The Wrong Debate Over Autism

[Guest guest]

The Wrong Debate Over Autism

Why focusing on thimerosal misses a larger story

From the Columbia Journalism Review

By Russ Juskalian http://tinyurl.com/2vw8qk

Back in 2005, CJR published a story by Schulman about

media coverage of " whether a mercury-containing vaccine " preservative

called thimerosal was to blame for an alarming spike in autism cases

among a generation of children. Last summer, yet another study was

released that showed no link between autism and vaccinations, and last

week came news of a lawsuit settlement that required a girl's medical

costs to be covered by the government after she was diagnosed with a

rare mitchochondria disorder and autistic symptoms related to

receiving nine vaccinations in one day. Clearly, the debate rages on,

so we decided to take another look at the press-coverage landscape.

Schulman concluded in his piece that the media had been too

quick to close the door on the potential link between thimerosal and

autism. " [W]ith science left to be done and scientists eager to do it,

it seems too soon for the press to shut the door on the debate, " he

wrote. He cited stories like a New York Times piece by Gardiner

and Anahad O'Connor in June of the same year, with the headline: " On

Autism's Cause, It's Parents vs. Research " .

Schulman, now an editor at Mother , noted that while the

vast majority of studies appeared to disprove a vaccine link to

autism, there were serious researchers (notably Dr. Mady Hornig and

Dr. Ezra Susser, both epidemiologists at Columbia's Mailman School of

Public Health; Deth, a Northeastern University pharmacologist;

and Jill , a professor of pediatrics at the University of

Arkansas) who supported the possibility that environmental factors—and

perhaps thimerosal in vaccinations—could at least be triggers for

autism in predisposed populations that might otherwise not have

developed the disorder.

(It's a lot like the global warming debate in reverse: almost

every major study said there was no credence to the autism-vaccine

link, but there were, and still are, a few credible voices out there

saying the case isn't closed.) So, where are we now? Last summer, a

report on vaccinations and neurological problems in children was

published in the New England Journal of Medicine and the

vaccine-autism debate got a little more fuel. Depending on which side

of the fence you stand, the argument can be made that coverage of this

report was good or bad. Autism is a touchstone issue, so it was often

mentioned in headlines and stories, even if only to note that the

study itself was not focused on autism.

A sample of stories and headlines from September 27, 2007,

paints a picture: Newsday: " CDC: Vaccines are safe; Though autism was

not a focus, study says mercury preservative in shots did not cause

neurological problems "

Federal health officials yesterday reassured parents that

childhood vaccines are safe and that kids who got routine

immunizations a decade ago when shots contained a controversial

mercury preservative are not at risk of neurological problems….An

investigation examining autism and thimerosal, the preservative that

once was added to common vaccines, is expected to be published within

12 months, scientists at the Centers for Disease Control and

Prevention said yesterday.

The New York Times: " Vaccine Compound Is Harmless, Study Says,

as Autism Debate Rages " Yet another study has found that a

controversial vaccine preservative appears to be harmless. But the

study is unlikely to end the increasingly charged debate about vaccine

safety.

The Globe and Mail (Canada): " Vaccine preservative can cause

tics; But according to U.S. research, thimerosal does not appear

harmful to kids' learning skills or physical abilities "

" The scientific literature to date does not support a causal

link between autism and thimerosal, but it's important to say this

study isn't of autism, " she said. " There's a separate CDC study

ongoing that's going to get at that question to provide more information. "

Even more recently, the issue of an autism-vaccine link came up

in response to a settlement involving the government and nine-year-old

Hannah Poling. Poling started showing symptoms typical of autism

shortly after receiving a bundle of vaccinations when she was a

toddler. The government decided that Poling's vaccinations, given on

top of a rare metabolic disorder, caused her problems.

The headlines this time covered broader ground: KHBS Fort ,

" Vaccine-Autism Link Unproven By Controversial Georgia Case " ; Atlanta

Journal-Constitution, " Ga. girl helps link autism to childhood

vaccines " ; The New York Times, " Deal in an Autism Case Fuels Debate on

Vaccine " .

Not even McCain could let this one go by as was noted by

Benedict Carey in the Times, in a piece titled, " Into the Fray Over

the Cause of Autism " : " It's indisputable that autism is on the rise

among children, " Senator McCain said while campaigning recently

in Texas. " The question is, What's causing it? And we go back and

forth, and there's strong evidence that indicates that it's got to do

with a preservative in vaccines. "

With that comment, Mr. McCain marked his entry into one of the

most politicized scientific issues in a generation.

It appears that Schulman was on to something when he claimed the

media had taken too narrow a tack on the autism-vaccine link issue.

But he, too, may have had his keyboard aimed in the wrong place.

The problem with the coverage was not that the few credible

opposition voices didn't receive balanced coverage, but rather that

the whole issue of whether vaccines containing thimerosal or mercury

cause autism served as a distraction from the ongoing efforts to tease

apart the causes of this enigmatic disorder. That's not to say the

vaccine issue shouldn't be covered at all, but that there are many

more important—if less emotionally driven—questions related to autism

that deserve further investigation.

Is autism caused by environmental factors? Can it be triggered

by these factors? How does epidemiology try to solve these riddles?

Are some people genetically predisposed to respond to environmental

factors (like mercury)? Can we find a way to screen for these

predispositions (like Poling's metabolic condition)? What else is in

our environment that poses a risk?

Lest we forget about the long list of environmental contaminants

that have been pointed out going back to Carson's Silent

Spring, the AP just released its own investigation that found a wide

array of pharmaceuticals in tap water across America. A potent

reminder that while important, the vaccination story is only one part

of a bigger issue.

Schulman is right about one thing: when we simplify science to

" yes " or " no " questions the repercussions can be dangerous. And simply

because a few scientist are in the minority does not mean their

careers and their work should be dismissed with the wave of a hand.

We may never find an answer to the autism-vaccine debate that

satisfies everyone—and that's okay. Science pushes on, and the myriad

questions about autism will continue to be researched long after the

last mercury-containing inoculation is administered.