I am deeply concerned that there was someting in an earlier method of delivery which increased the likelihood of autism, but A: the increase in autism was there before the single jag and B: the non-scientific way in which Wakefield et al approached the matter was wrong, wrong, wrong. First, it was claimed the jag was the direct cause of autism – no evidence. Then that it somehow affected the GI lining or blood-brain barrier, allowing other infections to pass through – nope. Now it’s this method of delivery which is being blamed – maybe. Maybe there was another constituent which posed an increased risk, but your kak-handed approach has done great damage. Also to blame is the bombastic attitude of some areas of the pro-lobby to doubt and criticism. As much of a disaster as an outbreak of rabies in a guide-dog’s home.

The mistake of the scientific and medical establishment was to underestimate the grip this meme had on the general populace – they just couldn’t understand why people would accept a claim without any basis and reject all the evidence to the contrary.

What this study is picking up is that any vaccine effect is swamped by the trend; but we could have guessed that anyway from the fact that Wakefield was only able to trick up a dozen or so cases. It’s similar to the sample size issues that we covered ad nauseam in the Lancet/Iraq debate.

What appears to me to have happened is that peoples’ bullshit-detectors gave off a false positive. Looked at objectively, the scramble of the scientific establishment to crush Wakefield was outright disgusting behaviour (and this behaviour cannot at all be vindicated by Wakefield’s own later sins). Furthermore, we were treated for years to the sight of medical/government spokesmen turning up on television claiming that epidemiological evidence had “conclusively proved” things that epidemiology could not possibly have conclusively proved, because of the nature of the beast (think how long it took to prove that cigarettes cause lung cancer!). When a man is saying something he knows to be untrue (even if he is saying it in service of a larger but more complicated truth), he tends to look shifty, and it is my opinion as a professional judge of character that it was this nonverbal communication that the public reacted to.

However, because the incidence of measles in gut plus autism is very rare, while the incidence of rubella and measles is only rare, the risk ratios favour vaccination. I swear that if we had had a commonsensical debate about risk ratios, rather than trying to pretend that science had conclusively established that the ratio was zero to one and shouting down anyone who argued for a higher number, this whole fiasco need not have happened.

My personal assessment of the underlying science is that this is not a fear made up out of nothing; there are a (practically rather than statistically) significant number of autistic kids who have live measles in their gut and nobody appears to have a sensible explanation of how it got there. That is the sort of thing that medical science ought to be taking a look at; anyone who says that it shouldn’t “to avoid sending out the wrong message” has stopped being a scientist and become a politician.

On the other hand, Wakefield has disappeared up his own arse several years ago, and persists in making statements about vaccination which go miles beyond his evidence, and which often say things which don’t make sense to me given the risk ratios. I’m getting my kid done next week.

(Some may find it interesting that I was vaccinated against measles the old-fashioned way; I was sent round to play with a kid who had caught it so as to “get it out of the way” and not take the risk of catching it at the same time as another illness. This was pretty common practice when I was growing up, and probably also makes sense on a risk ratio basis given the very small likelihood of very nasty outcomes).

Because people cannot understand how their child came to be autistic, there is a very strong impulsion for them to grasp any explanation they are offered. I think MMR fitted that need.

Politicians like Tony Blair did not help this by failing to show that they were getting their own kids immunised, while telling everyone else it was safe.

When the public suspects they are being lied to by politicians, they are more often than not correct, sadly in this case, the politicians were telling the truth, but behaving as if they did not believe it themselves!

Advice on scientific method from Daniel (“******* is a prick”, “better start mugging up on Feynman-Kac derivatives”) Davies? That’s rich!

Cranky

Those feelings remained, for different reasons, when I read the scientific responses to this claim. It burns me that not only are people refusing important vaccinations (FYI both my children had the MMR jab as well as all other recommended inoculations) but that this type of media-grandstanding is diverting resources from more worthy studies.

Autism is inexplicably on the rise—we need to know why, but it seems as if the answer is going to be much more complex than proposed. Already there’s the credible argument that part of this rise is the increased recognition of the problem. But I’m not even so involved in this debate anymore. I prefer to devote my time to assisting my daughter to become as “high functioning” as she can.

If you were searching for answers for something that no one knows the source of, and there is no real cure for, and you want to prevent it from happening to others, perhaps you would be reaching for straws, sure.

And if there were mixed messages being bandied about for YEARS, do not be so surprised when people come up with not-so-logical explanations for events, especially when the media has been whacking this around for years now. Fine, have issues with people that don’t get their kids vaccinated. Great. But don’t discount the reasons behind the fear as though there is nothing there.

You want to tell me thar MMR is not the answer to the question? Fine, you are right, but now, there still remains the question, what causes autism? Why is there an increase? Do you know? Do you have the answer I am looking for? No, you don’t.

Walk a mile in my shoes before you judge me, and people like me.

“there are a (practically rather than statistically) significant number of autistic kids who have live measles in their gut and nobody appears to have a sensible explanation of how it got there”

I’m not sure where that comes from, I thought they were mostly studying autism plus bowel disorder patients and finding that. I could posit that children with a pervasive developmental disorder like autism might be more susceptible to MMR induced bowel disorder. I have no evidence, but then you have no evidence that MMR causes autism with bowel disorders.

On the other hand, it does seem like autism + bowel disorders is a real phenomenon, and that Wakefield helped to bring the attention of the medical community to it.

I do think that it’s worth going back and looking at why the hypothesis of a link to MMR caught fire with the parents of autistic children. Thinking Nurse, Ancarrett and Chance the Gardener all offer some important thoughts about that. Autism is one of the worst nightmares a dedicated parent can face: a child that you know and love who seems utterly normal, even unusually gifted, who suddenly becomes almost impermeable to normal human sociality and communication, and for reasons that no one can really explain. Around autism swirls a ferocious host of competing theories, some of which demand that a parent essentially buy and commit to them in order to begin some therapeutic intervention at a sufficiently early moment. Some of those hypotheses implicate the home environment and parental styles, others implicate the global environment, others implicate genes, and so on.

Every parent is haunted first by the possibility of their child being injured, getting seriously ill or dying; worse still is the nightmare feeling of responsibility for those events. It’s bad enough to think of your child being disabled or killed, it’s worse to feel that someone, some way, you might have been able to do something about it before it happened.

A hypothesis about autism that posits a clear, concrete cause that a conscientious parent could avoid is almost irresistable for parents of autistic children and parents who fear autism for their very young children. Which is all the more reason that anybody who wants to put a hypothesis like that up for testing had better be ultra-responsible: this is like offering water to refugees in the desert.