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Tuesday, June 24, 2014

Remembering the Burton Hearings

At Politico, former Henry Waxman staffer Sarah Despres recalls Dan Burton's vaccine hearings (h/t Brian and Phil):
It was difficult to watch the nation’s immunization program, a crown jewel of public health, responsible for saving so many lives, being attacked at high-profile congressional hearings — all on the basis of unscientific theories. And it was frustrating to see members of Congress giving equal weight to both sides of the argument when one was so clearly flawed. We staffers often talked among ourselves about the lives the committee was putting at risk.
Few legislators were prepared to stand up for science. Rep. Henry Waxman (D-Calif.), then ranking member on the Government Oversight and Reform Committee and a longtime advocate for children’s health and safe and effective immunizations, was one of a handful of members prepared to state that the evidence did not support a link between the MMR vaccine and autism. As for the others, the antivaccine evidence presented might have been shaky, but the science is complicated. And most members of Congress — on the committee and off — did not feel comfortable opposing the advocates and parents armed with heartbreaking stories of children whose autism seemed to come on just after they received their routine immunizations. A number of members made supportive comments about the committee’s work, and the hearings continued for a number of years.
We can see from the numbers the CDC reported this month that those hearings 14 years ago made a difference. They gave an unscientific theory the veneer of government-sanctioned legitimacy — enough for the Internet and a handful of celebrities to cherry-pick evidence presented to Congress and spread it. A study published in the journal Pediatrics in 2008 found that there were spikes in media coverage of the theory linking vaccines to autism after the two most high-profile hearings in 2000 and 2002. The same study also showed that parents were increasingly getting their information about vaccines from the Internet, where the work of the committee was widely covered.
Unfortunately, Despres does not accurately convey the findings of the Pediatrics article. (Michael Smith, et al., "Media Coverage of the Measles-Mumps-Rubella Vaccine and Autism Controversy and Its Relationship to MMR Immunization Rates in the United States," Pediatrics 121 (April 2008): e836-e848.)
There was minimal media coverage of the MMR-autism story apart from 3 periods. A large media spike in April 2001 that was responsible for the majority of stories during the study period was associated with the Institute of Medicine report that rejected a causal association between MMR and autism. Smaller spikes in 2000 and 2002 reported the 2 US House Committee Reform hearings on the MMR-autism debate. Even during periods of increased media coverage, attention to the MMR-autism story was short lived. For instance, 141 of the 171 stories in April 2001 occurred within 24 hours after the release of the Institute of Medicine report on April 23.
A review of the NIS data between 1995 and 2004 demonstrates a significant increase in both overall and selective MMR nonreceipt within the 2000 NIS cohort of which the MMR vaccinations would likely have occurred in close proximity to the publication of the article in 1998 by Wakefield et al. This increase in selective nonreceipt at a population level was not trivial; 1 in 50 children missed the opportunity for MMR immunization, and the rates were as high as 1 in 40 among children in private practices (data not shown). Significant media coverage of the MMR-autism controversy did not begin until nearly 2 years after this measurable increase in nonreceipt. To our surprise, selective MMR nonreceipt had already returned to baseline by the time this increased media coverage occurred. In the absence of widely reported newsprint, television, or radio reports, the likely explanation for the brief increase in MMR nonreceipt is that parents learned about the MMR-autism controversy from other sources.