This could be the most important book of 2008, but it has hardly made a ripple yet on this side of the pond, despite giving a starring role to our own Andrew Wakefield. It is Autism's False Prophets, by Paul Offitt, an American vaccinologist, co-inventor of the rotavirus vaccine and director of the Vaccine Education Centre in Philadelphia. If you have read Ben Goldacre's articles about the great MMR hoax and would like to know more, buy this book. In fact, since all Paul's royalties are going to autism research, buy two (it doesn't seem to have been published in a UK edition yet, but you can easily get one from Amazon for about a tenner). If you have the slightest doubts about vaccine safety, it will reassure you. Does anyone still need such reassurance? You might think the debate is over, the argument won, but several events this week have combined to prove that this is far from the case.
First came the news that the number of measles cases in the UK has risen above 1,000 this year for the first time since 1995. Over 150 children have been hospitalised by the disease, and one has died. Why? One reason is poor uptake of the MMR vaccine: only around 75% of children have received both doses by the time they start school, well below the 95% target necessary to ensure herd immunity.
Then came a Guardian poll and Comment Is Free thread, which saw an astonishing number of antivaxers crawling out into the sunlight, repeating all their tired (and thoroughly debunked) conspiracy theories. As Gimpy has pointed out, the poll was very badly worded and made it easy for the idiots to hijack the platform. It is worth reading through the comments, though, to see that there are still many people who believe (for example) that the Simpsonwood meeting was convened in secret to plan a coverup of the dangers of Thimerosal in vaccines. These people cite Robert Kennedy Jr, Jenny McCarthy and Thoughtful House as credible sources, while ignoring the vast piles of evidence that prove Thimerosal is safe. This shows how hard it is to argue with conspiracy theorists, because every bit of evidence against them merely serves to prove that the conspiracy is even bigger than they thought. Now, by writing this, I am in it too.
Now comes the story that should be the final nail in the coffin of the MMR hoax. Throughout the media furore over MMR in 2001-2002 there did seem to be one piece of evidence in favour of Wakefield's hypothesis: the presence of vaccine-strain measles virus in the guts of autistic children. Despite the large-scale epidemiological studies showing that MMR was generally safe, it remained a possibility that a subgroup of children might be at risk, perhaps because of some as-yet-unknown predisposing factor. This was roughly the position taken by Private Eye in their notorious 2002 supplement MMR: The Story So Far, and it made reasonable sense at the time. My son had his MMR in March 2002 (and again in 2005) without a moment's hesitation because it was clear than any risk was tiny and completely offset by the benefits, but I wasn't 100% convinced by the arguments of the MMR defenders because they could not explain Wakefield's virus samples. That changed in 2006, when it became clear that his results were false positives: new studies (reported by Ben Goldacre but hardly anybody else) had failed to find any measles virus in gut tissue from autistic children. Now we can see exactly what went wrong, and how Wakefield's samples were contaminated.
Will this end the debate, as it should? Of course not! Offitt's book lays bare the lunacy of the antivaxers: their willingness to dismiss anything contaminated by Big Pharma, their enthusiasm for alternative therapies, no matter how stupid or dangerous. Since he began his campaign to educate people about vaccine safety, he has become a target for hate mail and even death threats, but he remains upbeat and writes with good humour about his experiences. Several major vaccine-safety court cases will end in the next few months: let us hope science and reason triumph over passion and hatred. In the meantime, buy this book.
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