Vaccine-Autism Debate Moves to Small Screen

American Academy of Pediatrics worry TV show on autism could harm children.


Jan. 31, 2008 — -- For Dr. Peter Hotez, who has a 15-year-old autistic daughter, life is a daily struggle— from getting her dressed to finding a child psychiatrist to help the family deal with her need for rigidity and routine.

As a parent, Hotez wants a cure and better treatments for this unrelenting disorder that strikes nearly 150 in 1,000 American children.

But as a doctor who is constantly being asked by parents whether autism is caused by childhood vaccines, he worries that "unfounded science" could stand in the way of real research to help his daughter.

"Television is powerful and can create enough buzz to keep people concerned," Hotez told "But the overwhelming evidence is that the cause is genetic."

Hotez, a vaccine researcher at the George Washington University, is concerned about a fictional television show that taps into a belief by anti-vaccine groups that autism may be caused by mercury used in flu vaccines.

Today, ABC will premiere "Eli Stone," a legal show it calls a "drama-dy with fantastical elements." In the first story line, a jury awards the mother of an autistic child $5.2 million in damages after it is revealed that the CEO of a vaccine maker kept his daughter from getting the company's mercury-based vaccine.

Major health authorities, including the U.S. Centers for Disease Control and Prevention, the Food and Drug Administration, the Institute of Medicine and the World Health Organization, have all studied and rejected possible links between autism and vaccines.

Doctors say giving credence to that link would lead to a decline in immunization rates and could result in the deaths of hundreds of children. Last year, 74 children died of influenza and more than 300 have died in the last four years, according to the CDC.

At the heart of the debate is whether television shows created purely for entertainment can have a negative impact on public health.

"The claims of anti-vaccine groups fly in the face of overwhelming scientific evidence," said Hotez. "It's like religious fanaticism believing that mercury causes autism, and it's very frustrating for me because it distracts away from our genetic research efforts and services for our kids."

Autism, a wide spectrum of neurological disorders, affects 1.5 million adults and children at a cost of $35 billion annually, according to the Autism Society of America.

This week, the American Academy of Pediatrics fired off a letter to network executives urging them to cancel the show. ABC refused, but agreed to air a disclaimer and a link to the CDC's autism site.

The show's producers say it is "even-handed" and presents both sides. They say they never intended to suggest that children should not be vaccinated and argue that viewers do not look to fiction for medical information.

"ABC has not responded formally to us by letter, e-mail or phone call," said Dr. Rene Jenkins, president of the American Academy of Pediatrics. "We are very disappointed about that."

Jenkins said of the disclaimer, "The network is taking commendable efforts," but "we are still concerned."

The level of concern prompted the pediatrics organization to take the unusual step of releasing — several days early — a study that it said further discredits the dangers of mercury in vaccines.

In the study, University of Rochester researchers tested babies from Argentina, where mercury is still used in childhood vaccines. They found that the type of mercury used in the vaccines, which is biologically different from mercury in thermometers or pollutants that affect fish, clears very quickly from the infants' bodies.

The researchers say this offers further proof of the safety of flu vaccines, as they believe the mercury levels do not have time to build up between shots.

Disney's television group provided hundreds of copies of angry letters from groups such as the American Medical Association to the first lady of Mexico. One family wrote that their child had died of the flu because she wasn't vaccinated; another mother who had lost a son to meningitis urged ABC to cancel the show.

The network also received letters of suport. One letter from a mother of a "recovered" autistic child thanked them for "standing in the middle of the controversy and standing up against conventional medical practices, beliefs and rigid conventions that is designed to protect the pharmaceutical industry and a steady stream of continued income," wrote Edith McMillan, a family nurse practitioner.

"Eli Stone" stars Jonny Lee Miller as an ambitious lawyer who transcends greed after an aneurysm leads him to hear music and believe he is a prophet.

In the vein of other whimsical shows like "Ally McBeal" and "Boston Legal," singer George Michael dances and sings on a coffee table in a guest appearance as one of Stone's musical hallucinations.

Co-producer Greg Berlanti said he has "great respect" for the pediatrics group, but doubted the public would make medical decisions "based on a show about a guy hallucinating in his bedroom with George Michael."

Since the controversy, the show's producers have been "besieged with phone calls and e-mails from parents of children with autism in support of the show," he said.

"It was never the intent of the show, which is about so many other things, for anyone to take away that children shouldn't be vaccinated. It's not the message of the show."

The producers acknowledged that their research included talking to "scores of parents" with autistic children. "They were pleased that we portrayed the mother as smart and intelligent and not a crazy person," said Berlanti.

The show explores more than just the autism story line, including a custody battle involving a soldier returning from Iraq, a case of homosexual chimps being separated at a zoo and baseball players and steroid use.

But the American Medical Association says in a letter to ABC that giving credence to unfounded science is "no false fear."

In 2003 in Britain, media coverage on an "erroneous report" linking the measles vaccine to autism sparked a drop in immunization rates, resulting in multiple deaths and hospitalizations of children who had not been immunized, according to the medical group.

A 2004 report from the Institute of Medicine titled, "Immunization Safety Review: Vaccines and Autism" found no evidence of a link between vaccines and autism.

Marie C. McCormick, a pediatrician and professor at Harvard Medical School, served on the committee that wrote the review that rejected the connection between the mercury-based preservative used in flu vaccines and autism.

"If you go on blogs and the Web, there are a lot of anti-vaccine sites," said McCormick. "They continue to tout data that is showing an association, even if it is flawed. People don't know what is correct and [the belief in a link] is being continually reinvigorated."

The ingredient in flu vaccines that worries parent groups is thimerosal, a mercury-based preservative developed in the 1930s that helped prevent deep infections from immunization, according to McCormick.

By 2002, thimerosal was phased out of all childhood vaccines, except the one for flu, "as a precautionary measure," she said.

As the aunt of two autistic children, McCormick understands the frustration parents feel, but, she said, immunization is essential in combating infectious diseases, which are "only one plane ride away."

"Eli Stone" co-producer Marc Guggenheim says the producers don't oppose vaccinations. "Both my daughters have been vaccinated," he said.

"I think there's a huge difference between informing people about an issue and taking a stand and convincing people to take action," Guggenheim said.

Media critics say they, too, are wary of medical groups trying to steer fictional story lines.

"Anyone who uses the national storytelling medium of all time — television — should do it with a sense of responsibility and care," said Robert Thompson, professor of media and popular culture at Syracuse University. "But I don't want the [medical group] AMA telling people telling us what kind of stories to tell."

Thompson debunks doctors' arguments that viewers believe what they see on television. "If you watched soap operas you would believe that 50 percent of people get amnesia at one point," he said.

Mark Crispin Miller, professor of media, culture and communication at New York University, disagrees. Just because viewers know they are watching fiction doesn't mean that they don't get "confirmation for certain assumptions," he said.

"Regardless of the genre, television is a very topical medium," said Miller. Watching a recent episode of "Law and Order" that dealt with terrorism, "I certainly knew this was not a documentary, but I also found the drama to be credible and pertinent."

Propaganda, he reminds, "often comes disguised as narrative."

Meanwhile, Rachel Hotez spends 80 percent of her day out of school as her father seeks special services to help treat the complex symptoms of autism.

"Unlike an acute illness that resolves, this never goes away and we revisit the same problems day in and day out," her father said. "It really is demoralizing."

"The problem is they are trying to portray parents of autistic children as the next 'Erin Brockovich,' fighting the industry to own up to vaccines that cause autism," said Hotez. "It's high drama, but it's not factual. It takes away from the focus and time we have to really study the issue."

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