Science trumps speculation: MMR not linked to autism
■ A special vaccine court dismissed claims that the vaccine can cause the cognitive disorder.
Posted April 6, 2009.
The pitched debate regarding the purported link between autism and the measles, mumps and rubella vaccine -- a battle viewed on both sides as critical to shielding the defenseless from harm -- took the encouraging turn for which many physicians were hoping and landed in favor of protecting public health.
At issue was the consideration by a special vaccine court of test cases to determine if certain hypotheses of how vaccines could cause autism were legitimate and, therefore, warranted compensation to the affected parties through the federal Vaccine Injury Compensation Program.
On Feb. 12, a panel of U.S. Court of Federal Claims judges, known as special masters, released its findings. The special masters ruled that the vaccines were not to blame. In doing so, they lined up on the side of a massive amount of scientific evidence gathered by diverse and unrelated groups of investigators from all over the world -- including the Centers for Disease Control and Prevention and the Institute of Medicine -- that failed to find a connection between the vaccine and the disease. They also made clear the petitioners could not receive settlements through the VICP.
The vaccine court was right to reject the idea that the MMR vaccine, combined with the preservative thimerosal, caused the disabling autism that affects these children and their families.
Granted, the families confronting this reality every day are in a heart-wrenching situation. And their search for answers is acutely understandable. But science has long shown their arguments were misguided. The court's ruling will add momentum to efforts to redirect that search in a way that may lead to real progress in uncovering autism's causes, while not letting unfounded myths keep other children from receiving the proven protection from dreaded infectious diseases that vaccines provide.
That sentiment, at least, is the hope emanating from science, public health and organized medicine, including the American Medical Association. The AMA has long advocated the importance of childhood vaccination and worked to dismiss the flawed arguments that vaccines trigger autism. The AMA also urges that more research be done regarding the reported increase in incidence of autism, Asperger's and other pervasive developmental disorders and more training of physicians to enable them to identify these children and to assist families in accessing early intervention services.
It was from a mountain of research that the court's ruling flowed. A key element that makes the vaccine's court decisions so meaningful is the exhaustive nature of the proceedings -- tallying 5,000 pages of transcript and more than 700 pages of post-hearing briefs. The official record contains 939 medical articles, compared with the 10 articles cited in a typical vaccine case. In addition, 50 expert reports were filed, and 28 expert witnesses testified. By contrast, a typical vaccine case presents between two and six experts.
Thus, the court findings add significant weight to the already overwhelming body of evidence. It is important to note that physicians often recoil when judges make determinations about the practice of medicine. In this case, though, the court took on the task of determining causation based on evidence -- an inevitable question raised in light of the VICP -- and ruled with the strongest scientific backing.
This decision will not mark the last time the issue finds its way into a courtroom. The special court is still examining evidence regarding another causation theory that links autism with vaccines containing thimersol.
But many doctors in the trenches can view this development as a timely teaching tool -- and for good reason. It is one more authoritative voice helping to address credibly the tension parents feel about vaccination risks. After all, nearly 10 million doses of the MMR vaccine are distributed every year. At the same time, autism has become every parent's nightmare, and everyone hears the stories that fuel anxiety. But the court's decision, coupled with the scientific record, underscores the fact that vaccines continue to be one of public health's greatest accomplishments -- helping to protect against harm, not cause it.