The Vaccine-Autism Link: Causation, or a Corrupt Correlation?

Public health is worsening, autism rates are rising — and so are incident conspiracy theories, including claims that the root of the autism evil is vaccines. As the CDC reopens the vaccine-link debate bolstered by misinformation and false logic that correlation equals causation, it’s time to ask whether that claimed correlation even exists or if society is dissolving into a political hallucination.
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The word “epidemic” is both a headline-grabber and a cognitive paralytic: Hear the word, panic, and stop thinking. Having survived the COVID-19 pandemic, we are now drowning in an epidemic of epidemics: measles, chronic disease, obesity, and autism, to name but some. The increased prevalence of autism (the so-called epidemic) engenders the conviction that it must be caused by vaccines. The basis – presumably, correlation. But what if that correlation is a mirage?

“[S]omething is causing higher autism levels across the U.S., possibly including vaccinations.” 

President Donald Trump 

Overrun with a tsunami of epidemics, you’d never guess the American life expectancy increased from 60 in 1911, when the “autism” diagnosis was first introduced, to roughly 77 today. But not to fear. The CDC is expanding its almost half-billion-dollar effort to investigate causes of autism, focusing on a claimed causal link with vaccination prompted by President Trump’s observation of autism’s skyrocketing prevalence [1] as championed by HHS Secretary Kennedy. By September, the Secretary has  pledged to learn “what caused the autism epidemic…and we will be able to eliminate those exposures.” 

Vaccine proponents argue that the CDC’s new initiative is merely relitigating a flawed assertion (the nexus between vaccines and autism) that has long been debunked, inviting parents to avoid vaccinating while we rehash settled science. However, the increasing prevalence is indeed troubling and may justify a fresh look by arguably unbiased researchers. But, to justify the research and avoid wasteful efforts and diversionary tactics, the claimed correlative “facts” must exist.   Spoiler alert: they don’t.

What is Autism?

Autism is a social communication and interaction disorder characterized by difficulties in conversation, maintaining eye contact, facial expressiveness, and interpreting expressions in others. It includes a repetitive element or restricted patterns of behavior, often involving hyperintense focus, insistence on unvarying routines, and increased or decreased sensitivity to environmental or sensory stimuli. It is considered a spectrum disorder with varying levels of deficit. Intellectual impairment is not diagnostic of the condition, and when found, it is viewed as a co-morbidity.

Before “autism” was conjured as a separate disease in 1911, people with the condition were often diagnosed as schizophrenic; indeed, “autism” literally means “selfism.” Those who also manifested an intellectual disability were likely diagnosed as “retarded” and those with high intellectual functioning, like Nobel Scientist Paul Dirac and theoretical chemist Henry Cavendish (who discovered hydrogen), were just considered “weird .”Indeed, many geniuses manifesting bizarre behaviors consistent with ASD [autism spectrum disorder], like philosopher Derreck Parfit (who ironically conceived the “Non-Identity Problem”), have wondered if they were “on the spectrum.” [2] These people were always there- just without a disease label. 

2000 - The Year the World Almost Ended

A graph with a line and a number of children</p>
<p>AI-generated content may be incorrect.The increasing prevalence of autism cannot be disputed, growing markedly and steadily since the late 1980s, surging around 2000 when the prevalence was 1 in 150, increasing to 1 in 59 in 2014, and rising still further thereafter, with today’s statistics registering a prevalence of 1 in 31.

Perhaps not coincidentally, the diagnostic surge around 2000 coincided with the propaganda campaign of de-licensed doctor Andrew Wakefield. Wakefield debuted on the conspiracy scene in 1998 when he published an article in the British medical journal Lancet, falsely linking childhood vaccines and autism.  In 2000, that claim made its way to the US, when Wakefield testified before a US congressional committee. His research was subsequently rejected and finally totally debunked as the sordid episodes of his ethical lapses and financial conflicts of interest emerged.

For these and other infractions, including his alleged plans to market his own vaccine [3], Wakefield was struck off the British Medical Register in 2010.  But it still took twelve years before the Lancet retracted the article. 

The delayed retraction portended tremendous damage, including an uptick in autism diagnoses, parallelling epidemic upsurges. The 2017 measles epidemic in Minnesota’s Somali community was in no small measure fomented by Wakefield, who repeatedly proselytized to the community, leading to an approximately 45% reduction in vaccination while simultaneously increasing autism diagnoses.  (Correlation? What correlation?)  

“To our [Somali] community, Andrew Wakefield is Nelson Mandela and Jesus Christ wrapped up in one.” 

- J. B. Handley, co-founder of Generation Rescue, as reported by the NY Times

Avoiding the Social Stigma of Intellectual Deficits

While reviled today, it is hard to believe that less than a decade ago, Wakefield was heralded as a savior. Indeed, it might be said that Wakefield single-handedly inflated autism rates, as he brought the diagnosis to the attention of parents looking to explain why their cute and rambunctious toddler suddenly turned taciturn, troublesome, withdrawn, and unsociable – especially if this occurred shortly after vaccination (the age of vaccination and diagnosis being contemporaneous).

When the child is intellectually challenged, which occurs in over a third of children with autism, the autism diagnosis provides a more socially acceptable explanation than what once was labeled “mental retardation .”In my experience, for this same socially expedient reason, parents embarrassed by children who are intellectually impaired but not autistic often misappropriate an autism diagnosis for their child. This self-protective practice also allows them to blame the vaccine for their child’s condition (which they couldn’t do if the child didn’t carry the autism label). It also artificially inflates rates. 

 When Parents Demand the Diagnosis

Another explanation for the increased prevalence mirrors the greater education benefits allocated for autistic children. For this reason, parents often lobby for the diagnosis, even if it may not be warranted. 

CDC Keeps Changing the Diagnostic Criteria

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<p>AI-generated content may be incorrect.The increasing prevalence is, at least in part, attributable to the broader/looser definition evolving over time.   The first CDC-amended diagnostic criteria came in 1987, and by dint of a simple definitional change – there were more cases, coincidentally” synchronous with the beginning of rising autism rates. The definition was broadened yet again in 1994 and 2000. Not surprisingly, we saw still more cases. While cases seemed to plateau over the next decade, the diagnostic criteria were again changed in 2013, resulting in, wait for it, more cases. 

In 2022, some word-smithing changes were incorporated, and while not changing the criteria, the more nuanced wording gave greater flexibility to physicians making the diagnosis. Diagnoses increased in tandem.

 Confounding at Play:

Typically, causal relationships shoAutism rate among children U.S. 2022| Statistauld hold constant when stratifying by race, sex, income, or other ostensibly extraneous factors like domicile of diagnosis. Yet,  with autism, gross variations track these categories, signaling that perhaps confounding is at play. Indeed, boys are 3.4 times more likely to be autistic than girls (although this trend is rapidly changing), and prevalence is generally lower in white children and highest in Native Americans, with Black, Hispanic, and multiracial close behind. And poor children are more likely to be diagnosed with autism than wealthier ones. These findings cannot be reconciled if vaccination is the causal trigger

Correlation – What Correlation? 

We have been vaccinating for over a hundred years before the first autism diagnosis. The first Americans were vaccinated circa 1800 (for smallpox). By the early 1900s, most states had introduced a pre-school vaccine requirement. In 1977, a concerted vaccine initiative was undertaken. 

“By 1980, vaccination levels r[o]se among US children going to school for the first time. Vaccination levels[went]…  up to 96% for measles, rubella, and diphtheria-tetanus-pertussis (DTP), 96% for polio, and 92% for mumps.”

Yet, the early 1980s saw the lowest rates of autism, at .1 to. 4  per 1000.

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<p>AI-generated content may be incorrect.

While 1980 boasted high vaccination rates in children, autism didn’t spike until at least a decade later. And by 2019, when autism began its sharpest spike, vaccine coverage had sharply declined. As vaccine coverage began descending, autism continued to rise.  Correlation? Plainly, there isn’t any.MMR vaccination coverage in the U.S. before and after the COVID-19  pandemic: A modelling study | medRxiv

So, if it’s not the vaccines causing the autism epidemic, what is? 

The autism 'epidemic' may be real, but the vaccine connection isn’t. Manufacturing an artificial correlation to divert attention from social issues and other causes responsible for the uptick trespasses on two scientific no-nos: Correlation is not causation, while it is a seductive allure that diverts attention from finding the real culprit. That’s bad enough. But when bogus correlations are conjured and mined for political reasons, we are guilty of rank deception. It’s time we stop scapegoating shots—and start asking the right questions.

 

[1] Prevalence is the number of people in a population with a condition relative to the total population.

[2] Among famous people considered to be autistic are Charles Darwin, Barbara McClintock, Isaac Newton, Michelangelo, Bobby Fisher, and Nicola Tesla. 

[3] detailed by Brian Deer in  “The Doctor Who Fooled the World”

 

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