From time to time at Nobel Intent we cover science topics that can be, well, fractious. Evolution is one, climate change another. Some people take offense at dark matter. But the one that consistently draws the biggest mailbag would be vaccinations and autism. To refresh your memories, a doctor in the UK, Andrew Wakefield, hit the headlines a few years back with reports that the MMR vaccine was responsible for causing autism in some patients. This was seized upon by a sensationalist press, with the result that measles, mumps and rubella are becoming serious problems in some affluent areas of the US and UK.

It later turned out that Dr. Wakefield was in the pockets of a group of lawyers who were suing vaccine manufacturers. Wakefield began receiving money from these lawyers two years prior to publishing his findings, and his publication was subsequently retracted by the journal.

Lawsuits against vaccine makers aren't particularly new. In the US, the phenomenon was common enough in the 1970s and 1980s that pharmaceutical companies simply left the market, prompting the passage of the National Childhood Vaccine Injury Act, which provided compensation for children that were harmed as a result of vaccination.

This Vaccine Injury Compensation Program (VCIP) was in the news recently, following a successful lawsuit by the parents of Hannah Poling, a young girl who was diagnosed with a mitochondrial deficiency that caused neurological symptoms consistent with some of those present in autism spectrum disorders. The current New England Journal of Medicine features a perspective on the case and, for a normally staid and reserved publication, it's quite fiery.

The author, Dr Paul Offit, gives voice to the thoughts of many in the medical community over this decision, namely that it was thoroughly flawed, and that the VCIP has been somewhat less than scientific in its decisions, not just in the Hannah Poling case, but several others, unrelated to autism.

Despite absolutely no scientific evidence to support the claims that vaccination causes autism, this meme keeps propagating, and has even made appearances on the Presidential campaign trail. In the meantime, scientists and medical professionals will have to redouble their efforts to more effectively communicate with the greater public.

NEJM, 2008. 358:2089-2091