An Interview with Dr. Geri Dawson, Chief Science Officer, Autism Speaks, about the Organization’s Research Funding and Position on Vaccines and Autism
July 30, 2009
Let me start out by asking the question that seems to be on many people’s minds – Do vaccines cause autism?
Parents often look to environmental factors to explain their child’s autism, and they often have questions about the possible role of vaccines. Most scientists agree that autism is caused by a combination of genetic susceptibilities which interact with environmental risk factors. We have discovered some of the risk genes for autism, but we still know little about the potential environmental triggers.
We also have come to understand that there are many causes of autism, and that any one cause will likely only explain a minority of cases. Piece by piece, we must discover each of these causes so that effective treatments and prevention will be possible.
Could vaccines be one of the environmental triggers? Autism Speaks fundamentally is an evidence-based organization; so, let’s look at the evidence. The studies that have been conducted thus far – and there have been many – have specifically examined whether thimerosal, a preservative containing mercury previously used in many vaccines, or the measles-mumps-rubella (MMR) vaccine cause autism. Overwhelmingly, these studies have not found evidence for a causal relationship between either thimerosal or the MMR vaccine and autism. At the same time, some parents have reported that the appearance of autism symptoms coincided with vaccination, and thus have advocated for more research on the potential role of vaccines in autism. As an organization that is committed to understanding all the potential causes of autism, we cannot dismiss the concerns of parents, especially since autism may be caused by distinct combinations of genetic and environmental factors that may each account for only a small percent of overall cases. Although coincidence cannot be mistaken for causality, Autism Speaks believes that parental concerns merit thorough investigation.
It’s important to keep in mind that the lack of a relationship between vaccines and autism in large population studies does not mean that there cannot be any relationship in some individual instances. Immunizations can, in rare cases, have adverse consequences; this is well-known. It remains scientifically plausible that the challenge to the immune system resulting from a vaccine (or other immunological challenges) could, in susceptible individuals, have adverse consequences for the developing brain.
So, the answer to the question is that, given what the scientific literature tells us today, there is no evidence that thimerosal or the MMR vaccine cause autism. Evidence does not support the theory that vaccines are causing an autism epidemic. However, it is plausible that specific genetic or medical factors that are present in a small minority of individuals might lead to an adverse response to a vaccine and trigger the onset of autism symptoms. Autism has been found to be associated with inherited metabolic diseases which might lead to vulnerability to an adverse response to a vaccine. Recent studies point to a role of immune abnormalities in the biology of autism, raising questions about the effects of the immune challenges, including those associated with vaccinations. Autism Speaks is funding research that is focused on these questions.
If questions remain, what do you tell parents when they ask whether they should get their child vaccinated?
Let me be clear: Autism Speaks fully supports childhood immunization and strongly encourages parents to vaccinate their children. Our vaccine program is one of our nation’s most effective programs for preventing serious infectious diseases. If parents have concerns about the safety of vaccines, we encourage them to find a pediatrician with whom they can ask their questions and establish a trusting relationship. Working with their pediatrician, we trust that parents can make thoughtful decisions about their child’s health.
Some have argued that by continuing to study vaccines, this will raise fears in parents about vaccines. Are you concerned that by spending even a small amount of funds on vaccine research, this could cause some parents to refuse to vaccinate their child?
It is important that we do all we can to increase and preserve the public trust in our vaccine program. Declines in vaccination rates can lead to outbreaks of serious infections. Recent research suggests that approximately 28% of parents in the general population feel doubtful about vaccines, and close to 20% are choosing to delay or refuse vaccinations for their child. Studies have shown that the primary reason some parents are refusing to vaccinate their children is that they have lost trust and confidence in the medical community. Building trust and keeping open communication between parents and the medical and scientific community are essential. We believe that best way to increase parents’ trust in the vaccine program is not to dismiss their concerns, but rather to respectfully listen to their concerns and conduct rigorous research building on the best currently available science relevant to these concerns. For example, if we do discover that specific genetic mutations or medical conditions trigger or are associated with the onset of autism for a small minority of individuals, pediatricians could better explain to parents why the risk for their own child is extremely low; such a discovery also could allow pediatricians to screen for at risk children.
There seems to be a schism running through the scientific community regarding whether any more money should be devoted to vaccine research. What is Autism Speaks’ position on this debate?
There are sensible arguments on both sides of this debate: On the one hand, the scientific evidence thus far indicates that vaccination is not associated with autism. So some individuals may conclude that spending any more of our research funds pursuing this hypothesis is a waste of money. However, as long as there are testable and plausible scientific questions that have not been researched or addressed to help us understand the causes of autism, such as whether a minority of children might be at-risk for adverse responses, we are committed to addressing these questions. Until we discover what does cause autism – and it will not be one thing – Autism Speaks will continue to fund research that explores all plausible hypotheses.
We believe that focusing on the “schism” is misplaced: scientists, physicians and parents need to work together to answer these unresolved questions. Autism Speaks has a strong track-record of collaboration among all stakeholders, and thus we believe we are in a unique position to help move the discussion forward in a way that enhances respect and partnerships among all of the stakeholders.
How much of Autism Speaks’ research budget is devoted to studying vaccines?
The amount of funding we are devoting to research that is relevant to vaccines is only a small percentage of our overall research budget, about 2%. The bulk of our $33 million in research funding in 2008 is focused on identification of a wide range of genetic and other environmental risk factors, biological mechanisms, diagnosis and early detection, and discovery of effective treatments. We also invest a substantial amount of funds in developing resources for scientific discovery, such as the Autism Genetic Resource Exchange (AGRE), the largest private genetic data base in the world, and the Autism Tissue Program, a brain tissue donation program dedicated to autism research, among others. Hundreds of scientists are currently using these resources to advance our knowledge about the causes and underlying biology of autism spectrum disorders.
Is Autism Speaks the only major funding organization that is exploring a link between autism and vaccines?
No. In fact, we are currently collaborating with the National Institutes of Health on research projects that include vaccines as one of many potential environmental risk factors that may contribute to increased risk for autism. Both the CDC and the NIH are actively involved in funding research on the possible link between vaccines and autism. To learn more about the perspective of the Director of NICHD, Dr. Duane Alexander, on research exploring the role of vaccine and other environmental factors in autism, click here. The difference is that these federal agencies are in a better position to conduct studies on very large samples. Our funding tends to be focused on highly innovative smaller studies that can open up new avenues of research. Because private foundations have more flexibility in funding highly innovative research that can lead to breakthroughs, we feel it is important to remain open-minded and nimble in our approach to funding science.
How does Autism Speaks make funding decisions?
Our funding priorities are guided by a strategic plan that was created with input from outside experts from a wide range of disciplines and stakeholders, such as parents and clinicians. The final version of the plan was shaped and endorsed by our Scientific Advisory Committee, a group of world-renowned scientists, one third of whom also have a family member with autism. The strategic plan clearly describes our funding priorities, goals, and objectives. Investigators funded by Autism Speaks are required to submit a detailed proposal describing their proposed research which is reviewed by one of our scientific review boards (Scientific Advisory Board and Treatment Advisory Board). These boards are comprised of world-class scientists who score each proposal based on its scientific rigor, innovation, and relevance to our priorities and mission.
At least one stakeholder representative, typically a parent, attends the science review meetings and provides input about the relevance of a proposal to individuals with ASD and their families. Proposals that score well are then reviewed by our Scientific Review Panel, a group of six senior scientists, two of whom are also parents of children with ASD. This panel makes final recommendations for funding to the Autism Speaks Board of Directors.
Do parents’ viewpoints influence Autism Speaks’ funding decisions?
Parents’ perspectives, values, and input are part of our review process every step of the way. Although ultimately every project must meet rigorous standards of scientific integrity and must directly align with the priorities of our strategic plan, parents’ input ensures that each project has direct relevance to our families and our mission, which is to improve the lives of individuals with ASD. Individuals with ASD and their families and the very best science are the compass that guides our actions at Autism Speaks.
© 2009 Autism Speaks Inc.