Future news

Future news

The media, MMR and autism – a cautionary tale

EPA/Lindsey Parnaby

The Sunday Times of London reports on the rapid rise of measles around the world since the 1998 controversy provoked by Dr Andrew Wakefield’s research on the link between the MMR vaccine and autism. We media sociologists often struggle to find solid evidence of media effects, given the complexity of modeling the media-individual-society relationship, but here is an example of how journalism shapes social reality which is both persuasive and frightening.

To refresh your memory: in 1998 Dr Wakefield published results of research purporting to show that the rapid rise in the reported global incidence of autism from the 1980s onwards was connected to vaccine recommended by GPs for infants as a protection against mumps, measles and rubella (MMR).

The vaccine was effective, and the incidence of measles fell steadily until the late 1990s, by which time it had become rare by historical standards. A disease which had once caused deep distress and even death to millions of children was now becoming an exotic rarity under the benign influence of medical science.

At the same time, however, doctors were observing a steep rise in recorded rates of autism – up to 400% in some countries. Wakefield made the connection and sought to demonstrate with clinical research that children exposed to MMR were more likely to develop autism than those who did not, and published results to that effect in 1998.

His findings were widely reported in the mainstream news media, and taken very seriously indeed. At the height of the ensuing wave of publicity UK prime minister Tony Blair was subjected to a journalistic frenzy of questions on whether he had or had not put new-born son Leo in to the MMR vaccination program (he refused to answer at the time, on the principle of his baby’s privacy protection. Later, he let it be known that, yes, his son had been given the protection offered by MMR, and that he had no time for the Wakefield theory).

Wakefield has since been struck off, his research discredited. Before that could happen, alas, anxious parents all over the world stopped giving MMR to their kids, and the incidence of measles climbed to the point where the term ‘epidemic’ is regularly used to describe its spread. In Australia as of 2013 there were thirty ‘clusters’ of infection, a pattern seen all over the world.

Two medical conditions, then, and two examples of how the news media may help shape public perceptions and anxieties.

First, autism, or autistic spectrum disorder (ASD). ASD is not a disease or an illness, but a developmental condition associated with a range of behaviours ranging from OCD and social isolation to much more serious disabilities requiring full time care. It includes Asperger’s Syndrome, of which there has been a great deal of media coverage since the Hollywood movie Rainman (Barry Levinson, 1988), starring Dustin Hoffmann as the eponymous hero.

Before the success of Rainman few people had heard of or understood what autism, or Asperger’s, were. Afterwards, and through the 1990s, public and professional awareness of this new and somewhat mysterious condition grew. This was welcome, even if the Hoffmann character was not typical of people with ASD. It enabled resources and support mechanisms to be put in place where there had been none before, allowing many people with ASD to live independent and fulfilled lives.

As often happens, however, in a world where new ‘syndromes’ are a regular feature of science and health reportage in the media, the ASD label began to be over-applied, stuck on children with ‘conditions’ such as not eating ‘normally’, repetitive behavior, shyness and anxiety. Parents faced with ‘difficult’ children looked for answers and explanations, and autistic disorders were available. Not only that, following Rainman, they were almost trendy. Today there are ‘Aspy’ support groups online, and a growing literature of memoirs by people with various forms of ASD. Mark Haddon’s Curious Incident Of The Dog In The Night-time was a publishing phenomenon in 2003, selling two million copies in the UK alone (Haddon does not have Asperger’s, but is generally agreed to have written an authentic and compassionate account of the condition and its impact on a young boy’s life).

Autism is real, make no mistake, and for those who have it, or who have children or relatives with it, over-diagnosis is good if it comes with better public understanding. Better that than the invisibility of times past.

It is very probably genetically driven, so that it tends to run in families. It mostly affects males, and cannot be ‘cured’. Neither can it be ‘caught’ from the MMR vaccine, or any of the other environmental causes mooted since the 1990s to explain the upsurge in reported incidence. It is, rather, the increased cultural visibility of ASD, as seen in movies, documentaries, journalism and literature which more than anything explains the rise in diagnoses over the last two and a half decades in countries as far afield as Japan, Denmark and the United Kingdom.

In reporting MMR as a possible cause of autism, however, the media organisations all over the world who took Wakefield’s work at face value despite the lack of corroboration produced a less welcome movement towards heightened and unwarranted anxiety about a very safe and socially beneficial treatment for the very real disease of measles. It is estimated that parental participation in the MMR vaccination program fell by around 15% in those countries where Wakefield’s work was given most publicity. That means hundreds of thousands of families opting out. To this day, and even after Wakefield was struck off the UK Medical Register in 2010, some still fear to have their children vaccinated.

The spike in measles has been an unintended consequence of well-intentioned reportage of a dishonest researcher’s sincere-sounding theories. It stands as a warning, though – really, don’t believe everything you read in the papers. It could seriously damage your health.