I was just starting out in pediatrics in 1998 when Andrew Wakefield published the study that would haunt my entire career in primary care. The article in The Lancet claimed that the measles, mumps, and rubella (MMR) vaccine caused autism. The methodological flaws were readily apparent to followers of medical research: among many issues, the study involved only 12 children and was correlative—it didn’t prove causation. In short order, several larger and better conducted studies definitively countered Wakefield’s claim. Yet I spent the first ten years in primary care pediatrics discussing Wakefield’s misinformation with nearly every family before the MMR vaccine was given at a child’s 12-month visit. Painstakingly, I reviewed the issues with Wakefield’s work that were obvious to doctors—even at the time—and presented my patients with the steady accumulation of data that failed to find any association between MMR and autism.
Then, something historic and definitive happened. Next month marks the 15-year anniversary of what should have ended Wakefield’s false claim: In February 2010, The Lancet formally retracted his paper in the face of proof that the data had been manipulated. Wakefield’s research was found to be fraudulent and conducted with money from lawyers suing vaccine manufacturers; he was stripped of his medical license. I saw the welcome effects of this news in my practice too. Gradually, parents’ questions about MMR and autism became fewer and farther between. When asked, I was quick to cite abundant studies debunking the link between MMR and autism and to remind families that Wakefield and his paper had been discredited and retracted.
And now, it feels like we’re back where we started—as if this destructive myth had not been stripped of any legitimacy exactly a decade and a half ago. With the nomination of Robert F. Kennedy Jr. as President Trump’s choice for Secretary of the Department of Health and Human Services (HHS), the myth of vaccines causing autism is roaring back. This time, there seems to be no regard for scientific truth; the myth is advanced at the highest levels of the federal government and amplified by social media’s echo chamber.
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In his confirmation hearing on Jan. 30, when pressed repeatedly by both Republican and Democratic senators, Kennedy still would not acknowledge that studies show that vaccines do not cause autism. The completely discredited Wakefield study even reared its head again. “The journal retracted the study,” said Democratic Senator Maggie Hassan, when discussing the origins of the false myth of a vaccine-autism link. Hasan then accurately summarized Kennedy’s vaccine record: “relitigating and rehashing and continuing to sow doubt so we can’t move forward.”
Kennedy has made a career of ignoring that scientific evidence, which has already had real-world consequences. Kennedy’s 2019 visit to Samoa fanned the flames of vaccine hesitancy and reportedly contributed to the tragic deaths of 83 people, mostly children, in a measles outbreak. An HHS Secretary who prioritizes mythology over science—and fear over fact—will have disastrous consequences for the vaccine program in the U.S. It is the stuff of pediatricians’ nightmares.
In a way, I understand the appeal of looking for a scapegoat—even one that has been thoroughly examined and refuted. Myths like these persist because we want to understand why things like autism happen, and nowhere is the drive to understand more strongly felt than among parents. Which is the best car seat, the right age to start solid foods, or the proper sleep schedule? Parents, newly entrusted with safeguarding a human life, will do anything to protect their children.
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Yet, at some point in the first year of a child’s life, each parent (often in the middle of the night) must face the heartbreaking realization that they cannot protect their child from everything. This is the fundamental insecurity of parenthood: you can do everything right—read every book, cook all organic food, choose every playdate—and still have a child develop an illness or condition. It’s completely terrifying.
The myth of vaccines and autism taps right into this vulnerable population of parents struggling with the limitations of love’s protection. By claiming to explain the origin of autism, it offers parents the (false) hope that they can prevent autism simply by refusing a vaccine. In the absence of medicine’s ability to definitively identify autism’s causes, the myth’s certainty will tempt some people. Kennedy and his co-conspirators feed off this idea: even the wrong explanation is better than no explanation. Myths occupy the void created by the unknown.
But pediatricians, like parents, will also do anything to protect children. Our most effective tool to prevent serious illness is the safe and effective vaccine program. Vaccines have completely eradicated smallpox. Diseases like polio and diphtheria, once major causes of childhood death and injury, have vanished in the U.S due to vaccines. And in the last 50 years, the measles vaccine alone has saved more than 90 million lives worldwide: the equivalent of 3 to 4 lives per minute.
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As I often remind parents, there is nothing we can do as parents or pediatricians that provides the same tangible advantage as vaccination. How often as a parent are you offered the opportunity to protect your child from a deadly disease? No diet, school, schedule, or enrichment activity has the power or magnitude of vaccines’ benefits. The greatest gift I can offer patients—and one of the greatest gifts a parent can give their child—is a complete set of childhood immunizations.
This is not to say that parents, pediatricians, and scientists should not ask questions about the efficacy and safety of vaccines. We should: questioning and looking for proof is the basis of the scientific method. But after we ask the questions, we must listen to the answers that the evidence provides.
We do not yet fully understand the origin of autism. We can say, with certainty, the MMR vaccine is not the cause. But we’ve been able to say this for decades. The recent resurgence of this myth should not distract from the scientific proof that has solidified in the last 25 years.
Influential people are once again twisting the truth about vaccines for their own gain—and everybody else’s loss. Pediatricians must continue to counter this myth with science, evidence, and facts.
