Sunday, September 21, 2008

The rise and fall of autism vaccine theories

Salon features a book review by a physician journalist that traces the rise and fall of theories relating autism to vaccines. These theories are as dead as phlogiston, but strong supporters persist. Some of those supporters have financial motivations, but for others the belief has come to resemble religious devotion.

Most of the story was familiar to me, though I recall far more early skepticism than Dr. Parikh mentions. I think there was more early support among UK scientists, but US physicians were more suspicious. Those suspicions were justified, Lancet retracted the original article and the primary author is now suspected of fraud (emphases mine): Books | Inside the vaccine-and-autism scare

By Rahul Parikh

Sep. 22, 2008 | ... Dr. Paul A. Offit's new book, "Autism's False Prophets: Bad Science, Risky Medicine, and the Search for a Cure,

... Offit begins by tracing the history of the anti-vaccine movement to its roots in England in 1998: That's where a young, charismatic and ambitious researcher named Andrew Wakefield held a news conference to reveal he had discovered that the measles-mumps-rubella (MMR) vaccine causes autism. The prestigious medical journal Lancet subsequently published his paper. Soon, headlines warning parents about "child jabs" appeared on the front page of newspapers all over the U.K., and droves of parents began refusing the MMR vaccine. Despite the resurgence of measles in the U.K. as a result, Wakefield was hailed as a muckraker. The BBC even made a biopic about his fight against the establishment.

... Among the resulting press were Robert F. Kennedy Jr.'s "Deadly Immunity," published simultaneously in Rolling Stone and Salon, and David Kirby's blockbuster book, "Evidence of Harm," a damning account of the link between autism and vaccines and of our government's efforts to cover up a link between the two...

... it wasn't until 2004 that Brian Deer, an investigative reporter for London's Sunday Times, discovered damaging evidence against him. Despite what Wakefield claimed in his paper, his hospital's ethics committee never approved his experiments to put children to sleep under general anesthesia, do spinal taps on them, take biopsies of their intestines (one of the children was hospitalized after his colon perforated in several places) and take volumes of blood from their veins. Deer also discovered serious conflicts of interest: Wakefield's research was secretly bankrolled by a personal injury lawyer whose clients were suing MMR makers. Wakefield himself was given close to a million dollars to prove that the MMR caused autism. He had filed a patent for a new MMR vaccine at the same time he was doing his research. Upon learning this, Lancet retracted his paper, and he was charged with professional misconduct in 2005. If he is found guilty of misconduct, he will never practice medicine in the U.K. again.

The last nail in the coffin came in 2007 during an "autism omnibus proceeding" in the United States. (This is a federal hearing for several thousand parents who claim their children developed autism because of vaccines. Those parents are seeking compensation from the federal government.) Wakefield's former research assistant testified that his discovery about the MMR vaccine was, in reality, the result of contaminated lab equipment and that Wakefield knew this about but ignored it. In other words, as Offit writes, "Wakefield had crossed the line from ill-conceived, poorly performed science to fraud."

Eleven studies now show that the MMR vaccine doesn't cause autism (the most recent just came out). Six have shown that thimerosal doesn't cause autism; three have shown thimerosal doesn't cause neurological problems. Studies showing the opposite, like Wakefield's, use flawed methods, have serious conflicts of interest or have been conducted in animals whose results can't be extrapolated to humans.

... the father-and-son team of Mark and David Geier, one a doctor and the other with a college degree in biology. The elder, Mark, opened a homemade lab in his basement, where, under the patronage of anti-vaccine advocates, he works on his theories. They include prescribing Lupron to autistic children, a drug that several states use to chemically castrate sex offenders. The son, David, runs a medical-legal consulting firm, where he offers up expert witnesses for vaccine-injury trials. The two work hand in hand to make money both selling treatments and testifying as expert witnesses in vaccine-autism cases...
In addition to the obvious harm caused by falls in vaccination rates, these 17 research studies were a necessary but huge waste of time, money, and talent. I'd rather one of them had been spent on strategies for helping autistic children learn more effectively ...

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