The Autism-MMR scandal is the greatest scientific fraud in recent history. Last year the British Medical Journal revealed how Andrew Wakefield secretly worked for a lawyer to build a case to sue the makers of the MMR vaccine. Wakefield falsified a now retracted Lancet report on twelve children that he proposed suffered from autism as result of the MMR vaccine. Three of the children weren’t even ever diagnosed with autism and all of the children were recruited through an anti-MMR campaign funded by anti-MMR litigation. In essence the finding was to be predicted through simple statistics, autism is relatively common and all children are supposed to be vaccinated, so it shouldn’t be difficult to find twelve children with autism that were vaccinated.

The link is a classic case of illusory correlation, there is an increase in autism diagnosis that vaguely coincides with the introduction of the MMR vaccine. You could equally say that the increase in autism is a result of the introduction of the Euro, satellites or tetris. There is obviously no evidence for any of these claims but if you single out enough cases then some people will be convinced. The risk of illusory correlation is real now more than ever with the recent CDC report that 1 in 88 children (1 in 54 boys) have autism. According to the US National Institute of Mental Health (emphasis mine):

“The increase reported by the CDC might mean we are better at detecting children who meet criteria for ASD, but potentially we still are only halfway to the actual prevalence in the general population… Total population epidemiological studies suggest much or all of the increase is due to better and wider detection.” US NIMH

Worryingly however the US NIMH report goes on to state:

“Studies of administrative and services data suggest that better detection cannot fully explain the profound and continuing increase… Our working assumption is that there are both more children affected and more detected.”

This brings us back to the table regarding possible factors contributing to the possible rise in autism but we are certainly not to back to square one. There is possibly a real increase in autism prevalence, there is still however no evidence that the MMR jab is responsible. I repeat, there is no evidence that the MMR jab is responsible. Just to clarify, twenty separate studies have demonstrated that there is no evidence for a link between vaccines and autism. There is no evidence to the contrary, not a sausage.

Thus far the impact of the misinformation has been mostly limited to Britain, however recently Donald Trump has for some reason taken it upon himself to misinform millions of Americans that vaccines are causing autism:

Trump has of course provided no evidence for his crackpot claims. Concerned followers typing “MMR Autism” in to Google would be likely to click on one of the top results..

Given the demographics that follow a pompous media courting fat-cat like Trump, it seems likely that many of the millions that will have read Trump’s tweets will skip over the BBC and Wikipedia links and land on the Daily Mail’s coverage or worse on to a serious anti-vaxxer crackpot’s site. This risk is heightened by the effect of Google filter bubbles which lead delusional paranoid types to delusional paranoid websites all too keen to profit from their stupidity.

The Daily Mail does not actually cite any published research, as Ben Goldacre has reported, the “research” was in fact “a poster presentation, at a conference yet to occur, on research not yet completed, by a man with a well-documented track record of announcing research that never subsequently appears in an academic journal”. The Daily Mail remains the world’s most popular and most search engine optimised on-line news source. Trump’s claims have also been paroted by the Daily Mail’s US equivalent Fox News, the “most trusted” news source in America (that thud was the sound of my head hitting my desk) and quack heaven Natural News who line their story with “alternative” cures for everything from swine flu to aging to sell to the suckers who are unfortunate enough to land there.

It would be all too easy for us to say that those who listen to the likes of Trump, Fox, the Daily Mail and the quack brigade over the scientific evidence are liable to suffer through natural selection but there are two reasons we should avoid this stance. Firstly, the victims are children whose parents are being led astray. Secondly, the anti-vaxxers threaten the herd immunity of the whole of our species, causing infection, death and preventing eradication of disease.

The MMR scandal resulted in such a downfall in vaccine uptake that it directly led to a mumps epidemic and a measles endemic in the UK. It’s difficult to calculate the impact of Trump’s ramblings on global health. Trump has over a million followers, many of whom appear to be spreading his message with the added platform of Fox News. If over coming years we see US epidemics of diseases that are now well contained we will know who to blame.

Update: Yesterday a Media Matters study found that in 2011 ABC, CBS, NBC & FOX spent twice as much time covering Donald Trump as they spent on climate change.

References:

Deer B (2011). How the case against the MMR vaccine was fixed. BMJ (Clinical research ed.), 342 PMID: 21209059 (PDF)

Chen W, Landau S, Sham P, & Fombonne E (2004). No evidence for links between autism, MMR and measles virus. Psychological medicine, 34 (3), 543-53 PMID: 15259839

http://www.nimh.nih.gov/about/director/2012/autism-prevalence-more-affected-or-more-detected.shtml

http://www.who.int/vaccine_safety/topics/mmr/mmr_autism/en/

http://www.niaid.nih.gov/topics/pages/communityimmunity.aspx

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