Autism's False Prophets

By: Paul Offit, MD
Grade: D-
Genre: Nonfiction, medical, vaccinations

In 1998 Andrew Wakefield, MD, published a study in the British Medical Journal "Lancet" pointing to the MMR vaccine as a possible cause for autism. His statement couldn't have been timed better -- with autism numbers rising by the year and more and more parents demanding an explanation for what was happening it was the perfect moment to create the perfect media storm. His report led to drops in vaccination rates, changes in the vaccines themselves and launched an entire repertoire of bio-medical treatments to cure thousands of children of vaccine damage.

If the world needed any more books on the issue it was one that detailed the other side of the story. Where was science on this question? What did other doctors have to say on this issue? With warm, concerned people like Robert Kennedy Jr. and Jenny McCarthy giving a voice to the concerns of the anti-vaccine crowd, where was the voice of those saying vaccines were safe and effective -- and they could prove it?

Sadly, if this book is that voice their side is destined to lose. Dr. Offit begins well. He gives us his own history of becoming a doctor, then touches briefly on some of the scarier aspects of the debate. He points out the flaws in Dr. Wakefield's study and points to other studies which show the efficacy and safety of vaccines. And then he rapidly degenerates into finger pointing, name calling and a stand on intellectual superiority.

He begins by pointing out other therapies that parents have believed in that have been proven to be untrue -- most notably facilitated communication and secretin. He tried to come across as sympathetic but I found it to be more snide, that the point seemed to be that desperate people might believe anything and therefore can not be trusted to make a single rational decision.

Offit follows this up with saying exactly his point: that actors, celebrities and congressmen all trumpeted Wakefield's cause but as Senator Waxman said (and Dr. Offit supports): "Let us let the scientists explore where the real truth may be." This is, I think, the primary message of Dr. Offits book. He seems to hold forth, as Michael Fitzpatrick does in MMR and Autism, "We need to establish the foundations of an informal contract between parents and professionals that respects both our different spheres of expertise and - most importantly - the distinctions between them. Doing the best for our children means concentrating on being parents and leaving science to the scientists, medicine to the doctors and education to the teachers." This very example showed a fundamental lack of understanding of how medicine, education and even science work on the front lines. Doctors rely on evidence presented in dialogue with patients to reach a diagnosis. Teachers expect parents to take on educational roles as they help with homework. In fact, there are thousands of books out there explaining exactly why having a child in school feels like a full time job to many moms. And science on the front lines is an often messy business because things are moved from the comfortable world of the lab to the totally unregulated world of reality. The recall of tons of cars recently points to how things can go wrong from drawing board to execution.

Offit goes on to say that our courts get science wrong. Our media gets it wrong. He pulls out cases such as silicon breast implants (which have supposedly been proven NOT to cause cancer) to prove his point. But anyone over say 10 years of age knows that often our courts and media get things right. For every medicine they have wrongly accused of causing problems there is also one they have saved us from. He carefully keeps from giving balance to his point by mentioning none of this.

The book's finger pointing is aimed at Jenny McCarthy's lack of degree, at Wakefield's rather small kick backs from a legal firm that stood to benefit from vaccine suits, that some of the people who believe vaccines are harmful are religious (Oh, horror!), the fact that Robert Kennedy only got into environmentalism because of a misdemeanor in his youth (and his law firm does civil action suits, even if he doesn't),and most importantly that parents and most civilians (even our pediatricians) can't understand vaccine science. He makes no effort to explain it to us.

Dr. Offit pointed continually to scientists as experts, forgetting the other side also had degrees, many of them from prestigious institutions. But what bothered me most was that medicine, the type of science being talked about here, is big business. And history has shown us businesses need to be watched. He felt this business should somehow be exempt from public watch dogs. Start giving medicine away for free, having it made by non for profit's and the time may come when we watch them less often. It amazes me these people have the guts to be angry that people feel this way. Do they have any idea what a cop makes? And how the heck closely we watch that poor guy? A guy who literally risks his life to do his job? And yet reading this we are to believe that the multi-billion dollar vaccine companies should be exempt from public skepticism because we couldn't possibly understand what they are doing? And that we should trust government agencies to do the over sight and not question said agencies? Sorry, that's what a free people do.

There was much to be upset with in this book but I think the primary problem lay in the philosophy that permeated it. That the public couldn't understand and that it was therefore dangerous and wrong for us to question. What saddened me is that there was much he could have spoken of that people would have understood. Like why having even small handfuls of people opt out of vaccines is dangerous to the entire program, what epidemics look like of the diseases the protect against, what numbers we are actually talking about (number possibly harmed by vaccines vs. numbers will be harmed by epidemic), etc. Rather than reassuring me that I do the right thing by getting a flu vaccine for myself and my kids annually he made me wonder if I was the dupe of good advertising by an industry bloated with money. Bummer. I could really have used some reassurance.

Tea: You know the rule, don't waste a good cuppa on anything below a C. (Though a stiff drink of the Irish might make this more palatable.)