On autism

They did not succeed in convincing ABC to pull the debut episode of Eli Stone. But the American Academy of Pediatrics (AAP) was able to object to the litigation drama (in which fault for autism causation is legally found to rest in childhood vaccines) with the early release of a third-world-based study that finds thimerosal (mercury) in vaccines in Argentina to be swiftly secreted. What’s the connection? Although there isn’t any thimerosal in first-world vaccines anymore anyway, even if there was, it wouldn’t stay in a child’s system long enough to cause much of anything, let alone autism.

Some first world parents still refuse to vaccinate their children because of the fear that the vaccines will cause autism- now as common in children under five as one in 130. A 1998 British study linked the two, and despite the study being discredited soon after, the AAP responded by urging the removal of thimerosal from vaccines. So for about a decade now, first-world vaccines have been thimersoal-free. And autism incidence climbs…

There is an obvious question here as to why the third world still has to use what has for ten years up North been an unacceptable base for vaccine compounds. That there is inequity and dual markets for medicine and that the first world runs phase four trials on the backs of the third world is pretty damn clear. But it turns out the second-class vaccine isn’t any worse that the first, so the baffling thing in this case is what on earth constitutes precaution?

As a precautionary measure, the AAP urged an end to the use of thimerosal in vaccines. Because the media is never nuanced enough, and thimerosal is not exactly in vernacular use, the public heard a respected medical body saying “We don’t trust vaccines at the moment, something in them might cause autism”. As a precautionary measure, some parents lost faith in vaccination. Not most parents, but some.

What is surprising about this is that it contradicts a maxim in public health that risk aversion is antithetical to risk familiarity. So, for instance, even when we know irrefutably that smoking causes cancer, we do it anyway, everyday, but there is no chance in hell we are going bungee jumping. In this day and age, autism is the familiar risk- with incidence rates at nearly 1%, everybody knows somebody with an autistic child or student, and it is certainly more accessible than polio or rubella. Against the grain or not, there are some people who bungee jump, and there are some people who fear autism more than polio.

Now the AAP has changed its tune- not only are our first world vaccines definitely safe, but even thimerosal-containing vaccines are safe. This kind of back-and-forthing by medical associations and health agencies is relatively frequent. Just this fall a catfight broke out between the Canadian Cancer Society and the Canadian Breast Cancer Foundation, because the former adjusted its public health messaging around breast self-examination to holistic language, and the latter hissed at CCS’s inconsistency.

But surely the point of all this research is inconsistency, and more importantly, specificity. After a few decades of feminism and the era of evidence-based medicine, studies are supposed to use gender analysis. The results are expected to be inconsistent along gender lines. Studies are supposed to include subgroup analyses- it is for instance a wax seal of sophistication to find one ethnic background more predisposed.

But knowing more does not necessarily clarify how we should act to protect our health. The matriculation of medical “fact” has a paradoxical, or perhaps Socratic, ill-effect of plumping ignorance. We’re so precautious because of the knowledge gaps that we’ve become impotent to act.

A central tenet of feminist health theory is that women were guinea pigs for dangerous reproductive health “treatments” for decades (Thalidomide, DES, the original IUD, HRT, etc), and moving forward, precaution and woman-body-loving-preservation will be practiced. No more taking stuff to cure our uniquely feminine “concerns” until we are positive, without doubt, that the treatment is safe.

So we’re a little suspect of bringing silicon breast implants back on the market. And we’re a little suspect about the birth control pill brand that eliminates menstruation. And we don’t want episiotomies and C-sections and fetal heart monitors until you prove to us they’re not as unnecessary as recent research has led us to believe.

This year a new women’s health dynamite stick landed in provincial health treasure chests: the HPV vaccine, a roughly $400 multiple-dose vaccination for girls and women ages 9-26 that will prevent the strains of HPV that cause genital warts and 70% of cervical cancers. The hyped hubbub over autism and childhood vaccines has infected the word “vaccines” generally, even though intuitively we won’t catch autism at age twelve. (Or let’s hope we won’t, since publicly-funded autism therapy exhausts itself when children turn six!). So there is a deep vein of skepticism about the HPV vaccine, and no body (not even the anti-sex segments of the Catholic lobby) has been more vocal that the Canadian Women’s Health Network. Precaution is, after all, the golden ticket of health feminism.

They are advising against taking the first and only cancer-prevention vaccine. They are advising against government funding for something that was invented with women’s health in mind. Going back to the public health maxim of illogical risk aversion, they are advising against receiving a vaccine that can prevent the second most common cancer in young women because it might have side effects we don’t know about yet (after studies for a reasonable length of time and on hundreds of thousands of women). They are advising against a vaccination program because maybe it will make women and girls less prudent in the sack and less religious about their annual Pap. Yeah…maybe…if you don’t trust women and girls at all, and stop the commonplace promotion of safe sex and cervical screening…

Precaution about prevention is not safety; it’s like bathing in ignorance because the bathwater smells like vanilla nostalgia.