Saturday, August 27, 2011

Vaccines Cleared Again as "Culprit": or, Whose Mind Do You Trust?

For any parents out there seeking fresh reassurance that immunizations do not cause autism, perhaps this week's announcement of research results from the Institute of Medicine will provide some.

Using seventeen years of data, the institute found absolutely no link between immunizations and autism; more, it found that immunizations are overwhelmingly safe, and that bad reactions are exceptionally rare, especially considering how many vaccines are given across the globe.

But, tragically, those with a great deal at stake (mostly money) in perpetuating the falsehood that vaccines not only cause autism, but are responsible for a host of health problems, continue to deny the science and find ways to scare parents into skipping vaccines. As parents ourselves, we understand all too well how that visceral fear of harm coming to our children can be stimulated--and taken advantage of.

The National Academy of Sciences has nothing to gain by lying about the research. It is an independent body of researchers and scientists. The question of undue influence aside, the anti-vaxxers then ask if the science has been interpreted correctly. We would ask you to judge for yourself the qualifications of those minds from the Institute of Medicine (and all the minds responsible for producing the more than 1,000 vaccine studies the Institute analyzed) versus the qualifications of non-scientists, public relations professionals, and autism activists from anti-vax organizations like National Vaccine Information Center.

In order to continue believing the vaccine-autism non-link, you would have to believe in a decades-long conspiracy among the United States government, the greatest scientific minds in the country, university researchers, epidemiologists, including those from the Centers for Disease Control and the World Health Organization, pediatricians across the country, and drug-makers. That only a single man, over the course of this entire debate, has come forward to make "scientific" claims that immunizations and autism are related, is telling. One would actually think that more folks would take advantage of an opportunity to become famous--to be the one guy or gal who could definitely prove a link between vaccines and autism. More telling, though, is that that single man who did claim to find a link--Andrew Wakefield--faked his results, manipulated his subjects, kept that manipulated sample size to under fifteen, and was stripped of his license to practice medicine as a result of his fraud. The Lancet, which published this study, retracted it entirely. In contrast, the New York Times describes the Institute of Medicine this way:

The Institute of Medicine is the nation’s most esteemed and authoritative adviser on issues of health and medicine, and its reports can transform medical thinking around the world. 

We then turn to concerns  that have some real science behind them. For example, this study found that while exceptionally rare, immunizations can cause negative effects in some immuno-compromised individuals (much like any medicine might). It is in this area of the study that you will likely see many anti-vaxxers flock to in order to proclaim that the study "proves" vaccines are harmful. What you won't get from them is context.

Let's take the finding that one of the risks of receiving the chickenpox vaccine is that, years after the vaccination, some people (immuno-compromised individuals, such as those undergoing chemotherapy) can develop pneumonia, meningitis, or hepatitis if the virus used in the vaccine in a weakened form "reawakens" because of that cancer. This, you'll hear anti-vaxxers say--and many already have--proves that the safety of vaccines is still in question.

Not quite. Here's your context. The exact same risks of developing meningitis, pneumonia, and hepatitis are present in individuals who got chickenpox naturally. No, that's not quite right--the risks for developing these health problems are far *greater* in those who had chickenpox naturally. Read: the risk is greater in those who were not vaccinated and who contracted chickenpox the old-fashioned way. Or the new-fashioned way, I suppose: at "chickenpox parties," where unvaccinated children are exposed to an infected child so they can gain "natural immunity" in the form of the chickenpox virus.

We do find it heartening that as more and more of these conclusions from wide-ranging, objective scientific research firmly establish that there is no link between immunizations and autism, the retorts from anti-vaxxers begin to sound as error-ridden as they, in truth, are. In fact, I have noticed a note of desperation creeping into some of the quotes I've been reading in the press. Take the quote in the New York Times article from Sallie Bernard of SafeMinds, which contends there is a link between vaccines and autism. She says,  "I think this report says that the science is inadequate, and yet we are giving more and more vaccines to our kids, and we really don't know what their safety profile is."

It is interesting that a survey of more than 1,000 peer-reviewed research articles on vaccine safety, which finds no link to autism and very few adverse effects in the population to any vaccine, is considered "inadequate" to Ms. Bernard.

If you're still not sure whose scientific judgment to trust, you can compare credentials. Ellen Wright Clayton, the chair of the IOM's panel, is the Craig-Weaver Professor of Pediatrics at Vanderbilt, the Director of the Center for Biomedical Ethics and Society. She is considered one of the country's leading experts in Inborn Genetic Diseases, and as been a member of the IOM since 2006.

Sallie Bernard is the founder and former president of a full-service market research and marketing consulting firm and is the parent of an autistic chid.

Here is the New York Times article on the new findings by the Institute of Medicine. Vaccine Cleared Again as Autism Culprit.

Tuesday, August 2, 2011

Letter to the Editor

UPDATE TWO: Unfortunately, the response from MN Parent was pretty disappointing. There was no real correction. Instead, there was a clarification that no study has been shown to link vaccines and autism. Instead of acknowledging the other errors in the piece, the editors felt they needed to validate the mother's search for "truth"--apparently even if in that search she misinforms thousands of parents--and use this as a reason they do not challenge her facts. Also, the editors disputed the information I gave them about the state with the highest rate of autism. I guess the CDC isn't reliable enough. It's enough to make me think that this publication has an anti-vaxxer pretty high on the masthead. It's really too's an otherwise nice magazine.

UPDATE: I received a gracious reply from the executive editor of MN Parent. There might be a correction run in the next issue. I will keep you updated.

Editor's Note: In the August 2011 issue of Minnesota Parent, a local free publication distributed in Minnesota, a mother was profiled in the magazine's "Real Parents" feature. The parent, Jennifer Vanderhorst-Larson, is the parent of a ten-year-old autistic child. She seems like a nice lady. However, in her profile, and uncorrected by the editors of the publication, she makes some statements about vaccines and autism that are egregious and false, including the jaw-dropping assertion that "1 in 28 Somali children" are autistic (They make up 1 in 28 in a population of diagnosed autistic children.) I was literally sick to my stomach after reading her profile and decided I had to speak up. Below find my letter to the editor. I am posting this to encourage other Moms and Dads Who Vax to speak up whenever the media fails to do its job when discussing this issue. When we remain silent, we agree. And members of the media cannot be allowed to fall down on the job on this issue, when lives are at stake. 

Dear Editors,

I was distressed and profoundly disappointed after reading the Real Parents in this month's Minnesota Parent. As a mother and journalist, I have always enjoyed the reportage and first-person accounts in your magazine. But upon reading Jennifer Vanderhorst-Larson's profile, I was struck dumb. You profile a mother of an autistic child who is involved with special education efforts. That's great. However, you allow her to speak as an expert on vaccines, autism, and even the incidence of autism in the Somali community, all the while not doing any fact-checking of her statements, and writing, as the editorial voice introducing her, that her child was diagnosed with autism after his fifteen-month vaccinations, instead of stating how old Cade was when he was diagnosed, which would have avoided creating a link in the reader's mind. As you know, study after study after study has found absolutely no link between vaccines and autism. As you also know, children and infants have fallen ill and died from vaccine-preventable diseases because people are not vaccinating their children because of a fear of this non-existent link.

Just to give you a sense of how badly Vanderhorst-Larson got her facts wrong, she says that there was no study on combo vaccines when her son was vaccinated nine years ago. In fact, in 1997, this study ( was published in Clinical Infectious Diseases about the safety of the MMR combo vaccine when given with another vaccine. In 2001, there was this study in the Pediatric Infectious Disease Journal ( showing the safety of the dTap combo vaccine. Both were published ten or more years ago, before or within those first fifteen months of her son Cade's birth. More studies on combo vaccines have been published since ( and all of them have found the combo vaccines safe. This was a crucial piece of information left out of the profile, and it makes me wonder if it was intentional. In any case, Vanderhorst-Larson's comment that there were no studies on combo vaccines when Cade was vaccinated is incorrect and misleading.

She also says Minnesota has the highest rate of autism. This is incorrect. In the latest, most comprehensive accounting of autism diagnoses in this country, the CDC found New Jersey had the highest incidence of autism, 1 in 94. 

Finally, in what I think is the most egregious mistake in her story, she says 1 in 28 Somali children in the Twin Cities have autism. She may not understand the statistics she is looking at: the Minnesota Department of Health estimated that of diagnosed autistic children in Minnesota, you could expect to find a Somali child in one of every 28 diagnosed children. This is a far cry from 1 in 28 Somali children, which is what she states in her profile. There is, in fact, no firm number on the incidence of autism in the Somali community--and that is why the CDC just funded a study to discover the incidence and to understand why it seems to be higher than other populations. I won't bore you with her misapplication of the word epidemic in connection to autism and the possibility that it is, in part, a genetic disorder.

It's disappointing to see the vaccine-autism myth handled in this way by a trusted local publication that aims to support and educate parents, and usually does. I believe the responsible thing to do in this case would to have been either to keep to Vanderhorst-Larson's area of expertise--education and founding IT companies--and edit out her comments on vaccines and statistics (unless you planned to fact-check those statistics and her claims about vaccines, which didn't happen) or to run an editor's note with her profile pointing out that autism and vaccines have not been found to have any link, despite numerous studies that have looked for that link. This is not a matter of opinion; if it were, I wouldn't be writing to you. This is a matter of science and public health, and it is reckless for a publication like yours to let a parent spread false, misleading, and downright scary information in a forum such as your Real Parents profile, which I bet is a very popular part of your magazine. (Definitely the first page I turn to!)  Errors like Vanderhorst-Larson's, which are very, very commonly heard in the anti-vaccination community, cannot go uncorrected. I beg you to run an editor's note correcting her misstatements of fact, lest a new parent read these comments and choose not to vaccinate her baby because of them. Let that parent, at least, make that decision based on facts, not falsehoods. Thank you.

Ashley Shelby