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).