A good newspaper is never quite good enough, but a lousy newspaper is a joy forever.
—GARRISON KEILLOR
When parents became concerned that vaccines had caused their children’s autism, scientists responded by performing a series of epidemiological studies. All showed the same thing: vaccines weren’t at fault. But despite the singular, consistent, reproducible, and clear results of these studies—and consequent reassurances from national and international health groups—many parents remain fearful. Why? Why has there been such a deep and persistent rift between the science that exonerated vaccines and the public’s understanding of that science? Indeed, when people hear the word vaccines, one of the first things they think of is autism.
THE PUBLIC LEARNS ABOUT SCIENCE FROM LAWYERS, POLITICIANS, doctors, and scientists, most of whom filter their information through the media. Unfortunately, the motivations of scientists who perform studies differ from those in the media who describe them: one wants to inform, the other to entertain.
On August 7, 2005, Tim Russert of NBC’s Meet the Press examined the case against mercury in vaccines. Few journalists were more respected than Russert, a serious and thoughtful man whose programs were consistently praised for their excellence. If anyone could fairly review the subject of vaccines and autism, it was Tim Russert. But Russert succumbed to the journalistic ethic of the time. He invited two people onto his program: Harvey Fineberg, president of the Institute of Medicine and former dean of Harvard’s School of Public Health, and David Kirby, the journalist who wrote Evidence of Harm. By structuring his program as a contest, Russert eliminated any chance to inform his viewers. Here’s what went wrong.
At the time of the Russert interview, four of the eight studies that had exonerated thimerosal had already been published, and although it was still a source of controversy in the media and in court, the vaccines-cause-autism hypothesis was no longer viable among scientists. If Russert had genuinely wanted his viewers to understand the issue, he would have interviewed Harvey Fineberg only. Fineberg would have first explained what epidemiological studies are, how they work, and why they are the best way to determine whether one thing causes another. Then, he would have described how scientists would select two groups of children that are alike in all respects except one—their receipt of thimerosal. He would have described how the size of a study determines its statistical power: small studies may be sensitive enough to implicate thimerosal as a cause of autism in only one in 100 children, but larger ones could detect it in one in 1 million children. And he would have explained how scientists would randomly select children who had or hadn’t received thimerosal so as not to bias the results. By interviewing Harvey Fineberg only, Tim Russert would have given his viewers a better understanding of the strength and consistency of the epidemiological studies that had been done. The obvious problem with offering such a tutorial on network television is that it’s painfully boring. So Russert did what almost every other journalist who writes or talks about science does: he set it up as a controversy with no intention to resolve it. He pitted an entertaining journalist with a background in public relations against a careful, thoughtful scientist. One man was made for television; the other wasn’t. If questioned, Russert would have probably offered the journalistic mantra of “balance”: in order to flesh out a controversy, he had to provide both sides of the argument. But there’s a difference between balance and perspective. A more accurate balance—and a fairer representation of the prevalent view—would have been to have interviewed 1,000 scientists who, having reviewed the evidence that exonerated vaccines, represented one side, and a single scientist, like Mark Geier, who wasn’t convinced. But it also wouldn’t have been a very good television program. So Russert opted for a dramatic, one-on-one twenty-minute confrontation.
Harvey Fineberg remembers his appearance on Meet the Press. “It’s a little like the [Samuel Johnson] metaphor about hanging,” he recalled. “It concentrates the mind.” The result was predictable. Fineberg did a wonderful job describing the science that had exonerated mercury, a nearly impossible task given the few moments he had to do it. Kirby, on the other hand, dismissed Fineberg’s epidemiology with a wave of his hand and alluded to exciting new findings by researchers studying laboratory cells and experimental mice (such as those performed by Richard Deth and Mady Hornig). Fineberg didn’t have the time and Russert didn’t have the interest in hearing about how studies in the laboratory could never be as valuable as studies in hundreds of thousands of children. But that didn’t matter. It was great theater. Tim Russert had taken a boring subject like epidemiology and transformed it into an exciting confrontation: a war between a young journalist fighting for the rights of a disenfranchised group and a mainstream scientist who offered only epidemiological studies and their statistical results.
The Russert interview on Meet the Press shows why it is so difficult to educate the public about science. For his network, Russert’s success is judged in large part by the size of his audience and his ability to sell advertising; a show that carefully de-fines how epidemiological studies are performed won’t accomplish either. On the other hand, a confrontation between an enthusiastic muckraking journalist and a scientist who represents a faceless giant like the Institute of Medicine will. Judea Pearl, a professor of computer science at UCLA, said it best: “Journalists cannot simply pour gasoline into the street and pretend they bear no responsibility for the inevitable explosion.” The need to sell advertising—to be vivid, dramatic, and interesting—stands in constant opposition to the public’s understanding of science.
Harvey Fineberg (left) and David Kirby square off during a Meet the Press interview with Tim Russert, August 7, 2005 (courtesy of Getty Images).
Like most journalists without a scientific background, Tim Russert had little knowledge of the workings of science, so he didn’t focus on science. He focused on people—a scientist and a journalist. People are much more interesting than science. In the case of vaccines and autism, it isn’t hard to find scientists on both sides of the debate. But, in truth, it isn’t hard to find scientists on both sides of any issue, independent of whether it’s a debate. For example, to take this notion to an extreme, the science program Nova occasionally airs shows describing plate tectonics, the mechanism by which the earth’s surface moves. The concept of plate tectonics assumes the earth is round. But if the producers of Nova ever wanted to make plate tectonics more interesting, they could include a scientist who disagrees, claiming the earth is flat. Indeed, several scientists belong to the Flat Earth Society, an active, engaging group dedicated to “deprogramming” the masses since the sixteenth century. The mission statement of the Flat Earth Society would make for great television: “For centuries, mankind knew all there was to know about the shape of the Earth. It was a flat planet, shaped roughly like a circle. Then, in the year of our Lord fourteen-hundred and ninety-two, it all changed. Christopher Columbus, using an elaborate setup involving hundreds of mirrors and a few burlap sacks, was able to create an illusion so convincing that it was actually believed he had sailed around the entire planet and landed in the West Indies. As we now know, he did not.” Nova has chosen not to contradict the science of plate tectonics with the Flat Earth Society’s contention that the earth is flat. That’s because the earth is round. But the notion that vaccines cause autism has also been clearly disproved. Still, the issue is reported as a controversy.
ANOTHER INHERENT BIAS OF JOURNALISTS IS THAT THEY SEE themselves as defenders of the weak against the powerful. In the late 1800s, Finley Peter Dunne, an editorial writer for the Chicago Post, stated that journalists should “comfort the afflicted and afflict the comfortable.” In the vaccine-autism story, the media cast children with autism as the afflicted and pharmaceutical companies, public health officials, doctors, and scientists as the comfortable. When Tim Russert picked David Kirby for his show, he didn’t pick him because he was an expert on autism (Kirby had never diagnosed or treated a patient with autism); or because he was an expert on mercury poisoning (Kirby wasn’t a toxicologist); or because he was an expert on vaccines (Kirby wasn’t an immunologist, virologist, or microbiologist); or because he was an expert on epidemiological studies (Kirby had never performed or published an epidemiological study). David Kirby had no specific expertise in any aspect of the thimerosal-autism debate. But Kirby had written a book claiming that public health officials, knowing that thimerosal had harmed the unsuspecting children of America, had done everything they could to cover it up. David Kirby was a journalist’s dream—bright, articulate, young, and attractive; he was the plucky little guy willing to take on the evil big guy. Harvey Fineberg—cast unfairly in the role of Goliath—had been put in an impossible position before he had ever stepped onto the Meet the Press set.
Arthur Allen, the journalist who wrote Vaccine: The Controversial Story of Medicine’s Greatest Lifesaver and later debated David Kirby in San Diego, laments the manner in which the public is educated about science. “Every time some schmo who people have seen on television buys into [the vaccine theory] for whatever reason, it just keeps getting more of a life,” he said. “I find it distressing to see people like [David Kirby] being given more authority by the media than the CDC. There are things definitely worth investigating, and bad things get done by people. But that’s not always the narrative. That’s not what journalism is supposed to do. I still like the ‘comfort the afflicted and afflict the comfortable’ line about journalism, but that doesn’t mean misrepresenting things.”
Tim Russert wasn’t alone in his choice to tell the vaccine-autism story as a David versus Goliath tale. Virtually every major newspaper, radio station, and television network told the story the same way. (The David-versus-Goliath theme isn’t confined to television and radio; movies, too, often portray issues in medicine and science as a confrontation between people willing to take on the rich and powerful who are bent on destroying them. Movies like Lorenzo’s Oil, Erin Brockovich, Silkwood, and A Civil Action all described how the little guy can take on the big guy and win. Americans love these stories. All of these movies were riveting, and all did well at the box office.) Although the David-versus-Goliath theme is compelling, journalists typically miscast the players in the vaccine-autism controversy. When doctors and scientists stand in front of the media to dismiss the contention that vaccines cause autism, they are representing the little guy. In this case, the little guy is the autistic child subjected to harmful therapies or denied potentially life-saving vaccines.
NOT ALL NEWSPAPER REPORTERS CUT THEIR MORALS TO FIT THE style of the time. On June 25, 2005, Gardiner Harris and Anahad O’Connor wrote a lengthy article that appeared on the front page of the New York Times. The article wasn’t equivocal. Harris and O’Connor presented the epidemiological evidence disproving the notion that thimerosal caused autism; gave short shrift to the fringe scientists who disagreed; and criticized parents who subjected their children to radical, unproven, and potentially dangerous therapies. They offered a perspective based on good science, and they were hammered for it. Daniel Schulman, an assistant editor for the Columbia Journalism Review, denounced the article as shamefully one-sided. “The story cast the thimerosal connection as a fringe theory without scientific merit, held aloft by angry, desperate parents,” said Schulman. “The notion that supporters of the theory were disregarding irrefutable scientific findings was an underlying theme, drilled home several times. Readers were left with little option but to believe that the case against thimerosal was scientifically unsound. Several reporters I spoke with who have covered the thimerosal controversy described the Times story as a ‘hit piece.’” Schulman didn’t stop there. He praised journalists such as Myron Levin of the Los Angeles Times, Dan Olmsted of United Press International, and Craig Westover of the St. Paul Pioneer Press for their bravery in taking on powerful establishments. Westover specifically was praised for standing up to vitriolic comments on his blog following the mercury chelation death of Tariq Nadama. One blogger had written: “They finally did it, Mr. Westover. They killed a little boy trying to get that satanic mercury out of his little body. You have some blood on your hands. Like it or not, you do. There has been no autism epidemic and thimerosal doesn’t cause autism. I hope the parents of this boy point the finger at you and scream murder.”
Craig Westover considered his response. “I really do try to walk a middle line on this,” he said. “You have to go out and investigate this and be able to come to some sort of conclusion. Not definitely that thimerosal does or does not cause autism, but you have to come to the question of whether this theory is plausible or not. Otherwise, I think you’re doing a disservice to your reader.” Westover concluded that the thimerosal-autism theory was plausible. Later, he responded to the blogger: “This is the risk of a sin of commission,” he wrote, “and one I considered long and hard before I wrote my first article on this topic. I will stand on what I believe and accept the risk and the consequences if I am wrong.”
When Craig Westover wrote his articles, he knew that he was protected by the legal treatise of “absence of malice,” which states that a journalist cannot be held accountable for false statements unless it can be proved that he made them knowingly and maliciously. It’s a high bar. So it is unclear what Westover meant when he said he would accept the consequences if he were found to be wrong. He was wrong and Tariq Nadama is dead. Did Westover mean he would call up and apologize to the parents of Tariq Nadama? Or stand beside Roy Kerry, the physician responsible for Tariq’s death, after he had been indicted for involuntary manslaughter? Or issue a retraction in his newspaper? Certainly since he made the statement—during which time study after study continued to refute a notion he believed to be true—Craig Westover has done nothing to show he has accepted the consequences of his mistake. It’s easy to claim responsibility when you know you’ll never be held accountable.
ANOTHER OBSTACLE TO THE PUBLIC’S UNDERSTANDING OF SCIENCE is that journalists love scientific mavericks. “Journalists typically cover the news,” says Steven Pinker, a professor of psychology at Harvard University and the author of The Stuff of Thought, “with the finding that upsets the apple cart rather than the consensus.”
In the past, vaccine stories have had a remarkable sameness; doctors talked about how vaccines saved lives, and scientists talked about the wonder of creating them. Andrew Wakefield and Mark Geier were a breath of fresh air, taking a boring story and making it controversial, full of scandal and intrigue. They stood apart from conventional thinking; apart from government agencies, advisory committees, and pharmaceutical companies; and apart from the physicians’ mantra that vaccines were safe. They were among a precious few who appeared willing to speak truth to power. Long after Andrew Wakefield’s notion that MMR caused autism had been disproved, Melanie Phillips of London’s Daily Mail continued to represent him as a hero. “There are very powerful people who have staked their entire reputations and careers on proving Andrew Wakefield wrong,” wrote Phillips, “and they are willing to do almost anything to protect themselves. While Mr. Wakefield is being subjected to a witch hunt, and while the parents of affected children are scandalously denied legal aid to pursue the court case which may have finally brought to light the truth about MMR, those powerful people in the medical establishment are continuing to misrepresent the evidence.” Phillips was arguing that the history of medicine was studded with scientists who stood outside the system, were ridiculed for it, and were eventually proved right. Wakefield, according to Phillips, was no different.
In fact, all scientists, if they are to be successful, are iconoclastic. “Science,” says George Johnson in his review of Freeman Dyson’s The Scientist as Rebel, “is an inherently subversive act. Whether overturning a long-standing idea or marshalling the same disdain for received political wisdom, the scientific ethic—stubbornly following your nose where it leads you—is a threat to establishments of all kind.” Said J. B. S. Haldane, a British geneticist and evolutionary biologist: “Beware of him in whom reason has become the greatest and most terrible of passions.”
Scientists, bound only by reason, are society’s true anarchists. Indeed, some of the greatest advances in medicine have been made by scientists who initially stood alone. For example, Barry Marshall, working at the Royal Perth Hospital in Western Australia, argued that an unusual bacterium called Helicobacter pylori caused stomach ulcers. No one at the time believed that bacteria could survive the harsh acid produced by the stomach, much less reproduce and cause disease. But Marshall was so convinced by his findings that he swallowed a Petri dish full of the bacteria, later developing severe inflammation in his stomach. In 2005, Barry Marshall won the Nobel Prize in Medicine. Following up on the work of radiation biologist Tikvah Alper and mathematician John Stanley Griffith, microbiologist Stanley Prusiner, from the University of California at San Francisco, argued that proteins alone could cause infections. Scientists knew that bacteria, parasites, viruses, and fungi were infectious because each of these organisms contained genetic material that allowed them to reproduce. Prusiner’s notion that a single protein could cause an infection was heretical. But Stanley Prusiner was right. And his proteinaceous infectious particles (prions) were later found to be the cause of mad cow disease. Prusiner won the Nobel Prize in Medicine in 1997. And Albert Einstein, before he described his theory of relativity, proposed that light was composed of tiny particles. No one believed him. Later, researchers found that light rays were redirected by the gravitational pull of the sun, proving Einstein right. Einstein won the Nobel Prize in Physics in 1921.
Marshall, Prusiner, and Einstein had several things in common: they were decades ahead of their time, their findings were initially ignored, they stood their ground, and other scientists eventually proved them to be right. And, like Andrew Wakefield, all were considered to be rogue scientists and were criticized for their hypotheses. But unlike Andrew Wakefield and his proposal that MMR caused autism or Mark Geier and his proposal that thimerosal caused autism, all of these Nobel Prize-winning scientists had their work confirmed by other investigators—redundantly. For Wakefield and Geier, this hasn’t been the case; despite years of study, many groups of investigators working on several different continents have failed to support their theories. In short, not all rogue scientists are good scientists. “History is replete with tales of the lone scientist working in spite of his peers and flying in the face of doctrines,” wrote Michael Shermer, author of Why People Believe Weird Things. “Most of them turned out to be wrong and we do not remember their names. For every Galileo shown the instruments of torture for advocating scientific truth, there are a thousand or ten thousand unknowns whose ‘truths’ never pass muster.”
ANOTHER TRAP FOR JOURNALISTS IS THE LURE OF THE SINGLE study. After Andrew Wakefield published his paper in the Lancet claiming that MMR caused autism, journalists jumped at the chance to report his dramatic new finding. But scientific theories aren’t proven by the number of journalists who write about them. Novel, and in this case shocking, claims are best proved by further study. That’s because scientists, even excellent scientists working at prestigious institutions, often get it wrong—and it’s not hard to publish bad science. “Obviously, we are all interested in the truth,” said Arnold Relman, former editor of the New England Journal of Medicine. “But it’s mostly what happens after a study is published that determines truth.” For example, in 1981, Brian MacMahon and his colleagues suggested that coffee drinking could lead to pancreatic cancer. The study, which included extensive interviews with 400 cancer victims, was carefully performed, evaluated, and described; it was published in the New England Journal of Medicine, one of the best medical journals in the world. And MacMahon and his coworkers were from Harvard’s School of Public Health, a premier institution. The media carried this story as fact, and for a little while people were more circumspect about their coffee drinking. But Brian MacMahon was wrong. Study after study failed to reproduce his results, and the notion that coffee caused pancreatic cancer faded away.
Sometimes the public is confused and disillusioned when a much-heralded study fails to survive closer scrutiny, believing that science cannot be trusted to get it right. “It is important to recognize the fallibility of science and the scientific method,” wrote Michael Shermer. “But within this fallibility lies its greatest strength: self-correction. Whether a mistake is made honestly or dishonestly, whether a fraud is unknowingly or knowingly perpetrated, in time it will be flushed out of the system by lack of external verification.” Unfortunately, some people are uncomfortable with the fluidity of science, looking for something immutable and certain. “When better information is available, science textbooks are rewritten with hardly a backward glance,” says Robert Park, a professor of physics at the University of Maryland and the author of Voodoo Science: The Road from Foolishness to Fraud. “Many people are uneasy standing on such loose soil; they seek a certainty that science cannot offer. For those people the unchanging dictates of ancient religious beliefs, or the absolute assurance of zealots, have a more powerful appeal.”
To best serve their readers, journalists should be skeptical of any scientific study that appears to break new ground. Following astronomer Carl Sagan’s warning that “extraordinary claims require extraordinary proof,” they should wait until the next round of studies confirms the initial one before unnecessarily frightening the public. This hope, of course, is fanciful. The lure of dramatic headlines, advertising dollars, and ratings is far stronger than the desire to avoid scaring the public with an unconfirmed study.
PUBLIC OPINION IS ALSO INFLUENCED BY PARENT ADVOCACY groups and the public relations firms that work for them. During the thimerosal debate, Fenton Communications, hired by J. B. Handley’s Generation Rescue, constantly lobbied the media with press releases touting laboratory studies (like those of Boyd Haley, Richard Deth, and Mady Hornig) that appeared to contradict epidemiological studies. Fenton used the same strategy during the breast implant controversy—a strategy pioneered by a legendary public relations firm working for the tobacco industry in the 1950s.
In 1953, tobacco companies hired the most powerful public relations firm in the United States, Hill and Knowlton. The firm’s job was to seed doubt about the validity of epidemiological studies that clearly showed cigarette smoking caused lung cancer—to make the public believe the case against tobacco was a medical controversy. In the same way Robert F. Kennedy Jr., prominent politicians, and celebrities stepped forward to support the notion that thimerosal caused autism, Hill and Knowlton engaged entertainer Arthur Godfrey to defend cigarettes. During his weekly television variety show, Godfrey said, “I smoke two or three packs of these things every day. I feel pretty good. I don’t know; I never did believe that they did any harm.”
Hill and Knowlton also used personal testimonials to trump epidemiological studies. Advertisements by R. J. Reynolds, the maker of Camel cigarettes, featured people who had taken their own thirty-day test to determine if cigarettes were harmful. Elana O’Brien, a real estate broker, said: “I don’t need my doctor’s report to know Camels are mild.” (Dan Burton used the same strategy during his congressional hearings in which parent after parent testified that MMR caused autism, science be damned.)
Then Hill and Knowlton convinced Edward R. Murrow, the television journalist who hosted the program See It Now, to do a show on tobacco. (Murrow was a chain smoker, consuming sixty to seventy cigarettes a day.) As described by Allan Brandt in The Cigarette Century, “Hill and Knowlton got precisely what they had hoped for, an ambiguous conclusion noting that more scientific research would be needed to settle the question.” Following Murrow’s show, people were confused about the science proving cigarette smoking caused lung cancer, believing it to be a debate among scientists. “Hill and Knowlton had successfully produced uncertainty in the face of powerful scientific consensus,” wrote Brandt. “So long as this uncertainty could be maintained, so long as the industry could claim ‘not proven,’ it would be positioned to fight any attempts to assert the regulatory authority of public health.” (Both Arthur Godfrey and Edward R. Murrow later died from lung cancer.)
Fenton Communications can claim equal success. Most people would probably agree with the statement, “Vaccines might cause autism,” despite the publication of sixteen epidemiological studies that show they don’t.
ANOTHER OBSTACLE TO THE PUBLIC’S UNDERSTANDING OF SCIENCE is that it is often explained by lawyers with much to gain from championing a particular case. During the MMR debate, Richard Barr launched a Web site and distributed written materials explaining exactly how MMR caused autism; he was constantly quoted in the media. The same has been true in the thimerosal debate. Kevin Conway, Thomas Powers, Clifford Shoemaker, Sylvia Chin-Caplan, and lawyers for plaintiffs in vaccine cases have either been quoted in the press or on their Web sites explaining how mercury causes autism. All of these lawyers have been wonderful advocates for their clients. They have done much to convince the press and the public (which contains potential jurors) of the rightness of their cause. But lawyers aren’t scientists; they’re not seeking some scientific truth. They’re trying to win cases for those who are paying them to do it.
During the Omnibus Autism Proceeding, the job of the lawyers representing Michelle Cedillo had been particularly challenging. Because the science wasn’t on their side, plaintiffs’ lawyers resorted to several different strategies to win favor from the presiding judges. When Eric Fombonne reviewed videotapes of Michelle Cedillo, showing that her autism had begun long before receiving an MMR vaccine, he dealt a devastating blow to the petitioners. A reasonable response by Sylvia Chin-Caplan and the plaintiff team would have been to call their own experts to refute Fombonne’s testimony, but the evidence against them was too strong. So the lawyers appealed to emotion. To refute Fombonne’s testimony, Chin-Caplan called as her final witness Theresa Cedillo, Michelle’s mother. Theresa talked about how hard it had been to deal with Michelle’s illness and how, no matter what Eric Fombonne had said, she knew that her daughter was acting normally before she had gotten MMR. Chin-Caplan hoped the judges’ understandable desire to help a child who was suffering would cause them to ignore the videotape evidence that had been so devastating.
The choice to have Theresa Cedillo as the final witness wasn’t the only appeal to emotion by the petitioners. At the front of the courtroom was a podium for the lawyers to address the judges. When defense attorney Vincent Matanoski made his opening statement, he didn’t move it. But every time the petitioners’ lawyers addressed the court, they turned the podium around and addressed the audience, which consisted of journalists and parents. They knew that the Omnibus Autism Proceeding wasn’t going to be the end of this. They hoped their case against vaccines would eventually spill over into state courts in front of juries, not federally appointed judges. In state courts, plaintiffs wouldn’t be suing the federal government (which had a war chest of $2 billion); they’d be suing pharmaceutical companies (which had been on the hook for ten times that amount in recent medical-product litigation). And plaintiffs’ lawyers knew that potential jurors would be influenced by how the media covered this particular trial. The awkward positioning and repositioning of the podium was a comical reminder of the conflicting interests of the defense and plaintiff teams: the former was trying the case at hand, the latter was trying to influence the media and the public for subsequent trials.
After Eric Fombonne’s testimony, the only other strategy left to the petitioners’ lawyers was to question how scientists know things. They never disputed the fact that at the time ten separate epidemiological studies had exonerated MMR or that five had exonerated thimerosal; rather, they disputed the reach of those studies. Scientists are only human, they reasoned, they can’t know everything. Those studies certainly weren’t large enough to prove that vaccines couldn’t cause autism in one in several million children; no epidemiological study was that powerful. And 4 million children were born in the United States every year. Perhaps vaccines caused autism in only a handful—one of them could be Michelle Cedillo.
The plaintiffs’ argument that there are things we cannot know harkens back to the celestial teapot analogy first described in 1952 by philosopher Bertrand Russell. “If I were to suggest to you that between the Earth and Mars there is a china teapot revolving around the sun in an elliptical orbit,” said Russell, “nobody would be able to disprove my assertion provided that I were careful to add that the teapot is too small to be revealed even by our most powerful telescopes. But if I were to go on to say that because my assertion cannot be disproved, it is an intolerable presumption on the part of human reason to doubt it, I should rightly be thought to be talking nonsense.” Certainly it is true that scientists can’t know everything, that the scientific method has limits, and that epidemiological studies cannot detect extremely rare events. But to use these truths as a basis to claim that MMR and thimerosal caused autism, to build an industry based on mercury-binding therapies or chemical castration, and to sue the federal government and pharmaceutical companies for the harm they have caused is an unjustified and dangerous leap.
The celestial teapot argument hasn’t played well in state courts. Although almost all lawsuits against vaccine makers must first go through the federal vaccine court, there are a few exceptions. One pertains to children injured before 1986, when the National Childhood Vaccine Injury Act was created. In these cases, plaintiffs can take their chances in civil court. Such was the case of Jamarr Blackwell, an autistic boy whose parents sued Sigma Aldrich. The judge, Stuart Berger, didn’t buy the notion that vaccines caused autism in a small group of genetically susceptible children, recognizing the obvious flaw in the logic. “Indeed, if plaintiffs’ theory was based on generally accepted scientific principles,” wrote Berger, “the autism allegedly caused in this subgroup would not be a ‘rare event.’ Dr. Geier testified that 80 to 90 percent of the cases of autism occurring in the late 1990s were due to exposure to mercury in childhood vaccines. If that were true, and those cases presented themselves in the genetically susceptible subgroup, then epidemiological principles would dictate that a large proportion of the population would have that genetic susceptibility. Moreover, such an effect would have been detectable in epidemiological studies of the general population.”
POLITICIANS, BY WEIGHING IN ON SCIENTIFIC DEBATES, HAVE ALSO confused the public. During the vaccine-autism controversy, Joe Lieberman, then a Democratic senator from Connecticut; John Kerry, a Democratic senator from Massachusetts; Christopher Dodd, another Democratic senator from Connecticut; and Robert F. Kennedy Jr., a member of the most famous Democratic political family in America, all warned of the danger of vaccines—warnings that appeared on Don Imus’s national radio program and in full-page advertisements in the New York Times and USA Today. Why? Given the wealth of epidemiological studies clearly showing vaccines didn’t cause autism, why did these politicians stand up and tell the press and the public they did? A cynical view would be that they were paid to do it. Many Democratic politicians receive healthy contributions from the Association of Trial Lawyers of America (now the American Association for Justice), one of the most powerful lobbies in Congress. But the vaccines-cause-autism chant wasn’t sounded only by Democrats. Dan Burton, who held a series of hearings implicating vaccines as a cause of autism, is a Republican. So is Arnold Schwarzenegger, who was among the first governors to ban thimerosal-containing vaccines from his state. And perhaps the most persistent and effective fighter on behalf of the notion that vaccines have been harmful is Dave Weldon, a Republican congressman from Florida. Weldon introduced federal legislation to ban thimerosal from all vaccines, pressured CDC director Julie Gerberding to let parent advocacy groups direct autism research, and constantly questioned the motives and competency of the CDC’s Immunization Safety Office. The vaccine-autism debate has been stoked by politicians on both sides of the aisle.
The more likely explanation for politicians’ involvement in the autism debate is that they have been responding to their constituents—us. Or at least those of us who’ve been the loudest. Activist groups that are the best organized, best funded, and best connected are the ones most likely to gain political attention, and standing up against mercury isn’t a very heavy political load to lift. Unfortunately, by constantly beating the drum that vaccines cause autism, these politicians have failed to serve those for whom they are responsible: the children in their districts and states. Their scaremongering has only encouraged some parents to subject their autistic children to potentially harmful therapies or to withhold vaccines that might save their lives. In the name of protecting children, these politicians have worked against them. It’s been a disappointing parade to the congressional podium.
SCIENTISTS ALSO FAIL IN EDUCATING THE PUBLIC ABOUT SCIENCE. That’s because, for the most part, they’re reluctant to do it. “The reluctance of scientists to publicly confront voodoo science is vexing,” wrote physicist Robert Park. “While forever bemoaning general scientific illiteracy, scientists suddenly turn shy when given an opportunity to help educate the public by exposing some preposterous claim. If they comment at all, their words are often so burdened with qualifiers that it appears that nothing can ever be known for sure. This timidity stems in part from an understandable fear of being seen as intolerant of new ideas. It also comes from a feeling that public airing of scientific disputes somehow reflects badly on science. The result is that the public is denied a look at the process by which new scientific ideas gain acceptance.”
Because most scientists are reluctant to educate journalists or to stand in front of television cameras, the education is left to scientists with other motives. These scientists fall into two groups: those who ignore data and those who overinterpret them. The first group is represented by Andrew Wakefield and Mark Geier. Because they were convinced that vaccines caused autism, Wakefield and Geier shoehorned their data and disregarded studies that contradicted their hypotheses. Both have paid a heavy price for this, having been marginalized in the scientific and medical community. Wakefield, under investigation in England, sought refuge in the United States; and Mark Geier’s expert testimony has been thrown out of several different courtrooms. Both of these men had faith in their beliefs, even in the face of overwhelming data to the contrary. But Wakefield and Geier failed to recognize that science isn’t about faith; it’s about data. Eric Fombonne offered a rare glimpse into the mind of a good scientist in an exchange with Sylvia Chin-Caplan during the Omnibus Autism Proceeding. “Do you believe that autistic children do not have bowel problems?” asked Chin-Caplan. “Actually, I have no beliefs in general,” responded Fombonne. “What I look at is the evidence.”
But Wakefield and Geier are unusual. More common is the second group of scientists who seek out the media. This group is represented by Richard Deth and Mady Hornig, both of whom are excellent, well-respected, well-published researchers working at prestigious universities. Unfortunately, both committed the intellectual sin of overinterpreting their data. Deth had found that thimerosal altered an important metabolic pathway of cancer cells grown in laboratory flasks, and Hornig had found that thimerosal altered the behavior of a highly inbred strain of mice. Their studies were a far cry from proving that thimerosal caused autism in children. To be reasonable, Deth and Hornig could have presented their findings with the appropriate caveats (noting, for example, that cancer cells in flasks aren’t brain cells in people and that mice aren’t children). But they didn’t. They stood in front of congressional committees and television cameras and declared that thimerosal caused autism. Robert Park has commented on the phenomenon of scientists who descend into foolishness. “Even eminent scientists,” said Park, “have had their careers tarnished by misinterpreting unremarkable events in a way that is so compelling that they are thereafter unable to free themselves of the conviction that they have made a great discovery. If scientists can fool themselves, how much easier is it to craft arguments deliberately intended to befuddle jurists or lawmakers with little or no scientific background?”
SCIENTIFIC INFORMATION IS SHAPED BY THE SCIENTISTS, LAWYERS, and politicians who influence the media, as well as by the media themselves. But there is another influence, one that is arguably even more powerful: the culture in which scientific information is offered. The vaccine-autism controversy offers many examples of how our current culture distorts the perception of science.