A Broken Trust: Lessons from the Vaccine–Autism Wars

PLoS Biology, Public Library of Science, San Francisco, California, United States of America.
PLoS Biology (Impact Factor: 9.34). 06/2009; 7(5):e1000114. DOI: 10.1371/journal.pbio.1000114
Source: PubMed


Researchers long ago rejected the theory that vaccines cause autism, yet many parents don't believe them. Can scientists bridge the gap between evidence and doubt?

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Available from: Liza Gross,
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    • "In some European countries and in the USA, childhood immunisation is mandatory yet MMR vaccine refusal has increased, similarly leading to measles outbreaks [6,7]. Repeated assertions by the Department of Health for England and Wales and the U.S Centers for Disease Control and Prevention that the MMR vaccine is safe have had limited effect on allaying parents' concerns in some sections of the community [8-10]. More than ten years after the publication of Andrew Wakefield's now discredited findings [11], there is some evidence that parent trust in MMR has improved [12], yet significant numbers continue to lack confidence in making an MMR decision [9,13-19] and many criticise what is perceived to be the poor quality of information provided [9,17]. "
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    ABSTRACT: In the UK public concern about the safety of the combined measles, mumps and rubella [MMR] vaccine continues to impact on MMR coverage. Whilst the sharp decline in uptake has begun to level out, first and second dose uptake rates remain short of that required for population immunity. Furthermore, international research consistently shows that some parents lack confidence in making a decision about MMR vaccination for their children. Together, this work suggests that effective interventions are required to support parents to make informed decisions about MMR. This trial assessed the impact of a parent-centred, multi-component intervention (balanced information, group discussion, coaching exercise) on informed parental decision-making for MMR. This was a two arm, cluster randomised trial. One hundred and forty two UK parents of children eligible for MMR vaccination were recruited from six primary healthcare centres and six childcare organisations. The intervention arm received an MMR information leaflet and participated in the intervention (parent meeting). The control arm received the leaflet only. The primary outcome was decisional conflict. Secondary outcomes were actual and intended MMR choice, knowledge, attitude, concern and necessity beliefs about MMR and anxiety. Decisional conflict decreased for both arms to a level where an 'effective' MMR decision could be made one-week (effect estimate = -0.54, p < 0.001) and three-months (effect estimate = -0.60, p < 0.001) post-intervention. There was no significant difference between arms (effect estimate = 0.07, p = 0.215). Heightened decisional conflict was evident for parents making the MMR decision for their first child (effect estimate = -0.25, p = 0.003), who were concerned (effect estimate = 0.07, p < 0.001), had less positive attitudes (effect estimate = -0.20, p < 0.001) yet stronger intentions (effect estimate = 0.09, p = 0.006). Significantly more parents in the intervention arm reported vaccinating their child (93% versus 73%, p = 0.04). Whilst both the leaflet and the parent meeting reduced parents' decisional conflict, the parent meeting appeared to enable parents to act upon their decision leading to vaccination uptake.
    BMC Public Health 06/2011; 11(1):475. DOI:10.1186/1471-2458-11-475 · 2.26 Impact Factor
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    • "The results from these studies discredit the association of these illnesses with vaccination [18,46-48]. It is also important to note that amidst much media frenzy, the initial research article that suggested a link between vaccination and autism was retracted from The Lancet for numerous reasons ranging from unethical research practices, conflicts of interest undeclared by the authors, and questionable scientific methodology [49-51]. (Note that the lead author at the centre of this controversy, Dr. Wakefield, recently lost his license to practice medicine in the United Kingdom [52]). "
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    ABSTRACT: Despite over a century of clinical use and a well-documented record of efficacy and safety, a growing minority in society questions the validity of vaccination and fear that this common public health intervention is the root-cause of severe health problems. This article questions whether growing public anti-vaccine sentiments might have the potential to spill-over into other therapies distinct from vaccination, namely allergen-immunotherapy. Allergen-immunotherapy shares certain medical vernacular with vaccination (e.g., allergy shots, allergy vaccines), and thus may become "guilty by association" due to these similarities. Indeed, this article demonstrates that anti-vaccine websites have begun unduly discrediting this allergy treatment regimen. Following an explanation of the anti-vaccine movement, the article aims to provide guidance on how clinicians can respond to patient fears towards allergen-immunotherapy in the clinical setting. This guide focuses on the provision of reliable information to patients in order to dispel misconceived associations between vaccination and allergen-immunotherapy, and the discussion of the risks and benefits of both therapies in order to assist patients in making autonomous decisions about their choice of allergy treatment.
    Allergy Asthma and Clinical Immunology 09/2010; 6(1):26. DOI:10.1186/1710-1492-6-26 · 2.03 Impact Factor
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    ABSTRACT: The future of nanotechnology rests upon approaches to making new, useful nanomaterials and testing them in complex systems. Currently, the advance from discovery to application is constrained in nanomaterials relative to a mature market, as seen in molecular and bulk matter. To reap the benefits of nanotechnology, improvements in characterization are needed to increase throughput as creativity outpaces our ability to confirm results. The considerations of research, commerce, and regulation are part of a larger feedback loop that illustrates a mutual need for rapid, easy, and standardized characterization of a large property matrix. Now, we have an opportunity and a need to strike a new balance that drives higher quality research, simplifies commercial exploitation, and allows reasoned regulatory approaches.
    ACS Nano 09/2009; 3(9):2441-6. DOI:10.1021/nn901112p · 12.88 Impact Factor
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