Autism's False Prophets

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Autism's False Prophets
Autism's False Prophets frontcover.jpeg
Front cover of first edition
Author Paul Offit
CountryUnited States
LanguageEnglish
SubjectAutism and vaccine controversy
Publisher Columbia University Press
Publication date
September 5, 2008;14 years ago (2008-09-05)
Media typePrint (Hardcover)
Pages328 (first edition)
ISBN 978-0-231-14636-4
OCLC 221961980
618.92/85882 22
LC Class RJ506.A9 O34 2008

Autism's False Prophets: Bad Science, Risky Medicine, and the Search for a Cure is a 2008 book by Paul Offit, a vaccine expert and chief of infectious diseases at Children's Hospital of Philadelphia. The book focuses on the controversy surrounding the now discredited link between vaccines and autism. The scientific consensus is that no convincing scientific evidence supports these claims, [1] [2] and a 2011 journal article described the vaccine-autism connection as "the most damaging medical hoax of the last 100 years". [3]

Contents

Summary

Offit describes the origins and development of claims regarding the MMR vaccine and the vaccine preservative thiomersal, as well as subsequent scientific evidence which has disproved a link with autism. The book discusses possible explanations for the persistence of these claims in the face of scientific evidence to the contrary, as well as the proliferation of potentially risky and unproven treatments for autism. [4] The author takes a critical view of several advocates of a vaccine–autism link, including Andrew Wakefield, David Kirby, Mark Geier, and Boyd Haley, raising scientific and, in some cases, ethical and legal concerns. The book also explores divisions within the autism community on the topic of vaccines, as some parents consider the ongoing narrow focus on vaccines a distraction from more scientifically promising avenues of research. In this vein, Offit interviews Kathleen Seidel, a mother of an autistic child who has published investigations critical of those who profit from promoting vaccine–autism claims. [5]

Offit also touches on the heated and bitter debate surrounding vaccine claims. He describes receiving death threats, hate mail, and threats against his children as a result of his advocacy for vaccination. Offit declined to do a book tour for Autism's False Prophets, citing concerns about his physical safety and comparing the intensity of hatred and threats directed at him to that experienced by abortion providers. [6] Author's royalties from the book are being donated to the Center for Autism Research at Children's Hospital of Philadelphia. [7]

Reception

The book was the nucleus of profiles of Offit in Newsweek [6] and The Philadelphia Inquirer . [8] The New York Post reviewed the book positively, concluding: "Although arguably the most courageous and most knowledgeable scientist about vaccines in the United States, Offit lives in fear for his life and that of his family." [4] The Wall Street Journal also praised the book as "an invaluable chronicle that relates some of the many ways in which the vulnerabilities of anxious parents have been exploited." [9]

The Philadelphia Inquirer wrote that the book "names names and calls nonsense nonsense", and provides "important insight into the fatal flaws of the key arguments of vaccine alarmists." The Inquirer applauded Offit's focus on slanted and sensationalist media coverage of the vaccine–autism issue, but faulted Offit for not holding scientists themselves sufficiently accountable for their failure to communicate the facts to the public. [10]

The Rocky Mountain News noted that the book "turned the tables" on those who see a pharmaceutical-industry conspiracy behind vaccination, by pointing out that the advocates of the autism–vaccine link receive large sums of money from lawyers and lobbyists. The News applauded the book's deconstruction of "misinformation" from Don Imus, Jenny McCarthy, Joseph Lieberman, and Robert F. Kennedy, Jr., among others, but found Offit's "sarcasm and brow-beating of those he disagrees with" to be "grating". [11]

Salon reviewed the book as an "enlightening, highly readable, and ... timely" work which "deconstruct[s] the anti-vaccine movement as one driven by bad science, litigious greed, hype and ego." [5] Salon faulted Offit for minimizing the work that autism advocacy groups have done to raise awareness, create support networks, and obtain research funding; the review noted that Offit focuses instead on aggressive and scientifically "slanted" groups like Defeat Autism Now! and Generation Rescue. The review concluded that the book "effectively pulls back the curtain on the anti-vaccine movement to reveal a crusade grounded less in fact and more in greed and opportunism". [5]

Science called the book "forceful" and "an easy-to-read medical thriller about the consequences of greed, hubris, and intellectual sloppiness." [12] The review noted that Offit did not discuss the irrationality of human decision-making in the presence of relative risk and both anecdotal and empirical evidence, and mentioned that Offit did not carefully discuss the role of regression. In conclusion, the review observed that the book has emboldened the media to apply scientific principles, and called for using the book's momentum to shift resources from the autism–vaccination debate to research into causes and treatments. [12]

The Journal of Autism and Developmental Disorders said the book "makes an important contribution to popular debates about the etiology and treatment of autism spectrum disorders. The book is arguably the most detailed and thorough history available of the current anti-vaccine movement". The review noted one possible weakness: the book gives light coverage to the public's fundamental misunderstanding of the epidemiology of autism, in that the public fears an "autism epidemic" that may not in fact be occurring. The review concluded with a call to scientists and physicians to follow Offit's lead in communicating to the public even uncomfortable truths about autism. [13]

Four months after its release, The New York Times reported that the book had been endorsed widely by pediatricians, autism researchers, vaccine companies, and medical journalists, and was "galvanizing a backlash against the antivaccine movement in the United States." Many doctors are critical of "false equivalence" in media coverage of the vaccine issue, and now argue that reporters should treat the antivaccine lobby with the same level of indifference as AIDS denialism and other fringe theories. [14]

Later in 2009, the New England Journal of Medicine reported that the book effectively advocated for vaccines and refuted the vaccine–autism myth. It noted that a particular strength of the book is its outline of the scientific method and the basic principles of probability and causality, and its coverage of the difficulty of explaining science to the public, such as the difference between causality and coincidence. It noted as a weakness the book's several diversions into topics such as breast implants. [15]

Other largely favorable reviews appeared in BioScience , [16] in Health Affairs , [17] in the Journal of Child Neurology , [18] and in the Journal of Clinical Investigation . [19]

In a guest column for The Atlanta Journal-Constitution , neurologist Jon Poling panned Offit's book as "a novel of perceived good and evil". Poling, whose daughter was federally compensated for vaccine injuries, criticized Offit for attacking those with whom he disagrees: "In the story, Offit takes no prisoners, smearing characters in the vaccine-autism controversy as effortlessly as a rich cream cheese." [20]

See also

Related Research Articles

<span class="mw-page-title-main">Thiomersal</span> Organomercury antiseptic and antifungal agent

Thiomersal (INN), or thimerosal, is an organomercury compound. It is a well-established antiseptic and antifungal agent.

<span class="mw-page-title-main">Vaccine hesitancy</span> Reluctance or refusal to be vaccinated or have ones children vaccinated

Vaccine hesitancy is a delay in acceptance, or refusal, of vaccines despite the availability of vaccine services and supporting evidence. The term covers refusals to vaccinate, delaying vaccines, accepting vaccines but remaining uncertain about their use, or using certain vaccines but not others. The scientific consensus that vaccines are generally safe and effective is overwhelming. Vaccine hesitancy often results in disease outbreaks and deaths from vaccine-preventable diseases. Therefore, the World Health Organization characterizes vaccine hesitancy as one of the top ten global health threats.

The Vaccine Adverse Event Reporting System (VAERS) is a United States program for vaccine safety, co-managed by the U.S. Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA). VAERS is a postmarketing surveillance program, collecting information about adverse events that occur after administration of vaccines to ascertain whether the risk–benefit ratio is high enough to justify continued use of any particular vaccine.

Generation Rescue is a nonprofit organization that advocates the scientifically disproven view that autism and related disorders are primarily caused by environmental factors, particularly vaccines. The organization was established in 2005 by Lisa and J.B. Handley. Today, Generation Rescue is known as a platform for Jenny McCarthy's autism related anti-vaccine advocacy.

The 2000 Simpsonwood CDC conference was a two-day meeting convened in June 2000 by the Centers for Disease Control and Prevention (CDC), held at the Simpsonwood Methodist retreat and conference center in Norcross, Georgia. The key event at the conference was the presentation of data from the Vaccine Safety Datalink examining the possibility of a link between the mercury compound thimerosol in vaccines and neurological problems in children who had received those vaccines.

Thiomersal is a mercury compound which is used as a preservative in some vaccines. Anti-vaccination activists promoting the incorrect claim that vaccination causes autism have asserted that the mercury in thiomersal is the cause. There is no scientific evidence to support this claim. The idea that thiomersal in vaccines might have detrimental effects originated with anti-vaccination activists and was sustained by them and especially through the action of plaintiffs' lawyers.

A vaccine adverse event (VAE), sometimes referred to as a vaccine injury, is an adverse event caused by vaccination. The World Health Organization (WHO) knows VAEs as Adverse Events Following Immunization (AEFI).

<span class="mw-page-title-main">Paul Offit</span> American pediatric immunologist

Paul Allan Offit is an American pediatrician specializing in infectious diseases, vaccines, immunology, and virology. He is the co-inventor of a rotavirus vaccine. Offit is the Maurice R. Hilleman Professor of Vaccinology, professor of pediatrics at the Perelman School of Medicine at the University of Pennsylvania, former chief of the Division of Infectious Diseases (1992–2014), and the director of the Vaccine Education Center at The Children's Hospital of Philadelphia.

Boyd Eugene Haley is a retired professor of chemistry at the University of Kentucky.

Neal A. Halsey is an American pediatrician, with sub-specialty training in infectious diseases, international health and epidemiology. Halsey is a professor emeritus of international health and director emeritus of the Institute for Vaccine Safety at the Johns Hopkins Bloomberg School of Public Health, in Baltimore, Maryland. He had a joint appointment in the Department of Pediatrics at the Johns Hopkins School of Medicine and serves as co-director of the Center for Disease Studies and Control in Guatemala.

<span class="mw-page-title-main">National Vaccine Injury Compensation Program</span> U.S. no-fault system for litigating vaccine injury claims

The Office of Special Masters of the U.S. Court of Federal Claims, popularly known as "vaccine court", administers a no-fault system for litigating vaccine injury claims. These claims against vaccine manufacturers cannot normally be filed in state or federal civil courts, but instead must be heard in the U.S. Court of Federal Claims, sitting without a jury.

Claims of a link between the MMR vaccine and autism have been extensively investigated and found to be false. The link was first suggested in the early 1990s and came to public notice largely as a result of the 1998 Lancet MMR autism fraud, characterised as "perhaps the most damaging medical hoax of the last 100 years". The fraudulent research paper authored by Andrew Wakefield and published in The Lancet claimed to link the vaccine to colitis and autism spectrum disorders. The paper was retracted in 2010 but is still cited by anti-vaccinationists.

A fringe theory is an idea or a viewpoint which differs from the accepted scholarship of the time within its field. Fringe theories include the models and proposals of fringe science, as well as similar ideas in other areas of scholarship, such as the humanities. In a narrower sense, the term fringe theory is commonly used as a pejorative; it is roughly synonymous with the term pseudo-scholarship. Precise definitions that make distinctions between widely held viewpoints, fringe theories, and pseudo-scholarship are difficult to construct because of the demarcation problem. Issues of false balance or false equivalence can occur when fringe theories are presented as being equal to widely accepted theories.

The Immunization Alliance is an American vaccine advocacy consortium, assembled under the auspices of the American Academy of Pediatrics (AAP) in May 2008. The Immunization Alliance has called for a governmental information campaign, ongoing research into vaccine safety and efficacy, balanced media coverage, and restoration of confidence among parents due to vaccine hesitancy and the related controversies in autism.

The Autism Science Foundation (ASF) is a non-profit organization that funds evidence-based autism research and supports autism families. The organization was founded in April 2009 by Alison Tepper Singer, a former senior executive of Autism Speaks and the longest-serving public member of the Interagency Autism Coordinating Committee (IACC), and Karen Margulis London, co-founder of the National Alliance for Autism Research. Both Singer and London are parents of autistic children.

<span class="mw-page-title-main">Vijendra K. Singh</span> Neuroimmunologist

Vijendra Kumar Singh is a neuroimmunologist who formerly held a post at Utah State University, prior to which he was a professor at the University of Michigan. While affiliated with both institutions, he conducted some controversial autism-related research focusing on the potential role of immune system disorders in the etiology of autism. For example, he has testified before a US congressional committee that, in his view, "three quarters of autistic children suffer from an autoimmune disease."

An alternative vaccination schedule is a vaccination schedule differing from the schedule endorsed by the Advisory Committee on Immunization Practices (ACIP). These schedules may be either written or ad hoc, and have not been tested for their safety or efficacy. Proponents of such schedules aim to reduce the risk of adverse effects they believe to be caused by vaccine components, such as "immune system overload" that is argued to be caused by exposure to multiple antigens. Parents who adopt these schedules tend to do so because they are concerned about the potential risks of vaccination, rather than because they are unaware of the significance of vaccination's benefits. Delayed vaccination schedules have been shown to lead to an increase in breakthrough infections without any benefit in lower side effect profiles.

The Lancet MMR autism fraud centered on the publication in February 1998 of a fraudulent research paper titled "Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children" in The Lancet. The paper, authored by now discredited and deregistered Andrew Wakefield, and listing twelve coauthors, falsely claimed non-existent, causative links between the MMR vaccine, colitis, and autism. The fraud was exposed in a lengthy Sunday Times investigation by reporter Brian Deer, resulting in the paper's retraction in February 2010 and Wakefield being struck off the UK medical register three months later. Wakefield reportedly stood to earn up to $43 million per year selling diagnostic kits for a non-existent syndrome he claimed to have discovered. He also held a patent to a rival vaccine at the time, and he had been employed by a lawyer representing parents in lawsuits against vaccine producers.

Extensive investigation into vaccines and autism has shown that there is no relationship between the two, causal or otherwise, and that the vaccine ingredients do not cause it. Vaccinologist Peter Hotez researched the growth of the false claim and concluded that its spread originated with Andrew Wakefield's fraudulent 1998 paper, with no prior paper supporting a link.

Misinformation related to immunization and the use of vaccines circulates in mass media and social media in spite of the fact that there is no serious hesitancy or debate within mainstream medical and scientific circles about the benefits of vaccination. Unsubstantiated safety concerns related to vaccines are often presented on the internet as being scientific information. A high proportion of internet sources on the topic are "inaccurate on the whole" which can lead people searching for information to form "significant misconceptions about vaccines".

References

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  2. Doja A, Roberts W (2006). "Immunizations and autism: a review of the literature". Can J Neurol Sci. 33 (4): 341–6. doi: 10.1017/s031716710000528x . PMID   17168158.
  3. Flaherty DK (October 2011). "The Vaccine-autism Connection: A Public Health Crisis Caused by Unethical Medical Practices and Fraudulent Science". Ann Pharmacother. 45 (10): 1302–4. doi:10.1345/aph.1Q318. PMID   21917556. S2CID   39479569.
  4. 1 2 Goldberg, Robert (14 September 2008). "Autism's False Prophets: A Shot of Truth". New York Post . Retrieved 13 November 2008.
  5. 1 2 3 Parikh, Rahul (22 September 2008). "Inside the vaccine-and-autism scare". Salon . Archived from the original on 29 October 2008. Retrieved 13 November 2008.
  6. 1 2 Kalb, Claudia (3 November 2008). "Stomping through a medical minefield". Newsweek . 152 (18): 62–3. PMID   18998447. Archived from the original on 19 November 2008. Retrieved 13 November 2008.
  7. "Author Royalties From Autism Book Donated to Autism Research" (Press release). Children's Hospital of Philadelphia. 3 November 2008. Retrieved 13 November 2008.
  8. Avril, Tom (17 September 2008). "Expert sees no link between vaccines and autism". The Philadelphia Inquirer . Archived from the original on 20 September 2008. Retrieved 2 October 2008.
  9. Seebach, Linda (23 September 2008). "Charlatans to the Rescue". The Wall Street Journal . Archived from the original on 1 November 2008. Retrieved 13 November 2008.
  10. Collins, Huntly (21 September 2008). "Defending vaccines in the autism debate". The Philadelphia Inquirer. Archived from the original on 2 October 2008. Retrieved 14 November 2008.
  11. Ruskin, Steve (2 October 2008). "Autism's False Prophets: Bad Science, Risky Medicine, and the Search for a Cure". Rocky Mountain News . Retrieved 13 November 2008.
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  13. Grinker, Roy Richard (2009). "Offit Paul: Autism's False Prophets: Bad Science, Risky Medicine, and the Search for a Cure". J Autism Dev Disord. 39 (3): 544–6. doi:10.1007/s10803-008-0679-y. S2CID   26321942.
  14. McNeil, Donald G. Jr. (12 January 2009). "Book Is Rallying Resistance to the Antivaccine Crusade". The New York Times . Archived from the original on 2 April 2009. Retrieved 13 January 2009.
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