Evidence of Harm. Mercury in Vaccines and the Autism Epidemic: Medical Controversy

When Andrew Wakefield, the former Royal Free Hospital researcher who launched the scare about a link between the measles, mumps, and rubella (MMR) vaccine and autism in Britain, claimed that he had learnt everything he knew about autism from parents, this sounded merely disingenuous. In David Kirby's case, unfortunately, it appears to be true: he seems to take at face value every claim made by campaigning parents in the United States who believe that vaccines containing the mercury based preservative thiomersal caused their children to become autistic.

Figure 1.

David Kirby

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But parents may not be reliable guides. Kirby faithfully records one mother's account of how she brought her son from the United States to see Dr Wakefield at the Royal Free Hospital, which she described as an “old stone building, soot-coloured and depressing,” located “on Grays Inn Road in central London,” a site abandoned by the Royal Free some 30 years ago for a modernist tower block in Hampstead. Further descriptions of “halls filled with the cries of suffering children and the biting smell of rubbing alcohol” suggest skills in creative writing rather than scientific reporting.

Kirby echoes the conviction of parents who believe that vaccines are to blame for an “epidemic of autism.” He endorses their dismissal of the consensus among autism specialists that the most likely explanation for the increasing number of cases is the greater recognition of the condition among parents and professionals and the expansion of diagnostic categories. In response to the numerous epidemiological studies in different countries that have failed to confirm any link between vaccines and autism, Kirby reports the increasingly forlorn attempts of campaigners to discredit these studies and their authors. Disillusioned with epidemiology, campaigners have turned to biochemistry; and Kirby follows them into the laboratories of a handful of researchers, some funded by parent led campaigns, who claim to have shown evidence of a link between vaccines and autism. This evidence was systematically examined—and rejected—by the authoritative US Institute of Medicine last year.

Kirby also endorses campaigners' assertions that the symptoms of mercury toxicity are similar to those of autism. But the clinical features of these conditions are quite distinct. Mercury poisoning causes ataxia and dysarthria, visual field disturbances, and peripheral neuropathy. In mild cases it produces a non-specific anxiety and depression; in more severe cases, a toxic psychosis can result. None of these features is characteristic of autism.

The antivaccine campaigns have... diverted scarce reserves of energy and research funds into the pursuit of implausible hypotheses

In his determination to provide an account that is sympathetic to the parents Kirby enters into the grip of the same delusion and ends up in the same angry and paranoid universe into which campaigners have descended, alleging phone taps and other forms of surveillance as they struggle against sinister conspiracies between health authorities and drug companies. Yet, through his laboriously detailed account he inadvertently exposes the combination of junk scientists, opportunist politicians, and ambulance chasing lawyers who have jumped on the antivaccine bandwagon (the parallels between the anti-mercury and the anti-MMR campaigns are striking).

The first casualties of the antivaccine campaigns are the parent activists. Just as the anti-MMR litigation has collapsed in Britain, enriching lawyers and expert witnesses but leaving hundreds of parents with nothing but betrayed hopes, so attempts to claim damages alleged to result from mercury-containing vaccines in the United States are destined to fail, for the simple reason that the claims have no scientific basis. But, as Kirby also reports, the same parents are pursuing a range of esoteric investigations and treatments for their children, including chelation therapy to eliminate mercury, injections of vitamin B-12, and various dietary exclusions and supplements. These costly treatments are often provided by doctors involved in the anti-mercury campaign. Yet, for all the extravagant claims, neither the efficacy nor the safety of these techniques has been confirmed. Although Kirby reports that one family involved in the campaign has spent more than $500 000 (£260 000; €380 000) on such treatments, he appears oblivious to the dangers to vulnerable parents of quacks and charlatans peddling miracle cures.

The antivaccine campaigns have also been damaging to the wider cause of families affected by autism. They have diverted scarce reserves of energy and research funds into the pursuit of implausible hypotheses. Worse, they have fostered unwarranted guilt among parents over giving their children vaccines and equally unwarranted animosity against immunisation authorities and vaccine manufacturers. Kirby quotes a rare critical commentary on the anti-mercury campaign in a US newspaper: it complained that the campaign had stirred up a “hornets' nest of moral intimidation,” with “threats and harassment” and “attempts to silence” those with crucial roles in public health and scientific research. Perhaps worst of all, the declining uptake of childhood vaccinations resulting from the fears promoted by these campaigns may lead to the return of real epidemics of diseases, causing death and disability.

The only value of this woefully one sided account of the mercury and autism controversy is the insight it offers into the way that credulous journalists have contributed to the public nuisance and private distress caused by antivaccine campaigns.