Misinformation: Vaccines and ASD- Antonia
Answer
Q: What are vaccines?
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Vaccines as we know them now are injectable serums that stimulate an immunological response in the body that then protects an individual from future exposure to viruses and pathogens. There are two types of vaccines: attenuated and inactive vaccinations. Attenuated vaccines contain live, but weakened versions of a pathogen. With just a single dose, an attenuated vaccine will create a long lasting and effective immunological response that can protect an individual for a lifetime. Currently, there are attenuated vaccines available for measles, mumps, rubella, varicella, adenovirus, shingles, polio, and rotavirus. Inactive vaccines contain dead versions of a pathogen. Even though the pathogen is inactive, the body will still recognize it as a threat and begin to fight against the virus. Oftentimes inactive vaccines will require multiple doses to remain effective like the Hepatitis A vaccine. Despite having different methodologies both attenuated and inactive vaccines are safe and effective for protecting humans from deadly viruses.
Q: What is Autism Spectrum Disorder (ASD)
Derived from the Greek word autos meaning “the self”, Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that affects an individual's ability to interact, socialize, communicate, learn and behave. As of 2013, the DSM-5 (a diagnosis handbook created by the American Psychiatric Association) classifies previously separate diagnosis like Autism disorder, Asperger's Disorder, PDD-NOS, Childhood Disintegrative Disorder and Rett Disorder under one term and one set of diagnosis criteria (ASD). Statistics vary, but according to the CDC, 1 in 36 children have been diagnosed with ASD. Children are typically diagnosed by age two, with symptoms commonly appearing before the age of two. However, it is also possible to be diagnosed in later stages of life.
ASD can range in the type and severity of symptoms. Some individuals will need substantial support to accomplish daily tasks, while others will thrive in all but some aspects of daily life. The most common types of symptoms in individuals with ASD involve social communication impairments and repetitive/ restrictive behaviors. Social communication symptoms usually manifested in a challenges communicate or socialize with others. Some examples included difficulty making or maintaining eye contact, and issues related to maintaining back and forth communication. Depending on the severity of the symptoms some individuals will also have problems with language and language acquisition. Repetitive/ restrictive behavior symptoms included sensory sensitivity, the repetition of actions and sounds, specified interests, and strict schedule adherence.
Q: Do vaccines cause autism (ASD)? Where did the belief that vaccines cause ASD come from?
Vaccines do not cause Autism. Multiple large scale epidemiological studies have found no link between receiving a vaccine and developing ASD. The National Academy of Medicine (formerly the Institute of Medicine), looked at 8 different types of vaccines and found that apart from rare exceptions, vaccines are safe. Similarly, since 2004, 9 major epidemiological studies have found no relationship between thimerosal (a mercury based vaccine preservative) and ASD.
The myth that vaccines cause ASD stems from a 1998 study published in the Lancet. The now infamous study was led by a man named Andrew Wakefield. The study claimed to have found a link between the measles, mumps and rubella (MMR) vaccine and ASD in children. This shocking discovery made waves across the scientific world, and society as a whole. After the paper was published, scientists and researchers raised concerns and produced their own studies that refuted Wakefield’s claims.
In 2004, investigative reporter Brian Deer unearthed fraudulent behavior surrounding Wakefield and the 1998 MMR study. It was later proven that Wakefield was working with and receiving financial compensation from parents and lawyers that were in the process of suing vaccine manufacturers. By 2004, 10 of the 12 original study authors refuted the claims made in the 1998 study. In 2010, the Wakefield et al. paper was completely removed from the Lancet and Wakefield et.al were found guilty of ethical malpractice and misrepresenting the results of the study.
Q: Why did misinformation about vaccines and ASD become so pervasive in our society?
The involvement of the media, politicians and parent activist groups in conjunction with faulty science lead to widespread misinformation about vaccines and ASD. On February 28, 1998, Wakefield simultaneously published his findings in the Lancet and held a press release. Almost instantaneously, the British media exploded with articles titled “Ban Three-in-One Jab, Urge Doctors” and “Alert over Child Jabs”. In the years following the 1998 study, more than 1500 articles were written about the MMR vaccine and ASD. The media impact was so widespread that in 2003, a docudrama called Hear the Silence depicting the work of Andrew Wakefield aired on British television.
The involvement of politics and politicians also played a role in the spread of misinformation. Republican Congressman Dan Burton was one of the first to bring the issues surrounding vaccines and ASD to the federal level. On April 6, 2000 the Committee on Government Reform held a congressional hearing to investigate the relationship between vaccines and ASD. At the hearing, parents and scientists on both sides of the vaccine debate were able to testify. The congressional hearing catapulted the vaccine debate into the American mainstream media. Later on in 2005, politician Robert F Kennedy Jr. published an article for the Rolling Stones magazine titled “Deadly Immunity”. The magazine article contained countless errors and inaccuracies regarding the safety of thimerosal and the possible link to ASD. In the days following the publication of the article multiple retractions were released by Rolling Stones. However, the damage was done.
Going back to the Wakefield et al. study, the parent groups that helped fund the study were a part of JABS, an organization with the goal of warning parents of the dangers of the MMR vaccine. Parent activist group involvement in scientific studies definitely played a role in skewing the validity and safety of vaccines in the public eye. Some advocacy groups, like Safe Minds, partnering with politicians and journalists to further their agenda. While others, like Generation Rescue, created and published advertisements in major newspapers to spread misinformation regarding thimerosal and ASD. It is safe to say that parent activist groups helped shape public opinion regarding the safety of vaccines.
Q: What are the implications of the misinformation surrounding vaccines and ASD?
The immediate result of the belief that vaccines cause ASD is the increase in unvaccinated children. Upon the publication of the MMR vaccine study parents became afraid that vaccines will cause their children to develop autism and opted out of vaccinating their children. A study conducted in 2003 reported a decrease in MMR vaccination across England. The decrease in vaccinated individuals also resulted in various measles outbreaks across the UK and the United States. The outbreaks left children exposed to easily preventable viruses and their complications.
The notion that ASD is caused by something led to the belief that ASD could be “cured” or treated. These pseudo therapies and ASD cures ranged from harmless to incredibly harmful and dangerous. Some therapies and cures preposition by researchers included vitamin A, vitamin B12, steroids, plasmapheresis (the process of removing blood and replacing it with antibody free blood), head decompression, mercury chelation (the process of using chemicals to bond with mercury), and Lupron (a sex hormone suppressant). These therapies feed and contribute to the harmful idea that ASD individuals are “broken” and need to be “fixed”. When that is not the case.
Sources:
American Psychiatric Association. (n.d.). What Is Autism Spectrum Disorder?. https://www.psychiatry.org/patients-families/autism/what-is-autism-spectrum-disorder#section_0
Christopher Cumo. (2019). What You Need to Know About Autism. Greenwood.
Frigaard, M. J. (2016). Vaccines. In B. W. Lerner & K. L. Lerner (Eds.), Worldmark Global Health and Medicine Issues (Vol. 2, pp. 640-649). Gale. https://link.gale.com/apps/doc/CX3628100092/GVRL?u=cclc_sacol&sid=bookmark-GVRL&xid=b4f4369a
Knopf, A. (2021). Time to remember: Vaccines don’t cause autism. Brown University Child & Adolescent Behavior Letter, 37(7), 9–10. https://doi-org.sac.idm.oclc.org/10.1002/cbl.30559
National Institute for Mental Health. (n.d.). Autism Spectrum Disorder. https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd#part_2282
Paul A. Offit. (2010). Autism’s False Prophets : Bad Science, Risky Medicine, and the Search for a Cure. Columbia University Press.
Sathyanarayana Rao, T. S., & Andrade, C. (2011). The MMR vaccine and autism: Sensation, refutation, retraction, and fraud. Indian Journal of Psychiatry, 53(2), 95–96. https://doi-org.sac.idm.oclc.org/10.4103/0019-5545.82529
Vaccine Safety. (n.d.). Autism and Vaccines. CDC. https://www.cdc.gov/vaccine-safety/about/autism.html
World Health Organization. (2024, April 23). Vaccines and immunization: What is vaccination?. https://www.who.int/news-room/questions-and-answers/item/vaccines-and-immunization-what-is-vaccination