Vaccination has greatly diminished death, illness and suffering in the world. But no other medical technology has been so dogged with controversy. The book chronicles the development of the key lifesaving vaccines since the 18th century. It tells the stories of great scientists and their discoveries, of the protests and pain along the stumbling path of progress. This is the first book to tell the whole story of vaccination for a general audience. In light of controversies about flu vaccine and autism, it will be of particular interest to parents, pediatricians, public health workers and anyone fascinated by medical history. Read More>>

Also Available: Table of Contents and Index

Arthur Allen is a Washington DC-based journalist who has written on vaccine issues in The New York Times Magazine, the Washington Post Magazine, The New Republic, Atlantic Monthly, Salon and Slate.

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Painful home videos in the autism/vaccines trial

The government began its defense against the vaccines-cause-autism theory on Monday with expert testimony that Michelle Cedillo was showing symptoms of autism well before she got a measles vaccine. Using some of the same videos that the court had viewed during the testimony of Cedillo’s mom, Dr. Eric Fombonne pointed out behaviors in baby Michelle that he said were evidence of developmental delays.

Teresa Cedillo had presented the videos to show that the girl was normal before she got the MMR shot in December 1995, when she was 16 months old. But Fombonne, director of child psychiaty at McGill University in Montreal, asserted that her failure to respond to parental promptings, and her hand flapping, mouthing, and single-minded obsession with a Sesame Street video—all of these occurring when she was as young as 8 months old--were early warning signs of autism.

During her testimony, Mrs. Cedillo had testified that the video became a singular object of fascination to her daughter only after she got the MMR shot, suffered ten days of intermittent high fever, and went into decline.

As odd as it seemed for the court to be arguing about Sesame Street, Michelle’s response to the video was striking. As it was being put on, she would tense and flap her hands and legs, growl and stare fixedly at the screen.

“I have no doubt in my mind when I see that child that she is very abnormal and shows clear signs of global developmental delay and clear autistic type behavior,”  Fombonne testified. “It’s common that parents, especially first-time parents don’t pick up such abnormalities. And they should not blame themselves for that.  But with hindsight you do see these very clear patterns.”

Cedillo’s lawyers pointed out in cross-examination that not all autistic children show precisely the same symptoms as infants. As a parent of neurotypical children, I was able to detect some of the abnormalities that Fombonne pointed out. Other behaviors seemed like the kind of weird things that any baby might do.

But Fombonne also demonstrated that Cedillo had an abnormally large head circumference during her first year of life, a warning sign of autism. Her pediatrician’s chart showed delayed speech and motor control, which might be indicative of autism or mental retardation. He disputed that Cedillo had lost language after the shot, saying there was little evidence of much language before she received it. Fombonne acknowledged that Cedillo’s pediatrician had not noted any concerns about communication or behavioral issues until three months after the MMR shot.

Asked what she thought of Fombonne’s testimony, Teresa Cedillo shrugged and said that he was doing his job.

Introducing Fombonne and 11 other witnesses, the Department of Justice lawyer leading the government’s case dismissed last week’s testimony on the grounds that it lacked a plausible theory of harm. The lawyer, Vince Matanoski, noted that Marcel Kinsbourne, the final Cedillo witness and the one who was supposed to wrap up her case, scarcely mentioned thimerosal at all, and stated that if there was no measles virus present in her gut, he would have to withdraw his theory of MMR-induced autism.

Biological plausibility, Matanoski argued, “is not a daisy chain of 50 percent possibilities.” In a snipe at the credentials of some of Cedillo’s witnesses, Matanoski noted that his panel would include scientists who were “based in hospitals, not courtrooms.”

Earlier in his testimony, Fombonne described the varieties of autism, the first time the court had heard a careful explanation of the disorder. He noted that autism had probably existed for centuries despite the fact that it was only Leo Kanner, in 1943, who gave it a name.  Then too, Fombonne said, “onset” of autism is not when a parent first notices it. He compared it to cancer—a process that may be going on for weeks or months before it is detected.

Citing the literature with considerable mastery that was reflected in the paltry cross-examination (which focused on his paid legal consultation with the pharmaceutical industry since 2004), Fombonne stressed the clear genetic contribution to autism and the fact that in 90 percent of all cases, no clear cause is known. The few known environmental contributors have occurred in the first trimester of the mother’s pregnancy, he noted—for example rubella infection or thalidomide.

By 16 months of age a normal child would comfortably use 40 words, Fombonne stated, yet Michelle used only 10, and mostly in imitation, according to the records from a later neurological examination of the girl. She was also unable to sit without support until 11 months. Six months is the usual milestone.

Most poignant, perhaps, was video shown of the girl’s one-year birthday. Presented with a large wrapped box, Michelle leans on it with little interest, and does not respond to her mother and grandmother when they tell her to open it. The box slides away, and Michelle falls. She is straightened up and placed in front of the box again, facing the camera. But though she touches it, her grandmother eventually opens the present.

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Comments

MarkH

Sounds like post hoc ergo propter hoc problems - not surprising or uncommon in such instances.

_Arhur

Remember, baby Michelle is the Petitioner's test case, the one they chosen amongst 5000, the one on which they have the best scientific evidence.

The one that is supposed to be representative of a significant portion of the 5000 others.

Leila

Her development was extremely delayed. First smiles at 6 months? They should start at 2. Not sitting before 10 months, not walking independently at 17 months? Come on. How come her pediatrician didn't express any concern?

I think the videos and records are definite evidence that Cedillo was born autistic. If the vaccine caused other health problems for her, then it's another discussion, but I don't think the Petitioners have been able to present a strong case at all. Their experts were weak, in accute contrast with the respondent's, who are top-notch cientists in the field of autism.

_Arhur

Dr. Ward on Day 8 of hearings, readily admitted: "there's every reason to believe that the fever with onset seven days after the vaccination is associated with measles" on the basis of the temporal association.

Had the Cedillos sought relief at the Vaccines Court on that basis, they likely have obtained it. The fund is set up for the very purpose of indemnifying the cases of adverse reactions to vaccines.

Instead, they are the test case for a complex "scientific" theory, very speculative, that both the thimerosal and the attenuated rubeola virus in different vaccines combined to create both of Michelle's health troubles, the gastro-intestinal one, and her autism condition.

By doing so on the basis of flawed research, the Petitioners are hurting their own cause.

al

Honestly I think both sides are to blame. There is more than likely a subset of the population that are prone to adverse reactions due to genetic susceptibility. Anyone with half a brain knows that vaccines aren't safe for EVERYONE and there are things that can be done better such as allergy screening.
FACT: Vaccines Don't cause autism in healthy people...they are
Fact: Vaccines have the potential to cause harm in those who are susceptible... there are people who can't tolerate consituents of the vaccines.
We don't know if vaccines cause problems with Th2 immunity, it has never been tested
we don't know if vaccines cause changes in gene expression...it has never been tested.
Far anyone to say they are safe beyond a shadow of a doubt has no knowledge of current science, genetics, epigenetics, or neuroimmunology.
Those on both side of this debate have truly hurt the issue at hand. If vaccines do have anything to do Autism,they are only a part of the problem and the the damage is being done from vaccine #1 at 2 months old, not a magic reaction at shortly after MMR.
Secondly...Eric fombonne is after nothing but the spotlight because he does not publish research about ANY of the other Vaccines being safe only MMR. He preaches that early intervention is key yet puts people on an 18 month waiting list to get a diagnosis at his montreal clinic.

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