I promise that I'll get back to my tips for authors shortly, but this story caught my attention recently and deserves comment.
In 1998, Dr. Andrew Wakefield and colleagues published an article in the Lancet purporting to show an association between the development of autism and the MMR (measles, mumps, rubella) vaccine. Although this article was later renounced by 10 of its 13 authors and subsequently retracted by the Lancet, the topic caught on in the lay press and spooked a lot of well-meaning but scientifically illiterate parents. In addition, equally ill-informed but well-meaning celebrities like Robert F. Kennedy Jr. and Jenny McCarty have fueled these fears. Vaccination rates plummeted and frivilous lawsuit rates skyrocketed. Governments had to indemnify vaccine makers to prevent ALL vaccine production from coming to a screeching halt. As herd immunity dropped in susceptible populations, outbreaks of measles, mumps and rubella appeared across the world. Thousands of children and adults needlessly became ill and some needlessly died.
Actions have consequences.
Although the medical establishment might be accused of not policing itself as well has it should have, one man, a journalist, Brian Deer has been investigating this case for years. In a recent issue of the British Medical Journal (BMJ), Deer published the results of his re-review of the medical records and interviews with the parents of the 12 children comprising the Wakefield study. These children were said to have been "normal" before and autistic after receiving the MMR vaccine. Misrepresentations were found in all cases and, in particular, 5 of the children said to be "normal" initially were actually known to have significant developmental anomalies before being vaccinated.
In an editorial accompanying Deer's article in the BMJ, editor Fiona Godlee called the initial study an "elaborate fraud," knowingly perpetrated by the author, and urged editors of other journals to review all prior publications by Wakefield to see if they should also be retracted. Wakefield was stripped of his British medical license last May.
Of course, following the initial Wakefield study, there were MANY subsequent studies, none of which showed ANY association between autism and vaccination. And unlike the initial Wakefield study involving only 12 children, these subsequent studies involved MILLIONS of children (2 million in a study from Finland and 3 million in study from Boston University).
One might assume that this thorough debunking of the initial TINY (and now known to be fraudulent) outlier study might quickly put an end to all of this, but then again it probably won't. The press is certainly to blame in large part for this continuing silliness. They invariably present both sides of an argument as if they deserve equal weight. Thus, Dr. Wakefield is given equal time to spout off on this topic, as are other completely science illiterate "experts." As Bill Mahrer once said, when the argument is about a scientific issue, non-scientists don't get to have a voice in the discussion. And all issues do not have two equal sides. Yet, I fully expect to one day see a program on CNN or another major network called, "The Earth, Flat or Round? You Decide."
Medical researchers could, I think, help bring some rationality to this by addressing two issues in the lay press that crop up again and again in the comments of those who continue to believe this association.
1. Why is autism seemingly increasing in frequency? This seems to me to be almost certainly due to increased awareness. The term was virtually non-existent when I was a child. I first encountered the word as a junior in college. In the past, children with varying degrees of autism were undoubted labelled using terms ranging from introverted or shy, to mentally handicapped (the term at that time was "retarded"). The same argument can be made with regard to attention deficit disorder (ADD). It has always been around, we just didn't have a good name for it before. We called these kids, often boys, "daydreamers" when I was in elementary school.
2. Why are there anecdotal stories of apparently normal children becoming autistic after vaccination? Are vaccinations routinely given at about the same developmental time when the symptoms of autism become most obvious? Does the mild fever often associated with vaccinations exacerbate the symptoms that were there anyway? By statistical chance alone, how many cases of autism would be expected to develop around the time of childhood vaccinations in the U.S. population?
A recent poll on the MSNBC website, "TodayMoms" indicated that over 30% of parents currently believe in an association between autism and vaccinations. We can only hope that number will start to fall, but to paraphrase a quote from Ben Goldacre's book, "Bad Science," you can't reason someone out of an opinion they didn't use reason to form.