Editorial
The science of vaccine safety in the United States is at a critical juncture where careful evaluation and balanced discussion are essential. We face a system increasingly criticized for its reliance on studies plagued by conflicts of interest, selective reporting, and an unwavering commitment to predetermined conclusions. This dichotomy has created two clear columns in the ledger of vaccine safety science: one labeled “Objective Studies” and the other “Biased Studies.”
Our latest published study—leveraging comprehensive Medicaid data—is a much-needed vote for the “Objective Studies” column. It serves as a reminder of what is possible when science is conducted with transparency, independence, and a willingness to ask difficult questions.
The Fall of Objective Oversight
The Centers for Disease Control and Prevention (CDC) routinely misrepresents findings on vaccines and autism, including those by The Institute of Medicine (IOM). (The IOM was rebranded The National Academy of Medicine in 2015.) After rejecting over two dozen studies as useful, IOM’s final conclusion on neurodevelopmental disorders was based on only five studies (four of which were underpowered). CDC’s consistent portrayal of the state of science on the question of neurodevelopmental effects as rigorous and settled has contributed to the public’s loss of trust in the institution tasked with safeguarding public health through science.
These acts—betrayals of public trust—have underscored a disturbing trend in public health and biomedicine: the prioritization of narrative over evidence. Despite the IOM’s careful articulation of gaps in vaccine safety research in their reports, gaps in the effects of vaccines on neurodevelopment remain glaringly unaddressed. Worse, any attempt to fill them is often met with skepticism and outright hostility.
The latest study by Mawson and Jacob in this volume confronts these gaps head-on, particularly the long-overdue examination of preterm children—a population whose vulnerabilities demand precision medicine, not blind adherence to standardized schedules.
Medicaid Data: A Vote for Transparency
What makes this study stand out in a field riddled with bias and limitations of retrospective studies? Two words: Medicaid data. By examining the health outcomes of a large, representative sample of children, including unvaccinated controls, Mawson and Jacob were able to sidestep many of the pitfalls that plague smaller, less rigorous studies.
Key findings include:
- A clear association between the number of vaccination visits and increased odds of NDDs, including autism spectrum disorder (ASD).
- A dose-response relationship—the more vaccination visits, the higher the risk.
- Synergistic risks for preterm children, whose unique physiological vulnerabilities amplify the impact of early vaccination.
Unlike studies that cherry-pick data or exclude unvaccinated groups entirely, this analysis rests on methodological rigor. It acknowledges what so many others do not: science’s purpose is not to confirm, but to test hypotheses in ways that challenge them: If CDC’s historical position on vaccines and neurodevelopmental disorders was correct, these compelling results should not exist.
Objective vs. Biased Studies: A Stark Contrast
A significant number of vaccine safety studies exhibit characteristics of bias, undermining their reliability and the trust placed in them. These are characterized by selective data inclusion, overly restrictive definitions of adverse events, analysis-to-result via subjective variable selection, and outright dismissal of plausible hypotheses. For example, the CDC’s now-infamous 2004 study dismissed an initial, strong link between on-time MMR vaccination and autism only after multiple study redesigns following the inconvenient finding of a robust association in older children, specifically African American boys and children with “idiopathic autism.” These results were left out of the final report to the IOM, an omission that should cement skepticism of CDC vaccine safety “science” for any objective scientist or physician.
Mawson and Jacob’s study included unvaccinated children as a control group—a rarity in this field—which highlights the inadequacy of these biased approaches. Moreover, the study’s independence from pharmaceutical funding ensures that its conclusions serve only one master: the truth.
Implications for Policy and Public Trust
The new findings carry profound implications. They demand a re-evaluation of the “one-size-fits-all” vaccination schedule, particularly for vulnerable populations like preterm infants. They call for personalized strategies that balance the benefits of immunization with the risks inherent to individual medical histories.
They also reinforce the urgency of transparency. Public trust in vaccines can only be restored through open dialogue, evidence-based decision-making, and transparency in research. It will be restored by evidence that withstands scrutiny and policies that prioritize health over headlines.
A Call for Scientific Integrity
The emergence of a small army of objective scientists and physicians who prefer evidence over narrative gives reason for hope. Scientists, policymakers, and public health officials must choose which column they wish to align with. Will they perpetuate a system that prioritizes narrative compliance over objective inquiry? Or will they embrace the difficult, often inconvenient truths that arise from truly independent science?
This study—rooted in Medicaid data and a commitment to methodological rigor—stands as a testament to the latter path. It challenges us to do better, not just for the sake of science but for the millions of lives that depend on it. To their credit, the authors go to great lengths to provide an inventory of potential limitations of their study.
Conclusion: Toward a Future of Accountability
The state of vaccine safety science remains uneven, with gaps that must be addressed to achieve balance and credibility. Yet every study like this one brings us closer to tipping the scales toward understanding via objectivity. It is a small but significant step in a much larger journey—one that requires courage, integrity, and an unwavering commitment to the public good.
The road ahead will not be easy. But if we are to rebuild public trust and advance vaccine safety science, there is only one path forward: objective, transparent, and fearless inquiry.
