Wednesday 2 January 2013

The Vaccine Debate, My Opinion

I got into a rather heated debate on this subject over the holidays.  To preface, I do not believe there is a causitive connection between autism and vaccine.  I am willing to believe anecdotal evidence that parents have noticed difficulties with their children after vaccinations and certainly, some children will react better than others depending on the strength of their immune system. 

But I think parents who choose not to vaccinate their kids because of fears of autism are making a potentially dangerous choice, not just for themselves but for the rest of society.  Harsh, but it's what I believe.

As I see it, there are two big challenges to parents trying to make an informed decision about this.  The first is that the majority are not aware of how this potential connection between autism and vaccines came about.  The second is that we have become a society which is distrustful of those in authority.  We've caught corporations and the government in lies too many times to be completely sure of their honesty. 

First things first.  The history.

Andrew Wakefield was the man who first raised concerns about autism, gut issues and vaccinations.  At the time he was a medical doctor who had done a study which he claimed showed that some otherwise healthy children developed autism after being vaccinated and that he had found traces of the measles, mumps and rubella vaccine in their guts.  At the time, this was taken with great seriousness and launched a series of investigations.

The problem?  To begin with, bad methodology.  The study was based on 12 children who were recruited because their parents believed they had developed autism and gut problems after being vaccinated.  There was nothing to show that the children had been developing normally before the vaccination and indeed, it was determined that none of the children actually had inflammatory bowel disease.  Next problem, actual fraud.  He faked the lab results that showed the vaccine in the gut.  He faked the medical reports on their gut problems.

Wakefield claims he has been the victim of a conspiracy but has been criminally charged in Britain and had his medical licence stripped.  To me, the final nail in the coffin of his credibility is that the study was funded by a group which wanted him to make a new measles, mumps and rubella vaccine and asked him to find a way to discredit the current formula.

Some parents and anti-vaccination advocates still believe in Wakefield's results.  They have gone through several permutations of blaming various aspects of vaccinations.

Once the actual vaccine had been cleared by several independent studies, the attention shifted to the mercury-based preservative thimerosol.  Mercury sounds bad and it was easy to get the public stirred up about it.  California passed a state law banning thimerosol in all vaccines in 2006.  Since then, their autism rates have remained consistent with the rest of the country even though the children currently being diagnosed have never been injected with thimerosol.  To me, this is conclusive proof that the thimerosol was also not causing autism.  Again, I'm willing to believe that some children may react worse than others but it isn't causing the underlying problem.

The current focus is the number of vaccines, multiple vaccines given in a single injection and the age at which the vaccines are given.  Studies are being run to examine these factors.  But part of the problem is that because parents aren't vaccinating their children due to these fears, society as a whole has lost herd protection.  Thus there has been pressure to immunize kids sooner to keep them from dying after being exposed to previously prevented diseases.  For many decades, the number of deaths from measles in the US was 0.   Now that number has been increasing steadily.  It's not huge, but we're still dealing with children who have died from something which can be prevented.

I have two major concerns with this focus on vaccines.  One, the number of resources which have to go continuously into disproving the theories.  Valid concerns should be followed up, but I don't think this particular bugbear is ever going to be satisfied.  There will always be another factor they want investigated because they've already decided on the conclusion.  Second, I'm terrified that partial immunization of society will lead to vaccine-resistant versions of the diseases in question the same way overuse and under-follow-through of antibiotics led to antibiotic-resistant bacteria.

As I see it, the problem is less about the actual issue than about distrust.  Parents and anti-vaccination advocates cling to vaccines as the cause of autism.  They've already decided that and they're searching for the why of it.  The authorities have lost their credibility (deservedly so in a number of cases) but that leaves the situation vulnerable to those looking to take advantage of fear and desperation.  When an authority vacuum forms, people are vulnerable to con artists and passionate theorists of all stripes.

I'm all for proper studies and investigation of claims.  But there has to be a collective open mind about the results.  Fishing for predetermined results is bad science, no matter what the results are.  If someone has already decided that vaccines are to blame and will not accept any other conclusion, there's no possibility of honest debate and clarity.

Looking at the evidence as we understand it today, I don't believe vaccines cause autism.  I believe there is substantial evidence that not vaccinating causes even worse results.  As more evidence comes in, I will examine it and adapt my opinion accordingly.

I don't claim to be a conclusive expert on any of this material but I've tried to be fair in examining the opposing claims.  I understand the fear and desperation, the determination to assign blame and gain compensation.  It's terrifying to not know if something is hurting your children.  It's tempting to latch on to any explanation that seems plausible.  We crave certainty over the unknown.  But it's only by accepting the possibilty of the unknown that we can discover the truth.  If you don't know to look for it, it can never be found.

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