The Vaccination Debate Continues – What About Autism?

When pondering the question of whether or not to vaccinate their children, parents have cause to tear their hair out. Search the internet for some enlightenment on the subject and you will find much opinion, from lay persons and experts alike, on either side of the discussion. But what happens when two sides, one wanting to prevent autism and one wanting to prevent childhood diseases through vaccination – collide? Who is right?

In 1998, a study led by Dr. Andrew Wakefield was published in the prestigious British medical journal, The Lancet. Based on just twelve children with supposedly autism-like disorders, the study purported to establish a link between the mumps-measles-rubella (MMR) vaccine and autism. The offending substance in the vaccine was thimerosal, a mercury-based preservative believed to contribute to the development of autism and other brain disorders. Frightened parents rejected the vaccine in droves and measles made a comeback in the UK and elsewhere. Consider that nearly 90 percent of children receive vaccines at 15 months, the same time that many cases of autism are diagnosed. If autistic children are diagnosed soon after receiving vaccinations, parents may suspect a causal relationship. In 2004, however, ten of the Wakefield study’s co-authors rejected its conclusions and last year the study was retracted.

In the years following Wakefield’s findings, desperate parents of autistic children pinned blame on vaccinations based on science which turned out to be a fraud. An entire alternative industry, built around discrediting vaccinations and peddling questionable “cures” for autism has gained massive credibility with the public. High-profile figures such as Robert F. Kennedy, Jr., Jim Carrey and Jenny McCarthy have opposed vaccinations based on alleged government cover-ups and questions about profit motives behind vaccine safety studies.

As many as 125,000 children born in the US in the late 90’s may not have received the MMR vaccine because of bad press. The idea behind mandatory vaccinations of children is to induce herd (or community) immunity in hopes that vaccination of a significant portion of a population will provide protection for individuals who have not developed immunity. Only a small fraction of the population (or herd) can be left unvaccinated for this method to be effective, so most states require vaccinations before children enter school.

According to Dr. Darshak Sanghavi of the University of Massachusetts Medical School, the Institute of Medicine (IOM) reviewed dozens of studies related to vaccines and autism and concluded that “evidence favors rejection of a causal relationship between thimerosal-containing vaccines and autism.” The IOM is the esteemed advisor to the federal government on matters of public health, so as far as mainstream scientists are concerned, the vaccine-autism question is settled. The debunking of the Wakefield study simply adds weight to their conclusion.

Despite the back-and-forth of the controversy there are many parents, like Jenny McCarthy, who observed changes in their children following administration of the MMR vaccine and concluded the vaccine was to blame for the diagnoses of autism that followed.  Knowing that, left to their own devices, parents may question vaccinating their children in the absence of a disease threat and skip the shots, the United States decided in the favor of greater good and not individual rights, making vaccinations compulsory for admission to public schools and day-care centers. As a result, vaccination rates in the United States are higher than ever. About 80 percent nationwide are fully immunized – resulting in some of the world’s lowest rates of devastating but preventable infections.

In Britain, vaccination is optional, and MMR immunization rates fell to 80 percent overall after the Wakefield report and 62 percent in parts of London. According to the journal Science, cases of measles doubled. Since 1987, Japanese parents have made the decision whether to vaccinate their children. Many don’t, and now more than 100,000 cases of measles occur each year, with an estimated 50 to 100 deaths. Even if children survive, infection can result in deafness, seizures and mental disorders.

If I had a child with autism, I, too, might be inclined to believe that a foreign substance – maybe a vaccine – caused it. I might also seek a place to lay the blame so I could regain some sense of hope and control. If I was a parent, before vaccinating my child I would familiarize myself with my state’s policies and consider the scheduling of the vaccinations, as yet an unresolved question in the autism debate. Still, the overwhelming scientific evidence favors the efficacy of the MMR vaccine and allowing parents to decide against vaccination may harm herd immunity. So the question of personal freedom, in other words, may not be the important one when contemplating MMR vaccinations for our children.

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