Review
My dad (thank you dad!) sent me a link to this article I wanted to break down. The claim of the article, based on the title, is that there was a federal court case which ended in the CDC being forced to state they do not have enough evidence to claim that vaccines do not cause autism. A big claim for sure, since the CDC and doctors all over have been claiming that there is TONS of evidence that autism is unrelated to vaccinations. Let’s get into it!
My initial reaction
Wow! This would be crazy if it was true. It wouldn’t have a direct impact on me, other than maybe encouraging me to become more active in asking medical and government institutions to conduct more research. There is no reversal or cure for autism so it would not help my two boys. It would however mean that the medical community and government authorities need to double down and conduct some more research!
Is the claim valid?
Alright, so the article cites a federal case between the Informed Consent Action Network (ICAN) and the CDC. ICAN claimed that the CDC did not have enough evidence to back up their claim that vaccines do not cause autism. The result of the case completely contradicts the claim of the title. The title was “CDC lacks evidence”, the suit was “You do not have enough evidence”, the response from the CDC was “Here is the evidence” and gave 20 studies. What was the response from ICAN? Did they pursue it further saying that these 20 studies did not satisfy the claim? No, once receiving the 20 studies they closed the case, as is actually cited in the article. What does this mean? It likely means that once ICAN was presented with the 20 cases they felt like it was enough evidence, or at least they felt it was enough evidence for their case to not be worth pursuing legally. They firmly believed they would lose their case if they pursued it any further and did not want to spend any more money or draw any additional attention to that fact. My guess is they didn’t want to draw any attention. Why would that be? ICAN is a non-profit based solely around the idea of educating parents on the “dangers” of vaccination. I don’t think they want to actually lose a court case, it wouldn’t look very good.
ICAN actually does have an article on their site talking about the result of the lawsuit. No mention that they actually voluntarily dismissed their own case, but still interesting. They pointed out that none of the 20 studies talked directly about the vaccine ingredients that they asked about in the suit. They were not asking about MMR or Thimerosal which were the main points addressed in the studies the CDC provided. Still though… why voluntarily dismiss your own case if you felt your case had not been addressed properly?
The whole case was based around the fact that ICAN had submitted FOIA requests for “All studies relied upon by CDC to claim that the DTaP vaccine does not cause autism.” Which is pretty ridiculous in my opinion. FOIA requests are reserved for asking for information that you believe is not publicly available. The studies that the CDC uses to back its claim are cited at the bottom of the “Vaccines don’t cause autism” page. It is a very strange idea in general to think that the CDC would want to hide studies proving their own point. The medical community has desperately trying to convince people that vaccines are safe. They are extremely motivated to prove vaccinations are safe due to the recent resurgence of measles in Europe and the US which are largely thought to be due to people avoiding vaccinations.
It looks to me like the case was mostly a publicity stunt on the part of ICAN. They didn’t really prove anything and they gave up their case pretty fast. The article title is definitely click worthy but digging into the substance of the article and the claim of the title turns into essentially nothing. I want to assume that maybe they thought they were doing a good thing with this article. I want to assume that maybe they thought they were going to spur on more research as a result of publishing the article, but for me it just feels like click-bait. Which also feels like an abuse of a sad current situation where we don’t actually know what causes autism. People are looking for answers, people shouldn’t be doing that to draw people to their news website. In addition creating fear around vaccinations can be deadly. They prevent a wide range of VERY dangerous diseases that actually killed kids in the past. If this click-baity article actually participates in bringing those diseases back I know it’s author would feel ashamed of writing it.
Is the claim valid? In a way, yes. Is it newsworthy or interesting in any way? I don’t think so.
Do Vaccines Cause Autism?
While I disagree with the way the article was written and I don’t feel like ICAN made any sort of significant progress for autistic parents or autism with their lawsuit, I still feel like the question should be addressed. How do I, as an autistic parent, feel about vaccines?
Has there been a study on every ingredient in every vaccine to see if it causes autism? No.
Does this mean that the risk for autism could be elevated from getting a vaccine? Since the previous answer is no. The answer must be, it is possible.
Were I able to start life over again would I get my children vaccinated? Yes.
Would I feel 100% comfortable when they are getting vaccinated? No. Actually there some well documented potential reactions to vaccines that are much more serious than autism. For example check out the risks section of the DTaP vaccine. They look NASTY!
What am I trying to say here? Why would I get my own child vaccinated if it’s potentially very dangerous? The point is that everything in life is dangerous. Getting up, getting in a car and driving to church is dangerous. Being safe is not about completely eliminating all risks. Being safe is about reducing risks. Are the risks greater for children who do not get vaccinated? Definitely. Check out this chart from an our world in data article on vaccination:
So, doctors know that vaccines can be dangerous but they also know that the danger from vaccination is definitely much lower than any of these numbers. Now, if you have a child where you know that the risk of a health issue related to vaccination is much higher the CDC actually recommends you not get the vaccine. Why would that be? Again, this is all about risk reduction, if your risk from getting the vaccine is higher than normal you should go with a lower risk choice. In fact, since there are so many children being vaccinated the risk associated with not getting the vaccine is actually relatively low due to herd immunity and the disease not being able to become prevalent. The chances of your child ever encountering the disease are pretty low. If we all decided to stop taking vaccines though, that would be clearly bad. We would likely see these nasty diseases come back and become prevalent again.
I am getting way off point here though… I realize I didn’t quite answer my own question. I explained why I would get my kids vaccinated but let me try and answer that question again..
From the studies that I have read there is really not a 100% way to guarantee that vaccines do not cause autism, but on the contrary side there hasn’t been enough evidence to correlate vaccination with autism. There have lots of studies (here’s one on aluminum which ICAN said they couldn’t find) on the most suspect ingredients that have shown no correlation.
Do doctors know what causes autism?
Yes and no. Sounds strange right? It’s a common question I get asked as a parent with kids who have autism. The question is usually asked by people who believe that autism is a disease. You’ll likely be shocked to hear that it’s not. It’s a developmental disorder. It’s a very important distinction to make.
Websters definition of a disease is:
a condition of the living animal or plant body or of one of its parts that impairs normal functioning and is typically manifested by distinguishing signs and symptoms
Websters definition of a disorder is:
an abnormal physical or mental condition
In other words, diseases cause symptoms while a disorder is simply a named single or set of symptoms. The label “autistic” from a medical standpoint has no reference to what is actually causing the symptoms. It’s a just a name for the group of symptoms. So what are the symptoms that make a person diagnosed as ASD? You can read about the diagnostic criteria here. The basic gist of it though is that it is a VERY broad set of symptoms. Much broader than is typical of most disorders. There are also varying levels of these symptoms which makes the diagnosis even more broad. The diagnosis ranges from “people who have difficulty making friends” who would have just been called introverts or very shy in years past, to people like my oldest who has no intelligible speech and does not respond when his name is called.
So what does this have to do with understanding what causes Autism? Well, hopefully when you understand that Autism doesn’t refer to any one disease, it’s just a description of a set of symptoms, and when you understand exactly how many symptoms are grouped into this one set, you’ll understand that Autism is probably caused by hundreds if not thousands of different things. When you are asking the question “What causes Autism?” You are really basically asking, “What could possibly cause children to have issues developing socially while at the same time having either a restricted set of interests or super sensitive to sensory input or super insensitive to sensory input?” The diagnostic criteria is a little more specific than that but that’s the basic gist of it and I hope it at least gets the point across. We should technically always be finding new causes of Autism. If a person is shy and covers their eyes when they see the color yellow because it freaks them out for some reason, ASD. If the person is super outgoing but only has shallow relationships and doesn’t seem to understand what having a deep relationship means while also needing a lot of sensory input (i.e. I only feel alive when I’m in a crowd, or something to that effect), they have ASD. My opinion they are likely to have COMPLETELY different causes but they both have Autism Spectrum Disorder.
So, what do they know today that causes Autism?
Several different genes appear to be involved in autism spectrum disorder. For some children, autism spectrum disorder can be associated with a genetic disorder, such as Rett syndrome or fragile X syndrome.
There are also a few other things they have identified that increase your risk of displaying autistic behaviors. It may just be a family trait to be more introverted, like a steady routine, and avoid change. That would technically classify you as level one ASD and you’d get counted in the 1 out of 60 people who have Autism.
There have been concerns that the term is too broad to be useful but on the other side when the diagnostic criteria was last changed in 2013 psychologists argued that it was too narrow. The number jumped way up in 2013 because they combined four different conditions autism, pervasive developmental disorder, Asperger’s, and CDD into “Autism Spectrum Disorder” but studies showed that about 25% of people may have lost their diagnosis because their symptoms didn’t meet the broad criteria of ASD.
My personal opinion on it being this broad is that it is both useful and not useful at the same time. It is useful because they can direct medical professionals to refer people to an appropriate therapist. When a person is diagnosed with ASD they are likely to get the appropriate treatment. That’s actually the purpose of naming and categorizing the disorder this way. It’s not very useful because It confuses people when we are looking for a cure. We can’t absolutely CURE autism. Once we find a cause we can work on a cure or a prevention but as I pointed out they are likely going to be finding causes forever because the diagnosis is so broad.
Why is finding ASD causes so difficult?
ASD is a developmental disorder which means it likely has something to do with your brain. Unfortunately the best way to make a specific diagnosis related to the brain is with an MRI machine. An MRI machine looks like this:
The person getting an MRI must also be awake because seeing how your brain behaves when you are sleeping or under a heavy anesthetic likely has no bearing on how your brain behaves when you are awake and alert.
So… try taking a three year old child who is perfectly healthy and talking him into taking an MRI, let alone a child with autism. Sometimes it takes two of us to get pants on my kid let alone convince him to sit perfectly still inside of a giant metal tube for 30 minutes.
There was actually an MRI performed on an autistic person. That was Temple Grandin. She is a prolific writer and has a book called the autistic brain. Please read it. Anyway, she was an extremely rare case. One of her autistic traits is that she is abnormally fascinated with the brain, because of this she was able to force herself as an adult to undergo an MRI. The left-side of her brain is abnormally dominant and that may be the cause of her autistic behavior. So what caused the left-side of her brain to do that? We don’t know, it’s tough to tell without seeing it happen. Do all people with autism have a large left side of their brain? Hopefully you’ve got the point by now. No. Almost every case of autism is going to be different just because of how broad the diagnostic criteria is. But I digress..
Until technology for monitoring and studying brain activity progresses beyond the point of an MRI it is going to be very difficult to discover diseases and disorders that represent autistic symptoms. If they got it to the point that you could strap it on the kids head you might be able to in some cases of milder ASD (level 1 or level 2) be able to work with a therapist to convince your child to wear the device for a period of time. For the more severe cases the technology would have to be so good the kid wouldn’t be aware of it.
Conclusion
So in the end. I personally am not a fan of this particular article. I feel like it is at best not helpful (i.e. nothing new about autism) and at worst putting kids lives in danger by possibly convincing parents whose children would be low-risk when it comes to getting a vaccine to avoid the vaccine.
Should we be paying attention to what we put in our kids bodies? Yes.
Should we be doing research into what causes autism? Yes.
Should parents conduct a vaccine risk assessment with their doctor before getting a vaccine? Yes. Doctor’s are usually aware if it’s going to be dangerous for a child to get a vaccine but you should always ask anyway.
Should we be writing articles that might scare parents into not vaccinating when there is not sufficient evidence for them to avoid vaccination? No.
Was the CDC forced to state that they don’t have enough evidence? No, ICAN gave up after receiving the first 20 studies.