Friday, February 05, 2010

Vaccine-Autism Link & Professionals

The major study that ignited parent's fears that the MMR vaccine was linked to autism was retracted from the scientific literature this week. The 1998 study published in the Lancet by Wakefield and his colleagues was withdrawn from the journal.

This is a highly unusual step in the scientific publication process, but it reflects extensive review and investigation that revealed that both major ethical flaws in the data collection as well as scientific flaws in the methods.

Beford and Elliman wrote a very thoughtful editorial in the British Medical Journal on this issue highlighting the importance of educating the public. The note that health professionals were reluctant to engage in public debate on this topic. They write,
"If future debacles are to be prevented, professionals must enter the public arena, even though there can be unpleasant ramifications (both the authors of this editorial have received hate mail and an American researcher has even received death threats). However uncomfortable this may be, we must be firm advocates of what is best for children’s health, even if this seems to run contrary to 'patient choice'."
They also suggest ways that professionals can talk with parents about controversial issues stating,
"For these parents, providing clear and accurate information on the benefits and risks of the vaccine as well as the dangers of the diseases is only part of an effective approach. The nature of the communication with parents is crucial. They are more likely to respond to a professional who listens carefully and respectfully to their individual concerns, answers their questions honestly and openly, and acknowledges when information is lacking about a particular matter. With this approach, and repeated opportunities to talk, parents who at first decline immunisation may be willing to reconsider."
In short, it is not just the information that matters, but how we communicate the information. There are many important lessons to be learned from this controversy over the link between vaccines and autism. See other comments about the autism-vaccine issue.

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