The Autistic Journalist

Using words to explain the mind

Posts Tagged ‘medicine

West coast no refuge for unvaccinated

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Last year, I explored a Frontline documentary on vaccinations, and the traveling crew visited a Washington city to hear from parents who opted out of vaccinations. The Seattle Times via the Associated Press published a spiritual follow-up that studies Washington kindergartners from the 2009-10 school year, and discovered that six percent of students were missing at least one vaccine that is required in virtually all other states. The most commonly skipped vaccine was chicken pox (a vaccine that could have saved me an inconvenience, I carry scars from my bout as a child).

The number of school children fully vaccinated has steadily declined in Washington since 1997. A state law enacted in July is aiming to close a loophole that allowed parents to avoid providing proof of vaccination at schools. Accordingly, diseases prevented by vaccines are also increasing, with over 600 cases of whooping cough reported in Washington last year, more than double the 2009 rate. Nothing has changed about the concerns of vaccines, with apprehensive individuals pointing to data from the National Vaccine Injury compensation showing an estimated $2 billion has been paid out in cases claiming problems associated with vaccines. Scientists counter that it’s hard to prove cause and effect with the millions of vaccinated individuals with no long-term health problems, but doubt remains with some parents arguing doctors can’t prove vaccinations didn’t influence an autism diagnosis.

The article is simply the latest chapter in the vaccine debate I’ve explored heavily on this blog, but the Washington saga underscores the shift in people not fully vaccinated from the economically disadvantaged to well-educated parents who do their own research, which isn’t necessarily conclusive or even unbiased. The Frontline episode, “The Vaccine War,” explained how celebrities and other notable names can drive beliefs even without scientific backing, with Jenny McCarthy’s views on autism making headlines a few years ago (her book details how she “rescued” her son from the disorder). Worth repeating, vaccines are so effective at stopping previously perilous diseases that many of them have resurfaced only recently as a result of decreasing immunization rates. Parents have more time to be “nit-picky,” which means more opportunities to develop emotionally charged theories that carry little scientific weight. However, with feelings and emotions usually a stronger bond in the human psyche than facts and figures, concerns about vaccine safety will likely continue to remain difficult, if not impossible, to immunize.

Gauging the tipping point is difficult to ascertain with regard to time and intervention, as Washington’s state law now requires parents to meet with medical providers and provide proof a consultation took place. I doubt anyone in the scientific community is wishing for an outbreak to convince doubters with potential implications to the public’s health and media coverage, but general reporting on the vaccine controversy is growing to a tired cycle of studies disproving a link and worried parents whose beliefs can interfere with knowledge. I’ll continue to analyze the relation given its prevalence in mainstream media, but a fresh avenue could be traveled by examining attempts to reach out to critics beyond rehashing the benefits to reporters seeking to fill space or time in the news circuit.

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In face of ridicule, Wakefield fights for his theory

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Photo by Shaun Curry, Getty Images

The start to the 2011 calendar year was rocky for Andrew Wakefield, whose study was declared false by British journalist Brian Deer, who published several stories in the British Medical Journal highlighting Wakefield’s alleged false claims and unethical practices. Deer compared Wakefield, who lost his medical license after his study linking M.M.R. vaccines to autism was retracted last year from the medical journal Lancet, to a religious leader who occasionally uses the smoke and mirrors technique to goose the faith of his followers.

Deer’s investigation was one of many facets spilled out in an article by Susan Dominus for The New York Times Magazine, a longhand form of the country’s most recognizable newspaper. As with any form of magazine writing, the stories take on the form of novels and are more descriptive, too descriptive for me to summarize in shorthand form. That’s no reason to turn away though, as Dominus provides an insight on Wakefield no American reporter has offered before. Through her journey interviewing and shadowing Wakefield, we learn that Wakefield himself didn’t claim proof that M.M.R. vaccines were causing autism, but that didn’t stop his concerns from spreading worldwide the same way viruses spread through the body until its defense mechanisms can suppress it. If recent media coverage is any indication, Wakefield became one of the most reviled doctors of his generation, receiving blame for starting a panic that led to the resurgence of diseases long squashed by vaccinations.

Despite the wave of damning evidence which has led him to close himself professionally, he still draws followers, as 250 attended a discussion he conducted regarding his work. His supporters view him a hero when nearly everyone else paints him as a villain. Wakefield himself believes public health officials and pharmaceutical companies pay bloggers to post vicious material about him. Throughout the story, Dominus compliments Wakefield’s persuasive skills, even when the audience knows better. Wakefield continues to fight and promote his theory, with Dominus adding that the more he has sacrificed (he resigned from London’s Royal Free Hospital following his publicized concerns and now lives in Austin, Texas), the more he must believe in his theory, or all efforts will be rendered useless. Ironically, medical experts suggest aggressive studying of the M.M.R. vaccine following Wakefield’s 1998 media splash means the vaccine is one factor than can be ruled out in a disability still shrouded by mystery.

Dominus assures the readers that she isn’t necessarily siding in Wakefield’s camp, but she does give him an opportunity to present his case as other reporters who interview Wakefield quickly write him off as a discredited liar. By not falling into the dramatic trap that can detract storytelling from other outlets, readers of this story see why Wakefield continues his battle for reputation with his supporters waiting in the wings to back him up. We even learn a few personal anecdotes about his life before gaining his notorious status in Great Britain and most of the United States.

In order to obtain the behaviors, characteristics and traits Dominus lists regarding Wakefield, interviewing goes well beyond the simple press conference or brief one-on-one interview. Traveling with the source and immersing in the source’s comfort zone is common, and more relationship skills are needed to ensure you get the story requested in your assignment. In the case of Wakefield, encountering Dominus and her approach may have been more comforting since she offered a value other reporters decided to box away, even though she was no less neutral than shorthand writers covering the Wakefield saga. Ultimately, Dominus reveals the basis of Wakefield’s support comes from parents seeking answers who credit him or his associates for trying a possible solution, even if the strategy is cautioned by others (including casein and gluten-free diets, a media craze for a short time).

Magazine-style writing allows writers like Dominus to include more details and examine many subtopics of a story that traditional news articles can’t provide because of space or time constraints. Her observations may not remove Wakefield’s “villainous figure” in the eyes of the medical community, but just as the Marvel Comics movies emphasize human elements within their villains, Dominus’ story leaves Wakefield less clear-cut than previous mainstream glimpses portrayed him.

A “yes or no” question

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If British doctors successfully develop a test to detect autism, then the questions about getting the condition would be reduced to a simple ‘yes’ or ‘no.’

Like a pregnancy test, the test would detect the condition from a few drops of urine. The urine test would speed up diagnosis of the condition by removing psychological visits that are currently used to determine if someone is autistic. The test is based on research showing autistic people with different bacteria in their guts than other people. Depending on the success of test trials, the urine test could be widely available by 2015.

Of course, diagnosing autism wouldn’t only become faster, but more accurate. Many issues surrounding autism now, including its causes, are fueled by the lack of an objective way to detect the condition. Assuming that autistic children retain the different bacterial “fingerprint” as they become adults, the urine test could also put a hard number on just how many people are autistic. How diagnosis rates would be affected are unclear, but the test could halt the alarmist hyping of increasing diagnosis rates in mainstream media (1 in 110 for the United States, more than 1 in 100 for Great Britain).

The test would also remove the “gray area” with people who believe they’re autistic, but only possess certain traits of the condition and not enough to make a confident diagnosis.

At this point, I can’t see a risk of an adverse reaction from the public on the urine test. All the test will do is determine if someone is on the spectrum or not, it doesn’t pinpoint a cause for the condition. If we do see the test hitting the market, I doubt we’d see less furor from vaccine skeptics since children are given their first shot almost immediately after birth. Instead of claiming that children developmentally regressed after taking a vaccine, skeptics could claim that a child’s bacterial makeup was normal until a shot was administered. However, there would be no reason for skeptics to refuse a urine test since nothing will be placed inside a child’s body.

What may be limiting coverage of a potential breakthrough is the nature of tests and studies themselves. Developing new technologies is a time-consuming process, which doesn’t fit well in regards to the speed of developed societies. Speaking of speed, the urine test won’t be available to the public for at least five years. While we all say five years go by quickly when the time period is complete, it’s a very long time in communities where instant gratification is demanded and people get upset if problems aren’t fixed instantly (the current political mood is shaped by this mentality. Politics not your thing? Look at head coaches in sports who get called for removal when they barely get time to implement their style). Newscasts won’t likely lead with a story that could take more than five years to develop.

Even if progress goes at a snail’s pace, it’s the first sign that many people in the autism community have been looking for over the last few years. No longer would people have to wait for a child to lose developmental milestones before action is taken to help a child adapt. Quicker intervention is a tactic I’m sure no one would have a problem with.

Written by TheSportsBrain

June 9, 2010 at 10:06 am