By Nancy Snyderman, MD
Illustration by Lara Tomlin
Let me put my cards on the table. I believe that immunizations are the greatest scientific breakthrough of the past century.
Nothing trumps vaccines for lives saved. To me, the science behind the need, efficacy and safety of childhood vaccines is proven and continues to save lives around the world. But like any other doctor, my life experiences have also had a profound impact on how I view the world around me.
I grew up in Fort Wayne, Ind., during the 1950s when the fear of polio gripped every suburban family. My father, a young surgeon, performed tracheotomies on six children stricken with polio to help them breathe — all in vain as each went on to die from paralysis. I remember my father afraid to come home from the hospital and afraid to hug us, wondering if he might be transporting death to his family.
I vividly remember lining up in the cafeteria with every other student, waiting for our sugar cube with its drop of polio vaccine. Informed consent was a cursory formality. Scientists and public health officials believed that the health of society as a whole trumped the individual’s rights. Right or wrong, the realization that a certain percentage of the herd needed to be vaccinated to protect everyone was a driving force behind public health policy.
Years later, as a pediatric intern, I watched children die of pertussis, rotavirus and hemophilus. I was proud to be able to inoculate babies in my clinic against measles, mumps, rubella and polio.
So my faith in vaccines stems from my experiences. But my belief is also rooted in the science, science that I believe outspoken celebrities who are self-appointed vaccine experts are derailing. Pseudoscience and dollops of pop culture grab headlines and have created an environment rich with fear and misinformation. In essence, the science has been hijacked.
“As the months ground on, I opted out. I wouldnít do any more reports on autism. It just wasnít worth the hassle.”
At the center of this storm is autism: claims that vaccines cause autism; claims that thimerosal, the ethyl mercury preservative in some vaccines, causes autism; and claims that vaccines and thimerosal cause autism. All three hypotheses have been on public trial.
In June 2007, on NBC’s Today Show I reported about the National Childhood Vaccine Injury Act that was passed in 1986 as a way to protect the pharmaceutical companies that make vaccines from frivolous lawsuits. In the mid-1980s, only one vaccine manufacturer in the world remained, and its future was in jeopardy. The U.S. government created a fund, the Vaccine Injury Compensation Program, to compensate families in cases of known and proven vaccine injury. The report on Today was an update about a child who had just received compensation and groups of parents who had filed claims.
The question of whether vaccines cause autism came up during the television segment, and a statement I made triggered a series of events that I never saw coming. I stated that there is no science that substantiates a link between the MMR (measles, mumps and rubella) vaccine and autism. It was simple and true. There is no science. But that declaration put me in the crosshairs of a small but vocal group of people who believe otherwise.
I received the most vicious e-mails and letters I have ever received in 20 years of reporting. I was ambushed at 30 Rockefeller Plaza (where NBC News is located) by a reporter who came armed with a camera and screamed that I was lying to the American public. I was rattled. Never before had I been singled out like this. I received letters from congressmen, celebrities and lawyers. As the months ground on, I opted out. I wouldn’t do any more reports on autism. It just wasn’t worth the hassle. The fact that I cowered didn’t make me proud, but it did make my life simpler.
A bad bit of research from just over a decade ago did much to create this mess. In 1998, British gastroenterologist Andrew Wakefield announced at a press conference that he had discovered the cause of autism. He explained that his team had examined eight children with autism and all had lymphatic nodules studding the intestinal lining. All eight children had recently been inoculated with the MMR vaccine. He believed that this proved the vaccine caused autism and went on to publish this report in The Lancet. (This is an important reminder that even prestigious journals sometimes publish bad science.)
He believed virus from the MMR vaccine traveled from the arm to the intestines, causing inflammation there, which led harmful proteins to enter the bloodstream and the brain, causing neurological impairment. He didn’t let the fact that he hadn’t identified these proteins stand in his way (and neither did the journal). The hypothesis became conventional wisdom and 10 years later we are cleaning up after the damage.
Signs of autism may appear around the same time that children are vaccinated, but this was not considered in his hypothesis. His presumption stuck and has played out ever since. In print and over the airwaves, parents have been frightened with fringe science and shocking half-truths.
To date, 12 epidemiological studies have shown that MMR vaccine does not cause autism. Six have shown that thimerosal (the ethyl mercury preservative) doesn’t cause autism. And despite the removal of thimerosal from vaccines in 2001, the numbers of children diagnosed as autistic continue to climb.
I stayed on the sidelines, passing up offers to do reports on autism, no matter what the angle. And then a book by a man I had known 30 years ago as a pediatric intern landed on my desk and changed my mind.
Dr. Paul Offit is the chief of infectious diseases and professor of vaccinology and pediatrics at the University of Pennsylvania School of Medicine. Paul has written a book, Autism’s False Prophets: Bad Science, Risky Medicine, and the Search for a Cure. It is an eloquent read, succinctly laying out the science refuting a link between vaccines and autism. He has been a lone voice for years, braving insults and death threats. His courage made me realize that none of us can afford to sit on the sidelines when science is hijacked.
We will continue to have medical and scientific topics play out in the public and in Congress. It is the price we pay for living in a free society. Abortion and stem cell research are two examples. Autism is now in the same arena. But it is time to end the screaming matches, pop culture wars and false science. Physicians and patients alike have a vested interest in the truth, and sound science should lead the way. Challenging the status quo is fine, new postulates are welcome, but not at the expense of our children and the truth.