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Dispelling the myth of the vaccine-autism controversy

Vaccines Did Not Cause Rachel’s Autism: My Journey as a Vaccine Scientist, Pediatrician and Autism Dad by Peter J. Hotez reviewed

January 29, 2019

9:35 AM

29 January 2019

9:35 AM

Vaccines Did Not Cause Rachel’s Autism: My Journey as a Vaccine Scientist, Pediatrician and Autism Dad Peter J. Hotez

Johns Hopkins, pp.240, $22.95

Vaccines didn’t cause Rachel’s autism. Or Sam’s, or Daniel’s, or anybody else’s for that matter. The reason is simple. Vaccines don’t and can’t cause autism. Peter Hotez ought to know. A certified pediatrician, he’s one of the world’s leading vaccine scientists, developing vaccines against ‘neglected tropical diseases.’ He’s also the father of Rachel, an autistic and intellectually challenged young woman.

There is no vaccine controversy, just as there is no shape-of-the-earth controversy. Anybody who understands the scientific method knows that there is no link whatsoever between vaccines and autism, just as they know that they can walk as far as they’d like around the world without falling off the edge. In fact, the data on vaccines is some of the most thorough and compelling that exists. The prevalence of vaccines has permitted a meta-analysis of studies, covering more than 1.2 million children. It proves beyond all doubt that vaccines do not cause autism. It’s true that vaccines are administered during the early years when autism is most frequently diagnosed. It’s also true that many of those same children drink milk and eat apple sauce. But, as anybody who has glanced at a statistics textbook will know, correlation does not imply causation.

For those who understand and live with autism, there are other, more pressing concerns. Current research shows that brain changes indicative of autism are present at least a year before the onset of any symptoms, and are likely even latent prenatally. The idea that vaccines can have such dramatic effects on brain structure and function lacks scientific basis. It also belies the fact that autism is complicated. We now know that at least 65 different genes may be involved.

Aside from a dry read about antibodies and neglected tropical diseases, Vaccines Did Not Cause Rachel’s Autism is also Hotez’s personal journey with autism. With the permission of his daughter Rachel, he describes what it’s like for his family to raise an autistic child through her young adulthood. It’s touching and very real, detailing the ups and downs, successes and even regrets. The seemingly constant ‘need’ to prove that vaccines do not and cannot cause autism means that, regrettably, far too little research is made into autism’s actual causes and indicators. The anti-vaccine movement, Hotez writes, ‘deplete[s] a lot of the oxygen from the room with their nonsense and false allegations to the point where elected leaders…could easily lose track of what families with [autistic] children really need.’ It’s why he describes ‘the dozens of anti-vaccine organizations and websites’ to be ‘both anti-child and anti-family.’ They place their own ‘distorted ideologies ahead of the needs of children with ASD [autism spectrum disorder] and their families.’

Hotez, the founding dean of The National School of Tropical Medicine at Baylor College of Medicine in Houston, Texas, and the director of the Texas Children’s Hospital Center for Vaccine Development, presents an important historical account of global disease in the past century. Global vaccination is not just about saving one or two children out of a million; vaccination campaigns are the most effective global public health campaigns ever. By UN estimates, they saved nine million lives between 2000 and 2016. By 2020, an additional five-to-six million deaths may be prevented. It’s true that four million children still die of disease each year, but it’s important to remember that just 50 or 60 years ago, that number was three times as great. When you stop to think, the reduction in numbers is simply astounding.

Hotez’s prose is somewhat technical — most lay readers have likely never heard of schistosomiasis, a parasitic worm disease that is second only to malaria as the most destructive of parasitic diseases. But he combines his professional expertise in such intricacies with a personal account of how a growing anti-scientific trend harms the lives of autistic children and adults. He also gives a clear and convincing account of how vaccines have literally changed the world. No other public health initiative in human history has saved more lives.

Hotez reminds us that we should be more grateful for living in a largely disease-free world. Worldwide vaccination programs have been so successful that many of us erroneously think of the measles as an annoying rash, and not as deadly disease causing hospitalization, leading to severe pneumonia and encephalitis (brain inflammation). In the era of ‘fake news’, we need to encourage Hotez’s kind of scientific engagement. The more eccentric or wild an idea sounds, the quicker it spreads. Understanding immunology and how vaccines work takes some biology background and a little patience. Frankly, for those of us fortunate enough not to see disease on a daily basis anymore, it can be a bit boring. But clickbait us with a story about how the Center for Disease Control is conspiring with Big Pharma, and we’re all ears.

As Hotez clearly demonstrates, only our aggressive stance on universal vaccination maintains our epidemic-free status. It is painfully obvious that the cities, neighborhoods and communities that are less vigilant about vaccinations are seeing a reemergence of avoidable diseases, as in the recent measles outbreak in the US, which last weekend caused Washington state to declare a state of emergency. It doesn’t have to be this way; much depends on how we handle this current crisis. In a collective mea culpa, Hotez criticizes his own profession for dropping the ball on public engagement. Scientists are not part of our national discourse on many issues, even on issues directly relating to their expertise. That needs to change. Vaccines Did Not Cause Rachel’s Autism is Hotez’s shot across the bow, directly aimed at the non-scientific public. Hopefully, it’s a shot that will be heard around the world.

Rabbi David Shabtai, MD is a teacher, bioethicist, and congregational rabbi in Boca Raton, Florida.

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