more on autism and vaccines

This past Sunday the  NY Times Magazine published a story about Andrew Wakefield, and his rise and fall in the field of autism research, the connection between autism and vaccines, and the response he has received from the medical community, some autism advocacy groups, and his home country of Great Britain.

While its true that we all make mistakes, the key to going on with your life is to acknowledge yours, apologize if warranted, and take responsibility for any outcomes associated with the mistake(s).

Apparently, Dr. Wakefield has never acknowledged the issues related to his "research" on patients with autism, or his unethical use of normal children as controls-whom he paid to allow to have their blood drawn.

The article is fascinating reading, although quite long. It also describes the many studies that have attempted to duplicate Dr. Wakefield's original results and failed. Clearly the causes of autism are yet to be fully elucidated; and before we can truly find a cure, we must have a more clear idea of what underlies the syndrome, or spectrum of disorders. Today, most scientist believe that autism is a multimodality disorder, and has some genetic predisposition, coupled with some or many inciting events, or environmental stimuli that "turn the switch" on as it were. We have spent, as a community of medical practitioners, parents, advocates and scientists so much time trying to investigate the link between autism and the MMR vaccine, that we may have missed other potential causes of this devastating problem affecting an increasing number of our children.

The NYT article claims that Wakefield may be responsible for the recurrences of measles and pertussis that we have discussed in this forum before (see http://www.carilionclinic.org/blogs/ackerman/?p=1021 and http://www.carilionclinic.org/blogs/ackerman/?p=1059); however, we simultaneously know that vaccine rates in the United States are at the highest level ever (90%) and that most parents actually trust the information provided by their primary care provider. So, although I continue to wish that fewer families would reject vaccines for their children, I am encouraged to acknowledge that in most populations, most children are adequately immunized. The problems we have seen in Floyd, Va and elsewhere, may come about because the 10% who choose not to immunize, may congregate together in like-minded communities, creating more opportunity for exposure to diseases that many are not immune to.

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