Parents and advocates who believe vaccines cause autism were dealt a double blow this week. On the scientific front, a discredited 1998 study that launched the vaccine-autism debate onto the forefront made headlines, and on the legal front, a special U.S. court ruled that vaccines are not to blame for the disease.
The Office of Special Masters in the U.S. Court of Federal Claims oversees cases brought by "persons allegedly suffering injury or death as a result of the administration of certain compulsory childhood vaccines."
The court ruled on three cases, saying it "was abundantly clear that petitioners’ theories of causation were speculative and unpersuasive" – in this instance, that the MMR vaccine and thimerosal don’t cause autism.
Over 5,500 claims regarding vaccines and autism have been filed, so the court isn’t done yet. But the outlook isn’t good for the remaining claims that point to the organomercury compound thimerosal as the causal agent of autism, rather than the entirety of the vaccine – one of the masters stated that the petitioners "have failed to demonstrate that thimerosal-containing vaccines can contribute to causing immune dysfunction."
Unfortunately, as indicated by a statement by the consumer group National Vaccine Information Center's president, the rulings will likely not change the fervent believers of the vaccine/autism link.
Barbara Loe Fisher said the court’s ruling will do little to change the minds of most parents who suspect a link between vaccines and autism and more studies are needed. "I think it's a mistake to conclude that, because these few test cases were denied compensation, it's been decided that vaccines don't play any role in regressive autism."
Actually, Barbara, that is what has been decided. And as the head of a vaccine consumer group, you should be aware of the scientific precedent and plethora of evidence against the link. Sadly, if legal rulings and scientific evidence don’t convince you, nothing will, and there’s no point in debating with you any further.
Paul Offit, author of a number of scientific articles on vaccines, said in a Medscape article that "many people are reassured by these studies, although there are still a group of parents who hold that vaccines cause autism, much as some people hold a religious belief. To those people, it really doesn't matter how many studies you do, it’s not going to change their minds."
Wakefieldgate and the creation of a house of cards
Offit recently published an article in Clinical Infectious Diseases systematically disproving three main theories behind the vaccine/autism link. [Note: Offit is a co-inventor and co-patent holder of Merck’s rotavirus vaccine Rotateq. This doesn’t disqualify his research, but transparency is important.]
MMR: One of the theories – that the measles/mumps/rubella vaccine causes autism – was promulgated by Andrew Wakefield in a 1998 Lancet article.
The Wakefield article is making headlines this week, with a charge from a reporter who says that the medical records of the children shows all but one of the eight studied had autism symptoms before they were administered the MMR vaccine.
You read that right – eight. Only eight children, and "a mini-industry of lawyers and activists" was launched, "and caused millions of children to risk their lives on the result."
What happened? Wakefield’s article described eight children who received the MMR vaccines and within one month developed symptoms of autism. (Wakefield also parlayed these results into an argument for a gastrointestinal link to autism as well.) He hypothesized that the vaccine caused intestinal inflammation, which produced peptides that migrated through the bloodstream to the brain and affected development.
Somehow a number of factors escaped early detection, according to Offit’s CID article (although the research was later discredited). One, there wasn’t a control group. Two, the study was unblinded. Three, gastrointestinal symptoms did not predate autism in several children. Fourth, measles, mumps, or rubella vaccine viruses have not been found to cause chronic intestinal inflammation or loss of intestinal barrier function. And finally, putative encephalopathic peptides traveling from the intestine to the brain have never been identified (although to be fair, this doesn’t mean they don’t exist). Thirteen descriptive and observational studies have demonstrated that there is no link between MMR vaccine and autism, Offit says.
Thimerosal: The second theory Offit addresses in his paper is the thimerosal link.
In 1997, the FDA Modernization Act mandated identification and quantification of mercury in all food and drugs; two years later, FDA found that children might be receiving as much as 187.5 micrograms of mercury within the first 6 months of life. Despite the absence of data suggesting harm from quantities of ethylmercury contained in vaccines, in 1999, the American Academy of Pediatrics and the Public Health Service recommended the immediate removal of mercury from all vaccines given to young infants.
However, Offit says, because the signs and symptoms of autism are clearly distinct from those of mercury poisoning, concerns about mercury as a cause of autism were – similar to those with MMR vaccine – biologically implausible. A CDC study years later confirmed that conclusion. Seven descriptive or observational studies have also confirmed this finding.
Multiple vaccines: Finally, Offit addresses the theory that "simultaneous administration of multiple vaccines overwhelms or weakens the immune system and creates an interaction with the nervous system that triggers autism in a susceptible host."
This theory is flawed for several reasons, he says: one, vaccines do not overwhelm the immune system. Two, multiple vaccinations do not weaken the immune system. Three, although the exact cause of autism is unknown, autism is not an immune-mediated disease. Four, No studies have compared the incidence of autism in vaccinated, unvaccinated, or alternatively vaccinated children (although he acknowledges that these studies would be difficult to do practically and ethically).
What do autism societies say? Interestingly, a number of them, such as the Autism Society of America and Autism Speaks, make no mention vaccines as a causal agent. The CDC and NIH also refute the link.
The Autism Research Institute is one that clearly lists vaccines (along with environmental toxins) as one of the key triggers of autism and sadly advocates a number of opinions in editorials that are reminiscent of Barbara Loe Fisher.
So what’s next? I’m not sure. As Offit says, people like Fisher will find support from folks like those behind Age of Autism, who refuse to accept anything other than what they believe is truth. Meanwhile, CDC and NIH and others will continue to research possible risk factors for autism. [For a dramatic look at the issue, check out this episode of Private Practice online.]
Autism is a complex disease, and there's no denying that it can be a blessing and a curse. More research is needed, but we should expend our efforts on other triggers, and stop using vaccines as a crutch.