If you can stand another discussion about vaccine safety and autism, Wired magazine has an interesting article this month. ((I only say “if you can stand” because, as an autism professional, I think and talk about this all the time. I can never tell if people outside of the autism world think about it or are interested))
The article is written as a piece about Paul Offit, a pediatrician who invented the vaccine for the rotovirus and is a vaccine advocate. He is, therefore, vilified by anti-vaccine advocates. As the personification of the pro-vaccine “camp”, Dr. Offit has been the target of verbal attacks, threats, and lots of negative press.
In this article, the writer and Dr. Offit frame the discussion as one of science vs. pseudo-science.
He boldly states — in speeches, in journal articles, and in his 2008 book Autism’s False Prophets — that vaccines do not cause autism or autoimmune disease or any of the other chronic conditions that have been blamed on them. He supports this assertion with meticulous evidence. And he calls to account those who promote bogus treatments for autism — treatments that he says not only don’t work but often cause harm.
Paul Offit. “People describe me as a vaccine advocate,” he says. “I see myself as a science advocate.
Dr. Offit has several major points. First, he is unequivocal that the science does not demonstrate a link between vaccines (or any component of them) and autism or any other disorder. Second, that the risks of not vaccinating are much huger and more significant than the risks of vaccination. Finally, that a variety of people, with a wide range of knowledge and motives, are drawn to or pushing pseudo science in making the link between autism and vaccines.
On the first point
To be clear, there is no credible evidence to indicate that any of this is true. None. Twelve epidemiological studies have found no data that links the MMR (measles/mumps/rubella) vaccine to autism; six studies have found no trace of an association between thimerosal (a preservative containing ethylmercury that has largely been removed from vaccines since 20011) and autism, and three other studies have found no indication that thimerosal causes even subtle neurological problems. The so-called epidemic, researchers assert, is the result of improved diagnosis, which has identified as autistic many kids who once might have been labeled mentally retarded or just plain slow. In fact, the growing body of science indicates that the autistic spectrum — which may well turn out to encompass several discrete conditions — may largely be genetic in origin. In April, the journal Nature published two studies that analyzed the genes of almost 10,000 people and identified a common genetic variant present in approximately 65 percent of autistic children.
One of the problems in this part of the debate is the way that science works. We can’t prove a negative. We can’t prove that vaccines don’t cause autism. All we can do is test a hypothesis, and then say whether the data supports that hypothesis or not. That careful talk is heard by non-scientists as uncertainty or (worse) deception.
On the second point
In certain parts of the US, vaccination rates have dropped so low that occurrences of some children’s diseases are approaching pre-vaccine levels for the first time ever. And the number of people who choose not to vaccinate their children
In the June issue of the journal Pediatrics, Jason Glanz, an epidemiologist at Kaiser’s Institute for Health Research, revealed that the number of reported pertussis cases jumped from 1,000 in 1976 to 26,000 in 2004. A disease that vaccines made rare, in other words, is making a comeback.
Getting the measles is no walk in the park, either — not for you or those who come near you. In 2005, a 17-year-old Indiana girl got infected on a trip to Bucharest, Romania. On the return flight home, she was congested, coughing, and feverish but had no rash. The next day, without realizing she was contagious, she went to a church gathering of 500 people. She was there just a few hours. Of the 500 people present, about 450 had either been vaccinated or had developed a natural immunity. Two people in that group had vaccination failure and got measles. Thirty-two people who had not been vaccinated and therefore had no resistance to measles also got sick. Did the girl encounter each of these people face-to-face in her brief visit to the picnic? No. All you have to do to get the measles is to inhabit the airspace of a contagious person within two hours of them being there.
Sometimes people argue that there is herd immunity – it’s OK to not vaccinate your child because everyone else is vaccinated. There are a couple of problems with this logic. First, non-vaccinated kids seem to cluster (ie, some neighborhoods have more nonvaccinated kids than others) so the risk of disease is higher. Second, not all vaccines “take” so there’s already some burden on the herd immunity just from vaccinated folks.
There’s also the overall notion of risk,and parents’ rights to protect their kids
And he wants Americans to be fully educated about risk and not hoodwinked into thinking that dropping vaccines keeps their children safe. “The choice not to get a vaccine is not a choice to take no risk,” he says. “It’s just a choice to take a different risk, and we need to be better about saying, ‘Here’s what that different risk looks like.’ Dying of Hib meningitis is a horrible, ugly way to die.”
The author of this article is pretty obvious about her disdain for the antivaccine advocates, and makes no attempt to discuss what their motives would be. Maybe this is because it’s Wired Magazine, and their readers are presumed to be scientists or at least science-oriented. While I agree with Offit’s position, it almost takes away from his point for the article to be so dismissive.
OTOH, in the context of the loss of credibility for science and the growth of pseudoscience in the US, the vaccine debate becomes very compelling and interesting – not exclusively an “autism issue” but a symptom of a larger issue in our nation.