The Dilemma Parents Face
"The [Wakefield] study did a lot of harm when it was originally published," says Singer. "As a result of it, I split the vaccine for my second daughter, but a lot of people went farther, not vaccinating at all, and that's unfortunate, because what we know about vaccines is that they save lives."
Still, it's more common today for parents to know a child with autism and than to know anyone who suffered or even died from one of the diseases vaccines prevent. For them, avoiding anything that they feel might lead to autism can seem safer than choosing to get a vaccine for diseases that seem unlikely. Notable figures like actress Jenny McCarthy, who believes her son's autism may have been caused by vaccines, also help lend credibility to the idea that there is a link between the two.
"The reason these diseases are so rare is because of immunizations," says Gary L. Freed, director of General Pediatrics at the University of Michigan School of Medicine. "I took care of a child who died of measles encephalitis because he was not vaccinated. It was a horrible death that was needless and preventable, and those parents never forgave themselves for not vaccinating their child."
"Choosing not to get a vaccine or to delay vaccines is not a risk-free choice," agrees Offit . A new report from the Centers for Disease Control and Prevention (CDC) concludes that 2008's measles outbreak in San Diego -- the largest in almost a decade, triggered by an unvaccinated child who'd traveled to Europe -- struck people who had purposely not been vaccinated against the disease. "You don't have to live in the developing world to get measles," says Offit. "It's all boiling just under the surface. Drop your guard and these diseases come back with a vengeance."
Making a Good Choice
Amy Pisani, the executive director of Every Child By Two, an organization that advocates for childhood immunization, understands the hesitancy some parents feel when they enter their pediatrician's office. "I was pregnant at the time Wakefield came out, and I was nervous myself. I would listen to these presentations and worry, because it really sounded legitimate, and it was confusing. But I was really fortunate, because I worked at Every Child By Two, and I had access to all these experts at the CDC and the American Academy of Pediatrics (AAP) to help me make a good choice."
Pisani's organization, originally founded to train nurses and help low-income parents learn about the free vaccination program run by the government, now spends 70% of its time addressing parental safety concerns about vaccines and the importance of timely vaccinations. The organization has launched a website (vaccinateyourbaby.org) dedicated to getting the research in the hands of parents, so, like Pisani, they can get the most medically sound information available before making a decision. "It's a parent's responsibility to be concerned for their child," says Freed, "and we as a society have a responsibility to make sure there is factual information available to parents."
Nora Fitzpatrick, mother to two in Gaithersburg, Maryland, whose younger daughter was diagnosed with autism at the age of two, says the retraction of the Wakefield study has helped her to better answer her friends' questions about whether to vaccinate. "I feel a responsibility to be informed because we get asked so often," says Fitzpatrick. "When the retraction came out, I was super excited. Now I explain that the Wakefield study is how it all got started, and how it's been retracted. It's a huge relief that it's sort of definitive now."
Singer agrees. "We were right to do the studies, we were right to look at the link. But now those studies have been done, and the data is very clear. We looked, and the answer wasn't there." Still, Singer and Offit agree that until there is an answer, people will still ask questions about vaccines. "We're never going to be rid of the vaccine hypothesis completely," says Singer, "until we know what does cause autism, that's why it's so important for more research to be done." Stay tuned.