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Monday, February 12, 2007 9:54 PM
Subject:
No link of vaccine, autism
Posted on Tue, Feb. 06, 2007
Fact: No link of vaccine, autism
Arthur Caplan
is the Emanuel and Robert Hart Professor of
Bioethics at the University of Pennsylvania, where he co-directs the
Ethics and Vaccines Project
What must it be like to spend a
huge amount of time every waking day trying to change public health
practice - only to find out that you were wrong?
That is
precisely what has happened to the proponents of the theory that
mercury in vaccines - contained in the preservative thimerosal, which
once was used (and is used no longer) in vaccines - is responsible for
a nearly 20-year explosion in autism and other neurological disorders
among American children.
This urban legend has had very real -
and terrible - consequences. It has led, and continues to lead, many
parents to avoid getting their kids and themselves vaccinated against
life-threatening diseases. The failure to vaccinate has caused many
preventable deaths and avoidable hospitalizations from measles,
whooping cough, diphtheria, flu, hepatitis and meningitis. And fear of
vaccines puts each one of us at risk that we, our children or
grandchildren will become part of a deadly outbreak triggered by
someone whose parents avoided getting their child vaccinated for fear
of autism.
Recent research on many fronts in medicine and science has nailed
the coffin shut on the mercury-in-vaccines-causes-autism hypothesis.
The connection is just not there. Perhaps the key fact, which has
garnered little attention, is that thimerosal has been removed from
vaccines in this and other countries for many years, with no obvious
impact on the incidence of autism. The most recent data point toward a
correlation with nothing at all to do with vaccines: the increasing
age at which people (particularly men) have children seems to be
associated with an increase in autism and other neurological
problems.
Still, some of the most fervent anti-vaccine critics
cannot let go. They continue to tell devastated parents of children
with autism that vaccines are to blame. Others are still out on the
lecture circuit peddling books and articles that bash vaccines and
invoke mercury as a problem. Still others pepper the Internet with the
false message that vaccines and autism do go hand in hand - it is just
that the government, or the pharmaceutical companies, or organized
medicine, or all of them, are keeping the truth from us
all.
Less than two years ago, Robert Kennedy Jr. published an
article in
Salon.com alleging that the
government knew of and covered up the autism-vaccines connection.
Thimerosal was, Kennedy told large audiences and many media reporters,
to blame.
Kennedy was hardly alone in fingering vaccines as the
cause of the epidemic of autism affecting American children. David
Kirby's 2005 best-selling book, Evidence of Harm, and many other
articles, newsletters and advocacy blogs fanned the flames. Some
continue to do so.
Proponents of the thimerosal/mercury-causes-autism theory have
had a powerful impact on public opinion. When one of my students
recently conducted a pilot study of attitudes about the new
cervical-cancer vaccine, fears about autism were prominent among the
reasons many respondents gave for being wary of the vaccine. Friends
of mine continue to tell me of parents in Lafayette Hill, Voorhees,
Greenville and Downingtown who won't have their children vaccinated
because of the risk of autism. States continue to allow parents to opt
out of vaccines on "philosophical" grounds - perhaps the only arena in
American public life where "secular philosophy" is given legal
standing in public policy. And even some young health-care workers
report that they don't get important vaccines that would protect them,
their families and their vulnerable patients against death because of
worries about autism and vaccines.
Science and medicine have
not bought the thimerosal/mercury-autism link. For years the Centers
for Disease Control and Prevention, the American Academy of
Pediatrics, the Children's Hospital of Philadelphia's Vaccine
Education Center, the National Academy of Sciences, the Food and Drug
Administration, and countless other prestigious organizations and
scientists have said the data do not support mercury in vaccines as
the cause of autism.
Now, with the mercury long out of vaccines, what is there
left to say? Why won't the slandering of vaccines as the cause of
autism stop?
There has always been a great deal of antipathy
toward vaccines - in part because vaccines do have a tiny chance of
causing death or other serious side-effects. Parents who have been
through that hell have a hard time hearing or sending any other
message other than "vaccines are bad." And those who made careers out
of peddling the vaccine-autism link - in the face of a lack of
evidence - have really been motivated by a distrust of medicine,
science, government and experts, a distrust that has little to do with
scientific studies or expert opinions. Even government officials have
never really cared enough about public health to do much to counteract
the incredible damage the autism-vaccine proponents have done. That is
not acceptable.
Our nation is spending a fortune on plans to
cope with the prospect of a bioterror attack. State, city and federal
agencies are trying to figure a plan if avian flu mutates into a form
in which it can start killing people. Hospital officials are worrying
over how to cut back on preventable deaths in our hospitals and
nursing homes. Those in charge of keeping disease transmission in
hospitals, schools and public spaces to a minimum are fretting over
what steps to take. The answer to every one of these challenges
involves - vaccines.
This nation's future, its national
security, the safety of its health-care institutions, and the safety
of its citizens depends upon vaccination. It is way past time that
message got heard by parents, teachers, nurses, doctors, hospital
administrators, the media and politicians. If there has been a more
harmful urban legend circulating in our society than the
vaccine-autism link, it is hard to know what it might be. At a time
when vaccines may be our last best hope in facing some of the greatest
challenges we and our children face, this legend needs to be put to
rest. Vaccination, not vaccine-bashing, is what this nation
needs.
