Nov 27 2007

The Battle Continues Over Vaccines and Autism

I and some other medical science bloggers have spent much time addressing the claims of antivaccinationists and those who attempt to link vaccines and autism. This is because they are engaged in nothing less than an all out campaign to eliminate vaccines. They seem to be driven by ideology and fear, their tools are misinformation, lies, and logical fallacies, and they have been tireless in waging war against vaccines. On their side are dubious and discredited scientists, misguided celebrities, naive or scaremongering politicians, and families who range from sincere but misinformed to ideological true believers. This antivaccination movement overlaps considerably with those who are anti-science or anti-scientific medicine (promoting instead some form of “alternative” medicine). They also enjoy much support from anti-government conspiracy theorists.

Standing against these forces are those few scientists who take the time to confront their claims and set the record straight – mainly through blogs and the occasional article. Government agencies, like the CDC, try but have been fairly ineffective (and sometimes counterproductive) in the PR department. Mainstream scientists and scientific organizations have been doing good research and promoting good science and medicine, but have shied away from confronting the antivaccine cranks directly (sometimes because of direct intimidation).

So forgive us if we spend as much time as we do on this issue. Scientific medicine, and vaccines in particular, deserve defending.

The conflict has taken on a very concrete manifestation: almost 5,000 families are suing the Vaccine Compensation Program, claiming that childhood vaccines caused their child’s autism. Nine test cases are to be presented before the Omnibus Autism Proceedings (OAP) established for that purpose. This past summer the first test case, Cedillo, involving MMR and thimerosal, was concluded. The second case, Hazlehurst, concluded on October 18th, and the third, Snyder, just concluded on November 9th.

The transcripts of the testimony given so far on these three test cases are encouraging. Those scientists and experts defending the safety of vaccines have the facts on their side, and it shows. The MMR vaccine and thimerosal (a preservative in some vaccines) do not cause autism. The science is solid and pointing consistently in that direction, and the courtroom is generally a good venue for airing such evidence. Those claiming that vaccines do cause autism are basing their claims on sloppy science and sloppy thinking, and do not hold up under close scrutiny.

So I am hopeful that the OAP will reach the correct decision, but there is always a chance that emotion and deception will prevail so I will be keeping a close eye on this trial as it progresses. A decision is anticipated by summer 2008.

Meanwhile, the press is continuing to do its usual terrible job of reporting this story. This interview with the Hazlehursts follows the typical formula for such stories – focusing on the touching and personal story of a family while granting the scientific evidence a position of token skepticism only. For example:

The scientific experts testified at the national trial. But the testimony of the mom, dad, aunt and grandmom painted the picture of Yates.

“Three days past his vaccine, at his birthday, he’s dazed,” Angela said. “Twelve days after, he had a red, bumpy rash. We didn’t recognize it as a reaction. A month after that, in the bathtub, I’m saying, ‘Yates, Yates’ and he won’t look at us anymore.”

The real conflict that is going on is that between dry and abstract scientific evidence and emotional personal stories. Unfortunately, humans are inherently more compelled by the latter than the former. Lazy journalism, driven more by market forces than by professionalism and integrity, also favors the personal story. It makes for better copy.

The antivaccination ideologues understand this. They have lost the scientific fight – it’s over. Vaccines are the single most effective public health intervention devised by humanity. Vaccines are generally safe, and they do not cause autism. Thimerosal and mercury do not cause autism. Often, when a fight is lost in one arena (in this case the arena of science) ideologues will try to change the venue to one in which they feel they can win, in this case one of alleged respect for parents and families and the personal stories of sick children.

Jenny McCarthy overtly played the “mommy card” in defending her conclusion that vaccines caused her son’s autism. (And now she is working on a documentary movie to follow up her book making these claims.) RFK Jr. directly led the attack on this front with his article Attack on Moms.

Another example of this strategy of changing the venue is creationism. Creationist propaganda is full of claims that evolution requires faith and that scientists have faith in evolution or even science in general, and have reverence for Darwin. They want the conflict to be between faith in God vs faith in evolution and Darwin. They want to fight in the arena of faith because they have already lost, hands down, in the arena of science.

Scientists need to be more aware of such strategies. They innocently argue within the confines of scientific evidence and logic and then are blindsided by attempts at shifting the arena. I hope this does not happen to the experts giving testimony to the OAP (although from reading the transcripts, so far so good). Typical ploys include portraying scientists as cold, as not caring, elitist, nihilistic, or hopeless. Meanwhile, the defenders of nonsense are just trying to provide hope and comfort to the sick. Alternative medicine proponents have this strategy down, dare I say, to a science.

The only way for science and reason to prevail is for scientists to become better at keeping scientific conflicts within the arena of science. This requires that they recognize the strategy of shifting the arena and have rhetoric ready at hand to counter it. It also means not falling into common traps by saying naively stupid things (like calling every unusual occurrence a “miracle”).

It also means training the media and journalists to recognize this problem also, although this may be beyond our control. At the very least scientists should be aware that when they are solicited for a quote they may be getting set up as a token skeptic. Scientists need to discuss stories more with journalists, probe them for the story they are telling, rather then just feed them quotes about the science.

But I think that also scientists need to become journalists – we need to be better and more active at telling our own stories, of “framing” science stories the correct way, and of countering the myths that the enemies of science use to promote their ideologies.

The vaccines and autism story is a great example of the need for scientists to be more proactive in selling science and telling the story of science to the public. In the end, getting the science right doesn’t matter if the public is listening to the charlatans, and public policy follows. We need to tell the human angle of this vaccine story. Absolutely, this is ultimately about the science and what it says about the safety and effectiveness of vaccines.

But the science only informs the bigger conflict, and we need to also make it clear to the public that those claiming vaccines cause autism are fearmongering hysterics who are trying to sacrifice the health of the public on the alter of their paranoid ideology. They are trying to damage the health of your children because they are incapable of admitting that they were wrong, of fairly listening to what the scientific evidence is telling us.

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