By Chief medical editor
NBC News
updated 1/6/2011 4:57:14 PM ET 2011-01-06T21:57:14
Commentary

I am old enough to remember what polio looked like in the 1950s and 60s. I have held babies in my arms who have died of whooping cough. That you can prevent those illnesses with a very simple shot is among the greatest scientific breakthroughs in our lifetime. But one of the big problems is that vaccinations have been so successful, most parents in this country today have never seen nor heard of anybody who has had these illnesses.

You think it can’t happen to you.

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In 1998, British doctor Dr. Andrew Wakefield published one report of 12 children where he linked the MMR (mumps, measles and rubella) vaccines to autism. Since then, there have been numerous big studies -- including one with 530,000 children and one with 1.8 million children -- and no link was found. This week a major British medical journal showed that Wakefield and his colleagues faked the research on the child patients.

As a physician -- and I am a former pediatrician -- I can honestly say that when that report was first published, science and public health took a huge step backward. We have a lot of mistrust to mop up.

Since that first erroneous report was published, we have seen outbreaks of measles and whooping cough in various cities around the country. In fact, California in 2010 broke a 55-year-old record for the number of cases of whooping cough. That's directly related to parents who haven’t vaccinated their children.

For people who have compromised immune systems, are on chemotherapy or are a cancer survivor, if they come in contact with a child carrying one of these illnesses who hasn’t been immunized, it could be a death sentence. As a society, we have a responsibility to protect each other.

Story: Doctor defends research tying vaccine to autism

Despite Wakefield's work linking vaccines to autism being called "an elaborate fraud," many msnbc.com readers remain skeptical about the causes of autism. Read on for my answers to their questions.

We know that a human being can get a variety of different cancers yet they are all still cancer and we know that a variety of different things can lead to different cancers. Why is it illogical to conclude the same possibility for autism?
Jessica-1170252

We don’t know the cause. We certainly think there is a genetic component. If I look at just my family, I have a niece who is severely autistic and is institutionalized. I have a 16-year-old son with Asperger’s. My brother, who is a brilliant brain surgeon, has probably obsessive compulsive disorder and is mild on the autism scale. I have an uncle who is an engineer, but has social anxiety.

TODAYMoms: Do you believe there's a link between vaccines and autism?

When my son was struggling as a toddler, I was in as much denial as any other mother. But I still got him vaccinated because I never believed that vaccines caused it. When I did the soul searching, the signs were there before he would have gotten the vaccine.

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The first MMR vaccine isn’t given until 12 to 16 months. Almost all children will start to have some soft signs of autism around that time -- that’s what’s made the [Wakefield] report such an easy thing to buy. The timing of the vaccine and autism's early signs coincide. But just because two things happen around the same time does not mean that one thing causes the other.

I want to say to everyone, you’re entitled to your opinion. I know the pain of autism. But you’re not entitled to your own science. This is where we have to stand back and trust the concrete science. There is not a conspiracy here.

Why the sudden spike in autism? This what needs to be answered.
bklynj
Is it possible that there is just a rise in the diagnosis, not necessarily a rise in the disease?
igobarefoot

I think what we’re seeing is a rise in autism diagnosis because we’ve expanded the parameters of the autism spectrum to include things like Asperger's syndrome and mild cases that perhaps years ago would have been diagnosed as something else.

We still need to figure out why is autism increasing. What’s causing it? What are the environmental factors? What are the genetic factors? We know it’s more often found in boys. It may run in some families.

What I want to implore for people to do is close the book on vaccines and autism and take that money and those research dollars and sink it into good, honest, reliable autism research, so we can figure these questions out. No more wasting money on the stuff we know isn’t going to take us anywhere.

I think it would be safe to say that it's not a good idea to give brand new babies diseases in a vial just so they can learn to fight it. Think about it, the child has just come from a completely sterile environment. They don't even have an immune system. So giving them vaccines, at that point, is pointless and destructive. I think that on the whole vaccines are a good idea, but lets not overdo it. How about one at a time, and space them out more.
Dallas-2875007

Babies do have a strong immune system. When a baby is in utero, it is swimming around in sterile amniotic fluid. What happens when the water breaks and baby comes through the birth canal? That baby is colonized with trillions, not millions, trillions of bacteria and viruses. That’s the big immune bump.

There's no science to show spacing vaccines out further is any better. That’s when you start to skip a dose and get partially immunized children. It’s dangerous and it doesn’t make things better. The reason the vaccine schedule exists is we know this is the time a child is more susceptible to these illnesses.

The reason pediatricians started spacing shots was to appease parents, to say a little bit of something is better than nothing.

People react differently to these drugs so why isn't it possible for our children to react differently to the vaccines?
Caroline McLellan

Some kids do. There will always be a small percent of the population who may not be right for a vaccine. Your doctor will know it early, usually based on family history or history of allergies.

If you child was born with a bad immune problem or some other illness, your pediatrician may decide not to vaccinate. But that is a very, very, very small portion of the population. When you have a healthy child you’re being responsible and helping others by vaccinating your child.

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Video: Expert: Shaky autism study risked global health

  1. Transcript of: Expert: Shaky autism study risked global health

    MATT LAUER, co-host: Back now at 8:22 with a new report in a leading medical journal that claims a link between autism and vaccines is nothing more than a, quote, "elaborate fraud." And they say it was designed by the very doctor whose study first raised the controversial idea more than a decade ago. NBC 's chief medical editor, Dr. Nancy Snyderman , is here with details on this. Nancy , good morning to you.

    Dr. NANCY SNYDERMAN reporting: Hey, Matt.

    LAUER: This is a strong and dramatic turn. An elaborate fraud.

    SNYDERMAN: It's a damning report.

    LAUER: That is what they called the research of Dr. Andrew Wakefield .

    SNYDERMAN: Correct.

    LAUER: What's your response to this?

    SNYDERMAN: Well, this is an -- the British medical journal is calling out -- The Lancet -- they're saying that he fabricated data, that this was fraud, that he willingly changed the details about the kids he reported on, and they really do not mince their words. In the United States , this would be analogous to the Journal of the American Medical Association calling out -- say the New England Journal of Medicine . This is a very big -- and this is a shock that's going to be heard around the world in the medical community.

    LAUER: We have sat down with Dr. Andrew Wakefield on several occasions.

    SNYDERMAN: Yes.

    LAUER: He has been defiant on every occasion...

    SNYDERMAN: Yes.

    LAUER: ...saying that he absolutely is being vilified here. Now he has released a new statement saying, "There was absolutely no fraud. In the absence of adequate data on vaccine safety they continue to go after the man. What government and pharma fear in the UK is the exposure of the fact that the UK government indemnified the manufacturer. They don't understand why I won't just go away. There is just too much at stake," end quote.

    SNYDERMAN: What is at stake is his medical license , which he lost in England .

    LAUER: In the UK .

    SNYDERMAN: He does not have a medical license in the United States . And he's lost his job in the United States . The indemnification of a government to this pharmaceutical company is important for people to understand because there are so many bogus lawsuits that there were -- we were on the verge in the world of not having any pharmaceutical companies making any vaccines. So the government stepped in to, frankly, save a vaccine supply line.

    LAUER: So real quickly, when he says in the absence of adequate data on vaccine safety, that -- you completely disagree with that.

    SNYDERMAN: Two big studies, one of 530,000 kids, one eight-point -- $8 million -- with 1.8 million kids all showing no link. And let me read to you from the British Medical Journal . They said, "Who perpetrated this fraud? Well, there's no doubt that it was Wakefield . Is it possible that he was wrong but not dishonest, that he was so incompetent that he was unable to fairly describe the project? No."

    LAUER: All right.

    SNYDERMAN: So that's from the journal. That's not editorial opinion, that's scientific opinion.

    LAUER: And as a result of the work of Andrew Wakefield and the publishing of his work in the Lancet , a lot of parents chose not to vaccinate their children.

    SNYDERMAN: And we have seen epidemics around the world.

    LAUER: It spiked.

    SNYDERMAN: And we should say that Brian Deer , a non-medical journalist who, outside the traditional medicine...

    LAUER: Working in the UK .

    SNYDERMAN: In the UK . One dogged journalist, really stayed on this story, and did what the medical establishment, pharmaceutical, government bodies did not, decided not to do.

    LAUER: And yet, for some reason, Nancy , I don't think it's the end of this story.

    SNYDERMAN: But you know what...

    LAUER: It doesn't seem to ever end.

    SNYDERMAN: ...now we can say vaccines are safe. Get vaccinated, we have to put this behind us.

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