Autism Controversy Eats At Credibility of CDC

      By Alison Young for The Atlanta Journal-Constitution
http://www.ajc.com/metro/content/metro/atlanta/stories/0406metautism.html

      The Centers for Disease Control and Prevention, rarely the subject of
public controversy, is facing an emerging credibility crisis on the
emotional issue of whether old-style vaccines containing a mercury
preservative caused autism in thousands of children.
      The agency is being accused of cover-ups and scientific manipulations
by a vocal group of autism advocates and is facing questions from some
high-profile members of Congress.
      Martin Cowen of Jonesboro is convinced that CDC-approved vaccines were
a factor in 8-year-old son Lindsey's developing autism.
      As the debate and controversy increasingly finds its way into
pediatricians' offices, average parents of healthy children are questioning
whether vaccines are safe, sometimes even refusing inoculations.
      The CDC and other public health officials insist such questions lack a
basis in fact or science. Their greatest concern is that the broadening
debate holds the potential to put a new generation of children at certain
risk of deadly diseases if confidence in the safety of vaccines is lost and
they don't receive recommended shots.
      "I think it's huge," said Dr. Julia McMillan, a member of the American
Academy of Pediatrics committee that makes vaccine recommendations. "There's
no pediatrician in practice that doesn't confront this on a weekly basis:
families who are questioning the need for - and in some cases refusing -
vaccines for their children."
      But the academy and the CDC are in agreement: They say there is no
evidence to support a connection between autism and the mercury-based
preservative thimerosal, which they stress is no longer used in most
pediatric vaccines.
      "We simply don't know what the cause of autism is," Dr. Bob Davis, the
CDC's director of immunization safety, said Wednesday.
      Nonetheless, the CDC finds itself at the center of criticism.
      A full-page ad scheduled to run in today's editions of USA Today, the
nation's largest-circulation newspaper, accuses the CDC of "causing an
epidemic of autism" by recommending that children receive a series of
vaccines that until 2001 contained thimerosal.
      The ad, placed by a group of autism advocacy groups, quotes
environmental lawyer Robert F. Kennedy Jr. as saying: "It's time for the CDC
to come clean with the American public."
      But what stings public health advocates more is a letter sent Feb. 22
by Sen. Joseph Lieberman (D-Conn.) and seven other members of Congress. The
bipartisan group asks that the CDC not take the lead on a new study
examining the vaccine-autism issue.
      "If the federal government is going to have a study whose results will
be broadly accepted, such a study cannot be led by the CDC," the group wrote
Dr. David Schwartz, new director of the National Institute of Environmental
Health Sciences. The institute, a part of the National Institutes of Health,
will convene a panel in May to discuss how to analyze a key CDC database to
determine whether autism rates have dropped since thimerosal was removed
from vaccines.
      The letter was also signed by Sen. Debbie Stabenow, (D-Mich.), Rep.
      Dave Weldon, (R-Fla.,) Rep. Chris Smith, (R-N.J.), Rep. Carolyn
Maloney, (D-N.Y.), Rep. Dan Burton, (R-Ind.), Rep. Joseph Crowley, (D-N.Y,),
and Rep. Maurice Hinchey, (D-N.Y.).
      Agency officials said Wednesday they are proud of the CDC's work on
thimerosal safety issues and that they have looked hard to find a link as
well as to find any other cause of autism.
      "It was an unfortunate choice of language," Davis said of the
Lieberman letter. "They and everyone else are certainly entitled to their
opinion. We stand by all the research we have done."
      Public health officials who work with CDC are more blunt.
      "I think it's shocking," said Dr. Martin Myers, executive director of
the National Network for Immunization Information and a professor of
pediatrics at the University of Texas medical branch in Galveston.
      "The loss of public trust in one of the most extraordinary
institutions in the world. I'm not quite sure how that has occurred, but it
has, and that's one of the unfortunate consequences," Myers said.
      The controversy, which erupted as some autism advocates rallied on
Capitol Hill today in conjunction with National Autism Month, is gaining
political traction, moving well beyond an initial core of autism activists,
CDC, public health and congressional officials all agree.
      There are many parents of autistic children who believe, as do most
pediatricians and scientists, that there is no scientific evidence that
thimerosal caused autism and other neurological disorders. That issue was
settled for most in a widely publicized 2004 report by an expert panel
convened by the National Academy of Sciences Institute of Medicine.
      But the report has been the subject of controversy and intense
scrutiny since it was published.
      Parents of many autistic children insist that thimerosal caused the
disorder, because it appeared around the time their children received
vaccinations. Their advocates also point to what they say is intriguing new
research in animal models indicating that some individuals may be more
sensitive to thimerosal than others. Martin Cowen, whose family lives in
Jonesboro, is one such parent.
      Cowen is convinced thimerosal-containing vaccines caused his son
Lindsey's autism. Lindsey, who turned 8 last week, does not speak, has not
been toilet trained and cannot be allowed outdoors without being restrained
for fear he'll run into traffic, his father said.
      Cowen is highly skeptical of the CDC, a position shared by a cohort of
parents and advocates across the country.
      "An enormous effort is being made to deny the connection," he said of
the CDC. "What do I think their motive is? They are very interested in
having the herd vaccinated... They don't think of people as people suffering
individually. It's the greatest good for the greatest number."
      The National Immunization Program, run by the CDC, coordinates
immunization activities across the country. Increasing the rate of
immunization against disease is a cornerstone of public health.
      At the same time, the CDC also is charged with monitoring vaccine
safety. It's an inherent conflict of interest, said Weldon, a doctor before
he was elected to Congress.
      "They really do have a credibility problem," said Weldon, who serves
on the committee that decides the CDC's budget. "Part of the credibility
problem is it's asking them to investigate a problem that they may have
created."
      Weldon became involved in the thimerosal issue seven years ago.
      "Honestly, at first I was very dubious," he said. "As I looked at it
more and more, I began to feel there is some validity to this."
      Weldon said the recent interest by Lieberman and others on Capitol
Hill is a sign the issue is gaining political traction. Lieberman was
unavailable for comment.
      The controversy and public debate is likely to be further fueled by
the full-page ad being paid for by a coalition of the autism activist groups
led by Generation Rescue. The ad promotes a sophisticated Web site,
www.PutChildren First.org, which includes links to CDC documents, e-mails
and transcripts the groups say support their contention of an agency
cover-up.
      CDC spokesman Glen Nowak said many of the documents on the site have
been in the public domain for years, and are presented out of context and in
ways that may "look quite ominous" - when they're not.
      "It's a very challenging issue," he said. The CDC is bracing for a
spike in calls today from parents with questions and is increasing staffing
at its public help line, 1-800-232-4636.