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Autism Spectrum Disorder (ASD) rates around the world are skyrocketing for unknown reasons. Parents have fingered vaccines but studies have failed to confirm a link. Concurrently, aluminum, from vaccine adjuvants, has been found actively transported to the brains of animals inciting inflammation. Fluoride has been implicated in children’s brain dysfunction, and, fluoride has been shown to potentiate aluminum toxicity. No vaccine study to date has controlled for a practice widespread around the world – water fluoridation. Autism is more prevalent in United States cities that fluoridate their water supplies, and less prevalent in rural non-fluoridated areas even with high vaccination rates. This manuscript presents basic science and a hypothesis that fluoride could be potentiating the toxic neurological effects of aluminum in vaccines. This effect could lead to skewed data and confounding vaccine safety statistics by omission of this critical control factor.