April 7, 2000
After Disputes, House Panel Asks for Study of a Vaccine
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By PHILIP J. HILTS
ASHINGTON, 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.
