Research published in the most recent issue of the American Journal on Intellectual and Developmental Disabilities (AJIDD) is an article that revisits the dangerous – and mythical – connection between vaccines and the incidence of autism.
The brief history is this:
In 1998, the journal Lancet published a small, non-experimental study by Dr. Andrew Wakefield which proposed that autism was related to the Measles-Mumps-Rubella (MMR) vaccine. It launched a frenzy of activity among professionals, families and notable celebrity advocates. As expected, vaccines in general and the MMR in particular were examined with new energy. A common preservative, thimerosal, became a particular target of study and popular attention because it contains mercury.
For more than a decade, medical research has produced no credible evidence of a connection between vaccines and autism, the original 1998 article has been discredited by professional community and retracted by Lancet, and Wakefield has lost his license to practice medicine. Add to that the fact that autism rates have continued to rise in spite of the recent removal of thimerosal from almost all vaccines. Popular opinion, though, is another matter altogether. Parents’ decisions to immunize or not immunize are still subject to the perception of vaccine safety. In a 2010 study, about 11% of US parents had refused a vaccine for a child based on safety concerns. While the US remains the most vaccinated country in the world, a drop of more than 10% presents a genuine health concern.
The news gets worse for children with autism. The research published in AJIDD surveyed nearly 200 parents of children diagnosed with autism concerning their vaccine-related beliefs and practices. Half of the parents changed or completely discontinued their child’s vaccine schedule based on the belief that the vaccine contributed to their child’s developmental delay.
If a 10% drop in vaccine rates within the general population is considered a concern, what are we to make of a 50% difference among those who are already at developmental risk?
The conclusions of the study suggest “a lengthy delay in the translation of science to practice and public knowledge” and encourage the development of educational tools for, among others, parents and pediatricians. One wonders if that is enough. The sample group for this study was at no particular disadvantage insofar as access to information and rational decision-making is concerned. Statistically, in fact, it was a very well-educated group. Two thirds of the parents were college graduates.
It is interesting to note that the article is silent on the issue of the media and its role in all this. Few would disagree that media was at the center of fueling the alarming reaction to begin with and has provided a platform for those more committed to trendiness than truth.
Perhaps more serious consideration should be given to media sources as an avenue to reach those who need accurate information most. Dr. Gary Freed, lead author of the 2010 study referenced earlier all but suggests it in his conclusions, “Those who design public health efforts to provide evidence-based information must recognize that different strategies may be required to reach some groups of parents who use other information sources.”
While some (including me) may find celebrity voices and media sound bites a weak substitute for good research, we cannot deny their influence. Given what’s at stake, namely the well-being of a generation of children, is the media our best hope?
Filed under: BethesdaBlog 2012, Innovation Tagged: | AJIDD, autism, developmental disabilities, Dr. Andrew Wakefield, Dr. Gary Freed, intellectual and developmental disabilities, Lancet, mercury, MMR, thimerosal, vaccines