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MMR Vaccine and Autism: Vaccine Nihilism and Postmodern Science

Posted Sep 06 2011 2:44pm

In a commentary for the Mayo Clinic Proceedings, Gregory A. Poland, MD writes about MMR and autism. In case you don’t get the idea of his stance from the title of the article, MMR Vaccine and Autism: Vaccine Nihilism and Postmodern Science , it starts out with a quote:

Nothing is more terrible than to see ignorance in action.

Johann Wolfgang von Goethe

I’m sure people will counter that they are very “smart” and “well educated” and, therefore, not ignorant when they promote the MMR/autism notion. Is it ignorance, willful ignorance, bias, dishonesty, some mix or something else entirely that is behind the perpetuation of the idea? I don’t know. On a very real level, it doesn’t matter. What matters is the fact that the MMR hypothesis was wrong and that those who continue to promote it are causing a very real danger to society.

That said, here are Dr. Poland’s views in the introduction to his paper :

It is a truism that acting in one’s perceived self-interest is not always in one’s self-interest. Perhaps nowhere is this truer in contemporary public health than for the issue of the measles-mumps-rubella (MMR) immunization and persistent fears about a possible connection with autism. Although each of these 3 diseases had been controlled in the United States with the widespread use of the MMR vaccine, in the past decade those gains have been slipping. Even though the United States has had fewer than 50 measles cases per year during the past decade (mostly imported from other countries), 156 cases have already been identified in the first 6 months of 2011. 1 European countries such as England, Wales, Italy, France, Spain, and Germany are also experiencing substantial increases in measles outbreaks.

Why should we be concerned? Measles is the most transmissible human disease known. Even with modern medical care, approximately 1 of every 3000 infected persons die, and many more are hospitalized or otherwise harmed as a result. Population coverage (herd immunity) needs to be in excess of 96% to prevent outbreaks. In addition, measles is a disease for which eradication is both possible and planned, a goal that obviously cannot be met given current vaccine coverage levels.

This predictable sequence of falling coverage levels, followed by outbreaks of disease, has occurred because of decreased public confidence in the safety of the MMR vaccine. In large part, this has resulted from incorrect assertions that the vaccine plays a role in the development of autism, an idea promoted by Andrew Wakefield. No credible scientific evidence, however, supports the claim that the MMR vaccine causes autism, and indeed, national medical authorities and scientific professional societies have unanimously …

This article is commentary (i.e. not a research article), but there are some good points and questions made:

Why in the face of nearly 2 dozen studies and every scientific committee rejecting such an MMR-autism connection does this myth persist?

As expected, he notes the celebrity aspect of the vaccine-causation notion. He also discusses the recent paper in the PACE Law Review .

Under “Moving Forward”, Dr. Poland writes:

At some point, a point I believe we have well passed, the small group of people who claim such connections, who have no new or credible data, and for which their assumptions and hypotheses have been discredited must simply be ignored by scientists and the public and, most importantly, by the media, no matter how passionate their beliefs to the contrary. Such individuals are denialists at best, and dangerous at worst. Unfortunately, the media has given celebrities who comment on an autism-MMR link far more attention than they deserve, and the public, unfamiliar with the background science, has confused celebrity status with authority. Such a phenomenon has not been lost on those wishing to continue the discussion. As an example, J. Hanlon, cofounder of Generation Rescue (an organization that advocates for an autism-MMR vaccine link) commented, in regard to the finding that both Andrew Wakefield and his assertion of a connection between autism and MMR vaccine had been discredited, that to those who believe vaccines cause autism “Andrew Wakefield was Nelson Mandela and Jesus Christ all wrapped in one.”

Prediction: we will hear all about how this commentary is obviously worthless because the author didn’t correctly cite J.B. Handley. If you are wondering what I mean, read again, Mr. Handley is referred to as J. Hanlon. I wish the author hadn’t made that mistake as such small errors are exploited in exactly this way. But, at the same time, this puts some perspective on the situation regarding Mr. Handley. He is a well known name in a very small community. He has become one of the go-to people for comments critical of vaccination (as in the Jesus Christ/Nelson Mandella article).

Prediction 2: Dr. Poland’s article will be called an attempt at censorship (see the conclusion below). Probably with no sense of irony by the same people who recently stated that Autism Speaks should “Shut up, shut down and go away.”

Prediction 3: People will still refuse to see how strange the “Nelson Mandela and Jesus Christ” comment read to the majority of readers. OK, I am predicting the past here, but I expect this to go forward too. Dr. Poland didn’t pick this quote to place Andrew Wakefield in good light.

That all said, I agree with Dr. Poland. It is well past time for the MMR story to be set aside. Just because there are adherents to the idea doesn’t mean that news organizations need to give it false balance.

Dr. Poland concludes his article with a simple summary: the MMR/autism question has been investigated closely and no link is found. The decision to forgo immunization based on this fear is not without danger. Those who promote the MMR/autism link in the face of all the evidence are not working for the public good:

For anyone adhering to the scientific model of discovery, experimentation, and evidence, the trial is over and the jury back—there is no known scientific association between receipt of MMR vaccine and the subsequent development of autism. Making the decision to not immunize children with the MMR vaccine because of fear of such an association —rather than credible scientific evidence—places children and others at great risk as current measles outbreaks in the United States and Europe illustrate. Vaccine nihilists who continue to claim such associations are simply wrong, and they pedal an agenda other than for the public good. At this point, the antivaccine groups and conspiracy proponents promoting such an association should be ignored, much as thinking people simply ignore those who continue to insist that the earth is flat or that the US moon landing in 1969 did not really occur

He concludes simply but strongly:

There is no law against being foolish, nor any vaccine against ignorance; however, in the meantime the health of millions of children in the United States and worldwide is being placed at unnecessary and real risk through continued deliberate misinformation and discredited unscientific beliefs, and that should be a crime.

  1. Stuart Duncan:
    It's so wrong that this even needs to be written, or read... or discussed. I thought we had moved passed this to the "too many vaccines" argument or the "what about the other vaccines that haven't been tested" argument or the "who cares if Jenny McCarthy's son never had Autism?" argument?
  2. Prometheus:
    The usual "argument" I hear is "Yeah, so they've done studies showing that the MMR (and, to be fair, thimerosal) don't cause autism, but what about all the other vaccines? And what about the other components of vaccines (e.g. formalehyde, "anti-freeze", dead fetus parts, etc.)? And how about combinations (i.e. too many, too soon)?" In short, "You'll never convince me that vaccines don't cause autism as long as I can draw breath!" Outside of their own little (and shrinking) world, the die-hard advocates of "vaccines (in some mysterious and unexplained way) cause autism" are becoming - and may already have become - irrelevant. If you see them or hear about them these days, it is predominantly as a target of derision, as in "This is how ignorant and superstitious some people are." It's been a long, hard fall from grace, a fact that "Mr. Hanlon" knows only too well. Prometheus
  3. brian:
    Prometheus wrote:
    Outside of their own little (and shrinking) world, the die-hard advocates of “vaccines (in some mysterious and unexplained way) cause autism” are becoming – and may already have become – irrelevant. If you see them or hear about them these days, it is predominantly as a target of derision, as in “This is how ignorant and superstitious some people are.” It’s been a long, hard fall from grace, a fact that “Mr. Hanlon” knows only too well.
    Well, J. B. Handley (er, Hanlon) wrote this about his son's autism: "If it really wasn’t the antibiotics and vaccines that got him, I’m wasting a hell of a lot of time and money treating the wrong things." Yep.
  4. JJ:
    I think it's interesting that Dr. Poland can't even get the name of his enemy right and then complains about other people's ignorance. If anyone cares, here's a few of his funders according to the NEJM: Novavax Research Protein Sciences Research Wyeth Research Novartis Vaccines GlaxoSmithKline CSL Biotherapies - one of the world's largest flu vaccine manufacturing facilities CSL Limited Pfizer Inc PI on 2 pneumococcal vaccine studies Merck & Co., Inc. Powdermed vaccine Novavax Emergent BioSolutions - a global biopharmaceutical company Theraclone Sciences MedImmune LLC Liquidia Technologies, Inc Avianax PaxVax, Inc. EMD Serono, Inc. - biopharmaceutical division of Merck
  5. Sullivan:
    Dang, I forgot the prediction of "here's his conflicts of interest". JJ, did you forget to check that he's Editor-In-Chief of the journal "Vaccine"? Sure, I wish he'd gotten Mr. Handley's name correct. It's only polite, for starters. Also, it gives people the automatic out to ignore what he has to say. For many, all you have to do is mispell a single word or get some trivial factoid incorrect in the "Andrew Wakefield is a scientific fraud" story to be dismissed. But, treat disabled children unethically. Lie. Hide (and lie) about conflicts of interest. Make unfounded recommendations to change the way vaccines are given. Do any of those things and we are expected to just sweep them under the table as long as they are promoting the vaccine-autism connection. That all said, I do find it interesting that he misspelled Mr. Handley's name. Big fish. Very small (and shrinking) pond.

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