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Seth Mnookin: on vaccines, autism and how science shapes public debate

By | April 12, 2011, 7:49 AM PDT

Do vaccines really cause autism? And if not, why do we hear so much about it?

And what are the implications for organizations such as the Gates Foundation, which is plowing millions of dollars into preventative medicine for infectious diseases?

Seth Mnookin is a contributing editor at Vanity Fair and author of The Panic Virus: A True Story of Medicine, Science and Fear.

I asked him to crack open his reporter’s notebook and tell me more about what he discovered when he explored the scientific links between vaccines and autism — and what he learned about how debate in today’s society is as easily shaped by hearsay as actual fact.

SmartPlanet: You’ve written about the business of baseball and the ethical battles within a major publication. Why this?

SM: It wasn’t something that I had personal experience with, or that was really on my radar. It was something that, a couple of years ago, I started hearing about it more and more from my friends. I was curious.

The thing that struck me was that the discussions often seemed to be framed in the language of emotion. [Friends would say:] “It just feels like kids are getting too many vaccines these days.”

I didn’t know if it was right or wrong, but compared to how these same people would discuss things like climate change or evolution — scientific topics [for which] these people were dismissive of others who took on an emotional tenor — I was curious of why that was.

SP: So you dove in. What did you find? Why do people get emotional about this issue and not the others?

SM: Anything that involves children is very emotional.

Part of it is that it’s a topic that the media has done a really poor job of covering. It’s gotten a lot better over the last couple of years. One of my theses [in the book] is that once fear is present in a population, it’s really impossible to just un-scare people.

The fact that the initial coverage was so bad made it very hard to do a corrective. It’s also a topic that’s complicated and difficult to understand.

A lucky accident was that I did the shoe leather reporting first, and then spent a whole bunch of time reading science journals and going over evidence after that. I was then able to tell all these [sources] that I had no perspective and that I was trying to figure it out.

I’m trying to use this story as a lens to try to understand what counts as truth.

There’s an enormous amount of evidence that supports that there’s no connection between vaccines and autism. There are risks to everything, of course. But often, they’re not what they are portrayed to be. A lot of the people I termed “anti-vaccine activists” [in the book] feel very certain that vaccines are injurious in this way. When they discuss it, they talk about it with the language of certainty.

When scientists are trained, they’re taught that you can never say anything with certainty. Scientists won’t say I’m 100 percent sure human beings can’t fly, but will say that all of the evidence thus far says it to be that way.

Once I started reading the scientific papers, I expected there to be more evidence on both sides. This is not a subject about which there is a lot of legitimate debate related to autism.

SP: How much a role does history play? Today, almost no one gets the diseases for which we’re vaccinated.

SM: That’s huge. The fact that fear of a lot of these diseases has become pretty much notional for a lot of people in my generation has played a huge role.

We’re not familiar with people in iron lungs, or children who are hospitalized because of measles, or those who die of pertussis. The fear of any potential outcome [from a vaccine] far outweighs any fear of any of these diseases because people think they’re not going to get them.

When vaccines are effective, people think they need them less.

SP: Clearly there’s a disconnect between research and message. What’s the role of scientists to explain their science? Or is it the responsibility of government? Media?

SM: There’s not one. It’s all of the above.

Certainly, scientists — speaking very generally — have not done an adequate job explaining to the public what they do. Or accepting the fact that that is one of their responsibilities. They shouldn’t be able to accept public funding or support without making communication part of their job description.

Also, public health officials. When this current scare around autism cropped up 13 years ago, there was a sense with a lot of public health officials that everyone would see how ridiculous it was, and so there didn’t need to be a response.

That obviously wasn’t true. They’ve only realized and accepted within the last five years that they need to make sure people can get accurate information that’s easy to understand and to digest as it is to get wrong information.

And the media have a huge role. Despite the talk that people can get information on their own, our industry has the largest role in placing public perception on the issue.

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Andrew Nusca

About Andrew Nusca

Andrew Nusca is the editor of SmartPlanet.

Andrew Nusca

Andrew Nusca

Editor

Andrew Nusca is editor of SmartPlanet and an associate editor for ZDNet. Previously, he worked at Money, Men's Vogue and Popular Mechanics magazines. He holds degrees from the Columbia University Graduate School of Journalism and New York University. He based in New York but resides in Philadelphia.

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Andrew Nusca

Andrew Nusca
Andrew Nusca does not hold any investments in the companies he covers.
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0 Votes
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Good article.
He seems like a voice of reason on a tough topic.
Posted by Hates Idiots
12th Apr 2011
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Here's my key to filtering out bad science...
...that should also work for people with absolutely no scientific
background or understanding: When you start to see Hollywood
celebrities being treated as "experts" on scientific issues by
mainstream media outlets, automatically become dismissive. You
will rarely be wrong in doing so.
Posted by JohnMcGrew@...
12th Apr 2011
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Interesting
Seth Mnookin had an interesting thesis in that once fear is present in a population that it is hard to unscare them. I have followed the controversy over vaccines causing autism; the problem as Mnookin stated is poor communication between researchers and the public. The medical industry should have been more proactive about checking the possibilities that vaccines might be a cause of autism; and they should have acted sooner rather than let a controversy build up.

The corollary to Mnookin's thesis of fear is that once the public loses trust in the experts then it is almost impossible to regain that trust. This is where communication from and to the experts becomes important as well as taking effort to verify problems instead of ignoring them.
Posted by sboverie
12th Apr 2011
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@JohnMcGrew
I agree that healthy skepticism is good. Stanley Milgram did experiments that showed that people defer a lot of their judgement to experts. The experiment involved a teacher and a student, the stated purpose was to see if electrical shocks would improve learning. The actual experiment was to see how far people would go if told to continue by an authority figure. The scary conclusion of these experiments is that a third of the subjects were willing to continue adminstering shocks well into the lethal range as long as an authority figure told them to do so. The other scary part is that once the "teacher" began to shock the "student" that it was a slippery slope to keep shocking the student.

Scientists are human and tend to make human mistakes. This is one reason for peer review. Mnookin indicates that researchers are not explaining what they are doing or why; this leads to confusion in the public. It also would help to know the source of funding, industry paid studies are suspect for bias and managed conclusions that work for the industry but not the public.
Posted by sboverie
12th Apr 2011
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RE: Seth Mnookin: on vaccines, autism and how science shapes public debate
This article offers a cursory and ineffective dismissal of the anti-vaxer's assertions. If you want to see some definitive, science-based information that is all but irrefutable, watch this lecture:

http://video.google.com/videoplay?docid=-8119523476709184666#
Posted by Steamin' E.
12th Apr 2011
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RE: Seth Mnookin: on vaccines, autism and how science shapes public debate
Then this lecture:

http://video.google.com/videoplay?docid=6890106663412840646#
Posted by Steamin' E.
12th Apr 2011
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RE: Seth Mnookin: on vaccines, autism and how science shapes public debate
Things get even worse when science gets politicized... Typically by people who have little or no training/knowledge in the area of science they are using for their own gain (political and/or financial)!
Posted by GlueFactoryBJJ
12th Apr 2011
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RE: Seth Mnookin: on vaccines, autism and how science shapes public debate
@6 and @7

It's always good to have a radiologist from a fringe right-
wing organization ('HIV does not cause AIDS!' 'Suddenly,
in the past 3 years America has more than 7,000 cases of
leprosy because of illegal aliens!') present a lecture on a
topic that's far removed from his area of expertise. I'd
expect he also has an opinion on global warming, but then,
so do many people who don't understand the topic.
Posted by bepatienz
12th Apr 2011
+1 Vote
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Autism and vacines.
It is a tough subject.

I think the most telling data on vaccines and autism is out of California and the United Kingdom. Both did extensive work revamping vaccination production and methods of use over 20 years ago. In spite of their best efforts to address every concern about vaccines, both places saw an increase in autism rates over the same time frame.

The really scary data shows that autism rates have increased among the growing number of children receiving no vaccinations over that same time frame. So these unvaccinated children were no less likely to have autism, yet are more vulnerable to diseases like whopping cough.

The 2010 California whopping cough outbreak among unvaccinated children hit over 6,700 kids in the state killing at least 10.
Posted by Hates Idiots
12th Apr 2011
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RE: Seth Mnookin: on vaccines, autism and how science shapes public debate
To poster #8

I congratulate you on your brilliantly-executed ad hominem attack.

Of course, you'll understand why replacing substantive commentary with one of the oldest logical fallacies known to man might fail to persude me (or other intelligent perusers of these comments) that Dr. Ayoub's assertions lack merit.

And the "fringe right-wing organization" you allude to wouldn't happen to be the American Association of Physicians and Surgeons (whose 65th annual meeting was the venue of the lecture linked to in post #6), would it?

By the way, Dr. Ayoub studied neurology to the point where he was about to start his residency as a neurosurgeon, then switched to radiology. Discussing neuronal damage caused by Al and Hg are thus not quite "far removed from his area of expertise," especially given the number of years he's spent studying this particular topic.

But no; you're right -- you don't even have to evaluate his evidence to know that he's totally mistaken. You, however, seem to know what you're talking about (apparently even more so than those Gov?t agencies whose job it is to establish toxicity limits for substances such as heavy metals); so tell me this -- If pumping 250 mcg/kg of aluminum into a two-month-old infant wouldn't cause brain inflammation -- what level would?

No need to send your response to me; just send it along to David Ayoub, M.D. -- I'm sure he doesn't waste nearly enough time dealing with petty know-it-alls like yourself.
Posted by Steamin' E.
12th Apr 2011
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RE: Seth Mnookin: on vaccines, autism and how science shapes public debate
As someone with a child who developed an ASD (in his case, Arperger's Syndrome) shortly after having his first MMR (he was diagnosed as having pervasive development disorder initially - then Asperger's several years later), there is a link between the two events, even if it is not a causal link.

I know as an adult having multiple innoculations before travelling to the third world plays havoc with your immune system and well-being. Having three innoculations in one for a 15 month old will have a much greater effect. This would significantly increase the possibility of other ailments / conditions having an effect.

I had whooping cough, mumps, measles and chicken pox as a child and heartily endorse innoculations to stop future generations from suffering from these diseases. However, I think that while lumping innoculations up together may be administratively convenient, I don't think that this is in the best interest of the child.
Posted by mccarr
12th Apr 2011
0 Votes
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Message has been deleted.
Posted by zhengssm
Updated - 13th Apr 2011
0 Votes
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Broad problem, broad solution.
Concerns about mercury in vaccines and lumping multiple vaccines into a single does are all legitimate concerns. That is where California and the UK are scary.

They addressed those issues over 20 years ago by banning mercury from vaccines, banning grouped vaccines and even establishing schedules for vaccinations of infants to spread out the vaccines over a longer time.

None of that stopped the rise in autism occurrences.

Both areas also saw rises in autism rates among children never vaccinated, which is anecdotal evidence of an environmental or genetic factor involved. All of which fuels the need for further study on all fronts of the issue.

Being target locked on just vaccines as the cause may have delayed years of research into another area that might be a contributing factor.

The problem with pinning the cause to autism to one factor is the broad spectrum of conditions lumped under the name autism. It is entirely possible we could be dealing with multiple causes all contributing a small amount to what is viewed as a large increase at the surface.

A multi spectrum problem deserves a multi spectrum response. Which seems to be the author point.
Posted by Hates Idiots
13th Apr 2011
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RE: Seth Mnookin: on vaccines, autism and how science shapes public debate
@10

Now that it's clear that DTP, thimerosal, and MMR are not
responsible for an epidemic of autism, antivaxxer's seem
intent on finding some other reason to blame vaccines. The
problems with seizing on aluminum as the next candidate is
that during the first 6 months of life, infants could receive
about 4 milligrams of aluminum from vaccines but also
about 10 milligrams of aluminum in breast milk, about 40
milligrams in infant formula, or about 120 milligrams in soy-
based formula.
Posted by bepatienz
13th Apr 2011
0 Votes
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RE: Seth Mnookin: on vaccines, autism and how science shapes public debate
Couldn't help but notice that this blog is sponsored by IBM. Did
Bill Gates pull a few strings to get you this interview, Seth? I love
your following quote by the way, pure comic gold:

"It wasn?t something that I had personal experience with, or that
was really on my radar. It was something that, a couple of years
ago, I started hearing about it more and more from my friends."

Like Uncle Bob?
http://www.ageofautism.com/2011/03/seth-mnookin-bobs-your-
uncle.html
Posted by Jake Crosby
18th Apr 2011
0 Votes
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RE: Seth Mnookin: on vaccines, autism and how science shapes public debate
Hopefully this link won't bounce:
http://www.ageofautism.com/2011/03/seth-mnookin-bobs-your-
uncle.html
Posted by Jake Crosby
18th Apr 2011
0 Votes
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RE: Seth Mnookin: on vaccines, autism and how science shapes public debate
See March 21st, 2011:
http://www.ageofautism.com/jake-crosby/
Posted by Jake Crosby
18th Apr 2011
0 Votes
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I USED to believe vaccines were wonderful...
...then, after I had to quit work due to being seriously ill, as a measure to prevent further illnesses, I reluctantly consented to get the pneumovax earlier than the usual age, as I'd had pneumonia 4 times in 6 years ("walking pneumonia," good thing, staying home wasn't an option) & since the "sick building" we were all sure we worked in was somehow declared safe (I have NO idea how, though a lot of things I can't prove come to mind).

Usually, before this, my flare ups would resolve given some rest. They'd started to; I'd started to feel better, slowly, once my responsibilities were decreased. But after that vaccine, I flared so badly that I have NEVER recovered & continue to get sicker & sicker & sicker each day.

You CANNOT convince me that vaccine wasn't a factor. It wasn't too long before I went back mentally to how Mom was after they gave HER the Pneumovax. Here's how she was: SICK. Her CHF got SOOOOO much worse that within 6 months of receiving it, she could no longer live on her own with us doing long distance caregiving & help from the church, Meals on Wheels, & occasionally, home health nurses. I've since found anecdotal reports from other caregivers about how elders are fine until they have that vaccine. You can say they were old & had chronic conditions that would get worse anyway, & that's true. I just seriously doubt it would be a pattern of THAT much decline in THAT short a time in EVERY SINGLE CASE that I know about. In fact, going back to my nursing days, before the pneumovax became such a huge push (it does, after all, ONLY cover 3 types of bacterial pneumococcal strains & a max of 60% of all cases of pneumonia-there are tons of viral, fungal, & other types of bacterial pneumonias). I may have a faulty memory, but it seems to me that elders who got the vaccine had many more return trips to the hospital than those who, being in many cases much sicker than those who opted for pneumovax, didn't decline as fast.

I'd challenge nurses out there to do a study on the rates of admissions for exacerbations of CHF & other chronic illnesses before & after pneumovax administration. Let's see if it makes people worse. If so, it's costing CMS a LOT of money & needs to be re-evaluated.

I also started reading up more on my admittedly-rusty immunology & information about heavy metals in general & in vaccines. It's taken me a LONG time & a lot of notes; like I said, my health sucks even worse since that vaccine. I started reading anti-vaccine sites & pro vaccine sites. Keep in mind I was all for vaccines as a nurse. I'd had a case of measles when I was 5 that nearly killed me, & shortly thereafter, a case of chicken pox that did the same. I know how serious those illnesses can be. In further proof that my immune system has always been bad, I got rubella 3 times. I've had mumps that caused abdominal pain-but at the time, I was in "that time of month" & only recently recalled that the pain was similar to the pain I got from infertility treatment with Clomid, which caused ovarian cysts. Which means, possibly, my infertility could've been from mumps, but I put the pain down to the "usual" causes & to being, on several occasions (2 nursing & 1 living in the UK during the Chernobyl meltdown), overexposed to radiation.

Obviously, I thought it was great (at one time, anyway) that people could avoid those things with a vaccine. Now, I'm not so sure. The jury's still out, but I do know at least one vaccine has harmed me & my mother, robbing both of us of our independence & me of a chance to keep working instead of having to apply for disability. And THAT ticks me off.

If you want a good summary of the anti-vaccine folks' info, go to the vaccine council website http://www.vaccinationcouncil.org/. We have enough vaccine-worshipping sites between NIH & the Gates foundation alone, & there are many more.

Last question for Gates Foundation's vaccine-happy program:
Why don't you fix the conditions that cause the diseases instead of the more-expensive vaccination route? Adequate clean water, drought-resistant crops, good sanitation, would fix most of the problems that lead to disease-water-borne illnesses like cholera, for one thing, & that's a big thing on its own. That is what countless OTHER, more RESPONSIBLE, relief agencies, both secular & religious, are trying to do all over the world. Stop hunger & thirst, stop disease, by the simple expedient of teaching people what happens when they drink the same water into which their own waste (& that of the animals around them) goes, & how to get around the problem. Digging wells instead of using river water for drinking is one big one. That alone has saved countless lives. In the past, I was involved in attempts to create a cholera vaccine & I watched it make many volunteers seriously ill. I saved one man's life; the researcher was angry that I'd "spoiled" his study UNTIL he saw the patient & then apologized to us both. Had any of the other, non-ICU trained nurses been there, they'd have waited too long; I knew NOT to wait. I knew to ACT. In the interim, there have been countless other cholera vaccine attempts that have failed miserably. It seems to me that cholera vaccines will remain elusive. Clean water & sanitation training are, however, available NOW, viable NOW, & can PREVENT cholera NOW. The Gates Foundation could use all that money dedicated to vaccines to disease prevention by bringing water & drought resistant crops & sanitation training to areas where water-borne illnesses are rampant. It could do far more good that way.

Which makes me ask: What do these vaccines do, besides supposedly preventing illness, that has the Gates Foundation & so many other people at the UN, slavering over getting as many 3rd worlders vaccinated (as opposed to given a chance to get clean water & sufficient food & sanitation training, which is, after all, cheaper) as possible in as short a time as possible? What is the hidden agenda here? After all, the ROI doesn't make sense, does it? There HAS to be some reason to vaccinate people, then leave them starving & without clean water or the means to grow their own food, or training in sanitation, something else going on.

Gee, could it be that the conspiracy theorists might at least have a point? That maybe, just maybe, it's mass sterilization? Save the current generation from disease, leave them in their filth, unable to procreate, & then someone else gets their land-which, presumably, quite often sits atop some natural resource someone else wants? Hey, if you don't buy conspiracy theories, maybe you guy corporate greed?

As Chris Rock's character said in the first "Rush Hour" movie, "Follow the rich white dude." If you want to know the motive & where the next crime will be committed, that is.
Posted by bamyclouse@...
26th Apr 2011
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