I'm a pediatrician and physician-scientist with a lifelong passion for developing, producing and testing new vaccines for poverty-related neglected diseases. My wife Ann and I are also the parents of an adult daughter with autism and associated intellectual disabilities.
This past weekend the journalist, Sharyl Attkisson, wrote an op-ed piece in The Hill claiming that a "debate" about vaccines and autism has just reopened. She further states that Robert F Kennedy Jr.'s recently launched Children's Health Defense has accused U.S. Department of Justice attorneys of "alleged cover-up and misrepresentations" about vaccine-autism links and calls on the United States Congress, "for the sake of children," to "re-examine both sides of the medical science."
Since the start of the modern anti-vaccine movement 21 years ago, I have given a lot of thought to its major tenet claiming links between vaccines and autism, and in response, I just wrote a new book, "Vaccines Did Not Cause Rachel's Autism."
The book refutes those links while explaining the science of vaccines and autism and our very personal story about Rachel. I wrote it in response to serious declines in vaccine coverage in both the U.S. and Europe, resulting in a number of breakthrough outbreaks of measles (most recently in New York and New Jersey), childhood deaths from influenza and poor uptake of the cervical cancer vaccine. Rachel herself is quite proud of the book and is excited about her contribution to science.
Here I briefly summarize what the medical science says and why there is no debate.
Vaccines do not cause autism
There is no link between vaccines and autism. I traced the modern anti-vaccine movement alleging vaccine-autism links back to 1998 when a paper was published in The Lancet (a prestigious medical journal), claiming that the live measles-mumps-rubella (MMR) vaccine (especially the measles component) might lead to pervasive developmental disorder, a term then used to refer to autism.
That paper was subsequently retracted by the journal editors and shown to be fundamentally flawed and scientifically invalid. In addition, several large population-based studies showed that children who received the MMR vaccine were no more likely to get autism than children who were not vaccinated, while further studies found that autistic children were no more likely to have received the MMR vaccine than children not on the autism spectrum.
However, claims of autism and vaccines then shifted from the MMR vaccine, when it was alleged thimerosal preservative that used to be found in many childhood vaccines (but which now has been mostly removed) caused autism. Again, population-based studies showed no links between autism and thimerosal-containing vaccines and indeed after thimerosal vaccines were removed from markets in the United States, Denmark and elsewhere, autism rates did not decline.
From there, the assertions moved to the concerns that somehow spacing vaccines too close together was the issue, but that too does not hold up, and lately, there are new rounds of allegations claiming that aluminum-based adjuvants found in some childhood vaccines cause autism, which is also not true.
The point is that this is the modus operandi of the anti-vaccine movement — a strange type of vaccine "whack-a-mole" — forever looking for new vaccine links only to have them disproven time and time again.
We now have clinical studies with over one million children enrolled, showing there's no link between vaccines and autism, not MMR, not thimerosal-containing vaccines, not vaccines closely spaced, not aluminum-containing vaccines, not to mention the fact there is no evidence showing that there is a link.
Vaccines cannot cause autism
There is no reasonable plausibility of vaccines causing autism. In the last few years, we've learned a lot about the developmental pathways leading to autism and its associated intellectual disabilities.
There are at least 99 autism genes to fetal brain development, mostly related to the expression of genes in brain cells or communication between neurons. Many of these result in anatomic changes during prenatal development (pregnancy), meaning well before children ever get vaccinated. Now, through the process of whole-genome sequencing, we are also learning a lot about Rachel's autism and intellectual disabilities.
The Attkisson article describes some of the legal proceedings around claims of vaccines causing autism, and she quotes Kennedy's claim that the Department of Justice was involved in "one of the most consequential frauds, arguably in human history."
I'm not an attorney, but such claims were recently debunked by my colleague Dr. Dorit Reiss, a law professor at UC Hastings and by Dr. David Gorski, a surgeon-scientist who is the managing editor of the Science-Based Medicine weblog.
As someone who has a deep involvement with the autism community, a vaccine scientist who has spent three decades developing neglected disease vaccines and who takes no industry money and will never make a dime on our vaccines for the poor, I would ask the U.S. Congress to not waste taxpayer money on meaningless searches for cover-ups or phony links between vaccines and autism. Instead, we need meaningful government support for the autistic community and their families, including greater assistance for job placement and mental health counseling.
We also need further research into the neurobiology and developmental pathways leading to autism and possibly innovative strategies for mitigating some of its associated intellectual disabilities.
Peter J. Hotez M.D., Ph.D., is a vaccine scientist, professor of pediatrics and dean of the National School of Tropical Medicine at Baylor College of Medicine.