Suggestion of autism, vaccination link earns doctor harsh criticism
By Terry Murray
HALIFAX Dr. Walter Spitzer, the Canadian physician who could be considered the
"dean" of epidemiology, has come in for harsh criticism for saying there might
be a link between measles-mumps-rubella (MMR) vaccine and autism.
He stated that contention in a letter to the editor of the Globe and
Mail earlier this month in responding to the paper's news coverage of the fourth
Canadian National Immunization Conference here.
"I am embarrassed that he is an emeritus professor of epidemiology
at McGill (University)," said Dr. Noni MacDonald, dean of medicine and professor of
pediatrics and medicine at Dalhousie University.
In a keynote address at the conference, she added, "I think he
better go back and look at proper causality assessment before he makes that kind of a
statement. I would flunk him."
"Indiscriminately pushing for universal measles vaccination, as
(Dr.) Ciro de Quadros (of the Pan American Health Organization) has done at the Canadian
National Immunization Conference in Halifax, may be hasty and even irresponsible,"
Dr. Spitzer's letter said.
"It is not possible to rule out the possibility that excessive
rates of autism occur among children immunized with
MMR. The early epidemiological findings are worrisome. The clinical and laboratory data
strongly suggest the biological plausibility of a link between MMR and autistic disorders.
"I strongly endorse immunization as a pillar of public health
strategy for most diseases. But one should never surrender caution."
Another physician at the conference here argued that there are no
controlled epidemiologic studies supporting the hypothesis, but there is evidence against
it.
For example, a British study on the question showed a rise in the
incidence of autism in North London began before MMR
vaccine was introduced, said Dr. Robert Pless, a Canadian who is currently medical
epidemiologist with the Vaccine Safety and Development Branch of the National Immunization
Program at the U.S. Centres for Disease Control and Prevention.
Dr. Spitzer seems to have joined forces with immunization opponents,
speaking and testifying in the last year about the purported MMR-autism
link on behalf of parent groups opposing vaccines, such as the National Vaccine
Information Centre in the U.S.
Those groups may benefit from his impressive credentials. According to
his résumé on the McGill Web site, Dr. Spitzer was instrumental in helping create the
two major departments of epidemiology in Canadathe Health Services Research Unit at
McMaster University and the department of epidemiology and biostatistics at McGill, which
he chaired from 1984 to 1993.
He has also been involved in the Canadian Task Force on the Periodic
Health Examination, and was instrumental in attempting to deflate the scare, largely
confined to Britain in the mid-1990s, about thromboembolic complications of
third-generation oral contraceptives.
Most recently, he chaired a consensus conference on the use of
intravenous immune globulin for Canadian Blood Services and Héma-Québec. |