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Posts Tagged ‘vaccinations’

ABC Drama Takes on Science and Parents

 

Richard Cartwright/ABC

Jonny Lee Miller, left, as Eli Stone, with Laura Benanti as the mother of an autistic child, and William Topputo in “Eli Stone.”

 

Eli Stone, the evil corporate lawyer turned superhero defender of the downtrodden, recently made his debut performance on ABC by battling the dark vaccine menace. With this program, the public is once again bombarded by the sensational but utterly false premise that vaccines are a cause of autism. Here he helps defend a mother and her little boy, hapless victim of the pharmaceutical companies and their vaccine preservative, mercuritol (in real life, thimerosal), which has rendered him autistic. Those of us on the side of science and reason just can’t get a break. As a pediatrician, I struggle daily to reassure, explain, and convince parents that there is no rational basis for believing that vaccines are a cause of autism. That there is, in fact, just as much evidence that your astrological star chart can predict your future. Or that homeopathy is more than an expensive placebo. Reams of data from a very large number of well conducted studies have clearly and overwhelmingly (at least in the halls of science which, after all, are the only halls we should be traversing here, right?) refuted any notion of a purported link . There is not enough room to discuss the origins of that myth here (stay tuned for a future entry on that voluminous subject), but suffice it to say that there really is no controversy among respected scientists and physicians. If you follow an evidence-based approach to medical decision making, there is no conclusion to draw other than that absolutely no such link exists. As for the issue of the vaccine preservative thimerosal being a cause of autism, again the data do not demonstrate any evidence of a link. On a multitude of levels there is ample reason to reject any link between thimerosal and autism:

 

  1. All of the legitimate studies to date have failed to demonstrate any link. That’s a pretty good reason right there:
  2. The apparent increase in autism cases has continued even after the removal of thimerosal from vaccines.
  3. Finally, and a usually neglected part of the story, the kind of mercury contained in thimerosal (ethylmercury) is very different from the kind produced by industrial pollution, and that ends up in the fish you eat (methylmercury). While methylmercury becomes concentrated in the body’s tissues (most importantly the brain) and thus remains for prolonged periods, ethylmercury is much more rapidly eliminated, and is therefore much less readily stored by the body. Recent studies have demonstrated just how different the pharmacokinetic properties of these two types of mercury are in the bodies of infants. This is important when we consider the US EPA “reference dose” (RfD) for mercury. This is the upper level daily amount, over a lifetime, of a substance that is considered safe to the most sensitive individuals in a population. The RfD for mercury set by the EPA is 0.1 micrograms per kilogram of body weight per day. Many people who believe the thimerosal-autism link point to the fact that, before thimerosal was removed from vaccines, some infants received a total daily dose of mercury from vaccines that came close to or exceeded the EPA’s RfD for mercury. Keep in mind, however, that the RfD was based on long-term, life-time daily exposures, not one time or even multiple time exposures. Also, as a safety factor the RfD was set 10 times higher than the actual estimated safe level. But most importantly, the RfD for mercury is based on data for methylmercury, not ethylmercury. That is, all the assumptions about the hypothetical dangers of exceeding the RfD for mercury, on potentially a few occasions, are based on an RfD for the wrong kind of mercury. As discussed above, the data on the pharmacokinetics of ethylmercury suggests a very different, and far less concerning picture for thimerosal in vaccines.

Which brings us back to Eli Stone and his heroic quest to slay the evil, two-headed, medical-pharma beast. It’s nothing new to see television making mince meat of science. It is fiction after all. In fact, after the American Academy of Pediatrics wrote ABC to protest the airing of the show, the producers placed a disclaimer of sorts at the end of the show (while people were channel surfing or getting another beer from the fridge), stating that vaccines are important, and directing viewers to the CDC’s website. Needless to say, the damage was done. The danger of this kind of TV is that people actually do often believe what they see and hear on the boob tube. Even if they know that what they’re watching is fictional, the messages absolutely effect behaviors. Particularly when they are so often bombarded by misleading and factually incorrect information. In this case, those behaviors involve potentially very dangerous errors in judgement regarding an extremely important medical decision about childrens’ health. Of course, the real-life court room drama that unfolded last month, involving the Federal Vaccine Court, will do even more damage. While the court’s ruling in favor of the family of an autistic child said nothing about vaccines causing autism, the perception many have come away with is just that – that the government has conceeded that vaccines are a cause of autism. I will discuss this case in more detail in an upcoming post. But the two courtroom dramas, one fictionalized, the other frightfully real, will both serve to further tarnish the image of the greatest advance medical science has ever seen, and take us another step backward toward the prevaccine era, and the re-emergence of more childhood death and disease.

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