Thursday, August 14, 2008

A Queasy Comparison

As the mother of a child with autism, I’m occasionally asked what I think about “the vaccine thing,” i.e. the purported link between vaccines and autism.

To answer that question, let me tell you a story. It will seem unrelated at first, but stick with me.

From 1956 to 1983, pregnant women in the U.S. suffering from “morning sickness” had access to an effective medication called Bendectin. Unfortunately during part of that time another medication, thalidomide, was also on the market in a number of countries, as a sedative that also had some nice anti-morning-sickness effects (it was never approved in the U.S., but was distributed to some extent here on an experimental basis). The manufacturers claimed thalidomide was safe for use in pregnancy, though testing had been minimal or non-existent. After the 1957 introduction of the thalidomide, unusual birth defects began to appear in striking numbers. Thalidomide was removed from the market in 1962 and its manufacturers expended great effort in claiming innocence and trying not to be held liable for its awful effects, effects which turned out to be easy to replicate and impossible to deny.

Meanwhile, Bendectin continued to rise in popularity, eventually being used by as many as 1 in 10 pregnant women in the U.S. In the wake of the thalidomide disaster, Bendectin came under serious scientific scrutiny – so much so that perhaps no other medication has ever been so thoroughly studied for use in pregnancy. The results held firm in study after study: no adverse associations with Bendectin were ever established.

However, as one might expect in that large a population, a certain number of women taking Bendectin also gave birth to children with birth defects. After what happened with thalidomide, blaming Bendectin – despite all the studies to the contrary – was not that big a mental leap. Soon the lawsuits started to pile up. Eventually the manufacturer Merrell Dow pulled the drug off the market due to the financial pressure, but continued to mount an exceptionally successful defense to the various suits that came to trial, among them a class action suit brought by over 800 plaintiffs and an individual case that went all the way up to the Supreme Court and had an impact on evidentiary standards in the process.

No plaintiff ever received damages after a Bendectin-related trial. (Current Controversies in the Biological Sciences, p. 170)

So, there's been no Bendectin on the market for suffering pregnant women in the U.S. for the past 26 years, with no discernable decline in birth defects. Hospitalizations due to hyperemesis (extreme vomiting) of pregnancy, though, increased considerably. Click here & scroll down to see a chart of the trends. Fortunately for our neighbors to the north, a generic version of Bendectin called Diclectin has been available in Canada all along. And, as my OB advised me during my pregnancies, you can buy Bendectin’s ingredients separately, doxylamine succinate as Unisom and pyridoxine as Vitamin B6, and take ‘em yourself -- only on the advice of your own physician, please!

Now, back to the vaccines.

Vaccines do occasionally have adverse effects, sometimes dire ones. To take that fact into account, the U.S. government has set up the National Vaccine Injury Compensation Program (VICP), an alternative to the court system that provides for vaccine-injury compensation in cases where a credible scientific rationale can be advanced, without laying all the lawsuits on the backs of the vaccine manufacturers.

Thank God for the vaccine court. Because if there were no such process in place, autism-related lawsuits might well drive the vaccines right off the market in the U.S., just like Bendectin, despite all the science that finds no evident connection between vaccines & autism. And there’s no do-it-yourself over-the-counter alternative for protection against pertussis, diphtheria, measles, polio... all those diseases that used to kill and maim so many people before vaccines came on the scene.

People get into big online slugfests about vaccines and autism all the time. I'm not really spoilin' for a fight myself, because nobody wins those things. I could wish that coming out online in support of mainstream science and the American Academy of Pediatrics weren't potentially a lightning-rod kind of thing to do! What a world, what a world.

Anyway. That's where I'm coming from on the "vaccine thing." Just in case my readers would like to know.


Anonymous said...

Of course the other part of the thaldomide story is thatit was seen as non toxic( doctors were told, and told patients, that it was almost impossible to overdose on it.When birth defects started showing up,this was thought to be caused by genetics. A brave parent and uncle of two afflicted children went around the country collecting information from other parents that finally resulted in the problem being identified.
Wouldn't it be ironic if the same thing is happening now with autism?

JoyMama said...

Thing is, we're at a different point in the scientific inquiry. The false assurances about thalidomide were happening in an absence of scientific study, while the findings about Bendectin and vaccines rest on a mountain of evidence by now.

Anonymous said...

You have my vote for including this in a Skeptic's Circle.

The Bendectin story is a good for illustrating your points. Good Job! Barbara

mama edge said...

How many more millions of dollars are to be diverted from finding ways to help our children on the spectrum? Until people stop insisting on fighting this fight, we will continue to fund redundant studies that either (surprise) cannot find a link between vaccines and autism, or worse, find a scientifically-dubious link that researchers then spend even more money and time to debunk. Arggh!

And don't even get me started on all the "therapies" being touted as effective autism treatment despite having absolutely no data backing up the claims.

If I ever get as brave as you, I'll name those "therapies" and get a real blog-lashing.

Bravo, brave girl.

JoyMama said...

Barbara - thanks! We'll see what they say.

Mama Mara - thank you too, and arrghh, indeed. I don't imagine I'll be taking any therapies-controversies on, though, since my IRL audience hasn't been asking about it, and I don't figure on putting up lightning-rods without a directly Joy-related reason. There are others who do such a fine job of it, and it's more fun to post Joy-stories anyway!

Anonymous said...

Good morning! I'm on a timeline to get ready for the overnighter to transfer my firstborn from my loving embrace to the hands of the big university - just sayin' to emphasize I thought Mama Mara's comment was so good that I took the time to sign-in and carefully enter the inane wordvillificationcode to tell her and JoyParents so.

Yes, Yes! YES! Waste is never emphasized enough! Not just the waste of money, the lives of our children, of ourselves. Well, that's off my chest.

(If I go too far, JoyParents, I'll understand if this comment is deleted.)

If you haven't read her yet, Sharon at the The Voyage does an excellent job of bashing the anti-vaccine crowd.

JoyMama said...

Barbara/TherExtras -- I don't have an itchy trigger finger as far as comment-deleting is concerned. However, bashing (or the promotion thereof) isn't where I want to be coming from either....

I won't get delete-happy unless things devolve badly.

Meanwhile, congratulations on flying your first fledgling! I hope the semester gets off to a grand start.