In the book Autism's False Prophets, pediatrician and rotavirus vaccine co-inventor Dr. Paul Offit deconstructs the popular (and false) belief that vaccines are a cause of autism. The chapter "Science and Society," presented here in an exclusive excerpt, explores the question: If the connection between autism and vaccination has no basis in science, why do so many of us accept it as fact? Turns out the answer is far from simple — among the culprits are Oprah, Google and religion. Read on to learn how parents everywhere were duped — and for more, check out Babble's candid interview with Dr. Offit.

There is nothing to fear except the persistent refusal to find out the truth.
                                                                                                            — Dorothy Thompson

In a culture dominated by cynicism and hungry for scandal, many people believe that doctors, scientists, and public health officials cater to a pharmaceutical industry willing to do anything — including promote dangerous vaccines — for profit. So it's not hard to appeal to the notion that pharmaceutical companies are evil. Current movies certainly reflect this sentiment. In The Constant Gardener, released in 2005, a pharmaceutical company makes an antibiotic that is highly effective against multidrug-resistant tuberculosis. When the drug is found to have a fatal side effect, the company buries its victims in a mass grave outside of town and kills others who know about the problem, including the sympathetic wife of a government official. In The Fugitive, released in 1993, a pharmaceutical company hires a one-armed man to kill a doctor (Richard Kimble) when he finds that one of the company's drugs, nearing FDA approval, causes fatal liver damage. Neither the screenwriters nor the public considered these two scenarios implausible. Viewers were perfectly willing to believe that pharmaceutical companies hire hit men to kill people.

To some extent, pharmaceutical companies have brought this upon themselves. Twenty years ago, direct-to-consumer advertising of prescription medicines was uncommon. Now television viewers encounter a barrage of advertisements from pharmaceutical companies showing that medicines can be miraculous; people with allergies run comfortably through pollen-filled fields; and women skate effortlessly despite joint pain. Also, the types of drugs that are being made have started to change: more research dollars are being spent to develop lifestyle products, like those to combat impotency or hair loss. It's hard to argue the special place of an industry in society when it's hawking yet another potency product. Companies are starting to look like snake oil salesmen.

Good science will be reproduced by other investigators; bad science won't. So, if everyone appears to be in someone's pocket, who or what can be trusted? How can people best determine if the results of a scientific study are accurate? The answer is threefold: transparency of the funding source, internal consistency of the data, and reproducibility of the findings.

People have the right to know the funding source for scientific papers. For example, when Andrew Wakefield [the doctor who first proposed a connection between autism and the MMR vaccine] published his study of autistic children in the Lancet, he should have acknowledged that he had previously received money from Richard Barr and that Barr represented some of these children in a lawsuit against pharmaceutical companies. The irony in Andrew Wakefield's case was that not only did he fail to inform the Lancet's readership of his funding source, but he failed to inform his co-investigators, most of whom later withdrew their names from his paper. Although funding sources should be reported in every scientific paper, they're probably the least important factor in judging a study's worth or reliability.

More important are the strength and internal consistency of the data. When Lancet editor-in-chief Richard Horton found that Andrew Wakefield had received funds from a personal-injury lawyer, he was outraged. But Horton's anger should have been aimed at the obvious weaknesses in Wakefield's paper, not at his perceived motives. Andrew Wakefield had proposed that measles vaccine damaged children's intestines, allowing entrance of harmful toxins that caused autism. It was a hypothesis for which Wakefield offered not one shred of scientific evidence. Wakefield's paper shouldn't have been published not because he had received funds from a personal-injury lawyer but because his assertions were based on flimsy, poorly conceived science.

Probably the most important aspect of determining whether a scientific assertion is correct is the reproducibility of its findings. Superb, reproducible studies have been funded by pharmaceutical companies and poor, irreproducible studies have been funded independently, and vice versa. In the end, it doesn't matter who funds a scientific study. It could be funded by pharmaceutical companies, the federal government, personal-injury lawyers, parent advocacy groups, or religious organizations. Good science will be reproduced by other investigators; bad science won't.

Other aspects of our culture also determine how people process scientific information. During the past few decades, doctors have started to treat patients differently. No longer do they always take a paternalistic, I-know-what's-best-for-you-so-don't-worry approach. Doctors are more apt to encourage patients to actively participate in their own medical care. And nothing has empowered people more than the internet. Now patients have ready access to a wealth of information about health, medicine, and science. During a recent segment on the Oprah Winfrey Show, a celebrity mother was asked where she had gotten her medical information. "I attended the University of Google," she replied. J. A. Muir Gray, a British researcher and author of The Resourceful Patient, celebrates the culture of shared expertise. "In the modern world," he said, "medicine was based on knowledge from sources from which the public was excluded — scientific journals, books, journal clubs, conferences, and libraries. Clinicians had more knowledge than patients mainly because patients were denied access to knowledge. The World Wide Web, the dominant medium of the post-modern world, has blown away the doors and walls of the locked library."

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