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Autism's False Prophets: Bad Science, Risky Medicine, and the Search for a Cure [Hardcover]

Paul A. Offit

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Book Description

Sept. 18 2008

A London researcher was the first to assert that the combination measles-mumps-rubella vaccine known as MMR caused autism in children. Following this "discovery," a handful of parents declared that a mercury-containing preservative in several vaccines was responsible for the disease. If mercury caused autism, they reasoned, eliminating it from a child's system should treat the disorder. Consequently, a number of untested alternative therapies arose, and, most tragically, in one such treatment, a doctor injected a five-year-old autistic boy with a chemical in an effort to cleanse him of mercury, which stopped his heart instead.

Children with autism have been placed on stringent diets, subjected to high-temperature saunas, bathed in magnetic clay, asked to swallow digestive enzymes and activated charcoal, and injected with various combinations of vitamins, minerals, and acids. Instead of helping, these therapies can hurt those who are most vulnerable, and particularly in the case of autism, they undermine childhood vaccination programs that have saved millions of lives. An overwhelming body of scientific evidence clearly shows that childhood vaccines are safe and does not cause autism. Yet widespread fear of vaccines on the part of parents persists.

In this book, Paul A. Offit, a national expert on vaccines, challenges the modern-day false prophets who have so egregiously misled the public and exposes the opportunism of the lawyers, journalists, celebrities, and politicians who support them. Offit recounts the history of autism research and the exploitation of this tragic condition by advocates and zealots. He considers the manipulation of science in the popular media and the courtroom, and he explores why society is susceptible to the bad science and risky therapies put forward by many antivaccination activists.


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Review

Every child has a right to be vaccinated against deadly diseases. We started Every Child By Two to protect children from diseases. It didn't occur to me that I would also have to protect them from misinformation about life-saving vaccines. Paul A. Offit's book sets the facts straight.

(Rosalynn Carter, former first lady, cofounder of Every Child By Two)

Autism's False Prophets is a compelling story of heartbroken parents, understandably desperate for an explanation of autism, being taken in by false hopes unsupported by genuine science. This book goes to the heart of a question that affects every aspect of American culture and political life. Are public policies to be determined by evidence and reason or by emotions that, however intense they may be, have nothing to do with reality?

(Susan Jacoby, author of The Age of American Unreason)

A definitive analysis of a dangerous and unnecessary controversy that has put the lives of children at risk. Paul A. Offit shows how bad science can take hold of the public consciousness and lead to personal decisions that endanger the health of small children. Every parent who has doubts about the wisdom of vaccinating their kids should read this book.

(Peter C. Doherty, Ph.D., St. Jude's Children's Research Hospital and Nobel Laureate in Medicine for fundamental contributions in Immunology)

In his latest book Paul A. Offit unfolds the story of autism, infectious diseases, and immunization that has captivated our attention for the last decade. His lively account explores the intersection of science, special interests, and personal courage. It is provocative reading for anyone whose life has been touched by the challenge of autism spectrum disorders.

(Susan K. Klein, MD, Ph.D., Case Western Reserve Hospital, and Rainbow Babies and Children's Hospital, Case Medical Center)

[A] thoughtful and readable study.

(Library Journal (starred review))

Enlightening, highly readable and... timely.

(Rahul K. Parikh, M.D. Salon.com)

Arguably the most courageous and most knowledgeable scientist about vaccines in the United States.

(Robert Goldberg New York Post)

[Dr. Offit] has done a huge public service by exposing the tragic and dangerous place the anti-vaccine hysteria has taken us.

(Huntly Collins Philadelphia Inquirer)

An invaluable chronicle that relates some of the many ways in which the vulnerabilities of anxious parents have been exploited.

(Linda Seebach Wall Street Journal)

A good read and an important piece of work.

(Lisa Jo Rudy About.com)

More than a book about a disease, it is an ode to uncorrupted science and a cautionary tale that data alone is never enough.

(SEED magazine 1900-01-00)

[Offit] provides important insight into the fatal flaws of the key arguments of vaccine alarmists.

(Buffalo News)

A very good read.

(Dom Giordano The Bulletin)

A sobering indictment.

(Isabelle Rapin, M.D. Neurology Today)

Highly recommended.

(Choice)

A fascinating read... Eloquently and clearly written.

(Stan L. Block, MD Infectious Diseases in Children)

A very helpful book for both medical personnel and parents.

(The New England Journal of Medicine)

The book is a fantastic read. I recommend it to all physicians and their patients and families.

(Brian Alverson, MD Archives of Pediatric & Adolescent Medicine)

This is a powerful book which should be read by all professionals working in the area ofmedicine.

(Michael Fitzgerald Social History of Medicine 1900-01-00)

Paul A. Offit is one of the most respected scientists and clinicians in a field of vital importance to public health.

(Patricia M. Rodier BioScience)

[This] book doesn't just show that the anti-vaccine activists are wrong; it attempts to explain why, in our culture, they tend to win.

(Jason Fagone Philadelphia Magazine)

Detailed but easily readable... should be required reading for any parents who are considering denying vaccination to their children.

(Communication: The Magazine of the National Autistic Society 1900-01-00)

Arguably the most detailed and thorough history available of the current anti-vaccine movement.

(Roy Richard Grinker Journal of Autism and Developmental Disorders 1900-01-00)

[A] must-read... it will keep pediatricians and pediatric neurologists awake over the nightmarish possibilities of pseudoscience in the 21st century.

(Roger A. Brumback, M.D. Journal of Child Neurology 1900-01-00)

The vast range of professionals who may be enriched, professionally, by the book's contents extends to: psychologists, psychiatrists, neurologists, neuroscientists, speech pathologists, pediatricians, primary care physicians, geneticists, virologists, immunologists, vaccine experts, nurses, infectious disease experts, internists, gastroenterologists, epidemiologists, public health professionals, special education teachers, bioethicists, biochemists, biologists, biostatisticians, endocrinologists, pharmacists, pharmacologists, pharmaceutical industry professionals, health policy makers, journalists, politicians, and trial lawyers.

(Leo Uzych Metapsychology)

Seeking to help readers realize the truth about Autism, Autism's False Prophets is a much need read, not to be missed.

(Midwest Book Review 1900-01-00)

Review

No one has been more vocal-or courageous-than Paul A. Offit in exposing the false and dangerous claims of the growing antivaccine movement. Offit's latest book lays waste to the supposed link between autism and vaccination while showing how easily Americans have been bamboozled into compromising the health of their own children. Autism's False Prophets is a must read for parents seeking to fully understand the risks and rewards of vaccination in our modern world.

(David Oshinsky, winner of the Pulitzer Prize in History for Polio: An American Story)

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Most Helpful Customer Reviews on Amazon.com (beta)
Amazon.com: 4.2 out of 5 stars  134 reviews
256 of 314 people found the following review helpful
5.0 out of 5 stars "Please don't read it" - say anti-vaxers Sept. 18 2008
By Joseph S. - Published on Amazon.com
Format:Hardcover
If you look at all the negative reviews of this book so far, you won't find any indications that the reviewers have actually read the book. You will also note they urge readers not to buy the book. Once you read the book, you'll understand why.

Despite what others have said, the book didn't read like a "smear-fest." The closest it comes to that is the use of the word "quackery" in one place. What Dr. Offit has done is provide a well-referenced historical account of the activities of a sub-group of the autism community in the last decade.

If you are someone who tries to keep reasonably up to date with the political going-ons of the autism world, you might be thinking, "I won't learn much from this book." But you'd be wrong. There are many interesting tidbits of information you probably haven't heard of before; such as David Kirby's interaction with Curtis Allen of the CDC (page 151). There's also a lengthy discussion of the meetings and thinking that led to the decision to remove thimerosal from pediatric vaccines.

Perhaps there is some information the book is missing. For example, you won't find a discussion of Dan Olmsted's negligence in his Amish reporting. More could've been said of JB Handley's bullying tactics and his failed prophecies ("autistic children will be cured within 2 years"). There's no mention of John Best, a fringe but prominent member of the anti-vax movement.

This is understandable, though. A book is insufficient to air all the dirty laundry of the anti-vaxers. You'd need a whole encyclopedia for that.
254 of 314 people found the following review helpful
5.0 out of 5 stars An Important Book Sept. 30 2008
By David C. Brayton - Published on Amazon.com
Format:Hardcover
I just read an article about Jenny McCarthy--yes, that Jenny McCarthy. Ms. McCarthy has a child with autism and she is convinced that a vaccine caused her child's autism. She now considers herself an expert because she attended the "University of Google" (her words, not mine) and that she is right because "because there is an angry mob on my side" and "until [someone] walks in our shoes, [he/she] really has no idea."

That's right...because there is an angry mob on her side, the consensus of scientists that attended real schools and obtained real master and doctorate degrees in things like epidemiology and medicine, is wrong.

Dr. Offit faces a very challenging opponent and he did it with an exceptionally calm and rationale analysis of vaccines, why they are safe and more importantly, why the quacks and anti-vaxxers are wrong. And he did it in a style that is very readable by the lay person.

When Dr. Offit starts laying out damning facts against the anti-vaxxers, you will be left agape. For example, Dr. Wakefield took $800,000 from a plaintiff's attorney and used it to fund his studies and never disclosed where the funding came from, he never obtained informed consent and when he ran his studies past IRBs, they were anything but medically qualified. Just astounding. Of course, the results of his studies have never been duplicated and any physiological basis for his hypothesis has been debunked.

Yet, there are people who flock to Dr. Wakefield and give him lots of money for unproven and dubious-at-best treatments and cures. Very, very sad.

Dr. Offit also discusses how science is perceived in society. A lot of people simply don't "believe in" science and how science is done. Dr. Offit analyzes this later in the book and it is hardly comforting. (An excellent book about this phenomenon is Carl Sagan's Science as a Candle in the Dark.)

Probably the scariest part of the book is when groups like Generation Rescue hire public relations firms. Whilst I'm all for spirited debate, these groups will misrepresent any fact, omit crucial details and pander with the most vile and loathsome tactics.

Definitely a highly recommended book. Scary and depressing because science and vaccines have taken such a bad rap. But hopeful because there are folks out there like Dr. Offit, Orac and others that are willing to stand up for rational, evidence-based medicine.

While I feel for Jenny McCarthy and her struggles with autism, her incessant denial of huge amounts of science and evidence is causing thousands of parents to forego vaccinating their children. She is endangering our children and some will die from childhood disease that were once almost completely eradicated.
151 of 188 people found the following review helpful
5.0 out of 5 stars Excellent book! Sept. 22 2008
By watchman - Published on Amazon.com
Format:Hardcover
Fascinating and readable. "Autism's False Prophets" traces the histories of the MMR-autism and thimerosal-autism controversies, and discusses the science in clear, layman's language. I found the book very difficult to put down: it's a wonderful (and enlightening) read for anyone interested in autism, vaccines, or scientific controversy, and its "Science and Society" chapter should be required reading for any parent (or any person) researching vaccines or other medical decisions.
95 of 118 people found the following review helpful
5.0 out of 5 stars Autism Quackery Unmasked Sept. 21 2008
By Stephen Barrett - Published on Amazon.com
Format:Hardcover
Dr. Offit presents shocking details about the people and organizations who have been trying to scare parents into not immunizing their children. I was startled by the amount of money lawyers paid to doctors and other scientists who were willing testify in court that vaccines cause autism. Parents who are frightened about immunization should find this book reassuring.
35 of 44 people found the following review helpful
5.0 out of 5 stars From a Father within the Proximate Orbit of ASD Sept. 30 2009
By Alxsteele - Published on Amazon.com
Format:Hardcover
In 2000, just after the birth of our first son, I sat in a McDonald's parking lot, listening to an NPR report on the possible "casual relationship" between mercury (in vaccinations) and autism. I was understandably concerned, but as one thing drives out another, I did nothing about it. He subsequently had his immunizations and was fine. Our second son very early in life expressed moments of odd impulsivity which, as the years went on, turned into full-blown out-of-control impulsivity. Someone mentioned Sensory Integration Dysfunction (SID)--labeled by some medical professions as "not a real dysfunction" and labeled by other medical professions as expressions of some other disorder. After researching that, we were convinced--whether the symptoms were in isolation or part of something greater--our son was hyposensitive to vestibular and tactile inputs. (We've tried many experiments to help him process experiences in something of a more standard manner.) When our third son was born, our second son was too young for us to see his SID as being part of the "mostly normal range" of Autism Spectrum Disorder (ASD). And so the idea that immunizations might have played a part in our second son's disorder (dysfunction?) only came back to the fore as we've recently added a little girl to our family. I began to research as extensively as online medical journals would allow, and read books on the subject. It is with this background that I was recommended to, and read carefully, Autism's False Prophets. Know that I approached this topic as one suspect of the role of thimerosal in neurological disorders, specifically autism.

Autism's False Prophets is, as best I can find, a thorough treatment--background, history, scientific evidence and explanation--as I can find on the topic. The book starts with, and is quick to remind us of, true moments in history where diseases ran rampant throughout concentrated groups of people. Offit writes, "In 1916, polio became an American disease. In New York City alone, in one summer the virus paralyzed 10,000 people and killed 2,000" (xix). Starting here is helpful, because it reminds us all that the threat of non-vaccination are also real--assuming for a moment that the danger from vaccines is as well.

Offit documents how the earliest research identified classic expressions of autistic behavior. "In 1938, Leo Kanner...found that autistic children didn't talk much; when they did talk, they often talked to themselves. He also found that they played in a stereotypical and repetitive manner; demanded their toys and clothes remain in the same place every day; had an excellent memory for lists; and lacked imagination, choosing to interpret what was said to them concretely... Kanner noticed that parents of autistic children has similar personality traits, describing them as `cold, bookish, formal, introverted, disdainful of frivolity, humorless, detached, and highly--even excessively--rational and objective'" (1-2)

Autism hasn't changed much in its expressions, though it has increased substantially in its recurrence. "Since the mid-1990's, the number of children with autism has increased dramatically. Now, as many as 1 in every 150 children in the United States is diagnosed with the disorder" (3). Evidence of early- and wrong-therapy treatments are rampant, as Offit reminds us from the study of behavior therapy. He writes, "Behavioral theory uses imitation, repetition, and frequent feedback to teach children appropriate behaviors. But because some children require a high number of repetitions, programs might require as many as forty hours a week" (4).

And yet, for many, the question remains: do vaccines (or does thimerosal) cause autism? The scientific answer: no, not at all. The issues that play into that answer, however, are multiple. First, there is a general confusion on the way that the scientific method functions, as Offit points out: "Although the scientific method has almost singlehandedly brought us out of the Dark Ages and into the Age of Enlightenment, it can be difficult to explain how it works. Here's the problem. In determining whether, for example, MMR causes autism, investigators form a hypothesis. The hypothesis is always formed in the negative, known as the null hypothesis. In the MMR-causes-autism case, the hypothesis would be, `MMR does not cause autism.' Epidemiological studies have two possible outcomes: (1) Investigators might generate data that rejects the null hypothesis. Rejection would mean that the risk of autism was found to be significantly greater in children who received MMR than in those who didn't. (2) Investigators might generate data that do not reject the null hypothesis. In this case, the risk of autism would have been found to be statistically indistinguishable in children who did or didn't receive MMR. But there is one thing those who use the scientific method cannot do; they cannot accept the null hypothesis. This means that scientists can't prove MMR doesn't cause autism in absolute terms because the scientific method allows them to say it only at a certain level of statistical confidence" (208).

Secondly, there is confusion over the nature of mercury. Offit writes, "Mercury is part of the earth's surface, released into the environment by burning coal, rock erosion, and volcanoes. After it is released, it settles onto the surface of lakes, rivers, and oceans where it is converted by bacteria to methylmercury. Methylmercury is everywhere--in the fish we eat, the water we drink, the infant formula and breast milk we feed our babies. There is no avoiding mercury. Because everyone drinks water, everyone has small amounts of methylmercury in their blood, urine, and hair. A typical breast-fed child will ingest almost 400 micrograms of methylmercury during the first six months of life. That's more than twice the amount of mercury than was ever contained in all vaccines combined. And because the type of mercury in breast milk (methylmercury) is excreted from the body much more slowly than that contained in vaccines (ethylmercury), breast milk mercury is much more likely to accumulate" (114).

Finally, there is the confusion of self-evident information. Call it anecdotal or singular information: unfounded, self-discovered, and unrepeatable. This largely occurs when it comes to the "self-taught" of the internet. Offit writes, concerning one well-known vaccines-cause-autism spokeswoman, "[Jenny] McCarthy has trumped her pediatrician's four years of medical school, three years of residency training in pediatrics, and many years of experience practicing medicine by typing the word autism into Google. There she found a wealth of purported therapies her pediatrician didn't know about--therapies she believed had cured her son... By writing a popular book about her son's autism, Jenny McCarthy had become a media expert on vaccines" (242).

Ultimately, the issue of the case is brought down to whether suspicion and cynicism is enough to trump scientific evidence. Offit points out, "Because of the Internet, everyone is an expert (or no one is). As a consequence, for some, there are no truths, only different experiences and different ways of looking at the same things... The peculiarity of our current predicament is the selective withdrawal of trust from scientific and medical professionals, which is both unjustified and mutually damaging" (204).

The conclusion one is left with, after reading this book, is that hope and desire mingled with a hint of cynicism or suspicion, fed by the (usually) well-intended remarks of some people can blind us to truth. Here are just four of the results from epidemiological studies:

"In August 2003, Paul Stehr-Green published a paper in the American Journal of Preventive Medicine. Stehr-Green studied children with autism in Sweden and Denmark from the mid-1980s through the late 1990s. He found the risk of autism increased after thimerosal had been removed from vaccines" (106).

"In September 2003, Kreesten Madsen, an epidemiologist from the University of Aarhus in Denmark, published a paper in Pediatrics. Madsen examined the medical records of 1,000 children diagnosed with autism between 1971 and 2000. Like Sehr-Green, he found that between 1992 and 2000, after thimerosal had been removed from vaccines in Denmark, the incidence of autism skyrocketed" (107).

"[I]n September 2004, John Heron, an epidemiologist from the University of Bristol in the United Kingdom published a study in Pediatrics. Heron examined the records of 14,000 children who had received different amounts of thimerosal in vaccines between 1991 and 1992. He wanted to see if he could find a relationship between the amount of thimerosal babies had received and the risk of neurological problems. He did. The more thimerosal children received, the less likely they were to be hyperactive or to have difficulties with hearing, movement, or speech" (107).

"The same month...Nick Andrews, an epidemiologist from the Communicable Disease Surveillance Center in London, also published a study in Pediatrics. Andrews examined the records of 100,000 children who had received different amounts of thimerosal. Like Heron, Nick Andrews found the more thimerosal children received, the less likely they were to develop neurological problems like attention deficit disorders" (108).

"Finally, in January 2008, Robert Schechter and Judy Grether from California's Department of Public Health took a closer look at the rates of autism from 1995--six years before thimerosal had been removed from vaccines--to 2007, six years after it had been removed. They found what everybody else had found: the rates of autism continued to increase" (109).

At the end of this book, one is left forced to accept the findings of these (and other studies) or else conclude that all epidemiological studies are suspect. If one finds himself in this latter group, he must object to everything: every medicine that is available, every diagnosis, every prescription, every advice but that which he himself is able to verify--by the very least of his experience. Offit notes, "Although some parents have been skeptical of the scientists and public health officials who failed to find that vaccines caused autism, questioning their motives and occasionally threatening them, they haven't been similarly skeptical of the vast array of autism therapies, all of which are claimed to work and all of which are based on theories that are ill-founded, poorly conceived, contradictory, or disproved" (119). Nor are such parents universally suspicious of suggestions regarding the food pyramid, recommended exercise levels, over-the-counter medication, or other epidemiological studies that support other widely (and mainstream) approaches to medicine. If we reject the findings of the scientific method--it must be universal.

Offit's best advice (which I took and implemented) was that "If parents want to do genuine research on the subject of vaccines, they should read the original studies of the combined MMR vaccine; and analyze the ten epidemiological studies that examined whether MMR caused autism. If they want to research thimerosal, they should read the hundred or so studies on mercury toxicity, as well as the eight epidemiological studies that examined whether thimerosal caused harm" (203).

He writes, in conclusion, "The science is largely complete. Ten epidemiological studies have shown MMR vaccines doesn't cause autism; six have shown thimerosal doesn't cause autism; three have shown thimerosal doesn't cause subtle neurological problems; a growing body of evidence now points to the genes that are linked to autism; and despite the removal of thimerosal from vaccines in 2001, the number of children with autism continues to rise. Now it's up to certain parent advocacy groups, through their public relations firms, lawyers, and celebrity spokespersons, to convince the public that all of these studies are wrong--and to convince them that the doctors who proffer their vast array of alternative medicines are the only ones who really care" (247).
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