I’ve written about controversial debates like vaccines and autism long enough to know when to expect emotional reactions and what they mean. Along with finding and reporting the best version of the truth available, reacting to critics and re-evaluating how you do what you do is part of the journalist’s job description. Among the things I do: I consider e-mails from critics and readers private and not-for-publication, and I refrain from engaging them in long debates.
I do consider issues raised by critics and my responses fodder for publication, however. And in recent weeks I have written more than once that one of the closest truths I have found on this subject is a July 2008 CBS News interview with former National Institutes of Health (NIH) Director Dr. Bernadine Healy.
In an interview with correspondent Sharyl Attkisson, Healy, who was appointed to head the NIH in 1991 by President George H.W. Bush, was passionate and tactful and minced few words. When Attkisson pointed out that public health officials say the science proves vaccines do not cause autism, for example, Healy replied:
“I think you can’t say that,” instantly buttressing her position, “You can’t say that.”
Healy's concern revolved around evidence that there are subgroups of children who are susceptible to developing autism in response to vaccines, vaccine ingredients or the vaccination schedule. Those in charge of protecting public health have not only the tools to identify them, she said, they have moral and ethical obligations to do so.
“This is the time when we do have the opportunity to understand whether or not there are susceptible children,” she said at the interview’s beginning, “perhaps genetically, perhaps they have a metabolic issue, a mitochondrial disorder, an immunological issue that makes them more susceptible to vaccines.“
When Attkisson asked if government and public health officials have “turned their back” on children who might be predisposed to vaccine-induced autism, Healy said yes. They have ignored parents whose children regressed into autism following vaccinations and refused to honestly study the issue.
“I think government, or certain public health officials in the government, have been too quick to dismiss the concerns of these families without studying the population that got sick,” she said. “I haven’t seen major studies that focus on 300 kids who got autistic symptoms within a period of a few weeks of a vaccine.”
Healy, the current health editor and columnist for U.S. News & World Report, cited a 2004 report from the Institute of Medicine (IoM), of which she is a member, as proof the government has turned its back on potentially vulnerable kids.
“It basically said, ‘Do not pursue susceptibility groups; don’t look for those patients, those children, who may be vulnerable,’” she said. “I really take issue with that conclusion.”
Healy found the public health establishment’s lack of interest in identifying vulnerable subgroups shocking. “If you know that susceptible group, you can save the those children,” she said. “If you turn your back on the notion that there is a susceptible group, that means you are, what can I say?”
The Harvard- and Johns Hopkins-educated physician and cardiologist took particular umbrage with the IoM’s rationale for not pursuing the hypothesis that some kids are vulnerable to vaccine-induced autism. The report, Healy said, expressed explicit concern that such lines of scientific inquiry could damage public health by scaring people.
"I haven’t seen major studies that focus on 300 kids who got autistic symptoms within a period of a few weeks of a vaccine."
“I don’t believe the truth ever scares people,” she said. “And if it does have an edge to it, then it’s the obligation of those who are delivering those facts to do it in a responsible way so you don’t terrify the public.”
Citizens, she insisted, are smarter than the IoM report gives them credit for. They understand the risks from polio, measles, rubella, diphtheria and other preventable diseases. And the job of the public health community and physicians is to ensure that the vaccines against them are delivered as safely as possible.
If susceptibility groups, particular risk factors or a safer vaccine schedule were discovered, citizens would not lose faith in vaccines. “I think the public would respect that,” she said.
More important, the former professor of medicine at Johns Hopkins and dean of the Ohio State University College of Medicine and Public Health said, is the issue of scientific integrity. “I don’t think you should ever turn your back on any scientific hypothesis because you’re afraid of what it might show,” Healy insisted.
"I don’t believe the truth ever scares people."
And she criticized the type of science that has been produced on the vaccine-autism connection, specifically population-based, epidemiological studies that have found no connections between vaccines and autism.
“Populations do not test causality; they test associations,” she said. “You have to go into the laboratory, and you have to do designed, research studies, on animals.”
Healy said her position on vaccines and autism has evolved. “When I first heard that there was a link between autism and vaccines, I thought, ‘Well, that’s silly,’” she said. “Really. I tended to dismiss it just on a superficial kind of reading.”
But as she delved into it, her opinion changed.
“If you look at the basic science,” she said, “if you look at the research that has been done on animals, if you also look at some of these individual cases, and if you look at the evidence that there is no link, what I come away with is: The question has not been answered.”