To vaccinate or not to vaccinate?[SIZE=-1]
For parents looking for information on vaccines, the Web can be a confusing place. Misinformation abounds about a purported link between childhood vaccines and autism, and anti-vaccination Web sites have been on the rise in recent years. Naturally, that can cause parents anguish about when and whether to vaccinate their children. But the science is clear; there is no concrete evidence of a link between vaccinations and autism. Meanwhile, largely because of the movement by a determined minority against vaccination, long eradicated diseases are gaining a new foothold, making vaccination as important as ever.Another in a long line of studies, this one by researchers from Columbia University's Mailman School of Public Health, and released this month in the Public Library of Science, has also helped dispel the myth of a link between the measles, mumps and rubella (MMR) vaccine, and the development of autism in children.
Another theory, that mercury in thimerosal?a preservative that was once used in many vaccines?causes autism has also been disproved by several reliable studies. Nevertheless, thimerosal has been removed as an ingredient in most vaccines as a precautionary measure to lower children?s exposure to mercury (thimerosal is still used in most flu shots and is considered safe).
Yet the notion that such a link exists remains strong in our popular consciousness. For example, Jenny McCarthy, an actress who wrote a book about her son with autism, regularly appear on television shows and other outlets to bolster the vaccines-cause-autism myth. Unfortunately, this kind of anecdotal evidence may be more convincing to people than well-controlled clinical trials.
To understand the pervasive myth, consider its history. Autism is commonly diagnosed in early childhood, around the same time that children get vaccinations, like MMR. Some parents of autistic children reported that after vaccination, their children had an illness, such as a high fever or intestinal inflammation, and then were diagnosed with autism. In 1998, The Lancet, a British medical journal, published a study that hypothesized, but didn't prove, a link between the MMR vaccine and autism. Upon its release, the lead researcher, Andrew Wakefield, held a press conference to promote the link and the debate has raged ever since. But even as the vaccine debate continued, that study was discredited.
A new book, "Autism's False Prophets," published this month by Columbia University Press retells the heated history of the debate. The author, Paul A. Offit M.D., is chief of infectious diseases and the director of the vaccine education center at the Children's Hospital of Philadelphia, and is also an inventor and patent-holder of the rotavirus vaccine RotaTeq. Offit reviews the story behind the 1998 Lancet study, which examined 12 children with autism and 14 controls. The findings, which hypothesized a link, were never confirmed by other studies and the autism link was retracted in 2004 in the Lancet by 10 of the study's 13 authors, after it was revealed that the lead researcher had hidden a conflict of interest. Wakefield had been partly funded by a legal aid society investigating a potential lawsuit on behalf of parents of children with autism against the manufacturers of the vaccine. What's more, some of those children were subjects in Wakefield's study.
The thimerosal theory hit the press next, spurred by articles in The New York Times Magazine and Rolling Stone. But studies continued to show no link, and with thimerosal no longer used in most vaccines, the autism rate has not been reduced. Those who believe that vaccines cause autism, now mostly claim that some combination of vaccines spur the development of the disorder. But there is no science to date that supports this hypothesis either.
There is evidence of the return of long-eradicated diseases, however. Measles, a highly contagious disease, was declared eliminated in the U.S. in 2000, but outbreaks of infection attributed to incoming travelers have increased this year. The disease once infected 3 to 4 million people a year causing 450 deaths and 4,000 cases of measles-related brain infection each year. At least 131 cases have been reported so far this year, the most in twelve years and officials cite parents' refusal to vaccinate children as the leading cause for the jump. There have also been outbreaks of other childhood viral diseases, such as polio, and mumps, in recent years. All of those can be prevented by vaccines.
The notion that childhood vaccines cause autism is a belief based on anecdotal experiences that is not backed up by the facts. There is now good scientific evidence that such a relationship does not exist. But not vaccinating children, or delaying to do so, can potentially have serious individual and public health consequences. The collective time lost from school, the individual misery, and the formidable complications (brain injury, deafness, and others) make it worthwhile to once again make those diseases obsolete.
Consumer Reports' medical advisers strongly recommend childhood vaccination. See our recommendations for kids and adults.
?Kevin McCarthy, associate editor
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