Autism Spectrum News recently sat down with Dr. Paul Offit, author of the newly released book “Autism’s False Prophets” and Chief of Infectious Diseases at Children’s Hospital of Philadelphia (CHOP). The book examines the theory that vaccines cause autism and the cottage industry of potentially harmful therapies and false hopes that it spawned. All proceeds from sales of the book will be donated to the autism research program at CHOP.
Q: Dr. Offit, what is the main message of your new book?
A: Reasonably, some parents are concerned that vaccines might have caused or worsened their child’s autism. From their point of view, their child was fine, received a series of vaccines, and then wasn’t fine anymore. The main message of this book is that the medical and scientific community has responded to these concerns by performing many studies to determine whether parental fears are well-founded. The results of these studies have been clear, consistent, and reproducible. Vaccines don’t cause autism.
Another reason that I wrote the book is that the persistent fears that vaccines cause autism has done a lot of harm—harm from not getting needed vaccines, harm from potentially dangerous treatments to eliminate mercury, harm from elimination diets that deprive the body of calcium, harm from therapies as absurd as testosterone ablation and electric shock, and harm from the continued diversion of research dollars away from more promising leads.
Those who oppose vaccines in this country have taken the autism story hostage, much to the detriment of the children whom they claim to represent.
Q: Why does the notion that vaccines cause autism persist?
A: I think that there are many reasons for this. First, some people continue to hold onto the notion that vaccines cause autism with religious zeal, unwavering in the face of contrary evidence. They have been convinced by marginal scientists or physicians who have promised cures based on the notion that vaccines are the problem. Second, many in the media have been quite irresponsible on the subject, continuing to present the notion that vaccines cause autism as a scientific controversy when it is no longer a controversy among scientists who have looked at the data. Stories carried as a controversy are far more likely to gain attention and sell advertising than those that present the issue as resolved. Third, some politicians have taken up the cause and clearly had an impact on the public’s perception of the issue. Fourth, information on the Internet can be misleading, confusing the public about the quality of the science that exonerates vaccines.
It’s been frustrating to watch the manner in which good science has been distorted through the opaque prisms of the media and the culture.
Q: Many parents of children with autism are concerned about the current CDC vaccine schedule. How do we know that the schedule is safe?
A: Today, young children receive vaccines to protect them against 14 different diseases. Because some vaccines require more than one dose, children can receive as many as 26 inoculations by two years of age and up to five shots at one time. The concern that too many vaccines might overwhelm a baby’s immune system is understandable, but the evidence that they don’t is reassuring.
Before a new vaccine can be licensed by the Food and Drug Administration (FDA), it must first be tested by something called “concomitant use studies.” Concomitant use studies require new vaccines to be tested with existing vaccines. These studies are performed to make sure that the new vaccine doesn’t affect the safety or effectiveness of existing vaccines given at the same time, and vice versa. Because concomitant use studies have been required for decades, many studies have been performed showing that children can be inoculated with multiple vaccines safely.
Q: Why not delay immunizations until children are older, just in case?
A: The desire by some parents to separate, space out, or withhold vaccines is understandable. This choice, however, is not necessarily without consequence.
First, delaying vaccines will only increase the time during which children are susceptible to certain diseases. And some of these diseases are still fairly common. For example, chickenpox, whooping cough (pertussis), influenza, and pneumococcus still cause hospitalizations and death in previously healthy children every year. For example, before the chickenpox vaccine, every year about 70 children died from the disease.
Second, spacing out or separating vaccines will require children to visit the doctor more often for shots. Researchers have found that children experience similar amounts of stress, as measured by secretion of a hormone called cortisol, whether they are getting one or two shots at the same visit. This study suggests that although children are clearly stressed by receiving a shot, two shots aren’t more stressful than one. For this reason, more visits to the doctor created by separating or spacing out vaccines will actually increase the trauma of getting shots.
Finally, the immunological challenge to an infant’s immune system is miniscule compared to what children encounter and manage in their environment every day. Within one week of birth, babies are colonized with trillions of bacteria that line the nose, throat, and intestine. Babies mount an immune response to these bacteria to make sure that they don’t invade the bloodstream and cause harm. Indeed, the immunological challenge from an ear infection or a cold is far greater than from all vaccines combined.
Q: I’m sure you’ve read the August CDC report indicating that measles cases in the U.S. are at the highest level in more than a decade, with nearly half of those involving children whose parents rejected vaccination. What do you make of this?
A: Measles is imported into the United States every year, usually from countries in Western Europe or the Middle East. Imported cases also started this outbreak. The difference this time is that the disease took hold, spreading from one unimmunized child to the next and eventually infecting about 130 people. The fact that the virus spread easily shows that at least in some communities enough children aren’t getting immunized so as to cause a critical breakdown in herd immunity. That’s new. And should be a warning shot to those wondering when the tipping point will come—when enough parents have chosen not to vaccinate their children that others are at serious risk. I think that this outbreak shows that the tipping point has arrived.
Q: Why did you choose to donate the profits from this book to Children’s Hospital?
A: Probably the most frustrating aspect of the vaccine-autism controversy is how it has diverted the media and the public’s attention away from exciting research in autism.
Dr. Paul A. Offit, MD is the chief of Infectious Diseases and the director of the Vaccine Education Center at the Children’s Hospital of Philadelphia as well as the Maurice R. Hilleman Professor of Vaccinology and professor of pediatrics at the University of Pennsylvania School of Medicine. He has received numerous awards, including the J. Edmund Bradley Prize for Excellence in Pediatrics from the University of Maryland School of Medicine, the Young Investigator Award in Vaccine Development from the Infectious Diseases Society of America, and a Research Career Development Award from the National Institutes of Health. An international expert on rotavirus-specific immune responses, Dr. Offit is the co-inventor of the rotavirus vaccine RotaTeq, for which he received the Jonas Salk Award from the Association for Professionals in Infection Control and Epidemiology, the Gold Medal from the Children’s Hospital of Philadelphia, and the Stanley A. Plotkin Award in Vaccinology from the Pediatric Infectious Diseases Society. He will donate all royalties from sales of this book to autism research.