You cannot put a timeline on credible scientific inquiry.
You can put a timeline on a false narrative which is exactly what RFK Jr and his allies have done for the last several decades. And that’s exactly what they will continue to do, unless our elected officials dosomething about it.
Ironically, I am currently in Vienna, having presented at this years’ ESCMID Global (the European Society for Clinical Microbiology and Infectious Diseases). More to come on the conference, but it is not lost on me that the US is doing everything they can to erase global health, infectious disease research, and health interventions.
Anyway, let’s get into it.
RFK Jr. doesn’t know what the term epidemic means
RFK Jr., Calley Means, David Geier, and his MAHA allies aren’t scientists. They don’t understand basic scientific principles, yet undermine experts that have devoted their lives to studying and understanding these topics.
An epidemic is a sudden increase in the number of cases of a disease above what is normally expected in that population, in that area.
Generally this applies to communicable diseases (infectious), but certain types of non-communicable health issues or diseases can also qualify. Epidemics share the following characteristics:
- Acute or rapid-onset in nature
- Unusual in scale or spread, especially among a population or region
- Often caused by a transmissible or external factor (sometimes involves both)
- Increases public health burden
- Requires collective measures to address factors causing the health burden
Epidemics historically involve the new emergence or new spread of a pathogen in a given species. Examples include:
- COVID-19, caused by the emergence of a new human virus, SARS-CoV-2. As a new pathogen in humans, it spread rapidly as a global epidemic, a pandemic.
- The Listeria outbreak linked to Boar’s Head deli products. Listeria monocytogenes bacteria are everywhere, but insufficient food hygiene factors led to contamination and spread of illness within the food supply.
- The current measles outbreak in Texas and surrounding regions is considered an epidemic — and it is linked to the measles virus and the external factor of plummeting vaccination rates which have now allowed measles to spread.
Ironically, RFK Jr. has continued to downplay the rapid and continued spread of measles which is unequivocally an epidemic. The measles outbreak is not normal in a developed nation that eliminated measles 25 years ago, is fully preventable. RFK Jr. has contributed to its existence and its continued expansion, especially as HHS has done nothing tangible to stop the outbreak.
RFK Jr. finally conceding that vaccination is the most effective preventive tool for measles is less than the bare minimum an HHS Secretary should do during the worst outbreak in 30 years. That’s even more true when he followed the statement with his same lies about nutrition, supplements, and more.
Non-communicable public health issues can fit the criteria of an epidemic, when external factors drive a rapid rise.
- Gun violence in the US is considered epidemic. It’s a uniquely American health issue on the rise. Gun violence is now the number one cause of childhood mortality in the US today. External factors are sociopolitical, ideological, and access to guns.
Non-communicable health epidemics share the same features as infectious epidemics: a rapid increase in prevalence or incidence, a substantial burden on public health, and a measurable change from historic trends.
There is no autism epidemic and autism is not a disease
Autism is a non-communicable, neurodevelopmental condition. Today, it is referred to as autism spectrum disorder (ASD) because it has a spectrum of presentations and a range of symptoms.
Autism does not have epidemic characteristics. Autism trends are:
- Gradual changes over the last several decades
- Linked to changes in diagnostic criteria, access to healthcare professionals, and better recognition of symptoms within communities
- Not associated with rapid increases in negative health outcomes or health burden
- Not caused by sudden or rapid development of the condition
Calling autism an epidemic manipulates a scientific term to push a false narrative.
Suggesting autism is an “epidemic disease” — not just a disease but something that needs to be “cured” is ableist and disgusting. Autism is not a disease. It is a neurological presentation that diverges from stereotypical ideals and as a result, people with ASD have been othered and are not provided appropriate tools to thrive in a society not set up for them.
I say that as a scientist with common decency and an aunt to a sweet, intelligent, incredibly observant girl with ASD.
Suggesting autism is caused by “toxin exposure” allows wellness charlatans to exploit vulnerable parents.
That is the very thing David Geier, RFK Jr’s appointee to find the “cause” of autism, profited off of for years. He sold unproven and harmful chelation treatments, chemical castration protocols, and abused children as part of his unproven and dangerous “detox” protocol for autism. (more on him, below)
David Geier is NOT a vaccine skeptic. Stop calling him that. He’s anti-vaccine
Autism rates have increased, but it’s not because more people are “getting autism.”
You’ve seen the Tweets and memes, right? Autism is skyrocketing! Autism prevalence was 1 in 10,000 in the 1970s and now it’s 1 in 36. It’s an epidemic, and it’s being driven by all the chemicals kids are exposed to, right? It’s gotta be. No other explanation.
These talking points are parroted by RFK Jr., Del Bigtree, the anti-vaccine community, Mark Hyman. Even Huberman has jumped on the bandwagon…really, anyone who doesn’t understand science or stands to profit off wellness industry rhetoric.
You can see how, when it is presented that way, it could lead members of the public to fall prey to this disinformation.
That’s not what is happening when it comes to autism.
First: a difference between incidence and prevalence (something Calley Means, wellness grifter extraordinaire and “advisor” to RFK Jr., still doesn’t get)
Prevalence is the total population of people existing with a condition at a point in time. It encompasses everyone previously diagnosed as well as newly diagnosed.
Incidence is the rate of new cases of a condition within a given period of time. We usually normalize that to population size, so that general population growth does not give the false appearance that a rate is increasing. Usually, incidence is represented as # per 100,000 per year (or similar).
If prevalence of a condition increases over time, it can be a function of increased new cases, but it can also reflect the ability to newly diagnose something, changes in diagnostic criteria, or a combination of these factors.
Breast cancer prevalence and incidence rose 300% after the development of mammograms in the 1970s. This wasn’t because more breast cancers suddenly occurred but that prior to mammography, it was impossible to identify early breast cancers. Increased prevalence and incidence was a result of earlier diagnosis, ultimately improving outcomes.
The number of autism diagnoses has increased over the last few decades due to changes in diagnosis.
Neurological, psychiatric, and psychological conditions are characterized in large part through the Diagnostic and Statistical Manual of Mental Disorders (DSM). The first DSM was published in 1952, preceded by earlier materials like the Statistical Manual for the Use of Institutions for the Insane in 1917.
DSM-II came out in 1968, followed by DSM-III (1980), DSM-IV (1994), a text revision in 2000 (DSM-IV-TR), and DSM-V is the current version, published in 2013.
I’m sure you understand we’ve come a long way in our knowledge over 70 years, right? But according to those rampant infographics circulated by Children’s Health Defense, in the 1970s, autism only occurred in 1 in 10,000 individuals, yet…
The DSM-II did not even include autism.
There wasn’t even a name for autism in the 1970s! Children with stereotypical autism symptoms were classified under childhood schizophrenia which only included symptoms like social withdrawal, communication challenges, and repetitive behaviors.
Then that infographic jumps to 1995, the early 2000s, and to today, to make it seem like something in the 1990s and 2000s led to a skyrocketing of autism.
They use these graphs to suggest the “cause” was vaccines, specifically, the “toxic chemicals” in vaccines. We did see the development of new vaccines in recent decades to prevent against deadly and debilitating diseases (below). That’s a good thing — and isn’t causing autism (thanks, science!).
Suprise! In 1994, the DSM-IV expanded the definition of autism to include what is now called Autism Spectrum Disorder (ASD).
This included a broader umbrella of characteristics that individuals with ASD may present with. It included more information and education to benefit pediatricians, educators, and parents, which gradually has increased awareness since its publication. However, lingering confusion on how to apply those expanded criteria remained.
The DSM-IV-TR was published in 2000 to clarify identifying and diagnosing ASD based on those expanded criteria of the DSM-IV. This facilitated increased recognition of ASD, especially for less stereotypical presentations.
The fields of neurobiology, psychology, childhood development, and psychiatry were less well-developed several decades ago. Today, we have better awareness, a larger pool of trained professionals, and more parents willing to seek medical consultation for symptoms that present that may be a result of ASD.
Autism prevalence has increased similarly among countries globally.
The prevalence of ASD depends on health infrastructure and whether a country recognizes the changing criteria for autism. But:
- In the US, population-level prevalence of ASD was 2.00% in 2011 (1 in 50) and is now estimated at 1 in 31 as of 2022.
- In Japan, current prevalence is estimated to be 1 in 32.
- In South Korea, prevalence is 1 in 35, also an increase from their previous estimate of 1 in 38 (2.64% in 2011). Fun fact: that’s higher than US estimates in 2011. Are they screaming about an autism epidemic?
- In Canada, 2019 data shows ASD prevalence to be roughly 1 in 50. In looking at the data, you can see large disparities between more developed provinces and less developed provinces, underscoring that access to health systems for diagnosis impacts recognition.
- In Australia, a similar increase in prevalence is also noted, with 2022 estimates putting ASD to affect 1 in 40 individuals.
Rates of ASD in girls continues to lag behind boys. This is likely influenced by underdiagnosis in girls, akin to diagnosis disparities in ADHD among girls and women.
The recently published MMWR on US prevalence of autism states:
“Increased identification of autism, particularly among very young children and previously underidentified groups, underscores the increased demand and ongoing need for enhanced planning to provide equitable diagnostic, treatment, and support services for all children with ASD.”
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If there was an “epidemic” of autism, you would see disproportionate changes based on regional or population distinctions. That doesn’t exist. Autism is not an epidemic, it is not a disease, and it is not something that needs to be demonized or “fixed.”
What do we know about the causes of autism?
After decades of research, better understanding of neurological and psychological development, we know quite a bit, and good quality research continues to add to that.
1) There is NO link between vaccines and autism.
RFK Jr. has been profiting off of this lie for over 25 years. By continuing to repeat this rhetoric, he will continue to profit. His appointment of David Geier, a man with zero scientific and medical credentials (birds of a feather, am I right) to “investigate” this link, is not only absurd, but incredibly dangerous.
All largescale studies continue to show this. A non-exhaustive rundown:
- A cohort study including Danish 467,450 children in JAMA (Journal of the American Medical Association).
- A nationwide cohort study of 657,461 Danish children in Annals of Internal Medicine.
- A retrospective cohort study of 537,303 children in the New England Journal of Medicine (NEJM).
- A retrospective cohort study of over 500,000 US in Vaccine.
- A retrospective cohort study of 95,727 US children in JAMA.
- An epidemiological analysis of children with and without autism in the Lancet.
- A global review conducted by the Institute of Medicine (US) Immunization Safety Review Committee.
- A systematic review of 67 studies involving millions of children in Pediatrics.
- A scientific review in Clinical Infectious Diseases.
- A systematic review of 10 primary studies in Pediatrics.
Read the below article I wrote in January for more details on each of these:
A recent study did NOT show vaccines cause autism, but RFK Jr. keeps pushing the lie
RFK Jr. founded and was the CEO of the Children’s Health Defense and makes millions of dollars with anti-vaccine activism through CHD, his ties to vaccine lawsuits, books, and speaking engagements.
2) Genetics is the biggest factor in autism development.
Studies continue to add to the body of evidence that ASD traits are based in genes passed down through sexual reproduction.
Twin studies support a genetic cause of autism.
Twin studies comparing identical (monozygotic) versus non-identical twins (dizygotic) provide robust evidence to this. The probability that both twins will have ASD is roughly 90-99% if twins are monozygotic, compared to 31-67% if the twins are dizygotic (variations by study design and definitions of ASD).
These data also refute claims that “chemical exposures” within a household or family are a major contributor to developing ASD.
Autism runs in families. Studies show non-twin siblings of individuals with autism have a 20% likelihood of also being diagnosed with ASD. That’s a 7-fold increased chance over population-level rates, which is consistent with inherited gene patterns. That likelihood increases in families with multiple members that have ASD.
The average genetic linkage of autism and ASD is estimated to be about 83%.
Genes involved in regulation of other genes and neurological development are linked to ASD.
Many genes are involved in ASD, so we don’t know all of them and how their expression, lack of expression, extent or timing of expression, etc., all come together to lead to ASD development, but we do have some understanding.
Research has identified genes implicated in ASD development. These include a study in Cell in 2020 identifying 102 gene alterations changed among samples from patients with ASD compared to neurotypical samples. Other studies, such as an organoid model-based study in Nature, report similar findings.
Many genes identified have regulatory functions: they directly impact the expression of other genes (and resulting proteins produced through gene expression). Others are involved in neural communication, particularly those important in early brain development.
Prenatal development may impact autism, but to a much lesser degree, and not because of “chemical” exposures.
Another claim is that autism runs in families because they’re all exposed to the same “environmental toxins” and it’s that, not genetics, that causes autism. This trope by RFK Jr. has allowed him to make millions via civil tort-based lawsuits where he recruits sympathetic plaintiffs to target a supposed evil [big X chemical company].
There is no quality evidence to support this and the term “environmental toxins” is a meaningless but emotion-laced phrase used by wellness influencers to scare people.
What’s real about prenatal environment and ASD development?
Some prenatal exposures have weak association with slightly increased autism risk—but these associations don’t exist without a genetic link to ASD. Also remember: association is not causation, and that’s even more true when the association is weak.
For the sake of being thorough, these include:
- Infections during pregnancy, like maternal rubella and cytomegalovirus (CMV).
- Severe preterm birth (linked to a myriad of neurological and physical conditions)
- The use of valproic acid during pregnancy (used to control seizures)
What’s not real about prenatal environment and ASD development?
Exposures to: glyphosate, parabens, phthalates, “chemicals” in food, pesticides, GMOs, aluminum salts in vaccines and antiperspirants, other vaccine ingredients, food dyes, BPA, preservatives, etc.
There are zero credible studies that any of these are related to ASD. They are common villains among wellness influencers who use the appeal to nature fallacy, chemophobia, and general fear-mongering to spread unfounded claims.
RFK Jr.’s autism rhetoric isn’t just wrong, it’s harmful.
RFK Jr.’s recent statements are more of the same from him and others who push disinformation about autism and the causes. Disinformation about autism:
Stigmatizes people with autism. Calling autism an epidemic and a disease when it is neither dehumanizes people with autism. It implies they are a burden, a public health issue, or something to be solved. RFK Jr. even said people with ASD are less valuable humans.
Fuels dangerous wellness behaviors. Autism lies started with anti-vaccine rhetoric. The continued perpetuation discourages vaccinations and directly contributes to resurgence of deadly and preventable diseases like measles. Wellness rhetoric undermines robust science to sell unproven “cures” — the very business model of MAHA allies like David Geier: selling chelation treatments, “detoxes,” and hormone-based chemical castration protocols.
Exploits and blames vulnerable parents. A theme of wellness disinformation is to attribute health fully to personal choices. If there is an unexpected outcome, it’s your fault. That’s false. You didn’t do something wrong if you have a kid with ASD.
Undermines credible scientific research regarding ASD. Diverting resources and defunding quality research to chase after conspiracies wastes time, money, harms public health, slows educational tool implementation, and legitimizes dangerous lies that stigmatize marginalized people.
There’s no autism epidemic
Increased recognition is a result of better tools and awareness. We need evidence-based information, not lies and conspiracies. RFK Jr. isn’t just egregiously wrong when it comes to the science—he promotes a regressive narrative that harms people with autism, their families, their ability to access real resources, and the science and public health that is the foundation of it all.
RFK Jr. is a threat to public health.
His actions, both this week and throughout the last several decades, make him objectively disqualified to lead HHS. He should be removed from this role immediately.
Now, more than ever, we all must join in the fight for science.
Thank you for supporting evidence-based science communication. With outbreaks of preventable diseases, refusal of evidence-based medical interventions, propagation of pseudoscience by prominent public “personalities”, it’s needed now more than ever.
More science education, less disinformation.
ImmunoLogic is written by Dr. Andrea Love, PhD – immunologist and microbiologist. She works full-time in life sciences biotech and has had a lifelong passion for closing the science literacy gap and combating pseudoscience and health misinformation as far back as her childhood. This newsletter and her science communication on her social media pages are born from that passion. Follow on Instagram, Threads, Twitter, and Facebook, or support the newsletter by subscribing to her Substack.
