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A pediatric treasure: Autism’s False Prophets
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Rarely does a physician find a detailed cogent explanation of an enigma in medicine that has plagued him for years.
Have you ever seen the television show, “Magic’s Biggest Secrets Finally Revealed”? This show will enlighten the viewer as to the sleight of hand performed by the big-time magician. We now have a comparable expose, in this case a book elucidating the mysterious appearance of the myths that have evolved around vaccines and autism in children.
The author, Paul Offit, MD, is the chief of pediatric infectious diseases at Children’s Hospital of Philadelphia, one of the lead developers of the human pentavalent rotavirus vaccine, and, in the interest of full disclosure, a member of this publication’s editorial board.
His book, “Autism’s False Prophets — Bad Science, Risky Medicine, and the Search for a Cure,” is a compelling book that should be read by every physician, nurse or interested parent involved in the vaccination of children.
Vaccine controversy
The book explores four recent vaccine controversies: 1) the measles-mumps-rubella vaccine and autism link, 2) the thimerosal and autism link, 3) the snake oil cures perpetuated by both, which prey upon the fears of desperate parents of children with autism, and 4) how the author’s stance to shine a light on the nefarious underworld of vaccine innuendo and under-the-radar payments to a few key scientists had created a terrifying nightmare in his personal life. Shockingly, the antivaccine “mafia” sometimes resorts to incredibly threatening behavior against clinicians of science. Read the book for more.
Dr. Offit admits up front he is not a developmental specialist and he is no expert in autism. But it is clear that he understands the plight of families with autistic children and how they can come to staunchly defend their positions against vaccines. Coupling medicine’s past mistakes and our own experts’ waffling with vaccines (albeit both are rare) has created a challenge to medicine’s credibility with journalists, politicians and parents; for example, think intusussception with rhesus rotavirus vaccine.
Subsequently, for vaccines we are supposed to no longer look at a risk/benefit ratio in preventing disease, but rather we must march to the new mantra: “we can accept NO risk at all” for vaccines. Primum non nocere, or first do no harm, even if it does remarkable good. The morbidity and mortality that could be prevented with a particular vaccine has become inconsequential if one listens to the vaccine nihilists. And boy, with the shock-talk radio, internet and blogs, has it become incredibly easy to scare people with temporal serious adverse events, which are rarely ever causal. Although Vaccine Adverse Event Reporting Safety data can be helpful, it must be interpreted in light of a background rate of the particular finding in the general population, which seems to be an extremely difficult concept for many reporters to grasp.
Grilling by parents
Not a day goes by in my office when I am not grilled about the safety of vaccines. Do you really understand the “looming threat” of measles-mumps-rubella, thimerosal (which is no longer contained in a substantial amount in any pediatric vaccine except for some influenza vaccines), and multiple vaccine antigens in causing autism in infants and toddlers? If a clinician wishes to really understand how this all evolved, they MUST read this book. It will provide the in- office arsenal to understand the origins of the problem, along with the additional verbal tools and references to defend one’s scientific positions more clearly. We all already know that the Institute of Medicine, the CDC and World Health Organization have each found no evidence for a link between vaccines and autism.
Offit’s book describes in succinct detail the incredibly sordid background surrounding this purported “scientific breakthrough” by a group of British investigators. Before the book came to press, I had personally searched out some of the background on MMR-autism panic created by Andrew Wakefield, a British gastroenterologist.
Much of the material for the book on Wakefield’s thinking can be confirmed by searching the website of Brian Deer of the Sunday Times of London, or linking the keywords: Wakefield, MMR and Deer.
Envision a real-life plot of a John Grisham novel with a boatload of money exchanging hands between lawyers and alleged independent scientists. These scientists were developing a patent application for a competing new MMR vaccine, which they even alleged could prevent autism. Duplicity abounds as 11 of the 12 families with purported measles particles in their child were suing vaccine companies. All this can be found in this book as well.
As Offit reveals, “Beginning in 1996, Chadwick was in the operating room during the collection of both intestinal biopsies and spinal fluids from autistic children.” He had personally tested all specimens for measles RNA by PCR. The Lancet 1998 paper reports that all 12 patients had detectable MMR vaccine particles, yet the work could not be repeated by independent investigators. What then happened? Read the book.
Offit’s book is a fascinating read, and it leaves no duplicitous stone unturned. He portrays in painful detail, how and probably why a scientist had misled his coauthors and co-investigators into believing his scientific discovery of an MMR-autism link. This falls into Offit’s category of scientists “who choose to ignore the data,” as I first mentioned. The cascade of events that followed from this bogus discovery by Wakefield is astonishing. The lay press dissemination of a single medical report from 12 patients almost totally dismantled the developed world’s vaccine program.
Six years later, after the damage was done, Wakefield’s publication in the Lancet was retracted, with nearly all of his co-authors recused from the original paper. But it was too late. Furthermore, some politicians, personal injury lawyers and parents “were angry and frustrated. They needed someone to pay for the vitamin injections, blood tests, antifungals, antivirals, mineral supplements, cranial manipulation, special diets, sonar depuration, hyperbaric oxygen, Lupron and chelation,” Offit reports in his book. One by one, Offit provides the lack of science behind most of these purported “cures” for autism.
Pseudoscience, false prophets
The book itself is eloquently and clearly written and can easily be understood by most parents. So as a pediatrician one can recommend that some of your parental fence-sitters on the issues of vaccine should purchase and of course read the book. The book often cajoles parents to be especially mindful of all the false prophets and pseudoscience involved with management and cures for autism.
As is Offit’s style, the book is painfully honest and credible, as it even takes to task a few of our own pediatric expert policy makers, a portion that made me quite squeamish.
But overall, kudos to one of our best and brightest vaccine wonks for his valiant effort to explain the pseudoscience and the false prophets behind the nightmare of delayed and missed vaccines.
By the way, all of the proceeds from this book are being forwarded to research in autism. So either way, you cannot lose when one purchases this book. If it does not turn out to be a true treasure for your pediatric practice, you have at least contributed to an important charity.
Stan L. Block is a Professor of Clinical Pediatrics at the University of Kentucky and the University of Louisville and is a full-time pedatrician in a private practice in Bardstown, Ky.