Sunday, August 30, 2009

Dateline NBC: A Dose of Ratings

Tonight's Dateline NBC with Matt Lauer included a sit-down interview with Dr. Andrew Wakefield, now the Executive Director at Thoughtful House in Austin, TX. Dr. Wakefield has been surrounded by controversy for many years because of his research that hypothesizes that some children may be predisposed to develop autism when exposed to certain environmental triggers. While I admire, in part, Dateline's desire to approach this subject, their treatment of the issue was superficial. Like most television programs, ratings are king. I felt like Dateline framed the issues as "either/or" rather than discussing the pros and cons of each point of view. The American Pediatric Association had the last word with their letter to Dateline stating that vaccines are safe and have not been proven to cause autism.

People familiar with the controversy immediately recognize this straw man argument. Dr. Wakefield and other researchers have repeatedly said that they do not know if vaccines, specifically the MMR, cause autism. There is, however, some evidence and peculiar links between some cases of autism and autoimmune diseases and bowel disease. I believe that Dr. Bryan Jepson, also at the Thoughtful House, and others have clearly proposed that some autism may be a result of environmental triggers for some children with a predisposition for autism. This predisposition may be a result of environmental toxins or genetic factors that we have yet to discover.

Dateline was not unfair to any of its guests, but they did not take the time to explore many of the complications behind all of the points of view. Although they did confront several of the people about their conflicts of interest while doing research, the entire vaccine industrial complex was not even mentioned as having their own ethical problems. Mr. Lauer often offered slick visual displays of stacks of research proving Dr. Wakefield wrong without a thorough discussion of the many ethical and research design problems that plague most of those studies.

I have had discussions with my own pediatrician and other doctors about the safety of vaccines. I am concerned that they attend professional conferences and workshops where the research supporting the safety of vaccines is touted and presented in abstract form and then accepted at face value. While I understand the difficulty of thoroughly vetting each research study, I think it is vitally important before continuing this debate.

I had several other thoughts while watching this program. I was struck by the statement from the supporters of vaccines that each vaccine has been tested and proven safe. I did not hear them say that the combination of vaccines over a very short period of time had been tested as being safe. These studies simply have not been done. Each vaccine company studies the safety of each vaccine, but where are the studies by the medical community to discover the safety of giving up to 30 different vaccines to children before they are four or five years old? Common sense seems to suggest that infants and developing children may have unknown reactions to having their immune systems shocked so many times in short succession.

I also did not prefer that the program continually lumped all autism together as one condition. Autism is a huge spectrum disorder that is still not well understood. The program did mention that a possible genetic link has been found to be common in a small percentage of children with autism. Why is that not a universal link? I tend to believe that many cases of autism may eventually be attributed to other conditions and diseases. Although many children present with symptoms of autism, they often have seizure disorder, specific syndromes or mental retardation. What truly is autism? I think that the medical community should not be so defensive about people questioning the safety of vaccines and realize that there may indeed be portions of the population that may encounter more risk than benefit from a vaccine.

I do not accept the argument that we should all be vaccinated for the good of society regardless of the lesser side effects. I would prefer that we all strive for the safest vaccines possible instead of ignoring the possible down sides of a vaccine just because the proposed benefits outweigh the risks.

My last concern is not related to NBC, but rather a hope that research and progress that might be made by the Thoughtful House will not be overshadowed by the alliance with Dr. Wakefield. He arrives to the United States with much stigma that must be overcome if we are to advance the discoveries about autism.

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