The Vaccine-Autism Link...Or Lack Thereof

The Vaccine-Autism Link...Or Lack Thereof

Originally composed August 4, 2018

Editor's Note: The anti-vaxxer quandary will not go untouched, as I intend to devote a future article, possibly more, to dissecting the bizarre phenomenon. For now, this article explains the origins of the misconception and clarifies reality.

All too often, many people-and smart ones, at that-speak as if factually about the link between vaccines and autism, citing a causal effect of the former on the development of the latter. In fact, 18% of Americans believe this link to exist, according to a 2011 poll cited by Time. Meanwhile, virtually every major scientific organization has openly rejected this presumption. Googling "vaccine and autism" will quickly reveal this unified position among organizations ranging from: the federal government's Center for Disease Control (CDC); news outlets like Discover Magazine, the Washington Post, and TIME; online healthcare publisher WebMD; even "Autism Speaks," a non-profit resource for information about the disorder. Study after study conducted around the world has failed to replicate the one-time conclusion pointing to a correlation. In fact, meta-analyses of data have indeed shown that autism occurs less among children who've received vaccinations and less among children whose siblings have received vaccinations. Yet still, so many people militantly and erroneously disagree.

So where does such a deep-rooted and outright incorrect myth stem from? Unlike many urban legends with ambiguous origins, we can pinpoint exactly where this one began.  In 1998, British doctor Andrew Wakefield published a paper in The Lancet claiming a definitive link between the MMR (measles, mumps, and rubella) vaccine in small children and the development of an autism spectrum disorder. He also said that, according to his research, the vaccine also increased the likelihood of certain bowel problems. Nobody paid attention to the bowel-related claim, but news of a childhood vaccine causing autism spread like wildfire, certified fake news before anyone used that term. Though scientists around the world acted fast to debunk this baseless claim, the misinformation spread even faster. Media outlets around the world covered this sensationalistic story in a way that most argue helped to disseminate the incorrect info even more. 

At any rate, many parents assumed these reports as fact right away. Unfortunately, many Westernized countries with some of the best healthcare systems in the world such as the UK and Japan saw vaccination rates dip after 1998. In Britain, modern medicine had all but stamped out measles and mumps, which saw a resurgence following the release of that paper. Japan's situation had more complexities, with an already-low rate of vaccination and the administration of the vaccine to children at a later age than elsewhere in the industrialized world. Even controlling for these factors, their country also saw rates of infection rise. It's very troubling when nations with the resources to eradicate these diseases saw many of its citizens willfully reject modern medicine on completely false grounds.

Possibly one of the most perplexing aspects of this bizarre story is asking ourselves, how does such a large portion of the population readily disregard empirical, scientific fact in favor of something alternative that they hear? This happens primarily via three major mechanisms to three clusters of people.

The first means by which so many people refuse to accept empirical evidence on this matter (and related ones as well) is easily the saddest. Generally relatives of autistic individuals make up this group, though others certainly comprise it as well. Oftentimes, when things beyond our control happen, human beings want to attribute meaning and-by extension-a cause. If something good happens, people may chalk it up to luck, or divine intervention, etc. Meanwhile, not-so-good things require a source of blame, and usually a more seemingly tangible one: the devil, money, the government, immigrants, your ex-wife, illegal drugs, or in this case, a vaccine. Sadly, when the mind struggles to comprehend why something as unfortunate as autism would afflict as many as 1 in 50 Americans, and when one of those 1 in 50 happens to be the person's child or sibling or relative, humans try to ascribe a simplified explanation to a complex-or even unknowable-problem. The fact remains that even our most advanced neuroscientists still can't say for certain precisely what leads to the development of autism in children, though they often cite genetics, premature birth, and an older mother giving birth as some potential, probable factors. Christian Scientists lump into this category at its most extreme pole, though in a distinct way because of their belief that diseases and disorders derive from a spiritual malady only curable through things like prayer; naturally then their denomination rejects vaccines as well as pretty much every facet of modern medicine in favor of getting in touch with God to heal. 

The second group of people rejects science by a somewhat similar means, though patently different, too. Whereas the last group mentioned forms its ideas when people try to grasp how things happen in an effort to simplify the issue, this group attempts to explain why things happen by needlessly complicating the matter. We've all met at least one person that religiously distrusts anything claimed by the government, major corporations, or other entities of the establishment. And yes, a lot of solid evidence exists to discredit a lot of these entities: the CIA routinely overthrows governments, props up dictators, sells illegal guns and drugs to generate cash so as to eliminate a paper trail, they even spent over a decade performing mind-control experiments on U.S. citizens (don't believe me? Look up Project MKULTRA). Oil companies...don't even get me started with that one. Pharmaceutical companies cover and alter details about their drugs, like in 1990s when Purdue Pharma told doctors that OxyContin was a non-addictive painkiller. The list goes on. People-and groups of people-have motives, which they'll go to great lengths to protect or pursue.

Now, nobody should ever blindly swallow the tripe put out by our politicians and their tentacles, or billion-dollar companies, or news agencies, etc. However, it's equally important for people not to immediately accept the truthiness of information that attacks the legitimacy of said entities, especially for the simple fact that it syncs up with their values or preconceived notions. In the case of the MMR vaccine, people in this camp will call attention to the pharmaceutical industry being just that-an industry. According to some skeptics, manufacturers cover up the side effect of autism so that they can keep selling vaccines. While it is true that pharmaceutical manufacturers turn a profit by selling vaccines like MMR, they wouldn't actually sell vaccines if they cared solely about the money. When somebody gets vaccinated, they receive a drug once. If only money makes up the reason companies sell vaccines, in this case MMR, why as a company go through so much effort to lie as extensively about its side effects as they would need to in this case, only to sell a drug which a patient needs to take only one time? To truly cash out, wouldn't a heartless profit-hungry corporation rather keep the patient sick so that they can treat them with an expensive drug or cocktail of drugs and other procedures repeatedly over an expended span of time? Because a vaccine is a one-and-done thing. These companies could just as easily withhold the vaccine(s) and instead treat the fevers and coughs and pain and whatever other symptoms that arise from diseases. Unlike a sole MMR inoculation, patients would need to fill these hypothetical medications monthly to deal with any effects the disease inflicts, including long-term effects after the body has fought off the disease itself. 

Simply because a product sells in the free market doesn't make it or its business inherently evil, just as the fact that a product can do good doesn't mean the business behind it has an inherently good or positive mindset or effect on the world. All too often, confirmation bias skews the logic of individuals as they look and listen only for info that supports their pre-existing beliefs. So for this group, it wouldn't matter if the overwhelming bulk of factual evidence said that politicians regularly accept bribes vis-a-vis lobbyists which influence the way that they vote, or that the CDC takes the correct stance by saying the MMR vaccine does not cause children to become autistic, or that nobody has evidence that Secret Service operatives are not primarily reptilian creatures from beyond the moon. It wouldn't matter. For a variety of reasons to be discussed in a later post, many people will simply never believe the government. Or the medical community. Or any establishment. Or logic, for that matter.

The last group: their path to falseness begins when new information (or misinformation) first hits the scene. In this case: circa 1998, a controversial article comes out in The Lancet, a respected medical journal. Because of the revered status of the publication coupled with the attention-grabbing claim, news agencies begin to report the story, drastically increasing the concept's circulation. Like in whisper down the lane, each retelling mutates the original content, even if just slightly; also, some journalists compress the findings to fit into a one-page article or a 30-second sound byte. Whether or not intentionally, every time reporters retell the story they state it more and more factually versus speculatively. And every time the average person hears it again, they accept it more and more as fact.

By the time that information to the contrary comes out, the original story has long since expired from the news cycle. After all, they don't call it the news for no reason. Meanwhile, by then a large chunk of the public will have solidified its opinion, oftentimes on a subject which had never previously crossed their minds. For example, how many people really contemplated a link between a measles vaccine and developing autism before 1998? Very few, if that. Yet by the time the medical community could conclusively refute Wakefield's findings, millions of people had though about the issue upon the media's provocation. While the average person will revise their opinions in the face of new evidence, a striking percent of people simply cannot or will not do that for whatever reason. Some people went back to trusting the MMR vaccine immediately afterwards, whereas in other segments of the public it took many more years to sway their opinion; another group still never reversed their opinion of the vaccine.

So why does this matter that much? People have a right to believe or disbelieve whatever they want to. Sure. Yet even so, a bunch of people buying into pseudoscientific theories doesn't only make our population collectively stupider, but it actually damages public health. According to CDC estimates, among children born between 1994 and 2003, in the course of a lifetime, vaccines-including MMR-will prevent 322 million illnesses, 21 million hospitalizations, and 732,000 deaths from the diseases they prevent. On the bright side, the mainstream implementation of MMR among other vaccines helps save lives and reduce healthcare costs.

On the other hand, virtually all medical personnel conclude with conviction that foregoing vaccinations in children does tons of damage. In the somewhat infamous words of pediatrician and vaccine specialist from the Children's Hospital of Philadelphia, Dr. Paul Offit, "that paper killed four children." In The Australian, Pulitzer-prize winning journalist Laurie Garret quips that "our data suggests that where Wakefield's message has caught on, measles follows." Editor of The BMJ, Fiona Godlee, goes as far as saying that in relation to the damage caused by Wakefield's fabricated study, "it is hard to find a parallel in the history of medical science."

The interesting dilemma regarding the third group of disbelievers comes from trying to figure out who bears the brunt of the responsibility for such widespread ignorance. Most directly one must blame former-Dr. Wakefield, who deliberately falsified his study (among other grievances, e.g. unnecessary colonoscopies of autistic children). Certainly, he remains to blame in the concrete sense. As a result of this scandal he has lost his medical license in the UK, and rightfully so. Still, in a more abstract way, this dilemma reveals an interesting phenomenon in the realms of public, media, medicine, and government-a feedback loop which makes it difficult to dispel many bits of misinformation despite the best efforts of experts and officials. 

The government has probably played the most responsible role in this fiasco, unlike in most cases. Every state requires that children have the MMR vaccine prior to starting Kindergarten in the public school system. The federal government has spent billions of dollars over the years in various ways to perpetually vaccinate this society's young. Plus, over the years, the CDC and other agencies have repeatedly run campaigns to spread awareness of vaccination and to eliminate myths like the autism link.

The healthcare industry, another surprise to some, also did its part to mitigate the ignorance. In 2015, 91.9% of 19 to 35 month old children in the U.S. had already received the MMR vaccine. Less than 1% didn't have the vaccine by the time they started school. Any healthcare professional will defend the positive effect that vaccines have had on society overall. All doctors will deny a link between MMR and autism due to a lack of any actual evidence. 

Then the reason this group of people still believes in the link between MMR and autism is because of, primarily, the dichotomy of media and its audience. Interestingly enough, though the government and healthcare have tools in place that at least try to limit their capacity to derail away from their intended purposes, the media and even more so the populace have no such restraints. 

Except in a few specific cases, freedom of speech prevents any governmental body from telling a magazine, news network, or website that it can't report on a specific story. Thus any number of journalists can repeat stories that may or may not have much truth to them; they can spin a story, omit certain facts and highlight others, and so on. Or they could simply create a whole new headline altogether. Nobody's stopping them from talking about an entirely new topic-in theory. But pragmatically because of their unquenchable thirst for viewers, it makes more sense to report on already hot topics. Catering to ears in an environment with many competing noises means that to get any attention, a sound must be either very loud, very unique, or both. 

Meanwhile, and of course obviously, nobody has the authority nor ability to tell a person or group of people what to think. People think some far-out, even disturbing things; everybody has the potential to and everybody does. Thus, the media's sensationalist reporting styles feed off of the general public's unanchored mentality, with its stories coming from that very pool of people given no limit to what they can say. Simultaneously, without limits, the media consistently broadcasts subjects which invoke individuals into taking in hearsay as fact, assuming somebody else verified its validity.

None of these trends have an inherently good or bad nature. With that said, in the case of the vaccine-autism myth as well as plenty of other topics, this dynamic keeps millions of people unknowingly in the dark. At least in the first group mentioned, those people arrived at their beliefs through their own independent thought. The second group developed its own viewpoint through critical observation, for better or for worse. Yet this third and perhaps largest group seemingly just absorbs whatever it hears first, most, and loudest.

And so, we live in a world where hundreds of follow-up studies spanning two decades have unanimously failed to replicate the findings of Dr. Wakefield's original "study," which a British investigation deemed "utterly false" by the same publication which he originally "deceived" to publish the paper in. Essentially every major media company, government body, and healthcare agency publicly and conclusively reject the former doctor's findings 20 years ago. Nonetheless, tens of millions of Americans and even more beyond its borders still believe the blatantly unfounded claims he cited. The President of the United States, Donald Trump, has brought up the unsubstantiated link between vaccines and autism close to two dozen times, consistently defending the lie. Even with any insight into how a myth like this can perpetually permeate an industrialized society, it still surprises many to find that mothers of small children would rather risk their children catching deadly diseases versus willfully allowing them to receive shots which a single, now-discredited doctor said may lead to some non-fatal side effects like the developmental disorders on the autism spectrum. Parents with no education on the subject baselessly contest the proven fact that children who've received vaccinations like MMR actually have a lower risk of becoming autistic than their non-vaccinated peers. 

But hey, maybe the case for how the MMR vaccine leads to autism has a better argument than the one made here. As with anything else, this author encourages you to see and hear the opposing viewpoint so you can figure out where you stand. Hopefully, after this article and their argument, you'll stand in the line to have your babies injected with the measles, mumps, and rubella inoculation. 

-The Man of Jackistan

Please Excuse My Poorly Formatted Works Cited:

-Time, measles vaccine poll. http://time.com/3701543/measles-vaccines-poll-anti-vaxxers/

-CDC, rate of autism between 1 and 2%. https://www.cdc.gov/ncbddd/autism/data.html

-CBS, interview Dr. Sanjay Gupta and Dr. Paul Offit, "that paper killed four children." https://www.cbsnews.com/news/dr-sanjay-gupta-confronts-autism-study-doctor/

-Wikipedia, "MMR vaccine controversy." (Used for general info and to explore sources) https://en.wikipedia.org/wiki/MMR_vaccine_controversy

-The BMJ, Fiona Godlee "hard to find a parallel" quote. https://www.bmj.com/content/342/bmj.d22.full

-ProCon.org, which states require what vaccines for school. https://vaccines.procon.org/view.resource.php?resourceID=005979

-CBS, CDC estimates how many lives etc vaccines save. https://www.cbsnews.com/news/most-us-children-get-vaccines-but-some-states-do-better-than-others/

-CDC, % of 19-35 mo. olds w/ MMR. https://www.cdc.gov/nchs/fastats/immunize.htm

-The Guardian, "utterly false," "deceived" when Lancet describing Wakefield's paper. https://www.theguardian.com/society/2010/feb/02/lancet-retracts-mmr-paper

-Real Clear Science, kids with autism less likely to be vaccinated. https://www.realclearscience.com/articles/2018/03/27/kids_with_autism_less_likely_to_be_fully_vaccinated_110588.html