Autism's false theories

The St. Petersburg (Florida) Times last week ran a feature story on the controversy surrounding autism and vaccines. I’ve written about this before and you can found many blogs and websites devoted entirely to autism - some good, some bad. The “controversy” is due to some people’s belief that autism is caused by the measles, mumps, and rubella (MMR) vaccine, which was first proposed in a 1998 article – later revealed to contain fraudulent data – by by Andrew Wakefield and colleagues. (10 of Wakefield’s 12 co-authors retracted their findings and repudiated the study.)

The St. Pete Times article does a better-than-average job at presenting the issue, although its title - “Debate rages over need for vaccines” – is very misleading, and I worry that the title alone will make some parents withhold vaccines from their children. But if you read the article, the reporter (Lisa Greene) does point out clearly that:

“Since then, the study [by Wakefield and colleagues] has been harshly criticized. Most of the researchers involved have retracted their results. In September, researchers who conducted a similar study said they found no link between measles virus and autism.”

Vaccines do not cause autism. After >20 studies, some of them quite large, there is no serious scientific debate over this question. But Greene makes an interesting point when she writes: “This is no longer principally a debate about science. The real question is whether Americans still believe in science — or at least, in the nation's scientists.”

That’s a good question. The anti-vaccine camp often uses conspiracy-theory arguments to make their case, as in “the government is hiding the truth” or “big pharma” doesn’t want us to know that vaccines are harmful. If you want to read some really extreme conspiracy-theory arguments, just look at what Robert F. Kennedy Jr. has been saying about thimerosal and vaccines. (And it worries me that his name is being floated for possible high-level positions in the Obama administration.) These arguments are indeed an effort to convince people (not just Americans, of course) not to believe scientists, but instead to believe, well, non-scientists, who make all sorts of other claims, ranging from the merely ignorant to the outright fraudulent. These frauds include people such as Mark and David Geier, who offer testosterone-reduction and chelation drugs to autistic children and claim that these treatments work, despite evidence that they don't - and that they might even cause serious harm.

Why do people prefer to trust quacks rather than science? Neurologist and skeptic Steven Novella has one explanation: “I know that when you are a parent of a sick child the gears of science may grind maddeningly slowly” and science hasn’t yet determined the cause, or a cure, for autism. So when someone comes along, perhaps someone with seemingly respectable credentials (but not always), and says he knows the answer, parents understandably want to believe it.

The St. Pete Times article includes a very interesting set of tables and charts (as a special supplement, not in the main article, alas) with real numbers showing the dramatic reductions over the years in the prevalence of measles and other diseases as vaccines were introduced. The press rarely does enough to point out what a major public health benefit vaccines represent, so kudos to SPT for their special report. As the Vaccine Ethics site at U. Penn says, “Vaccines are credited with having saved more lives than any medical treatment ever developed.”

Note: the title of this posting is a reference to Paul Offit’s outstanding new book, Autism’s False Prophets. I highly recommend it – Offit is a terrific writer who knows the science and the history of research on autism as well as anyone I've ever read.