Monday, June 18, 2007

Autism: Why The (Vaccine) Debate Rages

Sharyl Attkisson is the Capitol Hill Correspondent for CBS News.

I am not a subscriber to the vaccine causes autism theories. And I am no fan of David Kirby's ham handed presentation of the vaccine theories. But I do not bash parents who believe that there is a causal relationship. Nor do I think rational discussion of the issues surrounding the issues should be forbidden or research prevented. The following CBS article by Sharyl Attkisson is one of the best that I have read at explaining why many parents still believe that vaccines have caused their children's autism.

Autism: Why The Debate Rages

Posted by Sharyl Attkisson

Sharyl Attkisson is the Capitol Hill Correspondent for CBS News.

With the first autism case now being heard in federal vaccine court in Washington D.C., it makes sense to ask: Why is anyone even still debating the possibility of a link between vaccines and autism? After all, for years, many government health officials, advisors and vaccine manufacturers have said there's no association.

Here are a number of reasons why the question remains open:

1. While government scientists, advisors and pharmaceutical companies have been responsible for infinite lifesaving and life improving medical advances, they are not infallible.

• It's the same group that originally thought it was safe to use x-ray machines in shoe stores, gave pregnant women Thalidomide for morning sickness and once allowed mercury in medicines. They assured us Vioxx and Duract were safe painkillers, prescribed Rezulin for diabetics and then denied any of them were responsible for patient deaths. If we never questioned that group, we might not have discovered that Fen-phen and the dietary supplement Ephedra are not safe weight loss products, that antidepressants in kids can lead to suicidality and Viagra can cause blindness. The list goes on.

• When it comes to vaccines, the same group failed to predict that the 1990's rotavirus (diarrhea) vaccine would have to be pulled from the market after infant deaths. They encouraged use of the oral polio vaccine (eventually discontinued after it gave too many children polio). And they allowed the use of a mercury neurotoxin preservative in childhood vaccines, only to admit later that they hadn't thought to calculate the cumulative amount kids were getting as more and more vaccines were added to the childhood immunization schedule.

• Recent history demonstrates that too often, government health officials, mainstream doctors and pharmaceutical companies aren't on the leading edge of alerting us to health risks; they're bringing up the rear. Patients feel left to fend for themselves, seeking independent research and opinions on their own. They and their dogged, relentless determination have often been the catalyst that eventually brings medical dangers to the forefront.

2. Government scientists, advisors and vaccine manufacturers often take an all-or-nothing approach to vaccinations.

• Government officials and infectious disease experts I've spoken with are fearful that if vaccine side effects are better publicized, or if a link between vaccines and autism and ADD were made, the public would overreact and lose faith in the entire vaccination program. The result, they're afraid, would be parents refusing to give their children any vaccines, leading to new, deadly epidemics of preventable diseases. That indeed would be a disaster. However, their fears have resulted in something I call an all-or-nothing approach: they tend to promote nearly all vaccines for nearly all children as equally necessary and equally safe. Yet at the same time, if asked, they agree not all vaccines are equally safe, equally beneficial, equally necessary and equally tolerated by each individual child.

• Through the Internet and other resources, parents are now able to find research on vaccines and read it for themselves. They compare the government's all-or-nothing approach to the research and become skeptical that the government is presenting the whole picture on vaccine safety generally.

3. Government officials and mainstream scientists who dispel any vaccine/autism/ADD link have ties to vaccine makers.

• There's so much overlap among pharmaceutical companies, government scientists and advisors that the information they provide at least has the appearance of a conflict of interest. Government scientists and advisors often do not mention their connections to the vaccine industry when they provide opinions on the vaccine/autism/ADD issue.

• One of the best examples of this is the landmark autism/vaccine study published in Pediatrics. Early in his study, the lead author, CDC's Dr. Thomas Verstraeten, found statistically significant associations between the amount of mercury (thimerosal) exposure kids got from their childhood vaccines, and a wide range of brain disorders. However, the published version of the study (the one the authors say is accurate) found no evidence of a link to autism. Not disclosed was that Dr. Verstraeten had left CDC midstream during the study and had gone to work for Glaxo, a vaccine manufacturer. That failure to disclose was criticized in a later publication of Pediatrics, but it got little mainstream attention. Also getting little attention was a letter from well-respected scientists, also in Pediatrics, who echoed what parents of autistic children had been saying for months: they questioned the use and exclusion of certain data from Dr. Verstraeten's study that eventually reduced the statistical ties between vaccines and neurodisorders.

• University and government researchers and advisors often do research for vaccine companies, help develop vaccines (even profit from them), and/or are paid to consult for them. Often, these researchers do not disclose their industry ties when they publicly dispel the notion of a link between autism or ADD and vaccines.

• Lastly, the CDC is inextricably tied to vaccine makers through contracts and other business and financial relationships that open the door for the possibility of conflicts.

4. Non-profits which dispel any vaccine/autism/ADD link have ties to vaccine makers.

• Non-profits that promote vaccinations have ties to vaccine makers that they often do not disclose when giving their opinions on vaccine safety. One example is "Every Child By Two." This group contacted CBS News several years ago in an unsuccessful attempt to prevent one of our stories about the vaccine safety from airing. In forms filed for the IRS, the non-profit lists an official from vaccine maker Wyeth Pharmaceuticals as its Treasurer. It lists vaccine maker Chiron as a paid client.

• Another example of a non-profit tied to the industry is "The Vaccine Fund." Its President from 2000-2005 was Jacques-Francois Martin, formerly CEO of vaccine maker Sanofi-Pasteur, CEO of vaccine maker Chiron, and President of the International Federation of the Pharmaceutical Manufacturers' Association. While at The Vaccine Fund, his salary was paid by a company that says it "has developed particular strength in the vaccine industry and vaccine development."

5. The dual role of the CDC undermines the appearance of fairness.

• There is a perceived, if not real, conflict of interest with the government's Centers for Disease Control (CDC) heavily promoting vaccines, but also responsible for monitoring adverse events. At least two respected medical journals, the "American Journal of Public Health" and "Pediatrics" have published letters or articles recommending "greater independence in vaccine safety assessments" apart from "the highly successful program to promote immunizations." In short, the CDC's bread and butter is achieving high vaccination rates. But that role is in conflict with the agency's responsibility to fully research and disclose adverse events that could, in theory, bring down vaccination rates.

6. There is no definitive research proving a link between vaccines and autism or ADD, but there is also no definitive research ruling it out.

• Something rarely reported is that while there's no definitive study linking vaccines to autism or ADD, there is also no study definitively disproving a link. And there's a substantial body of peer-reviewed, published science from places like Columbia, Yale and Northeastern suggesting a link, or pointing to the need for further study.

• Many credible voices deny a link. But many other credible voices support the idea of a link. One example of the latter is George Wayne Lucier, formerly a senior official at the National Institutes of Health in Environmental Toxicology, an NIH advisor, member of the National Academy of Sciences Committee on Toxicity Testing and a scientific advisor for EPA who concludes " is highly probably that use of thimerosal as a preservative has caused developmental disorders, including autism, in some children." A lengthy Congressional investigation also concluded that the autism epidemic is likely linked to vaccinations.

7. Those who say autism and ADD are not linked to vaccines do not know what is causing the epidemics.

• The most frightening part of the autism/ADD epidemics is that if, indeed, they're unrelated to vaccinations, that our best, brightest public health experts still have no idea what is causing it. Excluding ADD, one out of every 150 American children are now being diagnosed with autism.

Vaccinations have provided lifesaving miracles in public health. However, it's undisputed that they are also responsible for many serious adverse events including brain disorders and, rarely, deaths. Trying to maximize the potential benefits of vaccines and minimize the harm shouldn't be seen as a threat to the nation's inoculation program, it's merely a logical step forward.

One scientist who testified for the plaintiff this week in The Vaccine Court said there's a way to test children for a hidden hole in their immune make-up that makes them susceptible to bad immune reactions from vaccinations. He said that, ideally, every child should undergo such a test before their first vaccinations. But he also said the test is very expensive and so "not worth it." Many parents might disagree. If they knew such a test was available, they'd find a way to pay for it. But such information has to be disseminated to the public before a first step can even be considered.

Mainstream medicine initially said that autism was caused by mothers who weren't affectionate enough with their children. If that doesn't teach us that we should always seek further knowledge and not necessarily accept what's spoon-fed to us by certain experts…then nothing will.

1 comment:

Maya M said...

Ms. Attkisson essentially claims that:
(1) Because government scientists and pharma companies are not infallible, we'd better believe nothing of what they say, even though we haven't the data and expertise needed to participate in a serious debate on these issues.
(2) Government scientists... have an all-or-nothing approach to vaccination which is bad. They should minimize vaccine complications by providing individualized immunization scheme for each child. (In fact, even if we don't ask how much time and money this would cost, for most vaccine complications it isn't possible at the moment to predict in which child they will happen.)
(3) Officials and scientists who dispel the vaccine/autism link have ties to vaccine makers, so we mustn't believe what they say. (Don't ask about the ties of off-mainstream scientists who do find vaccine/autism link.)
(4) Essentially the same as above.
(5) CDC doesn't provide enough data about the adverse effects of vaccines. (This is the only point which I find agreeable).
(6) There is no definitive research ruling out vaccines-autism link, because no matter how many such studies are publshed, we can always say they aren't enough and find somebody arguing for the opposite opinion.
(7) Vaccines may be linked to autism because those who deny the link cannot explain the autism epidemic. (But it isn't proven that the epidemic is real. Some studies deny it, e.g. Shattuck P.T. (2006), The contribution of diagnostic substitution to the growing administrative prevalence of autism in US special education, Pediatrics 117: 1028-37).
The next citation summarizes what I dislike in Ms. Attkisson's article:
"Patients feel left to fend for themselves, seeking independent research and opinions on their own. They and their dogged, relentless determination have often been the catalyst that eventually brings medical dangers to the forefront."
Translation: Medical science could never overcome its fallacies without the contribution of lay people with enlightened revelations about the cause of their medical problems, so go on with your "research", you are no worse than any doctor or scientist.
Conclusion: I think CDC and its analogs in other countries should provide thorough descriptions of vaccine complications and not force anybody to vaccinate. After enough parents see their unvaccinated children die of measles or their unvaccinated daughters give birth to babies with full-blown congenital rubella, perhaps some truths will find their way to people's heads.