Sunday, November 09, 2008

Autism's Vaccine War Should Be Ended


I am a "neutral" in autism's vaccine wars.

I do not accept that a connection between autism and vaccines has been established by medical and scientific study. Nor do I believe that such a connection has been conclusively dis-proven by epidemiological study. I find it disconcerting that both camps in the autism-vaccine wars throw increasingly angry rhetoric, including cheap insults, at anyone who offers an opinion on the issue. Public Health authorities should encourage the research necessary to obtain evidence to resolve and bring an end to the autism vaccine wars.

I am the father of a 12 year old boy with Autistic Disorder, assessed with profound developmental delays. I am not a scientist or a scientific researcher of any kind. I am also a humble small town lawyer who looks primarily to those who do the research, and to medical and psychological professionals, for understanding of my son's Autistic Disorder.

The responsible authorities tell us that there is no vaccine autism connection and I accept that - for now. With that acceptance I am not in the anti-vaccine camp in the autism wars. I read with interest the information posted on the Age of Autism web site but do not subscribe to much of it.

Unlike those firmly entrenched in the other army in the vaccine-autism war though, I do not close my mind to the possibility that further research could establish such a connection. As a lawyer it is axiomatic that I must look at all the evidence, not just the evidence that suits a client's position, in order to properly represent that client. It has always been my understanding that science too re-examines its conclusions in the face of fresh evidence and that hypotheses are not excluded for policy reasons.

I remain open to the possibility that vaccines may contribute to, or trigger, the onset of autism in some children. I thought the comments of Dr. Bernardine Healy in her CBS interview with Sharyll Attkisson were worthy of follow up and rebuttal by responsible professionals. Dr. Healy is a former head of the National Institutes of Health in the United States who told Ms Attkisson that the vaccine autism could not be ruled out, that further research had been declined by health authorities for fear of what might be found:

"I think that the public health officials have been too quick to dismiss the hypothesis as irrational," Healy said. "But public health officials have been saying they know, they've been implying to the public there's enough evidence and they know it's not causal," Attkisson said. "I think you can't say that," Healy said. "You can't say that."

Healy goes on to say public health officials have intentionally avoided researching whether subsets of children are “susceptible” to vaccine side effects - afraid the answer will scare the public.
"You're saying that public health officials have turned their back on a viable area of research largely because they're afraid of what might be found?" Attkisson asked. Healy said: "There is a completely expressed concern that they don't want to pursue a hypothesis because that hypothesis could be damaging to the public health community at large by scaring people.

"First of all," Healy said, "I think the public’s smarter than that. The public values vaccines. But more importantly, I don’t think you should ever turn your back on any scientific hypothesis because you’re afraid of what it might show."
As an example, Healy points to the existing vaccine court claims.

CBS News has learned the government has paid more than 1,300 brain injury claims in vaccine court since 1988, but is not studying those cases or tracking how many of them resulted in autism. The branch of the government that handles vaccine court told CBS News: “Some children who have been compensated for vaccine injuries…may ultimately end up with autism or autistic symptoms, but we do not track cases on this basis.”

"What we’re seeing in the bulk of the population: vaccines are safe," said Healy. "But there may be this susceptible group. The fact that there is concern, that you don’t want to know that susceptible group is a real disappointment to me. If you know that susceptible group, you can save those children. If you turn your back on the notion that there is a susceptible group… what can I say?"

Government officials would not respond directly to Healy’s views… but reiterated, vaccines are safe.

Dr.Healy's comments about public health officials discouraging research into the vaccine hypothesis are clearly confirmed by reading the recommendations of the Institute of Medicine (IOM) Immunization Safety Review: Vaccines and Autism (2004) referenced in the CBS interview with former NIH Head Dr. Bernadine Healy ot the National Academies Press site. The document is 214 pages with hundreds of references to autism. Some comments in the Review:

At page 152:

BOX 2
Committee Conclusions and Recommendations

SCIENTIFIC ASSESSMENT

Causality Conclusions

The committee concludes that the evidence favors rejection of a causal relationship between thimerosal-containing vaccines and autism.

The committee concludes that the evidence favors rejection of a causal relationship between MMR vaccine and autism.

Biological Mechanisms Conclusions

In the absence of experimental or human evidence that vaccination (either the MMR vaccine or the preservative thimerosal) affects metabolic, developmental, immune, or other physiological or molecular mechanisms that are causally related to the development of autism, the committee concludes that the hypotheses generated to date are theoretical only.

SIGNIFICANCE ASSESSMENT

The committee concludes that because autism can be such a devastating disease, any speculation that links vaccines and autism means that this is a significant issue.

PUBLIC HEALTH RESPONSE RECOMMENDATIONS

The committee recommends a public health response that fully supports an array of vaccine safety activities. In addition the committee recommends that available funding for autism research be channeled to the most promising areas.

Policy Review

At this time, the committee does not recommend a policy review of the licensure of MMR vaccine or of the current schedule and recommendations for the administration of the MMR vaccine.

At this time, the committee does not recommend a policy review of the current schedule and recommendations for the administration of routine childhood vaccines based on hypotheses regarding thimerosal and autism.

Given the lack of direct evidence for a biological mechanism and the fact that all well-designed epidemiological studies provide evidence of no association between thimerosal and autism, the committee recommends that cost-benefit assessments regarding the use of thimerosal-containing versus thimerosal-free vaccines and other biological or pharmaceutical products, whether in the United States or other countries, should not include autism as a potential risk.

The above recommendations noted that because there was an absence of experimental or human evidence concerning a vaccine autism link any such link remained theoretical only. It did not say that there was no possibility of such a link or that such a link had been dis-proven. The recommendations expressly discouraged investigation of a possible autism vaccine link for cost-benefit reasons. The IOM expressly discouraged the type of research that might have provided the evidence that it said was lacking and necessary to establish a vaccine autism link.

The IOM strategy of abandoning investigation of a possible autism-vaccine link has not enhanced public confidence in the safety of vaccines. The denials and insults thrown at leaders of the "vaccines cause autism" camp will only increase the suspicions of those who distrust public health authorities and their assurances that vaccines do not cause, contribute to, or trigger autism.

It is time for the IOM and other public health authorities to investigate and obtain the "experimental or human evidence" to either refute or confirm, in whole or in part, the autism vaccine hypothesis that it referenced in 2004.

It is time to end the autism vaccine war.




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2 comments:

Anonymous said...

I appreciate your well thought out response to the Autism - Vaccine discussion. I am a little disappointed at lack of urgency. I feel that somewhere in this whole mess is a crime of negligence and a conspiracy to avoid the issue until this generation goes away. Parents without resources need help from parents like you to force open this can of words. I pray your passive intelligent response wakes someone up. As in the fight for any advancement in human rights it takes a sustained front page effort to bring about change. I have a lot more to say but I will use my blog to write more. Thank you for the effort.
http://www.causecast.org/member/tanners-dad

Marni Wachs said...

There are many credible and intelligent people who ask these same questions.

To all:
Don't let anyone tell you otherwise. The mainstream medical community denies what Harold just wrote so eloquently.