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Sunday, Jul 5, 2009
A pediatrician traces the rise of the anti-vaccine movement that falsely linked thimerosal with autism and turned parents away from the most lifesaving medicine in history.
By Rahul K. Parikh, M.D.
Read more: Books, Parenting, Health, Science, Reviews, Autism, Book reviews, Dr. Rahul Parikh
Sept. 22, 2008 | Early in Dr. Paul A. Offit's new book, "Autism's False Prophets: Bad Science, Risky Medicine, and the Search for a Cure," he describes a threatening letter he received from a man in Seattle. "I will hang you by you neck until you are dead!" it read. The FBI deemed the threat credible, assigning Offit a protective officer who, for the next few months, followed him "to and from lunch, a gun hanging at his side." He then recalls a suspicious phone call from a man who recited the names of Offit's two children and where they went to school: "His implication was clear. He knew where my children went to school. Then he hung up." These days, the hospital he works in regularly screens his mail for suspicious packages.
Such stories usually come from pro-choice physicians on the front lines of the abortion debate. But Offit is no obstetrician. Rather, he is a baby doctor -- the chief of pediatric infectious diseases at the Children's Hospital of Philadelphia. The threats against him and his family have come not from antiabortion advocates, but rather from anti-vaccine crusaders who believe that vaccines cause autism. Offit, it turns out, has been targeted by them because he helped to develop a vaccine that prevents rotavirus, a serious gastrointestinal infection in children, and because he has been staunchly pro-vaccine in a time when there are many doubts about their safety.
His book investigates the anti-vaccine movement and is a tough rebuttal against his critics, who call him "For Profit Offit" because he worked with drug companies to develop the rotavirus vaccine. Nevertheless, the book is an examination of science and society that's enlightening, highly readable and -- given the recent news about the resurgence of vaccine-preventable diseases as a result of parents' refusal to vaccinate their children -- timely.
Offit begins by tracing the history of the anti-vaccine movement to its roots in England in 1998: That's where a young, charismatic and ambitious researcher named Andrew Wakefield held a news conference to reveal he had discovered that the measles-mumps-rubella (MMR) vaccine causes autism. The prestigious medical journal Lancet subsequently published his paper. Soon, headlines warning parents about "child jabs" appeared on the front page of newspapers all over the U.K., and droves of parents began refusing the MMR vaccine. Despite the resurgence of measles in the U.K. as a result, Wakefield was hailed as a muckraker. The BBC even made a biopic about his fight against the establishment.
In 2000, the news crossed the pond. Indiana Rep. Dan Burton, himself the grandfather of an autistic child, worried she had been injured by vaccines, and held a congressional hearing to publicize Wakefield's findings. Several scientists in the American medical community testified that they, too, had research showing that something in the MMR was suspicious. Just as in England, the media here swarmed. Among the resulting press were Robert F. Kennedy Jr.'s "Deadly Immunity," published simultaneously in Rolling Stone and Salon, and David Kirby's blockbuster book, "Evidence of Harm," a damning account of the link between autism and vaccines and of our government's efforts to cover up a link between the two.
Kirby focused on the notion that thimerosal, a mercury-based compound used to protect vaccines from contamination, is causing an epidemic of autism. This despite the fact that thimerosal was removed from vaccines in 2001, even though it had been used for decades and no studies had been done to verify there was a danger. (Not unexpectedly, this decision, made abruptly by leaders in the medical community, raised even more suspicion about vaccines and autism). Kirby's book became the centerpiece of the anti-vaccine movement and brought him fame. He started speaking widely on the subject, earning appearances on programs as well regarded as "Meet the Press." He even began talks to turn his book into a movie by the same company that made "An Inconvenient Truth." In describing all of these factors -- shocking medical research, media publicity, political endorsements and conspiracy theory -- Offit shows us how vaccines, the most significant and lifesaving medical therapy in history, fell from grace.
But it's at this point, about a third of the way into his book, that Offit begins deconstructing the anti-vaccine movement as one driven by bad science, litigious greed, hype and ego. As early as the 2000 House hearings, scientists expressed unease about Wakefield's methods, worries that Rep. Burton and the media dismissed. But it wasn't until 2004 that Brian Deer, an investigative reporter for London's Sunday Times, discovered damaging evidence against him. Despite what Wakefield claimed in his paper, his hospital's ethics committee never approved his experiments to put children to sleep under general anesthesia, do spinal taps on them, take biopsies of their intestines (one of the children was hospitalized after his colon perforated in several places) and take volumes of blood from their veins. Deer also discovered serious conflicts of interest: Wakefield's research was secretly bankrolled by a personal injury lawyer whose clients were suing MMR makers. Wakefield himself was given close to a million dollars to prove that the MMR caused autism. He had filed a patent for a new MMR vaccine at the same time he was doing his research. Upon learning this, Lancet retracted his paper, and he was charged with professional misconduct in 2005. If he is found guilty of misconduct, he will never practice medicine in the U.K. again.
Next page: Is the focus on vaccines a distraction for the autism community?
What the Poling autism case means
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