April 7, 2000

After Disputes, House Panel Asks for Study of a Vaccine

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    WASHINGTON, April 6 -- After a long and contentious hearing, Republican and Democratic leaders of the House Government Reform and Oversight Committee, who agreed on little else, agreed today to ask the Department of Health and Human Services to study whether vaccination caused a small number of cases of autism.

    The agreement came after arguments among witnesses and sparring between leaders of the committee, which held the hearing. The hearing was called by its chairman, Representative Dan Burton, an Indiana Republican whose granddaughter has autism. He said she may have contracted it from a vaccine even though current research has not found any connection between the onset of autism and a vaccine for measles, mumps and rubella.

    Representative Henry A. Waxman of California, the ranking Democrat on the committee, prodded witnesses and complained to Mr. Burton that the hearing was unfairly stacked to show a connection between vaccination and autism. While getting the science right is important, Mr. Waxman said, getting parents to mistrust vaccines would certainly lead to deaths from diseases that generally have been contained.

    Mainstream medical organizations and leaders in the field of immunization agree that there is no convincing evidence for the theory that the vaccine, MMR, for measles, mumps and rubella, causes autism, a brain disorder characterized by an inability to socialize and a tendency to engage in constantly repeated actions or comments.

    The leading proponent of the idea that MMR vaccine may cause some cases of autism is Dr. Andrew Wakefield of the Royal Free and University College Medical School in London. He said he took his cue from parents whose experience of autism seemed to be different from the usual. In most cases, the disease is believed to be genetic; it appears gradually in the first two years of life as a failure to speak, the beginning of repetitive motions, and a withdrawal from social interaction. But the parents with whom Dr. Wakefield dealt said it came on rather suddenly, over a period of months, and often just after vaccination with the triple vaccine.

    The signature symptoms, he said, are bowel pain, inflammation and erratic bowel habits, in children who also begin to show the usual mental symptoms of autism. Dr. Wakefield has published studies on a dozen such cases, and will soon publish reports on another 60 cases.

    On the opposite side, apart from the skepticism of most of the medical community, is Dr. Brent Taylor, a senior colleague of Dr. Wakefield's at the same London medical school.

    Dr. Taylor has done the largest study to date on the subject, involving 498 autistic children in London. He found no relation between the children's vaccination dates and the onset of their disease.

    But Mr. Burton said: "We owe it to our children and grandchildren to insure we're being diligent in looking for causes of autism. We can't stick our heads in the sand and ignore the possibility."

    Among the parents who testified, and who became teary-eyed along with most of the people in the packed hearing room, was Shelly Reynolds of Baton Rouge, La. She said her son Liam was a normal, bubbly child who would sing nursery tunes. But within days of his vaccination, she said, he lost his ability to speak and interact.

    She told the committee, "Parents like me are relying on you to demand that the pharmaceutical companies retrace their steps once again, and the public health community look at the possibility that these things might not be a coincidence."

    Complicating the whole question, and making it more urgent at the same time, is the dramatic rise in the reporting of autism in several countries, including the United States. In the 1960's, it was variously estimated that there were 1 to 4 cases of autism for every 10,000 children. By the 1990's, the numbers had increased more than fourfold, to 12 per 10,000 children in England and up to fivefold in some studies in the United States.

    It is unclear, however, whether the increase is the result of more publicity about autism, which has become much better known in recent years, especially after the 1988 film "Rain Man," with the actor Dustin Hoffman starring as an autistic man. After listening to exchanges of scientific details for two hours, Mr. Waxman read the language of a proposed letter to the Secretary of Health and Human Services, asking for an impartial study of the question. Mr. Burton agreed to co-sign it, but added that he would continue to hold further hearings until better answers were forthcoming.

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