A broken trust: lessons from the vaccine–autism wars

Researchers long ago rejected the theory that vaccines cause autism, yet many parents don't believe them. Can scientists bridge the gap between evidence and doubt?

This week, the open-access journal PLoS Biology investigates why the debunked vaccine-autism theory won't go away. Senior science writer/editor Liza Gross talks to medical anthropologists, science historians, vaccine experts, social scientists, and pediatricians to explore the factors keeping the dangerous notion alive - and its proponents so vitriolic.

Pediatrician Paul Offit has made it his mission to set the record straight: vaccines don't cause autism. But he won't go on Larry King Live - where he could reach millions of viewers - or anyplace celebrity anti-vaccine crusaders like Jenny McCarthy appear. ''Every story has a hero, victim, and villain,'' he explains. ''McCarthy is the hero, her child is the victim - and that leaves one role for you.''

When she read that hecklers were issuing death threats to spokespeople who simply reported studies showing that vaccines were safe, anthropologist Sharon Kaufman dropped her life's work on aging to study the theory's grip on public discourse. To Kaufman, a researcher with a keen eye for detecting major cultural shifts, these unsettling events signaled a deeper trend. ''What happens when the facts of bioscience are relayed to the public and there is disbelief, lack of trust?'' Kaufman wondered. ''Where does that lead us?''

Despite overwhelming evidence that vaccines don't cause autism, one in four Americans still think they do. Not surprisingly, the first half of 2008 saw the largest US outbreak of measles - one of the first infectious diseases to reappear after vaccination rates drop - since 2000, when the native disease was declared eliminated. Mumps and whooping cough have also made a comeback. Last year in Minnesota, five children contracted Hib, the most common cause of meningitis in young children before the vaccine was developed in 1993. Three of the children, including a 7-month-old who died, hadn't received Hib vaccines because their parents either refused or delayed vaccination.

Now, more than ten years after unfounded doubts about vaccine safety first emerged, scientists and public health officials are still struggling to get the story out. Their task is made far more difficult by the explosion of misinformation on the Internet, talk shows, and high-profile media outlets, by journalists' tendency to cover the issue as a "debate," and, as Kaufman argues, by an erosion of trust in experts.

Information technology has transformed the way trust and knowledge are produced, Kaufman says: ''Scientists have to consider their role in this changed landscape and how to compete with these other sources of knowledge.'' Simply relating the facts of science isn't enough. No matter that the overwhelming weight of evidence shows that vaccines don't cause autism. When scientists find themselves just one more voice in a sea of ''opinions'' about a complex scientific issue, misinformation takes on a life of its own.



  1. Harold L Doherty Harold L Doherty United States says:

    The limitations of the studies discounting a vaccine autism connection has been described by Dr. Bernadine Healy, former American Red Cross and NIH head, who points out that such studies do not necessarily address at risk population subsets. See (Fighting the Vaccine-Autism War, Leading Dr.: Vaccines-Autism Worth Study).

    "There is no evidence that removal of thimerosal from vaccines has lowered autism rates. But autism numbers are not precise, so I would say that considerably more research is still needed on some provocative findings. After all, thimerosal crosses the placenta, and pregnant women are advised to get flu shots, which often contain it. Studies in mice suggest that genetic variation influences brain sensitivity to the toxic effects of mercury. And a primate study designed to mimic vaccination in infants reported in 2005 that thimerosal may clear from the blood in a matter of days but leaves inorganic mercury behind in the brain.

    The debate roils on - even about research. The Institute of Medicine in its last report on vaccines and autism in 2004 said that more research on the vaccine question is counterproductive: Finding a susceptibility to this risk in some infants would call into question the universal vaccination strategy that is a bedrock of immunization programs and could lead to widespread rejection of vaccines. The IOM concluded that efforts to find a link between vaccines and autism "must be balanced against the broader benefit of the current vaccine program for all children."

    Wow. Medicine has moved ahead only because doctors, researchers, and yes, families, have openly challenged even the most sacred medical dogma."

    Dr. Bernadine Healy,Fighting the Vaccine-Autism War, US News and World Report, April 10, 2008

    In case anyone missed the last point, Dr. Healy indicated that the IOM in 2004 expressly discouraged research of a possible vaccine-autism war because of fear over the potential impact of such research on public confidence in vaccines.

    Teresa Binstock, in 1999 also pointed out that vaccine-autism research, and environmental causes of autism research, were expressly discouraged by pressure to conduct genetic oriented bases of autism research. To receive research funding researchers had to subscribe to the "it's gotta be genetic" autism paradigm.

    Dr. Julie Gerberding and Dr. Duane Alexandre have also stated that there is more research that could be done on the vaccine autism link. One such study in particular could look at autism prevalence in vaccinated versus unvaccinated groups . Apparently a study of incidence of whooping cough in unvaccinated children has been done recently so why not look at the incidence of autism in unvaccinated children and compare that rate to those who are vaccinated?

    Simply repeating, ad nauseam, a less than accurate statement that a vaccine autism link has been "disproved" will not convince parents who see their children develop autism symptoms after vaccination.

    It is time to do some real research, the type that was discouraged by the IOM in 2004. THEN you might convince everyone that vaccines are jim dandy safe. Or maybe the irrational belief that vaccines, although obviously of great benefit to the public could not possibly have any harmful effects, would suffer a setback.

    Stop talking down to concerned parents. Prove your case, really prove your case and trust might be restored.

    • Sandra Sandra Canada says:

      I doubt that more scientific studies on the "link" between vaccines and autism will be fruitful, either in reducing the incidence of autism, or of convincing parents to have their children vaccinated with the present vaccines, a new protocol, or to stop advocating against scientific evidence because it is all tainted by corruption.
      Science has no place in the autism-and-vaccines/immune/diet/whatever world that the advocates inhabit. I am a mother with a Canadian Grade 12 science diploma and these people's science illiteracy is either absent since elementary school, or abrogated for more glowing forms of knowing like "motherhood" or new age inspiration. Perhaps the sociological study of why this view of autism is so popular is the best way for science to be applied to this risk to human health.

  2. Michael Wagnitz Michael Wagnitz United States says:

    They can spin it all they want, here are the facts;

    0.5 parts per billion (ppb) mercury = Kills human neuroblastoma cells (Parran et al., Toxicol Sci 2005; 86: 132-140).

    2 ppb mercury = U.S. EPA limit for drinking water (http://www.epa. gov/safewater/ contaminants/ index.html# mcls).

    20 ppb mercury = Neurite membrane structure destroyed (Leong et al., Neuroreport 2001; 12: 733-37).

    200 ppb mercury = level in liquid the EPA classifies as hazardous waste based on toxicity characteristics.

    25,000 ppb mercury = Concentration of mercury in multi-dose, Hepatitis B vaccine vials, administered at birth from 1991-2001 in the U.S.

    50,000 ppb mercury = Concentration of mercury in multi-dose DTaP and Haemophilus B vaccine vials, administered 8 times in the 1990’s to children at 2, 4, 6, 12 and 18 months of age and currently “preservative” level mercury in multi-dose flu, meningococcal and tetanus vaccines. This can be confirmed by simply analyzing the multi-dose vials.

    The real debate is, do brain damaged kids behave in such a way that a psychiatrist will label them as somewhere on the "spectrum".

The opinions expressed here are the views of the writer and do not necessarily reflect the views and opinions of News Medical.
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