Autism, Vaccines, and The Oprah Effect

Oprah Winfrey is The Media Queen. On the air for over twenty years, Oprah’s self-named syndicated talk show has roughly forty million viewers weekly. Aside from her television success, the media mogul has a steady monthly following of 2 million readers for her O magazine, has her own satellite radio channel, and an extremely popular Web site. Oprah’s personal fortune has been estimated by Forbes to be $2.7 billion – and yet her media empire is continuing to grow. Oprah recently signed a deal launching The Oprah Winfrey Network, a cable television channel that will feature Oprah-approved programming on health and living well. On May 28, CNBC aired “The Oprah Effect,” a documentary illustrating the power and influence she holds, specifically when a product or service is mentioned on her television show or in her magazine. While it is hard not to respect her as a talented and savvy TV host and businesswoman, many take issue with Oprah’s frequent promotion of a wide variety of dubious medical practices, pseudoscience, and mysticism on her show (see Newsweek ). One of Oprah's guests, Jenny McCarthy, former Playboy model and actress turned autism activist, has been promoting the vaccine-autism controversy. McCarthy's campaign drew coverage in the Fall of 2007 after she was invited by Oprah to promote her first book about "curing" autism. McCarthy insists that her son, Evan, developed autism from the measles, mumps and rubella (MMR) vaccination he received as a baby. Along with supporters of her campaign, McCarthy believes that the increase in the number of shots given to children coupled with the chemicals used to preserve vaccines have created an epidemic of autism. Furthermore, they believe that doctors, the government, the media and drug companies are hiding or ignoring the truth. Despite repeated rejection by the scientific community, the theory has generated a movement, resulted in thousands of legal claims, and has even elicited occasional harassment and threats against scientists whose research proves otherwise.

Discover Magazine's article titled "Why Does the Vaccine/Autism Controversy Live On?" explains the history of this heated debate,

"The decadelong vaccine-autism saga began in 1998, when British gastroenterologist Andrew Wakefield and his colleagues published evidence in The Lancet suggesting they had tracked down a shocking cause of autism... In a dramatic press conference, Wakefield announced the findings and sparked an instant media frenzy. For the British public, a retreat from the use of the MMR vaccine—and a rise in the incidence of measles—began. (Update 2/2010: Revisiting 'Autism, Vaccines, and The Oprah Effect')

In the United States, meanwhile, fears would soon arise concerning another means by which vaccines might induce autism. Many vaccines at the time contained thimerosal, a preservative introduced in the 1930s to make vaccines safer by preventing bacterial contamination. But thimerosal is 50 percent mercury by weight, and mercury is known to be a potent neurotoxin, at least in large doses. In 1999 new federal safety guidelines for mercury in fish stirred concerns about vaccines as well.

The U.S. government responded by ordering that thimerosal be removed from all vaccines administered to children under age 6, or reduced to trace amounts. (Some inactivated influenza vaccines were exempted.) The step was described as a “precautionary” measure. There was no proof of harm, government researchers said, just reason to worry that there might be. Meanwhile, scientists launched numerous studies to determine whether thimerosal had actually caused an autism epidemic, while some parents and their lawyers started pointing fingers and developing legal cases...

Epidemiological studies have cast grave doubt on Andrew Wakefield’s MMR hypothesis—and so have subsequent scandals. Nearly all of Wakefield’s coauthors have since retracted the autism implications of their work; The Lancet has also backed away from the study. A series of investigative stories published in The Times of London unearthed Wakefield’s undisclosed ties to vaccine litigation in the U.K. and, more recently, suggested he fabricated his data (which Wakefield denies)."

The U.S. Court of Federal Claims in Washington, D.C. ruled that vaccines do not cause autism in each of three critical test cases handed down on February 12, 2009. The court particularly denied any link between the combination of the MMR vaccine and vaccines with thimerosal and the range of disorders linked to autism.

On the Oprah show, McCarthy's theory went virtually unchallenged as Oprah lauded McCarthy for her bravery, and did not invite a physician or scientist to represent the many studies contradicting the vaccine-autism link. Oprah merely read a short statement from the Centers for Disease Control stating that there is no science to prove a connection and the problem is under continued government examination. McCarthy responded, "My science is named Evan, and he's at home. That's my science."

"That's right." David Gorski, a cancer surgeon who blogs at Respectful Insolence, a top medical blog known for its pro-vaccine stance, writes, "Science doesn't matter. Only McCarthy's poorly informed ideas formed by the misinformation she found about autism on the Internet do."

"If I had another child," McCarthy wrote on, "I would not vaccinate."

Gorski explains in his blog that parents like McCarthy "misunderstand science and expect scientists to prove that vaccines don't cause autism. Unfortunately, conclusively proving a negative is not possible in science. We can assign probability based on data, and numerous studies tell us that the chances that vaccines contribute significantly to autism is vanishingly small, but non-scientists think that it's possible to prove that vaccines don't cause autism and become suspicious when scientists qualify their statements."

Since parents started to deny their children vaccines, the spread of epidemics and newly unfettered infectious diseases has risen. Scientists at the Johns Hopkins Bloomberg School of Public Health recently found while investigating whooping cough outbreaks in and around Michigan that, "geographic pockets of vaccine exemptors pose a risk to the whole community.” Those that have been skeptical about vaccines may be forced to realize that a number of potentially deadly diseases are just a plane ride or playground away. Ironic, isn't it? Vaccine skepticism and not the vaccines themselves are now beginning to be the true public-health threat.

A year after her first appearance on the Oprah Show, McCarthy was invited back to continue to discuss and expand on her views and claims about the connection between vaccines and autism. Since then she has become a semi-regular guest on the show. In May, Oprah announced that her production company had signed Jenny McCarthy, for a talk show of her own as well as various other media projects

Oprah denied any endorsement of any of her show's guests in a statement to Newsweek,

"The guests we feature often share their first-person stories in an effort to inform the audience and put a human face on topics relevant to them. I've been saying for years that people are responsible for their actions and their own well-being. I believe my viewers understand the medical information presented on the show is just that - information - not an endorsement or prescription. Rather, my intention is for our viewers to take the information and engage in a dialogue with their medical practitioners about what may be right for them."

I think that Gorski's conclusion says it best, "The bottom line is that, whatever good Oprah may have done with her money, when it comes to medicine and science, on balance she does far more ill than good. Her intentions may be the best in the world, but that is only why she is the living embodiment of the the belief that feelings trump science, and as such she has no mental filter of critical thinking to keep out pseudoscience and quackery. Couple that with her great influence and power, and the result is the Oprah-fication of the popular discourse about medicine in the media... Indeed, Oprah is one of the most potent forces in American for the undermining of critical thinking and science-based medicine in existence."

Read Andrew Wakefield's 1998 Paper:

WAKEFIELD, A., MURCH, S., ANTHONY, A., LINNELL, J., CASSON, D., MALIK, M., BERELOWITZ, M., DHILLON, A., THOMSON, M., & HARVEY, P. (1998). Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children The Lancet, 351 (9103), 637-641 DOI: 10.1016/S0140-6736(97)11096-0