AMA Rejects Call for More Research on Vaccine Link to Autism, Reaffirms Immunization Policies

There's no need for more research into a possible link between vaccines and autism. But there is a continuing need for support of ongoing research into the true etiology of autism and its treatment. And physicians should continue to take a lead role in extolling the benefits of vaccines to health policymakers and the public.

Those were among the messages recently sent by the AMA House of Delegates, which met June 13-17 in Chicago.

A resolution submitted by the American Academy of Child and Adolescent Psychiatry, the American Psychiatric Association, and the American Academy of Psychiatry and the Law initially proposed that

Although delegates at the meeting overwhelmingly supported the first and third resolves, they steadfastly opposed the request for a council review of vaccine research.

California delegate and internist Melvyn Sterling, M.D., testified during a June 14 reference committee hearing that sufficient research on vaccines and autism already exists and clearly demonstrates the two are not linked.

"The science is compelling," said Sterling, who is a past chair of the AMA Council on Scientific Affairs, the precursor to the Council on Science and Public Health. "There's no reason to reinvent the wheel."

The reference committee agreed, concluding in its report that, "the relationship between vaccines and autism has been extensively studied by many scientific organizations, including the Institute of Medicine, and that further study by the AMA on this issue was not necessary."

That view was upheld earlier this year in the courts, when, in February, three federal judges ruled in three separate cases that there is no association between vaccines and autism.

The reference committee did recommend for adoption a substitute resolve that urges the AMA to continue to work with immunization advocacy groups to help physicians communicate to patients, parents, policymakers and the media that vaccines do not cause autism and that falling immunization rates have led to a resurgence of vaccine-preventable diseases and deaths.

Outbreaks of Haemophilus influenzae type b, or Hib, disease reported earlier this year in Minnesota and Pennsylvania, as well as a series of measles outbreaks across multiple states, serve as stark reminders of the ease with which vaccine-preventable diseases can reassert themselves in un- or underimmunized populations.

Meanwhile, another resolution related to vaccines was referred for decision after reference committee testimony was deemed inconclusive. That resolution, crafted by the California delegation, called on the AMA to encourage redistribution of state and federally funded influenza vaccine that stands to go unused to facilities willing to manage and distribute the vaccine for free to patients and physicians in poor and medically underserved areas.

The resolution also directed the AMA to work with other public health organizations to address issues of vaccine distribution.

AAP delegate Carol Berkowitz, M.D., testified that more information was needed to understand the impact of the resolution, and Rear Adm. Anne Schuchat, M.D., director of the CDC's National Center for Immunization and Respiratory Diseases, cited concerns about the limitations of the federal flu vaccine distribution system. Other speakers were apprehensive about vaccine being distributed based on socioeconomic status.

Against the backdrop of the recent decision by World Health Organization officials to declare the novel influenza A (H1N1) outbreak an outright pandemic, the AMA house adopted two substitute resolutions related to pandemic preparedness.

The first resolution directs the AMA to urge HHS, the CDC, and state and local health departments to urgently assess shortfalls in funding, staffing, and vaccine, drug and data management capacity to prepare for and respond to an influenza pandemic or other public health emergencies.

The resolution also calls for the AMA to urge President Obama and Congress to provide the funding and resources public health agencies would need in such an event, a need highlighted in a recent report from the Trust for America's Health that detailed numerous gaps in the nation's level of pandemic preparedness, including an inadequate public health workforce and insufficient domestic vaccine production capacity.

The second resolution asks the AMA to urge the CDC to develop and disseminate electronic instructional resources laying out procedures for physicians to follow in a pandemic or other public health emergencies.

Notably, AAFP already has a customizable disaster preparedness manual and related resources on its Web site.