IRA FLATOW, host:

You're listening to Talk of the Nation: Science Friday. I'm Ira Flatow. A bit later, we'll talk about the start up next month of the world's largest particle smasher. But first, that red, blotchy rash, it's back. We're talking about measles. Measles infections are on the rise according to the Centers for Disease Control and Prevention.

Expert say it's an alarming sign, because measles is usually the first vaccine preventable disease to pop up when vaccination levels drop. Of course, we've had the measles-mumps-rubella vaccine for decades. But some parents have decided not to immunize their children, because they believe that the vaccine, among others, that one and others cause autism.

A belief that's been debunked by a number of scientific studies. So, why is the public still debating a question that scientists say is solved. And could more infections be on horizon, if this trend continues? Joining me now to talk about this divide and its implications for the nation's public health is my guest, Paul Offit.

He is chief of the Division of Infectious Disease at the Children's Hospital of Philadelphia. Also, author of "Autism's False Prophets: Bed Science, Risky Medicine and a Search for A Cure." A new book that's just out today. He joins us by phone from Philadelphia. Welcome back to the show.

Dr. PAUL OFFIT (Chief, Division of Infectious Disease, Children's Hospital of Philadelphia; Author, "Autism's False Prophets: Bed Science, Risky Medicine and a Search for A Cure."): Thank you, Ira.

FLATOW: Give a little bit of history of why do you think these are - these diseases are rising again?

Dr. OFFIT: Because people are starting not to vaccinate their children. I think, you know, that certainly when I was growing up or my parents were growing up, vaccines were easy/uneasy sell, because they saw that these diseases cause hospitalization and death.

I think, you know, most - young parents today, not only don't see these vaccine preventable diseases, they didn't grow up with them. So, for them, vaccination becomes a matter of faith. Faith in pharmaceutical companies, faith in public health officials, faith in positions, and I think, you know, we live in a much more cynical, litigious time. That kind of faith is hard to come by.

FLATOW: Mm-hm. There are actually two big vaccine scares going on right now, are there not?

Dr. OFFIT: Vaccine scares?

FLATOW: Well, I mean, people are afraid to vaccinate their kids. That's basically what you're saying.

Dr. OFFIT: Yeah. I think again, it's, you know, what I think is happening is unfortunate, is that, you know, people get a lot of misinformation about vaccines, in the introduction, you mentioned that. The notion that vaccines cause autism is frankly a disproved one. You know...

FLATOW: Mm.

Dr. OFFIT: It's certainly understandable how a parent can be concerned about vaccines. You know, if the child's fine, they get a vaccine and they're not fine anymore. So raising the question, could the vaccine have done this is perfectly reasonable. But you know, science - it's a scientific question and it can be answered into scientific venue.

And as you said in the introduction, it has. I mean, the notion that MMR causes autism has clearly been refuted by many scientific studies, where hundreds of thousands of children who got MMR were compared to hundreds of thousands of children who didn't get MMR, till - to see whether the risk of autism was greater in the vaccine group, and it clearly wasn't.

FLATOW: Right. Yeah.

Dr. OFFIT: So, I guess the disappointing part for me and I suspect for you too, is that, you know, why if hasn't the science been compelling? Why is it that we have, you know, communities that are choosing not to vaccinate their children, that allow these measles outbreaks to occur.

FLATOW: Well, why do you think the science is not compelling?

Dr. OFFIT: I think we're not very good at explaining it. I think that the - that - you know, that scientific literacy isn't great. I think that, you know, people tend to see science as just one more opinion in a sea of opinions. I think that the media certainly can be confusing. I think the Internet could be confusing.

FLATOW: Mm-hm.

Dr. OFFIT: So, I think it's disappointing.

FLATOW: Mm-hm. Of course, people always pointed to Thimerosal with the mercury in it, and as the cause of it and it has been removed for years, has it not?

Dr. OFFIT: Right. So, that's exactly right. So, the first hypothesis was that measles-mumps-rubella vaccine causes autism, that sort of came in the late 1990s. Then that there was sort of seamlessly moved to the second hypothesis, which was Thimerosal, this ethyl-mercury-containing preservative that wasn't in several vaccines before 2001.

But remains only in the multi-dose preparations of influenza vaccine, that that caused autism. But you're right, essentially Thimerosal's been out of - first, the old vaccines since 2001. It hasn't affected the incense of autism. ..TEXT: FLATOW: Mm.

Dr. OFFIT: Plus, we have six epidemiological studies that have currently shown the children who received Thimerosal-containing vaccines are not at greater risk of autism, and those who received the same vaccines that were free of Thimerosal. So the question has been answered, but the media still does - at least in some parts - carry that as a controversy.

FLATOW: Of course, there are those who believe that, you know, we need to space them out. We're giving too many at once to our kids.

Dr. OFFIT: Right. And so now you will move to the third hypothesis as we keep moving on. You know, the notion that children get too many vaccines too early. But certainly if you look at the number of immunological components contained in the 14 vaccines that we give our children today, it's actually less than the number of immunological components that we gave in the seven vaccines for example, that we gave to children in 1980.

FLATOW: I mean, you really say in your book, you think that journalists are to blame for a lot of this?

Dr. OFFIT: Yeah. I think under sort of the journalistic mantra of balance. People try and fairly represent both sides. But this really is a scientific question that's been answered in a scientific venue, and so you have the side of the science and then you have the side of those who don't believe in the science. I don't see that really as the best way to educate or inform the public.

FLATOW: Mm-hm. After all these debates and whatever, have they had any impact on autism research?

Dr. OFFIT: I think it has in a negative - well, I think it certainly - we have a much greater awareness of what is the spectrum of a clinical presentation for autism-spectrum disorder. I think that's all a very good thing. I do think that this notion that vaccines cause autism has done a tremendous amount of harm.

FLATOW: Mm.

Dr. OFFIT: I think one is what you just alluded to, that it has continued to divert resources away from what are far more promising leads. And it's caused some children not to get vaccines from which they clearly benefit, and for some children it's meant that they've had been subjected to bogus and I think sometimes pretty dangerous and potentially fatal therapies on the notion that vaccines are the heart of the problem.

FLATOW: Mm. 1-800-989-8255. Chantal(ph) in Raleigh, hi.

CHANTAL (Caller): Hello.

FLATOW: Hi there.

CHANTAL: Basically I have a quick question for Dr. Offit. There - you know, he states that all vaccines are safe when given in multi-doses, you know, five and six shots at a time for a six week old, you know - there's - it's completely fine. But I beg to differ. There's a lot of aluminum in vaccines.

You know, a six-week-old can get up to 1250 micrograms of aluminum at one time. There has not been any studies they conducted to find out how aluminum can affect a child on the insides. It has been done for at the injection site, but not on the inside. So, there has been new studies to find out if aluminum rested in the child's brain? Is it, you know, sitting in the child's bones?

That's my main concern and that is the number one concern why I will not follow the CDC's guidelines. I will be a delayed vaccination mother. My child will be vaccinated on my own schedule. I just want to know what his take is on that.

FLATOW: OK, Paul.

Dr. OFFIT: Sure, Chantal. You raised a question actually that a number of parents have raised and are concerned about. You know, the - how about these other components that are in vaccines and Thimerosal is a mercury-containing preservative that was in vaccines.

Aluminum is contained in a number of adrevents(ph) which are ways that's sort of enhancing the immune response that are used in a number of vaccines as well. And again, it's you know, the doses is critical.

So, for example, the quantity of mercury that was contained in vaccines and, it's ethyl-mercury, not actually the environmental mercury, methyl mercury that people are probably more familiar with, is actually less than one - what one is typically exposed to if you breastfeed or frankly, even a bottle feed for you know, for that first six months of life.

Similarly, if you look at the amount of aluminum that's contained in vaccines, it's less than is contained in - it's in formulas and much, much less than there's contained for example in soy formulas. So, I think, you know, you have to put it in perspective. We live on the planet earth.

If we choose to live on the planet earth, that means that we're going to be exposed to both light metals like aluminum or heavy metals like mercury that are part of the earth's surface, and enter into the water that we're drink and consequently the infant formula that we give our children or the breast milk that we give our children.

And again, the quantities that are contained in vaccines are less than what is one is typically exposed to. So I think that the fear of aluminum is not a reasonable reason to delay vaccine.

CHANTAL: But even the FDA states that, you know, a prenatal baby, or even a child, or a person who has kidney problems should not receive over 50 micrograms of aluminum per day.

Dr. OFFIT: Right. And so if you look at those who are at risk...

CHANTAL: But how would we know? I mean, if you look at a child who we may presume may be completely healthy, and the FDA is saying, well, we do know that in children who, you know, are either premature who have kidney problems should not get more than this certain amount. So, why is it just OK to assume that giving the full 1250 micrograms is OK.

Dr. OFFIT: OK. So if you look at the studies that you were referring to, that look at children who are either severely premature, meaning born in sort of you know, 27, 28 weeks gestation, were those who have, you know, severe kidney abnormality, requiring chronic dialysis, their, you know, one can see, because they have an inability to excrete aluminum for the most part or much lesser ability to excrete aluminum.

CHANTAL: Right, it's just (unintelligible)...

Dr. OFFIT: Because they are at risk and - but to extrapolate, those date events to an otherwise, you know, normal newborn is I think unfair, and when you put it in the context of which children are typically exposed to regarding aluminum, it's really not a concern, shouldn't be a concern.

FLATOW: Chantal, is there anything that Dr. Offit could tell you to change your mind?

CHANTAL: Absolutely not. There is that concern I already know that to a certain extent. My child has already predisposed to a lot of other things on my husband's side of the family as well as some of mine. There's no way that I would give my child a six, you know, six shots at one time regardless. I do want to say to Dr. Offit. I need that...

FLATOW: So let me just ask you...

CHANTAL: Mm-hm.

FLATOW: So even if his studies are correct, then you admit or go back and research what he saying to be true.

CHANTAL: I do not put any faith into anything that my government tells me. I know that may sound absolutely absurd, but there is no independent studies done, and the day that I rest, you know, and fell that I can you know, sit back, and let a pharmaceutical company say they what they feel is correct and they're going to check - tell the CDC and everything else, you know, all of our study say everything is fine, when look at all the other drugs that have been recalled.

There have been vaccines that have been recalled, because of the different things, you know, that have been found faulty enough.

FLATOW: Yeah. So you don't - do you not believe in the system of testing drugs...

CHANTAL: No.

FLATOW: Is that what you're saying?

CHANTAL: Not when there are no independent studies done. The day that an independent - fully independent, where a pharmaceutical company - even Dr. Offit - he used to take millions by the pharmaceutical company. He's made his own vaccine, good for him. But there is no way I will sit there and completely rely on that information...

FLATOW: But the drug companies are the ones that do the test...

CHANTAL: There's no way, there has never been any independent studies done.

FLATOW: But Chantal, the drug companies are the ones that test the drugs.

CHANTAL: Exactly.

FLATOW: But, then...

CHANTAL: And I think that the government should have a say and say, we'll, fine. We're going to have - form our own independent people and do it on our own.

FLATOW: But you just said you don't trust anything the government does?

CHANTAL: As far as what the pharmaceutical company is telling them, that's correct . So the day, that they - the government...

FLATOW: Mm-hm.

CHANTAL: If they put them aside money, their own money, and say, we're going to this on our own to protect the children of this country and their grandchildren.

FLATOW: If you're saying the government does that.

CHANTAL: Yes, if the government does that.

FLATOW: Paul, can the government do that?

Dr. OFFIT: Well, actually that - number of interesting issues were raised. First of all, Chantal describes a number of factors simply incorrect, what I mean, I don't...

CHANTAL: Which ones?

Dr. OFFIT: I'll go through them. One, I don't make millions of dollars to speak about this...

CHANTAL: OK. Maybe about two million.

Dr. OFFIT: I think, I make nothing to speak about this safety of vaccines.

CHANTAL: No, but you're (unintelligible)..

Dr. OFFIT: Let me finish, Chantal. You just spoke, please let me finish. Two, is that if you spent 10 minutes talking to any of the people involve at the Centers for Disease, Control and Prevention where frankly pharmaceutical companies who do the research that does the phase one and phase two, and phase three safety testing for vaccines, I think you feel very confident about the process .

I think the fact that your - that you are distant to the process means that you're much more likely to view it with suspicion, but it's an unreasonable suspicion, because what the Food and Drug Administration requires for a vaccine is a very high bar.

I mean, if you look for example at safety testing for the pneumococcal vaccine was tested in 40,000 children pre-licensure, with the broader virus vaccine 70,000 children pre-licensure, or the HPV vaccine, 30,000 women for seven years pre-licensure. I would argue no drug is subjected to that sort of pre-licensure safety testing, nor are the catchment systems for drugs nearly as good as they are for vaccines. I think it's a tremendous system. I think it's - vaccines are frankly the safest best tested things we put in our body, because of those systems.

FLATOW: Mm-hm. We're talking about vaccine this hour at Talk of the Nation: Science Friday from NPR News. And so I go back to you again, Chantal. I'm just wondering if you just have a preconceived notion about this, and your mind made up that nothing, no amount of - even if the government panel that you say you'd like came back and said it was safe, would you - would that be still be good enough for you?

CHANTAL: If - like I said, if there's evidence that shows that there have been complete independent studies done, that's something totally different. But I'm not going to put my faith into a pharmaceutical company who's making millions off of this stuff. (Unintelligible)

FLATOW: Well, that's - this is our system works. I may agree with you on a certain level, but this is how all drug testing goes...

(Soundbite of laughter)

CHANTAL: I am not saying all vaccines are bad. I'm saying six at one time is absurd.

FLATOW: OK.

Dr. OFFIT: It's not absurd, Chantal, because if you look frankly...

CHANTAL: But, no...

Dr. OFFIT: When a child is in the womb, for example, they're in a sterile environment. Once they enter the birth canal and then enter the world, they're not in a sterile environment anymore. And the number of bacteria that live on a surface of their nose, or throat or intestine, are to literally in the trillions. Each of those bacteria has between 2,000 or 6,000 immunological components, and as a consequence, our body makes grams of antibodies to try and combat these bacteria to make sure that they just stay on the surfaces of our body, and don't enter into the lymphatics or blood stream.

The number of immunological (unintelligible) just contained in vaccines is not figuratively, it is literally a drop in the ocean of what you would typically encounter and manage every day. I mean, I certainly understand how any parent who lies a child down on that crinkly white paper and watches the child you know, receive four or five injections at once, can feel like it's too much. I mean that's make sense.

CHANTAL: OK. Answer me this, how many studies have been done on vaccine (unintelligible)...

Dr. OFFIT: But if you want to really carry yourself, Chantal, what you should do is take a cotton swab and just swab the inside of a child's nose, put it on a microscope, slide and look at it under the microscope, it's teaming with bacteria, two which one makes (unintelligible) response. Frankly, a single ear infection or a single cold is a greater immunological challenge than are all the vaccines that children receive. So it's just not a reason to fear.

CHANTAL: So tell me, how many studies regardless of whether they're independent done by the CDC or by the pharmaceutical companies has been done on vaccine loading, which means five or six vaccines at one time. How many?

Dr. OFFIT: Any - I would say in the - probably somewhere in the vicinity of the high hundreds to low thousands.

CHANTAL: I don't believe that.

Dr. OFFIT: If you look for example at any new vaccine that get licensed from the United States, you have to do by definition, by FDA requirement, something called concomitant-use studies, which is to say, for example, the new HPV vaccine comes on to the market or Rotavirus Vaccine comes onto the market, you have to show that that vaccine does not interfere with the immune response with the safety of existing vaccines, and similarly that existing vaccines don't interfere with the safety or immune response of that new vaccine. That has to be done for every new vaccine, so concomitant-use studies are the way to answer the question, can children receive all these vaccines at once safely.

FLATOW: Thank you, Chantal. And I can see - you can see why, Paul, you know. I don't think there's anything that you can say to some people or convinced, you know. Her last answer was, "I don't believe that."

Dr. OFFIT: Right and so...

FLATOW: There I - you can see the problem with vaccinations right there, or to getting people to get their kids immunized.

Dr. OFFIT: I agree. I mean, all you can do to try and calm fears is to try and present, you know, data in a recent manner. But you know, if someone's going to say, I think that actually there's a conspiracy to sell vaccines that pharmaceutical companies and the government, and people will speak about vaccines like me, are all part of that massive conspiracy, then you're obviously not going to be convincing.

But I honestly think that Chantal doesn't represent most parents. I think most parents, frankly, you know, read things in the media or hear about things, you know, on radio shows and are concerned, but are reassurable with good science. I do believe that's true of most parents.

FLATOW: All right, Paul, thank you very much for taking time to be with us.

Dr. OFFIT: Thank you.

FLATOW: Paul Offit is chief of the Division of Infectious Diseases at Children's Hospital of Philadelphia, and author of "Autism's False Profits: Bad Science, Risky Medicine, and the Search for a Cure." Out today. We're going to take a break and totally switch gears. Talk about the Large Hadron Collider, boy, is it large and colliding. Stay with us, we'll talk it about after this break.

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