If you’ve read my previous posts Dr. Bernadine Healy, you know I have some pretty serious concerns about how she represented the way the Institute of Medicine operated when they produced their report on Vaccines and Autism. Those statements were made in interviews with Sharyl Attkisson. Again, if you’ve been reading, you realize that Ms. Attkisson’s methods were a cause of concern for me as well. I have voiced these concerns with CBS news via fax.
Dr. Healy made some pretty bold assertions, and Ms. Attkisson failed to even attempt to follow up on them.
The prime example is when Dr. Healy proposed that
…“There is a completely expressed concern that they don’t want to pursue a hypothesis because that hypothesis could be damaging to the public health community at large by scaring people. “First of all,” Healy said, “I think the public’s smarter than that. The public values vaccines. But more importantly, I don’t think you should ever turn your back on any scientific hypothesis because you’re afraid of what it might show.”
I’ve noted before, that a statement of that magnitude, calling into question the very methods and motives of the IOM deserved followup by Ms. Attkisson. When someone makes a claim that an organization we all depend on to be independent and unbiased may have acted improperly, and unbiased reporter should make sure of the facts by checking with the real source before going ahead with the story.
Well, bloggers sometimes do the work that reporters fail to do. In this case, AutismLibrary asked the IOM for comment on some of the way the IOM and its process in handling the 2004 Vaccines and Autism report have been portrayed. Below (with permission) is the response that AutismLibrary received and blogged:
Thank you for your recent and very thoughtful message. As you know, the IOM’s Immunization Safety Review Committee most certainly did not suggest that scientific inquiry into the role of vaccines in autism should cease because the results could affect public perception of the value of childhood vaccinations. The public deserves better than that.
The committee’s 2004 report, Vaccines and Autism, states:
Determining causality with population-based methods such as epidemiological analyses requires either a well-defined at-risk population or a large effect in the general population. Absent biomarkers, well-defined risk factors, or large effect sizes, the committee cannot rule out, based on the epidemiological evidence, the possibility that vaccines contribute to autism in some small subset or very unusual circumstances. However, there is currently no evidence to support this hypothesis either.
After a paragraph in which the report follows that sentence with a discussion of the sparse literature regarding subsets of autism and the theoretical possibility of a vaccine-susceptible subpopulation, the report states:
While the committee strongly supports targeted research that focuses on better understanding the disease of autism, from a public health perspective the committee does not consider a significant investment in studies of the theoretical vaccine-autism connection to be useful at this time. The nature of the debate about vaccine safety now includes a theory that genetic susceptibility makes vaccinations risky for some people, which calls into question the appropriateness of a public health, or universal, vaccination strategy. However the benefits of vaccination are proven and the hypothesis of susceptible populations is presently speculative. Using an unsubstantiated hypothesis to question the safety of vaccination and the ethical behavior of those governmental agencies and scientists who advocate for vaccination could lead to widespread rejection of vaccines and inevitable increases in incidence of serious infectious diseases like measles, whooping cough, and Hib bacterial meningitis.
The committee urges that research on autism focus more broadly on the disorder’s causes and treatments for it. Thus, the committee recommends a public health response that fully supports an array of vaccine safety activities. In addition the committee recommends that available funding for autism research be channeled to the most promising areas.
Some readers have apparently failed to appreciate the full meaning and intent of the committee’s carefully written text. The report, as supported by the above-quoted paragraphs, clearly acknowledges the possibility that new information in support of hypotheses about susceptible subpopulations could emerge, at which time significant new research efforts might be appropriate. Whether the recent information about mitochondrial dysfunction will be the foundation for a major new research direction remains to be seen. The committee’s comment on the untoward consequences of discouraging vaccination was offered as an elaboration of their concerns about the unsubstantiated vaccine-autism hypothesis and not as support for their recommendations about an appropriate research agenda for understanding autism.
The scientists and clinicians on this committee evaluated the then-available scientific data in an unbiased manner. They reached their conclusions based on where the evidence led them. This principle—making recommendations only if supported by the evidence—guides all studies that IOM undertakes. I reiterate that the committee most certainly did not urge caution about pursuing the vaccine-autism connection in order to avoid frightening the public away from immunizations. The IOM stands ready to re-examine this issue should sufficient and relevant evidence emerge.
I almost put the entire last paragraph in bold for emphasis. Instead I’ll pull two lines out:
I reiterate that the committee most certainly did not urge caution about pursuing the vaccine-autism connection in order to avoid frightening the public away from immunizations
The IOM stands ready to re-examine this issue should sufficient and relevant evidence emerge
I read this as: there were no “completely expressed concerns” that affected the IOM’s study and that although they recommended rejecting the vaccine/autism hypotheses (thimerosal and MMR), they haven’t “turned their backs” on the subject. Should good research come forward (as with any subject in science) they will look again.
I do have one simple question: Shouldn’t Sharyl Attkisson approached the IOM for comment before going forward with this story?