Saturday, December 6, 2008

Autism's False Prophets

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.


Anonymous said...

The media have been very cruel and very stupid in dealing with this whole business.

Very cruel for encouraging a rather paranoid and ill-informed group of people motivated by grief, sadness and anger to express ludicrous opinions in public forums. Very stupid for the above and for continuing to do so once it was absolutely clear that there is no link between MMR and autism.

Anonymous said...

quicksilver said...

George Fisher from Gloucester died very recently a few days after his measles vaccine (MMR). His parents claim it was a direct result of vaccination. He responded with seizures to every vaccine before and this time the seizure was fatal. Dead at 18 months but an unqualified expert ( the coroner) on medical matters says no way a vaccine given a few days earlier was the cause. How would he know?
He gave the cause as SIDS. He might as eaisly have just said the heart stopped beating.
Constant denial of vaccine harm does not help medical science or safe vaccination.
The Danish database puts vaccine adverse events as high as 10 per cent a little way ahead of the 0 in UK and USA.

So one dead in 15 years from measles and one dead in one week from adverse measles vaccines but denied as linked. Seems very muddy waters to me.

How about the fact that this one boy that died actually was vaccinated against measles. What went wrong there?

Mike Eslea said...


Thanks for the reminder! I did mean to mention the Science Blogs
discussion. I had planned to blog about this book then but didn't get around to reading it in time. Shame you didn't like the book, but hey ho.

@ Quicksilver

You seem to accept the parents' claim uncritically while dismissing the coroner's view. Why the double standard? In any case, vaccine safety decisions should be based on large-scale studies rather than one case. And have you actually read Offitt's book? There's plenty there about adverse events and vaccine-injury compensation.

Also, far be it from me to argue with a chemist, especially one
"interested in chemicals"
, but you seem to be very worried about mercury without mentioning the difference between ethyl and methyl mercury. Aren't they as different as fine old malt (ethanol) and meths?

Jeffty Jeff said...

The difficultly always seems to lie in the saliance of adverse effects (adverse reactions to vacination in all probably cause by a different source) compared to the saliance of non-effects ("Child Vacinated Suffers No Ill Effects" says Front Page of The Current Bun). How can we, as scientists, hope to inform and improve society against a background of media frenzy, conspiracy theorists and ill informed blogs. Whilst the Wellcome Trust (and others) continue to attempt to foster a society open to the findings of science, all around us were faced with barriers.

242,000 deaths from measles in 2006 is a pretty compelling reason argument for the vacine.