Inside the vaccine-and-autism scare

The last nail in the coffin came in 2007 during an "autism omnibus proceeding" in the United States. (This is a federal hearing for several thousand parents who claim their children developed autism because of vaccines. Those parents are seeking compensation from the federal government.) Wakefield's former research assistant testified that his discovery about the MMR vaccine was, in reality, the result of contaminated lab equipment and that Wakefield knew this about but ignored it. In other words, as Offit writes, "Wakefield had crossed the line from ill-conceived, poorly performed science to fraud."

Eleven studies now show that the MMR vaccine doesn't cause autism (the most recent just came out). Six have shown that thimerosal doesn't cause autism; three have shown thimerosal doesn't cause neurological problems. Studies showing the opposite, like Wakefield's, use flawed methods, have serious conflicts of interest or have been conducted in animals whose results can't be extrapolated to humans.

Most of Offit's book takes readers through the public, political, legal and medical battle over vaccines. But he also takes them inside the autism community's own battles over them. Offit interviews Katherine Seidel, the mother of an autistic child who has published her own investigations of those who have profited from the vaccine-autism theory on her Web site, neurodiversity.com. Like many in the autism community, Seidel feels that the focus on vaccines has been a distraction, and that the only people who have benefited are those who sell "cures" to desperate parents, treatments lacking evidence of either safety or effectiveness. She describes the father-and-son team of Mark and David Geier, one a doctor and the other with a college degree in biology. The elder, Mark, opened a homemade lab in his basement, where, under the patronage of anti-vaccine advocates, he works on his theories. They include prescribing Lupron to autistic children, a drug that several states use to chemically castrate sex offenders. The son, David, runs a medical-legal consulting firm, where he offers up expert witnesses for vaccine-injury trials. The two work hand in hand to make money both selling treatments and testifying as expert witnesses in vaccine-autism cases.

Offit also uses the vaccine-autism debate as a case study in how easily society misconstrues science. We are all too eager, he believes, to hold up a single, unverified scientific study as fact. Instead, we should be skeptical about its conclusions and measured in our response to it until its results can be verified by future studies. He highlights many factual errors in articles by Kennedy and others. (Rolling Stone issued retractions in three separate issues; Salon issued five separate corrections of his piece.) But it is David Kirby against whom Offit levels some of his strongest criticism. Unlike other reporters who changed their views after newer research exonerated vaccines, Kirby has refused to budge. This even after he said, "If the number of three-to-five-year-olds [with autism] has not declined by 2007 ... that would be a severe blow to the autism-thimerosal hypothesis." (A 2008 article showed, in fact, that autism rates have continued to climb in the post-thimerosal era.) Offit describes how bizarre Kirby's thinking has become when, while speaking in 2006, he claimed that autism rates were increasing because of China's use of coal (he used a slide with the phrase "Mongolian Plume" written on it), the forest fires in California and an increase in cremations, which release mercury from dental fillings into the air. In the meantime, his movie deal is off. These days, he blogs for the anti-vaccine group Age of Autism, occasionally exporting his entries to the Huffington Post.

One thing that Offit perhaps could have done more in his book is to give autism advocacy groups greater credit for raising awareness, creating strong support networks for parents of children with the disorder and getting more money for research. While he focuses on those groups (like Defeat Autism Now! and Generation Rescue) that have been very confrontational and that support slanted science, there are many advocates (like Seidel) and groups (like Autism Speaks) that have been broader in their search for autism's causes and cure. It's for that reason that the National Institutes of Health is now funding autism research, centers like the M.I.N.D. Institute at the University of California at Davis have been created, and organizations like the American Academy of Pediatrics have published more specific guidelines for doctors regarding the diagnosis and management of autism. Nobody on either side of this argument will dispute this kind of success.

Offit effectively pulls back the curtain on the anti-vaccine movement to reveal a crusade grounded less in fact and more in greed and opportunism, as the book's title subtly but aptly suggests. For that reason, it is sure to inflame anti-vaccine crusaders. But this isn't a book written for them. Rather, it speaks to parents and others who are unclear, unsure or concerned about taking their children to see their pediatrician, and it offers them reassurance about vaccines and the doctors who give them.