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Stomping through a medical minefield

Do vaccines trigger autism? No, says Paul Offit and refuses to back down despite threats to his life


November 16, 2008 1:54:45 pm

Do vaccines trigger autism? No, says Paul Offit and refuses to back down despite threats to his life
Paul Offit—salt-and-pepper hair, wire-rimmed glasses—hardly seems like the kind of guy who’d receive a death threat. He’s a father who likes to hang out with his teenage kids, a doctor who wears khakis until they’re frayed. But Offit, chief of infectious diseases at Children’s Hospital of Philadelphia and an outspoken advocate for childhood immunisations, is at the centre of a white-hot controversy. He believes passionately in the safety of vaccines; his enemies, many of them parents who blame these shots for their children’s autism, do not. Offit says he’s been harassed in public, and received threatening letters, e-mails and phone calls.

Immunologists were hardly the target of such wrath when Offit, 57, entered the field almost 30 years ago. But today, frustrations and fears about a mysterious brain disorder that strikes up to one in 150 kids have given rise to the most angry and divisive debate in medicine: do vaccines trigger autism? Offit, a vaccine inventor, says “no.” His critics, who vilify him routinely on autism Web sites, say the question is still very much open. After the death threat—a man wrote, “I will hang you by your neck until you are dead”—an armed guard followed Offit to lunch during meetings at the Centers for Disease Control and Prevention.

But the scientist refuses to back down. In his new book, Autism’s False Prophets: Bad Science, Risky Medicine, and the Search for a Cure, Offit takes on his critics full-force, challenging them to prove the science wrong. Fearing for his safety, he isn’t doing a book tour. “People think of me as this wild-eyed maniac,” Offit says. “If I sat down with them for 10 minutes, they’d see that my motivation is the same as theirs. You want what’s best for kids.”

The anger is real and it’s deep. Parents who think vaccines are the culprit will continue to fight a government and pharmaceutical industry they do not trust. Such concerns have spread beyond the autism community.

Offit’s book is a critical assessment of the theories that have swirled around autism, the therapies marketed to fix it, and the people—the “false prophets”—who he says have taken emotional and financial advantage of parents seeking a cure. He documents “false promises” like secretin, a hormone derived from pigs that was said to improve symptoms. He dissects hypotheses that gave rise to fears—first, that the measles-mumps-rubella vaccine causes autism and later, that thimerosal, a mercury-containing preservative, is the culprit—then lays out the evidence against them, including more than a dozen studies showing no link.

It is not easy, however, to trump human experience with science. Lisa Jo Rudy doesn’t believe vaccines caused her 12-year-old son’s autism, but she won’t rule them out as a factor for other kids. Rudy, who writes about autism for About.com, says the anger is “an enormous overreaction”. Still, she’s not surprised that Offit’s absolutism aggravates his critics.

Recently, Offit set off a flurry of angry postings when he said that a baby’s immune system could handle as many as 10,000 vaccines. Then he upped the ante, saying it was probably “closer to 100,000.” Offit’s assessment is based on data showing the vast capacity of a child’s immunological response. Parents who worry children are getting too many shots too soon were incensed. And critics charge that Offit, one of three patent holders of a vaccine against rotavirus—which causes severe diarrhea and kills half a million children a year worldwide—is dependent on drug companies and motivated by greed. They call him “Dr. Proffit.”

Offit isn’t apologising. He acknowledges that he got a “small percentage” of the $182 million Children’s Hospital of Philadelphia received when it sold its interest in future royalties for the vaccine RotaTeq. And he has served as both a paid and unpaid member of a scientific advisory board at Merck, which makes RotaTeq. But Offit says money has never been his motivator. At the age of 5, he spent three weeks in a polio ward, where he was housed to recover from clubfoot surgery. “It caused me to see children as very vulnerable and helpless and, I think, drove me through the 25 years of the development of the rotavirus vaccine,” says Offit. Frankie Milley, who started a national organisation called Meningitis Angels after losing her 18-year-old son, Ryan, to the disease, says Offit readily hands out his number to parents concerned about vaccine safety. “He truly hurts for children who are suffering or who have died,” she says.
_ Claudia Kalb, Newsweek

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