. I know that questioning the big "science market"/health policy gurus brings a quick and vicious rabid response - and usually the retelling of the small pox victory and our debt to vaccines. I just say maybe there is always a small price to pay for our herding.

[Boobaloo]

avicenna: I can't thank you enough for your comment.

I am not an immunologist but, based on my research I came to similiar conclusions; you're much more credible than I am because of your education so Im happy that you took the time and energy to write this statement.

[TakeSake]

As for the flu vaccine, whenever I ask about getting the thimerosal free one the clinicians get really prickly.

Regarding dosage, there are all sorts of laws against having a kid even look at beer. If alcohol is that dangerous for children, why not at least some concern about something that cannot be metabolized?

[TakeSake]

For those who advocate keeping thimerosal:

What would be wrong with a thimerosal free vaccine in individual doses that was kept refrigerated?

[IamWebster]

Am I really on the Huffington site? An evidence-based post on autism and vaccines? I thought I'd never see the day. Typically this subject is covered by the desperate-­for-reader­s Kirby and largely commented on by the ill-informed. I have 2 kids with autism and there is simply no reasoning supporting the idea they are poisoned by vaccines. Kudos to you, Mr. Pollack, and even more to Huffington for finally, finally, FINALLY getting it right.

[HAP]

Thank you very much.

[thewhitewitch]

I have a son with autism & I agree.

[middleofnowhere]

wow. I'm truly relieved to see someone that knows something first-hand about Autism, to leave a well-informed comment. It's a shame that apparently many of the other commenters have either missed your comment, or just insist on continuing to believe whatever they want, that flies in the face of science.

[CraigWilloughby]

And you don't insist on believing whatever it is you want?

[anniepema]

To prevent some new, sporadic, autism, ETC. read the articles reprinted here: http://autism-prevention.blogspot.com/ COMMENTS APPRECIATED