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Article

January 7, 2011

Autism-Vaccine Link Discredited, but Is Damage Already Done?

News that a 1998 study linking autism to the measles, mumps and rubella vaccine was discredited took the media by storm this week. But many parents still aren't convinced the vaccines are safe, posing a dilemma for family physicians.

This article originally appeared on HCPLive.

It’s not every day that a scientific study dominates the mainstream media. But this week’s news that data had been misrepresented or falsified in the 1998 report in The Lancet linking autism to the measles, mumps and rubella (MMR) vaccine had people -- many of them parents -- flocking to news sites, looking for answers on what has been an extremely controversial subject during the past decade.

The question is: Was the British Medical Journal report that discredited the study -- and called it outright fraud -- enough to convince parents with lingering safety concerns to get their children immunized?

The facts are pretty compelling: The original study linking vaccines to autism involved just 12 children; since then, a study of 2 million children in Finland, and a separate Boston University study of 3 million children, both found no association between the MMR vaccine and autism.

Still, one in four parents believes some vaccines can cause autism, according to a 2010 study.

A poll posted on the Today Show website found that more than a quarter (26.9%) of those surveyed believe vaccines are linked with autism. Nearly 67% said they believed the research that showed there is no link, and another 6.4% said they were unsure.

For physicians, what’s perhaps most alarming is the impact the study has had on parents — a number of whom stopped taking their children to get vaccinated. According to a CNN report, vaccination rates dropped sharply in Britain after the publication of the Lancet report, falling as low as 80% by 2004. Measles cases sharply increased in the ensuing years.

In the U.S., more cases of measles were reported in 2008 than in any other year since 1997, according to the U.S. Centers for Disease Control and Protection. More than 90% of those infected had not been vaccinated, or their vaccination status was unknown.

Robert Melillo, MD, an autism expert and author of “Disconnected Kids,” called the Lancet report “a smoking gun, and it gave parents the validation they were looking for as a cause for autism," in an article in the New York Daily News.

If one study can influence so many people, can the discrediting of that same study have the same impact? The jury’s still out.

Kim Stagliano, a Connecticut mother of three autistic daughters told the Daily News that she believes her older two children, ages 16 and 14, got autism because of vaccines. She chose not to vaccinate her youngest child, and does not regret the decision.

Stagliano also continues to support Wakefield, telling the Daily News that, “The barrage against Dr. Wakefield is an unvarnished attempt to convince the American public that there is an ‘anti-vaccine' movement, while ignoring that American children are chronically sicker than ever and autism now hobbles at least 1% of American children.”

Colleen McGrath, 42, of San Diego, Calif., told ABC News that she heard Wakefield speak at a local autism conference in July 2010, and has decided to “selectively” choose which vaccines her children should receive. “I'm taking precautions because of what I've researched and seen and heard from friends, teachers, and other parents,” she said.

This is precisely what many physicians are worried about.

“There is no doubt that the unsubstantiated concern regarding the MMR vaccine caused by Dr. Wakefield has resulted in many cases of vaccine preventable diseases," said Gary Freed, MD, director of the division of pediatrics at the University of Michigan Health System, in the ABC News report.

"The damage that occurred over those years as a result of these concerns -- outbreaks of vaccine preventable diseases and in some cases, deaths -- cannot be reversed," added Ari Brown, MD, a pediatrician in Austin, Texas.

Meanwhile, Wakefield has taken the offensive, telling CNN’s Anderson Cooper that the author of the Journal article, Brian Deer, is “a hit man” who has been “brought in to take me down.” (Watch the video here).

And on her website, Generation Rescue, Jenny McCarthy as “much ado about nothing,” and condemned the message of the “vaccine-industry funded media circus.”

It’s an extremely hot-button issue that draws strong opinions from both sides -- will the recent findings finally put the debate to rest, or is it just another chapter in the autism-vaccine controversy?

What do you think, and how do you plan to address the topic with your patients?

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