Vaccines and Autism: A Matter of the Heart

By now you've no doubt heard about the verdict announced yesterday by the US Federal Court of Claims regarding the claims of a vaccine-autism link. Three federal judges ruled against three families---the Cedillos, the Hazlehursts, and the Snyders---who were seeking compensation from the National Vaccine Injury Compensation Program (NVICP).

You can read the decisions of the three Special Masters here. Dr. Steven Novella of the Yale University Medical School has a good summary of the decisions. He concludes with this:

The decisions reflect the overall impression of the scientific community - the theories behind the notion that vaccines cause autism are speculative and the evidence is strongly against them. Also, the experts who have looked at the evidence and have concluded that vaccines do not cause autism simply know what they are talking about, while the anti-vaccine experts were unimpressive and not persuasive.

This is a solid victory, much as the Dover decision (which thoroughly went through the scientific arguments for evolution and the nonsense of Intelligent Design) was for science and the teaching of evolution. We can now expect desperate spin from the anti-vaccine crowd. That should be fun (while also depressing) to watch. And, just as with ID, it is unlikely that even this solid trouncing will end anti-vaccine pseudoscience.

I would say, the inevitable déluge of news reports, analyses, and blog postings about the court's decision is simply painful. Painful because, as Kev at Left Brain/Right Brain wrote, "Three brave families .... were placed in harm's way not by an MMR injection but by a string of bad doctors, worse autism/antivax organisations and really terrible witnesses." These families have put out significant financial resources in the hopes, it seems, of winning their cases and compensation from the NVICP: The Cedillos apparently took a second mortgage out on their home so that they could attend the legal proceedings with Michelle, who requires substantial care.

In his ruling in the Cedillo case, Special Master George L. Hastings, Jr.----recognizing and indeed admiring the efforts of the families to do their best by their children--wrote:

The record of this case demonstrates plainly that Michelle Cedillo and her family have been though a tragic and painful ordeal. I had the opportunity, in the courtroom during the evidentiary hearing, to meet and to observe both of Michelle’s parents, and a number of other family members as well. I have also studied the records describing Michelle’s medical history, and the efforts of her family in caring for her. Based upon those experiences, I am deeply impressed by the very loving, caring, and courageous nature of the Cedillo family. Those family members clearly have done a wonderful job of coping with Michelle’s conditions, and in caring for her with great love. I admire them greatly for their dedication to Michelle’s welfare. Nor do I doubt that Michelle’s parents and relatives are sincere in their belief that the MMR vaccine played a role in causing Michelle’s devastating disorders.

Certainly, the mere fact that Michelle’s autistic symptoms first became evident to her family during the months after her MMR vaccination might make them wonder about a possible causal connection. Further, the Cedillos have read about physicians who profess to believe in a causal connection between the MMR vaccine and both autism and chronic gastrointestinal problems. They have visited at least one physician, Dr. Krigsman, who has explicitly opined that Michelle’s own chronic gastrointestinal symptoms are MMR-caused. And they have even been told that a medical laboratory has positively identified the presence of the persisting vaccine-strain measles virus in Michelle’s body, years after her vaccination. After studying the extensive evidence in this case for many months, I am convinced that the reports and advice given to the Cedillos by Dr. Krigsman and some other physicians, advising the Cedillos that there is a causal connection between Michelle’s MMR vaccination and her chronic conditions, have been very wrong. Unfortunately, the Cedillos have been misled by physicians who are guilty, in my view, of gross medical misjudgment. Nevertheless, I can understand why the Cedillos found such reports and advice to be believable under the circumstances. [my emphases]

I conclude that the Cedillos filed this Program claim in good faith. Thus, I feel deep sympathy and admiration for the Cedillo family.

The finger-pointing at science and scientists has already started, and calls for more studies already issued. I see no end to these, and not because more studies, more evidence, "more more more"---it is always more----is needed to prove to the 110th percent that there is no link between vaccines and autism. I see no end to these requests because there's a hunger out there among parents and families with children on the spectrum. There's a gnawing need to know and no science will ever satiate it. Just as there is a need to find a magic pill for autism, there's a need to identify the what, the thing, the it that caused autism.

I hope that scientists and the medical community can proceed with the care and respect shown by Special Master Hastings. Even while the scientific evidence refuting a vaccine-autism link accrues, that need to know is lodged as firmly as ever in parents. Those who continue to believe in a link between vaccines and autism, in the face of and in despite of the evidence, are well-positioned to present themselves as the mavericks who thumb their nose at the establishment, who go against "the mainstream" and, in the tradition of American individualism, stand up for the little guy and pioneer a new path. When parents write about their feelings at holding down a child so she could get a shot or their fear that something they were told would help a child has possibly hurt her, there's a tug on the feelings, on the heartstrings, that the measured conclusions of the best studies cannot approach.

The vaccine-autism issue is a symptom of the emotions and the realities that parents of autistic children live with every day, and it's this emotional core that not all the peer-reviewed studies, not all the Special Masters' verdict, not all the proverbial tea in China (even if it's being touted as the latest autism treatment) can upstage. And before more resources and energy are expended about this more and more discredited theory of autism causation, those emotions, that need, must be acknowledged, and must be reckoned with.

Image by CarbonNYC.