“I Had Questions About Vaccines, Too”

I UNDERSTAND WHY parents are concerned about vaccinating their children; even hesitant. When it came time to vaccinate my own children, I had questions, too. In 1998, a paper was published in one of the most respectable medical journals, The Lancet, that alleged a link between vaccination (the measles, mumps, and rubella (MMR) vaccine in particular) and autism. Another paper by the same group showed measles particles in children diagnosed with developmental disabilities.

The public took notice, likely motivated in part by the possibility of an answer to the difficult mystery of the cause of autism. There were some reasons it seemed this link might have made sense. Vaccines are given at about the time children are commonly diagnosed with autism, and it is human nature to think back about what might have happened about the time the condition was diagnosed. Diagnoses of autism were rising, and at the same time the number of childhood vaccines were increasing in number. Rates of vaccination plummeted in the UK after publication.

In 1998, this was not just an academic concern for me personally. My 22-month-old son, David, had been diagnosed with autism a few months previously in October 1997, and I had to decide whether to vaccinate my newborn, Jonathan. I read through the papers carefully. As a general medicine physician, and with an undergraduate degree in molecular biology, I had more insight than most as to the strengths and weaknesses of the two papers. After much thought, I felt that the benefits of vaccination still greatly outweighed the potential harms.

I had (and still have) seen only a handful of measles cases in my career, but measles is a frightening disease with significant mortality, morbidity (including encephalitis, a dangerous inflammation of the brain), and a universally fatal complication, subacute sclerosing panencephalitis. Together with my wife, a physician expert in infectious diseases, and our pediatrician, we elected to vaccinate all our children according to the recommended schedules.

It honestly never occurred to me that the paper could be fraudulent, but eventually 1src of its 13 authors distanced themselves from the interpretation of the paper, and an investigative journalist (Brian Deer) found fatal methodological errors in the paper that could only have been deliberate. In addition, the lead author did not disclose that he was planning to market a new vaccine in competition to the standard MMR. He was subsequently “struck from the list”—removed from the list of practicing physicians, and is unable to practice in the UK. The paper was ultimately retracted by the journal in 2src1src, which lost much credibility by ever publishing it.

Unfortunately, much damage was done, and there are still people today who believe that vaccines are dangerous and who refuse to vaccinate their children. In the intervening years, many of these children have come to me and my colleagues in adult medicine as young adults to get caught up on their vaccinations.

Since that time, a large number of studies (well over a hundred, following millions of children) have examined, using multiple methods and in multiple countries, whether vaccines increase the risk of autism. At least one of these studies was funded by anti-vaccine groups, but the results are consistent: no evidence of increased risk of autism from vaccines. The level of certainty from these studies is so high that in my opinion, no further resources need to be spent on answering this question, which is answered as completely as that the Earth is round.

When the data that vaccines weren’t linked to autism became overwhelming, other hypotheses were considered. One was that it’s the mercury in vaccines; however, mercury poisoning doesn’t look at all like autism; the type of mercury is not the type to cause toxicity, and the amounts are too low. Further, removing mercury from vaccines didn’t affect autism rates.

I do not blame parents for being concerned, even hesitant. Vaccines are powerful medications that do have the potential for side effects, although they are only very rarely serious. Further, most modern parents have no idea how serious childhood illnesses can be. Before the vaccine, hundreds of thousands of kids got sick each year just from measles, and hundreds died, while thousands became disabled. Doctors and scientists know better, and while there are a few exceptions, the consensus of the scientific community is that there is no increase in risk of autism among vaccine recipients.

Although the exact causes of autism (which is not just one condition) are not known, it is clear that changes in brain and behavior can be spotted long before children get vaccines. In the meantime, work continues on how to help autistics live their best lives.