I want to thank all of you who took the time to read the book and comment. Many of you had kind things to say about the writing and content, clearly understanding what I was trying to do and why I did it. I’ll try and answer as many questions that were directed at me as I can, writing a blog entry every morning.
I’ll start with the easier questions.
We tried to get companies that publish audio books interested in this book, but were unsuccessful.
All of my royalties from the sale of this book will be donated to the Center for Autism Research at Children’s Hospital of Philadelphia. I have found the director of the center, Bob Schultz, to be a careful, thoughtful investigator. But this isn’t set in stone. I’m open to other suggestions.
I wrote the chapters introducing Wakefield and thimerosal without providing any evidence to refute those theories because that was the way it played out in the press and to the public. I thought that this would give the reader a better sense of what really happened during the early stages of the controversy.
Many bloggers continue to question whether mercury in vaccines causes autism. Given the amount of information available to refute this claim, I find this astounding:
First, prior to its removal from vaccines in the spring of 2001, it was possible that children less than 6 months of age could receive as much as 187.5 micrograms of ethylmercury in thimerosal. But because mercury is part of the earth’s surface, and is contained in our water, that wouldn’t have been their only source of mercury. A typical breast fed child would receive about 360 micrograms of environmental mercury, methylmercury. Because environmental mercury is eliminated from the body 10 times more slowly than the ethylmercury in thimerosal, it is much more likely to accumulate.
Second, six epidemiological studies consistently showed that children receiving thimerosal-containing vaccines were not at greater risk for autism than children receiving lesser quantities of thimerosal or no thimerosal in vaccines.
Third, within months of thimerosal’s removal from vaccines in 2001, the quantity of ethylmercury to which young infants were exposed dropped from 187.5 micrograms to 0 micrograms, without any appreciable decline in the incidence of autism. No single-dose vial of vaccine given to young children currently contains thimerosal.
Fourth, the signs of symptoms of mercury toxicity, as described in a wonderful article by Karin Nelson and Margaret Baumann referenced in the book, are distinct from autism. So it never made sense that mercury would cause autism.
Fifth, the reason that the American Academy of Pediatrics pushed to remove mercury quickly from vaccines is that there were not studies in place showing that the quantity of thimerosal in vaccines didn’t cause subtle signs of mercury poisoning. But no longer. The study by William Thompson and coworkers at the CDC answered that question. Thompson carefully defined mercury exposures before and after birth in about 1,000 children then prospectively performed more than 40 neurodevelopmental and psychological tests. Again, no differences in children exposed to greater or lesser quantities of mercury in vaccines. So thimerosal didn’t cause even subtle signs of mercury poisoning. Given that young children were exposed to more mercury from their environment than from vaccines, the results of Thompson’s study weren’t surprising.
So the epidemiological, ecological, and biological studies were all consistent.
A couple of bloggers praised the book for its tone, that I never appeared to get angry at the false prophets described in the book. The reason for that is that I’m not the father of a child with autism. If I were, I would have been quite angry. Angry because I think that the anti-vaccine forces have taken the autism story hostage. And angry that because of their influence, the media almost never carries stories about the real cause or causes of autism. In the July 11, 2008 issue of SCIENCE, Jim Sutcliffe summarizes the functions of the 30 or so genes that have now been associated with autism. A pattern is clearly emerging. Those genes code for proteins that involve the neurological synapse or proteins that are important in endocytoplasmic trafficking in neuronal cells. These kinds of studies might well lead to therapies that could modify the disorder. But you never hear about them. Never. Rather, we hear about how Jenny McCarthy treats autism by focusing on the gut–anti-fungals, elimination diets, etc. The media is perfectly willing to mislead parents for ratings. Shameful.