Vaccines and Autism: A Tale of Shifting Hypotheses

In recent years, increased rates of autism spectrum disorder have led to social divides. In turn, attitudes towards the once mundane use of vaccines to prevent disease have become a controversial topic. So much so, that the World Health Organization listed “vaccine hesitancy” as a threat to global health in 2019. A significant factor leading to such trepidation is public distrust of government and therefore government-funded medical institutions and practices. This reasoning, however, is not unfounded. The United States is a capitalist’s safe haven and therefore every aspect of American life is affected by the potential of profit. It is important to understand that the medical industry is just that; an industry, one driven by profit and consequently greed and corruption. To understand the controversy one must consider each side of the argument, only from this point can one further empathize and appropriately educate those jaded by the faults of modern medicine.

Considering this distrust, it is no surprise that some have turned their backs on Western medicine and particularly vaccines. As reports of autism have increased now more than ever, people are trying to better understand the disorder and its causes. Autism can result from genetic and environmental factors, ”autism tends to run in families. Changes in certain genes increase the risk that a child will develop autism. Research also shows that certain environmental influences may further increase or reduce autism risk in people who are genetically predisposed to the disorder”(Autism Speaks). Factors such as the intake of prenatal vitamins containing folic acid before contraception and throughout pregnancy may decrease the risk of autism, whereas; the advanced age of a parent, pregnancy and birth complications, and pregnancies spaced less than one year apart increase the risk of autism (Autism Speaks). Vaccinations and vaccinology have long pillars of Western medicine. While early iterations of vaccines had been attempted Edward Jenner successfully developed a vaccine for smallpox in 1796, which changed modern medicine as we know it. Since then, vaccines have been developed according to necessities growing more prevalent throughout the 1900s and of course present day. The CDC defines a vaccine as “The act of introducing a vaccine into the body to produce immunity to a specific disease.”(Center for Disease Control and Prevention)

While medicine had greatly advanced over the past century, this is not by some miracle. Like all progress, success has been achieved through means of trial and error, and vaccines are no different. There have been improvements and innovations in the way in which vaccines are created, stored, and administered over the years as addressed by the Journal on Developmental Disabilities in their article “Commentary: A Link Between Mercury Exposure, Autism Spectrum Disorder, and Other Neurodevelopmental Disorders? Implications for Thimerosal-Containing Vaccines” written by Lucija Tomljenovic, José G. Dórea. The article focuses on the possible relationship between thimerosal, a once-common preservative in vaccines, and neurodevelopmental disorders. As defined by the Centers for Disease Control, or CDC, Thimerosal is “a mercury-based preservative that has been used for decades in c the United States in multi-dose vials (vials containing more than one dose) of medicines and vaccines”. The main concern with thimerosal is the amount of ethylmercury, a known detriment to neurological function, within its composition. Therefore, the article asserts that the reasonings for using thimerosal are outdated and the practice should be stopped stating “known immunotoxic and neurotoxic substance in human vaccines should be reconsidered”(Tomljenovic, Dórea, & Shaw, 2012). The article cites animal studies that used doses of thimerosal relevant to levels of thimerosal in human vaccines, noting that the accumulation of mercury in the blood from thimerosal may be potentially hazardous. The article also mentions the faults of vaccine safety studies, claiming that controls used in these studies were not legitimate stating “the vast majority of studies on vaccine safety compare the full vaccine in question to either another vaccine, or to a vaccine containing the adjuvant such as aluminum.”(Tomljenovic, Dórea, & Shaw, 2012). This claim certainly brings up some apprehension, considering a true control would use the same vaccine, however, these findings are cited from a 2003 study so it is unknown if there are more studies that use proper controls.

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Conversely, an article written by Jeffrey S. Gerber and Paul A. Offit titled “ Vaccines and Autism: A Tale of Shifting Hypotheses”, addresses three main concerns parents and other vaccine-hesitant individuals often cite as evidence for the harm of vaccines. These concerns include; “the combination of a measles-mumps-rubella vaccine causes autism by damaging the intestinal lining, which allows the entrance of encephalopathic proteins; thimerosal, an ethylmercury-containing preservative in some vaccines, is toxic to the central nervous system; and the simultaneous administration of multiple vaccines overwhelms or weakens the immune system through a meta-analysis of data.”(Gerber & Offit, 2009). Gerber and Ofit hypothesize that previous epidemiological and biological studies fail to support such claims. The first claim refers to the infamous 1998 Wakefield study, which many think of as a catalyst for vaccine hesitancy amongst the public and initially caused a great stir in the medical community. The article quickly discredits Wakefield’s study, noting the lack of a control subject which immediately illegitimatized all causal findings of the study. When refuting controversy concerning thimerosal, the article firstly addresses the overall safety of thimerosal and refers to the American Academy of Pediatrics and the Public Health Service's recommendation to remove all mercury from vaccines as a mere “conservative precautionary directive”(Gerber & Offit, 2009). The article also acknowledges that even if there were potential detriments from thimerosal, this would be considered mercury poisoning, not autism. In regards to the number of vaccines in succession to one another the article contests that an infant's immune system can withstand multiple vaccines and even so, within the past 30 years, the number of vaccines children receive at once has decreased (Gerber & Offit, 2009). To conclude this misconception, the article insists that no actual studies have compared cases of autism in regular vaccine schedules, unvaccinated children, and alternatively vaccinated children to disprove or confirm this theory.

While the initial argument concerning the harms of thimerosal is compelling, there were no causal findings that the study brought to the table the study failed to even develop a correlational relationship between thimerosal and autism, if anything the study makes a better case against the use of thimerosal in general, not vaccines. While claims about thimerosal’s safety seem insignificant, the study did call attention to the potential flaws in studies regarding the safety of vaccines, bringing to light that controls used in these studies may not be reliable. While the study in which this evidence is cited is from 2003, this still feels fraudulent and makes one question the intentions behind this decision. In regards to the metaanalysis the information provided felt much more thorough and was explained in a more pragmatic and understandable way and actually citing studies with causal findings

Overall it's easy to assume that those opposed to vaccinations are misinformed or uneducated and while this can certainly be true when reviewing the first article it's easy to understand the fears one could have concerning ingredients such as thimerosal without a thorough investigation into its properties and role in a vaccine. However, this is no excuse for the shilling of biased and unscientific research used as fearmongering to demonize a disorder which many people live happy and fulfilling lives with.