The Association for Science in Autism Treatment has just published a fine overview of the Autism/Vaccine controversy.
After a brief review of the many studies researching the vaccine/autism link (in short: no link can be found), the paper dives into a deeply interesting aspect of this issue:
Why does the controversy still rage, when the scientific evidence is overwhelming?
Understanding the controversy will help us shift the debate back to the important issues: how do we best provide services, and where should research dollars be spent?
Follow me below the fold...
It is very important to note that after numerous studies, no link has been found. Of course, one cannot “prove” something does not exist (see: Sasquatch) but lack of evidence after much searching implies that other explanations should be sought. Famously, the Japanese government eliminated the MMR vaccine for one portion of the population, only to see a rise in Autism for that cohort. The CDC, the NIH, and the American Academy of Pediatrics all found no link.
The full article, with reviews of the research, can be found on the ASAT site.
So why the controversy? Why is scientific evidence being rejected?
In 1998, Andrew Wakefield published a study claiming such a link existed. As the ASAT paper puts it:
It is hard to understand how any reputable scientist, researcher, or MD could allow such material to be published; especially in light of the very serious repercussions that he surely must have known would follow...In fact, in 2004, The Lancet editor, Richard Horton, (although still trying to defend his decision to publish the essay) did admit that he had not known about Wakefield’s “fatal conflicts of interest” A month later, 10 of 13 of Wakefield’s coauthors on the study published a “retraction of an interpretation” concerning the study.
The ASAT paper documents the conflicts and the evidence for the flaws in the study, concluding:
In 2005, the General Medical Council of Great Britain charged Wakefield and two of his colleagues with ethical and professional misconduct. Wakefield refused to back down, taking his case to the public, and garnering wide support with his claims that he was being persecuted for speaking out in defense of children.
If there is no evidence for the link, why do so many promote the link between Autism and Vaccines so fervently? The ASAT study suggests that the “Victim/Villain/Victor” syndrome is at play. The children are victims, the big pharmaceutical companies are obviously villains, and the courageous speakers of truth to power are the victors (parents, celebrities, politicians, talk show hosts) “all rushing in to save the children!”
The media’s “he said / she said” approach to complex issues, combined with the drama of a fight over disabled kids, means that an issue for which the scientific evidence is overwhelming is treated as “controversial.” We see similar patterns in the media over global climate change, for example. It’s not about the science – emotion sells advertising.
Why does this matter?
Public health is put at risk, and money that could go towards effective treatment is instead spent on yet another study regarding vaccines. Advocates for the disabled spend precious time and energy debunking myths. And parents are led to engage in activities that don’t help their children.
Consider public health: in England, many parents have chosen not to immunize their children. In the last 10 years, cases of measles are 24 times higher! Read the story in the Guardian
In some larger sense, though, we as active members of our communities and political systems must become scientifically savvy. So many issues today require an evaluation of scientific evidence: climate, energy policy, health policy, education, ...
The ASAT article ends with a very handy set of recommendations for discerning fact from bunk, science from pseudoscience. A sampling:
Pseudoscientific Therapies: Some Warning Signs:
• High “success rates” are claimed
• Rapid effects are promised
• ...
• Testimonials, anecdotes, or personal accounts are offered in support of claims about the therapy’s effectiveness, but little or no objective evidence is produced.
• ...
The article concludes that the love of parents for their children must be coupled with the scientific research if we are to forge an enlightened path.
This article is a “must read” for anyone interested in the autism/vaccine controversy.
Update: Several folks in the comments were wondering, "That's all good, but what do we say to the parents?"
For parents with diagnosed children, help them move beyond the blame and guilt stages, and focus on to "what do we do for our child now?" ASAT also has an excellent resource for evaluating treatments.
For the the parents with a healthy child they don't wish to vaccinate, reviewing the history of smallpox, polio, rubella, measles and the rest may be a start. Then point out that Japan and Denmark stopped the vaccines, only to see autism continue to rise. And wish them the best.