Offit Paul: Autism’s False Prophets: Bad Science, Risky Medicine, and the Search for a Cure

In Autism’s False Prophets, Paul Offit, M.D., Maurice R. Hilleman Professor of Vaccinology, Professor of Pediatrics at The University of Pennsylvania, and co-inventor of a rotavirus vaccine, makes an important contribution to popular debates about the etiology and treatment of autism spectrum disorders. The book is arguably the most detailed and thorough history available of the current anti-vaccine movement and the increasingly widespread popular belief that vaccines and/or ingredients in vaccines are related both to autism and the changing prevalence of autism. Offit provides a sustained scientific attack against the misinformation disseminated by the media and a small but vocal group of anti-vaccine advocates. He pays special attention to the therapies and therapists (autism’s ‘‘false prophets’’) that emerged out of the current anti-vaccine movement. And by situating the autism debate in the larger context of the complex interactions between science, society, and politics, Offit identifies a set of problems that will resonate with nearly all medical scientists, whatever their field of expertise. Offit argues that false information, unscientific hypotheses, and inaccurate and simplistic media coverage on autism and vaccines are hurting the public health. In order to correct the misinformation, he focuses on the most common public fallacy about autism today: that the measles mumps rubella vaccine (MMR) and/or the mercury containing preservative, thimerosal, which was in many vaccines (but not in the MMR) until late 2001, cause autism. Public fears about MMR and thimerosal led to a decline in vaccination rates and an increase in preventable illness. For example, in 1995, 92% of British 2-year-olds were vaccinated against measles, and there were 112 recorded cases of the disease in the UK. A decade later, only 81% of 2-year-olds had received the vaccine and there were 958 cases. According to the World Health Organization, in 2005, 242,000 people died of measles worldwide, but because of the previous success of vaccine programs, most Europeans and Americans have never seen a case of measles and do not understand its dangers. Measles is on the rise in the US, as evidenced by scores of cases in Iowa in 2004, Indiana in 2005, and Massachusetts in 2006. So far in 2008, the US is having the worst outbreak of measles in years. The MMR fears first developed in 1995 when a doctor in England, Andrew Wakefield, published a paper in The Lancet claiming that a number of children had developed autism within a month after receiving the MMR. Although it is well known that the onset of autism is typically insidious, thus making it difficult to identify a moment when an autistic child’s disorder begins, many found Wakefield’s thesis plausible. It seemed to make little difference to the media and the wider public when it was revealed that Wakefield had serious conflicts of interest he had failed to disclose, that the majority of the co-authors retracted their support for the paper’s conclusions, and that The Lancet issued a partial retraction of the paper. Nor did it seem to make a difference when ten subsequent studies refuted the hypothesis that the MMR vaccine is linked to autism. The thimerosal story is less straightforward and must be attributed to a number of different players, such as Neal Halsey (a well respected vaccine expert), US government agencies responsible for overseeing immunization policy, politicians with a personal relationship to autism, such as Dan Burton (R-IN), two single-minded journalists named David Kirby and Dan Olmsted, small interest groups, such as SafeMinds (with which Kirby has been involved) and R. R. Grinker (&) The George Washington University, Washington, DC, USA e-mail: [email protected]