Monday, April 07, 2008
Fear the disease, not the protection
Steve Huff
Recent columns
From the RoundTable blog
It has the makings of a conspiracy thriller: The government requires doctors to inject a miracle drug into all children. An epidemic of mind-numbing disease emerges. The government denies responsibility. Lawsuits are quashed. The injections increase.
A brave man steps forward. Armed with deep suspicion and some alarming theories, he unites affected families into a grass-roots rebellion. Finally, when a special court rules in favor of a tragically afflicted young girl, the conspiracy blows open.
The medications, in reality, are childhood immunizations. The disease is autism. The brave man is journalist David Kirby. The special court was set up by the National Vaccine Injury Compensation Program. The afflicted girl is Hannah Poling.
In the 1990s, autism rates soared. A debate arose over how much should be attributed to changing definitions, improved surveillance, increased awareness and increased rates of disease. Kirby and others swore up and down that autism was rising as a result of vaccines.
In 2000, Hannah Poling was a vibrant, verbal, 18-month-old toddler. To catch up on immunizations, her doctor ordered five injections at once.
Hannah came down with fever and intestinal symptoms and eventually regressed, socially and neurologically. Finally, in 2007 the vaccine court conceded that her immunizations contributed to the development of her autistic symptoms.
I want to believe this conspiracy. No one distrusts Big Pharma and its coziness with government, nor decries the way that money and politics trump logic, safety and science, more than I.
I want to stand with Kirby and shake my fist at thimerosal, the mercury-based preservative used in vaccines since the 1930s. After all, mercury poisoning shares an alarming number of characteristics with autism: loss of verbal and motor skills, social withdrawal, repetitive movements.
Was the vaccine court's concession to Hannah Poling the smoking gun that Kirby and his followers have been waiting for? Unfortunately not. More later, but Poling's is a unique case that merely meets a set of legal criteria for reimbursement.
Here's a smoking gun, but it points the other direction: Five years or more after thimerosal left the scene, autism rates continue to rise.
This fact has not curbed Kirby's enthusiasm. In one breath he admits that science now points "beyond mercury"; in the next he chastises the scientific community for ignoring the science that implicates mercury.
His book, "Evidence of Harm," has not been revised and his Huffington Post blogs continue to mingle fact with misinformation, science with propaganda, case history with sob story and legitimate argument with logical fallacy. They are the words, in my opinion, of an intelligent, well-meaning, laser-focused maniac.
Maniacs, however, are sometimes correct. I suspect that over the next decade we will uncover a number of specific conditions that predispose to autism.
One group may include children with rare mitochondrial disorders like Hannah Poling's. These children develop normally until they encounter a biological stress such as infection, dehydration or, conceivably, a bolus of immunizations. The typical result is seizures or movement disorders.
Hannah did develop seizures. She also became autistic. Experts point out that similar stress could have occurred from chicken pox, measles or other conditions prevented by immunizations.
As the dust settles, I find myself squeamishly on the side of Big Pharma. While its motivation stems from the ability to make enormous sums of money in the name (or at least the appearance) of preventing disease, mine is magnified by the fear that parents will withhold immunizations. The CDC and other major medical societies express the same fears. The New York Times recently described just such a trend toward vaccine skepticism.
The diseases speak for themselves: polio, measles, mumps, rubella, chicken pox, tetanus, whooping cough, hepatitis A and B, rotavirus, pneumonia, sepsis, meningitis, diphtheria, influenza, cancer of the cervix.
The irony: Because immunizations have succeeded, we no longer fear the diseases they prevent. When the whoop of Pertussis rings across a community or the contortions of tetanus find their way onto YouTube or a child dies after a "measles party," perhaps the vaccine skeptics will refocus their fears.
Conversely, if a credible body of scientific evidence emerges against vaccines, I will eat my words and work tirelessly to repair the damage. It would be the perfect ending to this conspiracy thriller. As it stands, though, the plot is little more than pulp fiction.
Huff, who lives in Patrick County and practices family medicine, is a columnist for The Roanoke Times.
