Caplan on Vaccines and Autism
Art, who runs a vaccines and ethics project at Penn, is really going after the continuing claims that vaccines are linked to autism in any scientifically validated way. In the Philadelphia Inquirer he argues as much:What must it be like to spend a huge amount of time every waking day trying to change public health practice - only to find out that you were wrong? That is precisely what has happened to the proponents of the theory that mercury in vaccines - contained in the preservative thimerosal, which once was used (and is used no longer) in vaccines - is responsible for a nearly 20-year explosion in autism and other neurological disorders among American children.
This urban legend has had very real - and terrible - consequences. It has led, and continues to lead, many parents to avoid getting their kids and themselves vaccinated against life-threatening diseases. The failure to vaccinate has caused many preventable deaths and avoidable hospitalizations from measles, whooping cough, diphtheria, flu, hepatitis and meningitis. And fear of vaccines puts each one of us at risk that we, our children or grandchildren will become part of a deadly outbreak triggered by someone whose parents avoided getting their child vaccinated for fear of autism.
Recent research on many fronts in medicine and science has nailed the coffin shut on the mercury-in-vaccines-causes-autism hypothesis. The connection is just not there. Perhaps the key fact, which has garnered little attention, is that thimerosal has been removed from vaccines in this and other countries for many years, with no obvious impact on the incidence of autism. The most recent data point toward a correlation with nothing at all to do with vaccines: the increasing age at which people (particularly men) have children seems to be associated with an increase in autism and other neurological problems.
Still, some of the most fervent anti-vaccine critics cannot let go. They continue to tell devastated parents of children with autism that vaccines are to blame. Others are still out on the lecture circuit peddling books and articles that bash vaccines and invoke mercury as a problem. Still others pepper the Internet with the false message that vaccines and autism do go hand in hand - it is just that the government, or the pharmaceutical companies, or organized medicine, or all of them, are keeping the truth from us all.
Less than two years ago, Robert Kennedy Jr. published an article in Salon.com alleging that the government knew of and covered up the autism-vaccines connection. Thimerosal was, Kennedy told large audiences and many media reporters, to blame.
Kennedy was hardly alone in fingering vaccines as the cause of the epidemic of autism affecting American children. David Kirby's 2005 best-selling book, Evidence of Harm, and many other articles, newsletters and advocacy blogs fanned the flames. Some continue to do so.Proponents of the thimerosal/mercury-causes-autism theory have had a powerful impact on public opinion. When one of my students recently conducted a pilot study of attitudes about the new cervical-cancer vaccine, fears about autism were prominent among the reasons many respondents gave for being wary of the vaccine. Friends of mine continue to tell me of parents in Lafayette Hill, Voorhees, Greenville and Downingtown who won't have their children vaccinated because of the risk of autism. States continue to allow parents to opt out of vaccines on "philosophical" grounds - perhaps the only arena in American public life where "secular philosophy" is given legal standing in public policy. And even some young health-care workers report that they don't get important vaccines that would protect them, their families and their vulnerable patients against death because of worries about autism and vaccines.
Science and medicine have not bought the thimerosal/mercury-autism link. For years the Centers for Disease Control and Prevention, the American Academy of Pediatrics, the Children's Hospital of Philadelphia's Vaccine Education Center, the National Academy of Sciences, the Food and Drug Administration, and countless other prestigious organizations and scientists have said the data do not support mercury in vaccines as the cause of autism.
Now, with the mercury long out of vaccines, what is there left to say? Why won't the slandering of vaccines as the cause of autism stop?There has always been a great deal of antipathy toward vaccines - in part because vaccines do have a tiny chance of causing death or other serious side-effects. Parents who have been through that hell have a hard time hearing or sending any other message other than "vaccines are bad." And those who made careers out of peddling the vaccine-autism link - in the face of a lack of evidence - have really been motivated by a distrust of medicine, science, government and experts, a distrust that has little to do with scientific studies or expert opinions. Even government officials have never really cared enough about public health to do much to counteract the incredible damage the autism-vaccine proponents have done. That is not acceptable.
Our nation is spending a fortune on plans to cope with the prospect of a bioterror attack. State, city and federal agencies are trying to figure a plan if avian flu mutates into a form in which it can start killing people. Hospital officials are worrying over how to cut back on preventable deaths in our hospitals and nursing homes. Those in charge of keeping disease transmission in hospitals, schools and public spaces to a minimum are fretting over what steps to take. The answer to every one of these challenges involves - vaccines.
This nation's future, its national security, the safety of its health-care institutions, and the safety of its citizens depends upon vaccination. It is way past time that message got heard by parents, teachers, nurses, doctors, hospital administrators, the media and politicians. If there has been a more harmful urban legend circulating in our society than the vaccine-autism link, it is hard to know what it might be. At a time when vaccines may be our last best hope in facing some of the greatest challenges we and our children face, this legend needs to be put to rest. Vaccination, not vaccine-bashing, is what this nation needs.
Labels: autism, vaccination, vaccines
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I agree and support the cause for vaccinations. I work in the emergency room and probably 5 out of 30 parents will not have their children vaccinated. When asked they state it is because it will interfere with their bodies natural ability to fight of diseases on their own. I just cringe! They not only put their children at danger but as you stated, everyone they come in contact with as well.
- by Julia P. on Feb 8, 2007 at 6:38 PM | link
I agree with you that vaccinations are what this nation needs. With all the hype of the threat of autism I think the only way this fear will be over come is showing parents that the vaccines are no longer using mercury. Even though this was never proven to have caused autism, the fear is there and will continue to be there until health care providers educated the population extensively. This should begin at the first prenatal visit. I also think that there should be policies put into place to make it mandatory no matter what their "belief" may be. I do not think that it is fair for a select few to have that kind of power to determine if there may be a major outbreak of whooping cough brought on by the unvaccinated. There is a possiblity that a new pandemic of these old diseases can mutate into a new strain when they infect a vaccinated person and then what? There needs to be someone from homeland security placed on this topic to come up with a policy and enforce that proper education is out there to the community.
- by H Stetz on Feb 8, 2007 at 9:55 PM | link
I had a child almost four years ago. Soon after he was born we had to decide if we were going to vaccinate him. Many people in our church didn't "believe" in getting it done because of the mercury/thimerosal theory. We really liked and respected these people's opinions, yet for us (esecially me-with a nursing background) we dedided to vaccinate. It's scary because you want to do the best for your child, and not harm him/her in any way. We believed the alternative of "catching" one of the deadly diseases was worse than the theory of thimerosol and autism.
- by dabepo on Feb 8, 2007 at 10:27 PM | link
I do agree that more should be done to publicize the fact that thimerasol is not longer a threat in vaccines. But, I don't think that doing that will neccessary sell the public on the concept that vaccines are safe. True "safety" in medical treatments takes a long time to prove, not just controlled research studies and a star on the forehead by the FDA. Once an adverse reaction has been publicized it is hard to get those people back. With new vaccines, who wants to be among the first to receive them until they have been proven to be safe over time?
- by Holly James, RN on Feb 9, 2007 at 7:58 AM | link
I was frustrated by the absence in Professor Caplans op-ed piece of any hard data supporting his central thesis -- that [t]his urban legend, the concern about a possible link between vaccines, mercury and autism, has led, and continues to lead, many parents to avoid getting their kids and themselves vaccinated against life-threatening diseases. Professor Caplan contends that failure to vaccinate has caused many preventable deaths and avoidable hospitalizations from measles, whooping cough, diphtheria, flu, hepatitis and meningitis. But where are the data indicating an actual decline in vaccination rates? And, to the extent public health experts have documented such a decline, what data link the decline to fears about mercury in vaccines? Regretably, in lieu of hard data, Professor Caplans piece refers to anecdotal hearsay (e.g., "friends of mine continue to tell me of parents in Lafayette Hill, Voorhees, Greenville and Downingtown who won't have their children vaccinated because of the risk of autism."). Frustrated by the absence of meaningful data, I did a quick Google search, which right off the bat yielded http://www.dhhs.gov/news/press/2004pres/20040729.html, a 2004 CDC press release containing the following:
"The U. S. Department of Health and Human Services today announced that the nation's childhood immunization rates are at record high levels, including significant increases in rates of immunization for chickenpox and pneumococcal pneumonia, the two most recent additions to the childhood immunization schedule. Thus, unless and until someone can point to contrary data, I question whether the rest of us need to be as concerned as Dr. Caplan that some people would like the public health establishment to rule out more convincingly the possibility of a vaccine-mercury-autism link.
- by Joseph Cortellini on Feb 9, 2007 at 7:10 PM | link
I have an 8 month old who has received all his vaccines. The risk of what may happen outweighs all the other risks in my opinion. I also feel that there needs to be proof though that the vaccines are safe. I would not want my son to receive something that is in the "trial period". There are religions and such that are against vaccines. Their beliefs need to be supported as well though.
- by Vanessa Nolf on Feb 10, 2007 at 5:51 PM | link
It is maddening that people are being led to believe that vaccines are harmful to their children and themselves, especially when the risks associated with not getting vaccinated can be deadly. Many-if not most-people do not even know that mercury was allegedly causing autism, or that the preservative containing the mercury (thimerosal) was removed from vaccines years ago. They heard "vaccines cause autism" and took it as the undisputed truth, forgetting that vaccines have saved millions of people from contracting life-threatening or body-maiming diseases and illnesses. I have acutally heard parents say that because vaccines cause autism, they would not even risk getting their children vaccinated because the vaccines are "pointless anyway; nobody even gets whooping cough or polio [etc.] anymore." They neglect to realize that incidences of these diseases in this country have been virtually eradicted BECAUSE of the vaccines! As a parent, I also become a little nervous when my child has to be vaccinated, but not because of autism. My nervousness stems from the possibility of adverse reactions as a result of an allergic reaction. However, the risks of not having her vaccinated are far more likely, and therefore more frightening.
- by Karen on Feb 11, 2007 at 12:06 PM | link
Even with my medical background and education regarding vaccinations, I still hesitated when the doctor asked me if I wanted my child to be vaccinated. My first thought was, "How do I know for sure that that vaccine is mercury/thimerosal-free?". But I think people need to realize that even though they think they are doing what is in their child's best interest, the repercussions of opting out of vaccinations can be deadly. Although autism is scary, I would rather take that chance rather than put my child at risk for a potentially fatal virus or disease. I think, even with years of education, it will be difficult to persuade some parents to put their beliefs of mercury-related autism aside and try to see the benefits of vaccinations. It's a tricky situation, though, because what I believe is good for my child may not be the same for other parents.
- by A. Patton on Feb 11, 2007 at 5:54 PM | link
It is natural to be hesitant to put your kids at risk for harm. I think the risks are worth the potential damage posed by not getting children vaccinated. It would be difficult to accept a child getting a virus or disease by something you could of easily prevented.
- by Diane Annarino-Kot on Feb 11, 2007 at 7:36 PM | link
My children are both teenagers now and both received their vaccinations. When they were small I was much more fearful of what would happen to them and what the long term affects would be if they would develop the actual "sickness" they were being vaccinated against. That thought always seem to eradicate any concerns I had about the risks of the vaccinations themselves. I felt like I was protecting them, not putting them in harms way, by vaccinating them. It seems to be the minority of parents that are concerned about the safety of the vaccines and the chances of autism. I would like to see stats about the actual autism rates in the U.S. versus underdeveloped countries where vaccines are not available. I personally would need more definite proof that vaccines cause autism to withhold such a valuable tool for my children.
- by Lisa (Gearhart) Campbell, RN on Feb 12, 2007 at 1:36 AM | link
I am one of the parents that has been through the experience of a serious reaction to a vaccine. My son was nine months old when he reacted to his third DPT shot and was paralyzed from the waist down among other manifestations of the reaction. I ask a lot more questions now about vaccines and medications. My son is fine now, but believe me, the tiny risk does not seem tiny when it affects your child. Does having a reaction to one vaccine predispose someone to having reactions to other vaccines? I do not buy into the autism stories, but I think there are questions about vaccines that need to be asked and answered.
- by rbilan on Feb 12, 2007 at 2:34 PM | link
I am one of the parents with a child that suffered from the tiny risk of side effects from a vaccine. My son was 9 months old when he reacted to his third DPT shot, and was paralyzed from the waist down among other severe complications resulting from the reaction. Since then I ask a lot more questions about vaccinations and medications. I do not buy into the autism stories, but I do believe there are questions about vaccines that need to be asked and deserved to be answered.
- by rbilan on Feb 12, 2007 at 3:00 PM | link
Autism has been around long before vaccinations were available. No one knows the direct cause of autism but current research is pointing toward a genetic component. Unfortunatly, parents with 1 autistic child have an increased risk of having a second child with autism. We are seeing more cases of Autism because of better, more diligent screening. As parents you will always worry and blame yourself for any suffering your child endures.
Looking at history we see that Polio has been nearly eraticated, Small Pox is no longer a threat and thousands of children are not dying of MMR. Therefore in my opinion, vaccination would be the only logical choice.
- by gigirl on Feb 12, 2007 at 10:52 PM | link
I have mixed emotions about "mandatory" vaccinations. Do we live in a communist state that we cant say what vaccinations we will accept? Sure misleading or false information is infuriating, but this goes on both sides of the situation too. Should we all be vaccinated for a POSSIBLE avian flu outbreak? Where will it end? Possible infections are endless. Drug companies do like to make money and so do the people who own their stock. How do we know that they have our best interest at heart or only a hunger for our dollars?
- by Joyce on Feb 12, 2007 at 11:20 PM | link
I agree, not getting vaccinated due to misinformation is terrible. Now if you avoid being vaccinated because of religous reasons that is your choice, I feel. We have better screening tools for Autism and alot more information to the public so parents are getting their children tested more. That probably accounts for the increase in incidence of the disease.
- by Ruby Fultz on Feb 13, 2007 at 5:38 PM | link
Vaccines continue to keep our nation's children safe from deadly disease. It is just easy to blame vaccines for a terrible neuological condition that impacts not only the childs quality of life, but the whole family. The risk to children is greater if not vaccinated. I grew up in the 'polio' age and am very glad that I received the vaccine. My school mate did not and contrated this disease that had lifetime consequences. The more information that dispels the myth of mercury in vaccines that can reach the public and to educate parents of children needing vaccinations, perhaps this issue will become moot. I do not want to return to a time where children die needlessly from a disease that can be prevented. Information is power.
- by Lisa A. Powers on Feb 17, 2007 at 3:28 PM | link