Review: Autism's False Prophets by Paul Offit, MD

Autism's False Prophets:Bad Science, Risky Medicine and the Search for the Cure by Paul Offit, MD, is a page-turner. It's well written, suspenseful and loaded with interesting characters. It's also a sharp-edged condemnation of a large group of parents, journalists, researchers and activists — many of whom are absolutely certain that Offit's conclusions are dead wrong.

Offit starts his book with the words, "I get a lot of hate mail." This is an understatement. Offit has become a lightning rod for an entire community of people who believe unwaveringly in a connection between autism and vaccines. Offit claims to have received death threats and threats against his children, and based upon the response to blogs and reviews of his book, I am sure he's telling the truth.

Offit then goes on to explain his personal interest in vaccines and outlines his career as he became a major player in the field of immunology. Over the years, Offit has become the Chief of Infectious Diseases and the director of the Vaccine Education Center at the Children's Hospital of Philadelphia, one of the top children's hospitals in the United States. He's also the co-inventor of the rotavirus vaccine.

Offit's book explores the process by which, today, the autism/vaccine controversy has become such a major issue. He sets the stage by describing how mothers and physicians worked together to create treatments which, under scientific scrutiny, appear to have little or no real efficacy.

He starts off with the story of how secretin, a hormone, became one of the first "miracle cures" for autism and was later debunked as a treatment (though it is still touted by some as having real benefits). He goes on to describe the rise and fall of another autism treatment, facilitated communication (FC), which purported to provide nonverbal autistics with a voice. Facilitated communication, too, was debunked: tests made it clear that the facilitators, and not the autistic subjects, were actually typing out responses to questions. Nevertheless, FC remains a treatment of interest to many families.

Next, the book turns to the compelling story of Andrew Wakefield, a British doctor whose gastrointestinal research led to the theory that the mumps/measles/rubella vaccination (MMR) was at least partially behind a huge increase in autism diagnoses. Wakefield, who is now practicing in Austin, TX, was the subject of a television drama and became a heroic figure to many. Offit points out all of Wakefield's supposed errors and questionable tactics, but it's important to note that Wakefield remains a major figure in the autism world.

At the end of the chapter entitled "The Implosion," Offit states: "Karoly Horvath (secretin) and Andrew Wakefield (MMR vaccine) had proven to be false prophets in the quest to find a cause and a cure for autism. In the next few years, parents would turn their attention to another vaccine component, and yet another group of unlikely heroes."

In fact, while Offit suggests that secretin and MMR are no longer under debate, they are both still very much in the public eye.

In succeeding chapters, Offit writes at length about how thimerosal (a mercury-based preservative in vaccines) became the focus of public anxiety. Then he explains why he believes the public preoccupation is misinformed. At the end of the section, he makes clear his certainty that any real concerns about a mercury/autism connection have been put to rest.

Of course, there are many who agree on this point - and many who disagree. Those who disagree are vocal in their opinion, and are not shy about making their perspective known.

During the course of these chapters, Offit describes and rebuts the work of a great many people who were — and are — actively involved in the autism world. Congressman Dan Burton, journalist David Kirby, researcher Boyd Halsey and others are all discussed at length, and in the long run, are represented as flat-out wrong in their ideas and recommendations.