Ignoring the Experts: Autism and Vaccinations

By necessity, engineers are experts in their professional field compared to the public at large.  And as we've discussed many times before, expertise confers both privileges and responsibilities.  Most of the time, engineers and other experts who inform the general public about questions of interest find that the public at least listens to them, and usually takes what they say seriously.  But not always.  And when expert advice and information is ignored, we have to go beyond strict logic and rational thought and deal with a wider range of human behavior.

All that is to preface an issue that on the surface, seems to fly in the face of logic and even common sense:  the question of whether autism is caused by the routine measles-mumps-rubella (MMR) vaccine that, until recently, was a non-controversial part of every baby's medical care in industrialized countries. 

Then in 1998, one Dr. Andrew Wakefield published an article claiming that he'd found a link between the unexplained rise in incidence of autism and something about the MMR vaccine, possibly the tiny amount of mercury present in it used as a preservative. 

To parents of autistic children searching for a reason why their son or daughter has such a debilitating disease, Dr. Wakefield seemed like a godsend.  Here at last was something to blame.  At the time, his report made huge headlines and spawned parents' groups who took up the cause of delaying or abstaining altogether from MMR vaccines. 

Trouble was, according to the vast majority of medical experts, Dr. Wakefield's paper was deeply flawed.  Of course, other labs and researchers got onto the bandwagon and started investigating the alleged link.  From what I have read and from a recent report in the Annals of Internal Medicine on a Danish study of over 600,000 children for eleven years, there is no statistical link between MMR vaccine and autism.  None.  It just doesn't happen, according to the best and most judicious scientific knowledge we have today.  And this is not new news.  In 2010, Wakefield was found by the British General Medical Council to be guilty of dishonesty in connection with his paper, which was retracted by Lancet, the journal that published it.  Wakefield is as discredited as a professional can get. 

But none of this seems to matter to a persistent group of people who keep sharing and encouraging the idea that vaccines cause autism.  In the latest attempt to stifle this misinformation, the president of the American Academy of Pediatrics, Dr. Kyle Yasuda, wrote letters to Google, Facebook, and Pinterest, asking them to do more about the vaccine misinformation that is spread through YouTube, Instagram, and Google's search engine. 

Dr. Yasuda cites the danger of increased measles outbreaks, such as the one that occurred in connection with Disneyland in the winter of 2014-2015.  Over a hundred cases were identified in this outbreak, and four out of five of the victims were either unvaccinated or could not show proof that they had been vaccinated for measles.  One out of five of the victims had to be hospitalized.

While in my long-ago youth, measles was just part of growing up, it wasn't a necessary rite of passage.  It can lead to complications involving many bodily systems and can even kill you.  A world without measles is unquestionably a better world than one with the disease.  And until Dr. Wakefield started meddling with his fraudulent paper, we were well on the way to eradicating measles much as smallpox has been eradicated—through systematic vaccinations and the hunting down of outbreaks with treatment, isolation, and more vaccinations.

But something has changed in the way U. S. society (and societies in many other Western countries) view experts and their opinions.  Maybe it started in the general 1960s rebellion against authority.  Granted, the 1950s were a little too conformist for many peoples' taste.  But most of what everybody knows is known by authority.  If we all had to learn our physics, chemistry, and mathematics from experience, most of us would never finish and we would be continually reinventing the wheel.  In case you hadn't noticed, one of the big differences between what G. K. Chesterton called "civilization versus savagery" is that civilization accumulates knowledge (and sometimes even wisdom), thus saving succeeding generations from the trouble and expense of figuring the world out all over again. 

With the advent of the Internet, this process became much easier.  Instead of shipping piles of paper around, we ship bits, which are much lighter.  So light, in fact, that any yahoo with a computer and Internet connection can set himself up as an authority and, once he finds the key phrases that trigger fears or anxieties enough to get his message to go viral, he can get more attention than those who have dedicated their lives to the pursuit of expertise and truly know what they are talking about. 

I am sure that some of the parents of autistic children are entirely sincere in their belief that autism is caused by vaccinations.  But sincerity of belief on the part of individuals makes absolutely no difference to objective truth, which is true for everybody all the time.  That's what objective truth means.  Part of the problem is that for many people in advanced countries, the worst thing that's happened to them is not that bad compared to routine life occurrences that were common fifty or a hundred years ago.  I am old enough to recall the fear that every summer brought when a few kids in town would come down with polio.  That was banished with the polio vaccine, at least in the U. S.  But people who grow up protected by things that ward off terrible diseases, sometimes do not appreciate what the protection is doing for them, and are liable to throw it away if persuaded that along with the great but invisible good it does, the protection (e. g. MMR vaccines) is even suspected of doing some harm—especially if it is mysterious harm such as having a baby born with autism.

Engineers tend to think that logic reigns supreme, and if you just explain a thing to someone and make them see the logic in it, they'll automatically agree with you.  The ongoing controversy about autism and vaccines shows that this assumption is a bad one.  And wise engineers should be prepared to deal with the emotionality and, yes, even irrationality, of the public whenever their activities get into controversial areas.

Sources:  An online version of the article "New study finds no autism, vaccine link" by Nicole Villalpando of the Austin American-Statesman appeared on Mar. 5, 2019 at https://www.austin360.com/entertainmentlife/20190305/doctors-urge-tech-companies-to-stop-misinformation-as-new-study-finds-no-autism-vaccine-link.  I also referred to the CDC summary of the California measles outbreak at https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6406a5.htm and the Wikipedia article on Dr. Andrew Wakefield.