Study finds no connection between MMR vaccine and autism
BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7437.421-a (Published 19 February 2004) Cite this as: BMJ 2004;328:421
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I think the reason Brent Gaddis is confused is because of the way the
MMR and autism story has been reported in the popular media.
One of the first things journalists are taught at journalism school
is that it is important to be balanced, and always to give both sides of
an argument. This works well for political journalists, as there are
opposing views to most political stories. It would be quite wrong for a
journalist to report the government's views on the latest political issue
without also reporting the opposition's views.
Unfortunately, it works considerably less well for science
journalists. It is true that some medical stories reflect genuine
controversies, such as whether we should screen for prostate cancer. Here,
giving equal weight to both views is no bad thing. The trouble arises when
one point of view is supported by overwhelmingly greater evidence than the
other: journalists still feel they have to give both sides of the story
equal prominence, which grossly distorts the story.
A great deal of research has been done on the possible link between
MMR and autism. Although it is never possible to prove a negative, the
research has shown convincingly that if any link exists, it must be
extremely small. Nonetheless, a vocal minority of anti-vaccinationists
have managed to keep the story going, which has been made possible by
journalists' well intentioned, but misguided, sense of duty to report
their views.
It is important to realise that the anti-vaccinationsists' point of
view is supported by almost no evidence. In a previous BMJ rapid response
on this topic [1], I asked the simple question 'Are there any published
studies with a sample size of more than 12 that have shown a causal link
between MMR vaccination and autism?'
That question has yet to be answered, which I suggest may provide the
clear answer that Gaddis is looking for.
References:
1. http://bmj.bmjjournals.com/cgi/eletters/327/7428/1411#44490
Competing interests:
My company provides consultancy services to various clients, who have occasionally included vaccine manufacturers. We would be happy to work for anti-vaccinationists as well if they were to agree to our normal evidence-based approach.
Competing interests: No competing interests
Here's some more: Will every Medical professional who vaccinates a
child sign a form to say a) the child is perfectly healthy and has no
medical weaknesses or sign of autism or vulnerability to haemorrhage b)
that if such events happen after vaccination they will be financially
responsible for caring for this child throughout the rest of their lives -
or - if they die - they will compensate for the loss of their lives.
Competing interests:
I assess children on the autistic spectrum
Competing interests: No competing interests
Dear Brent,
here is some common sense; get your child vaccinated
Competing interests:
None declared
Competing interests: No competing interests
As a soon to be parent, I must say that it is frustrating and obvious
that there is not a clear answer one way or the other here. There seem to
be so many opinions, positions, studies, etc... and the problem that
parents today face is that there is no clear answer from the
people/organizations who are supposed to be protecting the population.
Every single couple in my "soon to be parent classes" expressed concern
about immunizations and autism. I have been around long enough to see
that the opinions of medical doctors change, the FDA removes drugs that
they previously approved, etc... These things happen and to follow
blindly is scary if not dangerous. Especially when dealing with our
children. Can somebody tell me who thought that putting one of the most
toxic substances on the planet (i.e. mercury or mercury derivative) into
the bloodstream was a good idea. Break a thermometer, call HAZMAT. Other
than that, shoot that heavy metal right into the bloodstream. It is scary
that that went on for so long before it was halted (we hope the drug
companies are telling us the truth now)
There are too many vaccines. Its a big money business. Don't think
otherwise. Chickpox vaccines? For what? Hell, everyone I know had the
chickpox. Flu vaccines? Please. Each year they tout them on the news.
Most of the time, they later state that the vaccines didn't address the
particular flu strain for that year. Oh and by the way, some of them
still contain thimerosal. Why is that?
Until such time that parents see an actual unbiased study that is
conclusive and definite, there is going to be confusion. How about this
for an idea: Create a cross discipline team of researchers (i.e. medical
doctors, chiropractors, government officials, drug company manufacturers,
etc... - make it a sort of a "cross functional jury") to conduct a study
together. That way, the members of the "jury" would be forced to keep
each other in check as far as scientific approach, force each other to
ignore biases or other "interests", etc... It is way too easy to bend
statistics to prove a position. Way too easy. It seems that for every
study or statement that denies a link between MMR and Autism, there is a
conflicting study or statement from a doctor or chiropractor suggesting a
link. All of this is very confusing to the average parent.
You experts need to figure it out. You are the experts and as a
society, if we can fly a person to the moon or make a bomb hit a house
1000 miles away, we can surely conduct an unbiased study and come up with
a damn answer. As parents, we are counting on you.
Until that happens, I'm not letting anyone stick a needle in my child
for any vaccination. The lack of conclusive evidence one way or the other
coupled with the lack of unbiased, unrefutable research is not comforting
as a parent. I want to believe that the CDC and our govt and medical
community is looking out for our best interests. However, the length of
time it is taking to figure this out and either establish the link or
disprove it is ridiculous considering all the smart people who are
involved.
I'm to the point of reverting to what I perceive as common sense.
That is, sticking a needle in the arm of a baby and injecting soemthing
foreign into the bloodstream just doesn't sound like a good idea to me.
Especially before their little immune systems are able to handle it.
Competing interests:
None declared
Competing interests: No competing interests
Trying to relate just MMR or just thimerosal to autism is a losing war because there is more than one parameter that needs to be present for autism to start. Furtheremore, epidemiologic studies are not going to prove anything since they can be manipulated at will.
Prof. Boyd Halley at the chemical department of the university of Kentucky suggested that thimerosal suppresses the immune system allowing the attenuated measles virus to get a foothold inside of
intestinal cells that leads to the inflammatory bowel disease (IBD).
He showed in his experimental (and not epidemiologic) studies about thimerosal effect that the presence of aluminium (MMR while free of thimerosal is high in aluminum) dramatically increased the rate of neuronal death (brain cells) caused by thimerosal. He also showed that antibiotics especially tetracycline and ampicillin increased the toxicity reaction to thimerosal.
In other experimental studies, he found that neurons pre-incubated with estrogen demonstrated substantial protection against thimerosal-induced neuronal death. In contrast, a low nano-molar level of thimerosal that gave less than 5 percent neuron death in three hours resulted in 100 percent cell death by the addition of one micromolar level of testosterone. This may explain why boys are four times more affected with autism than girls.
All these studies can be duplicated at very low cost in any biochemistry lab by chemists who dont have any competing interest. Why not start with that?
The current vaccines are still not thimerosal free. A hundredth of a percent is still highly toxic to infants. A millionth of a percent is 10 microgram per liter which is high by any standard used. Vaccines should be free (zero concentration) of any toxic metal, ethanol, or formaldehyde before they are considered safe.
Competing interests:
Kid with autism
Competing interests: No competing interests
Dear Sir:
I agree with F. Edward Yazbak, MD with the studies that he calls for.
There is no reason why they shouldn't be done especially if we want to
stop the autism epidemic and prevent more children from developing
regressive autism. It is not a coincidence that more and more children are
getting regressive autism after receiving the MMR vaccine at 15 months.
Recently the CDC and the American Academy of Pediatrics are now
reporting that 1 out of 6 children are diagnosed with a developmental
disorder and 1 in 166 children are diagnosed with an autism spectrum
disorder (1). Several years ago it was reported that 1 in 500 children had
an autism spectrum disorder, then 1 in 250 children had an autism spectrum
disorder and now it is 1 in 166 children that have an autism spectrum
disorder.
The Autism Autoimmunity Project has kept track of the US Department
of Education figures regarding autism for school aged children from 6 to
21. The US Department of Education started tracking autism in 1991/1992
and have consistently used the same diagnostic criterion for autism. In
2000/2001 there was a total of 78,717 children with autism (2)nationwide.
In 2001/2002 the nationwide total of autism increased 19,130 to 97,847 (3)
and in 2002/2003 the nationwide total of autism increased 20,755 from
97,847 to
118,602 (4). I anticipate that the 2003/2004 figures that will be out in
October 2004 will show an even larger increase.
The critics of the link between the MMR vaccine and autism should pay
attention to the figures of autism that are continuing to skyrocket. At
The Autism Autoimmunity Project we will continue to document the numbers.
More clinical science needs to be done and denials of a link to the MMR
vaccine and autism will not help the children/adults already affected nor
will it stop the autism epidemic. The critics should be explaining to us
with clinical science why children with autism have measles in the gut,
why they test positive for myelin basic protein antibodies and why they
have elevated measles antibody titers. The critics should also work to see
what we can do to reverse the damage of those children/adults with autism
with treatments.
Hopefully, the attitude of the critics will change so that we can
stop the epidemic of autism. If not, then we maybe reporting in the next
five to ten years that autism affects
1 in 50 children, 1 in 25 children and yes, 1 in 2 children.
That, in deed, would be a tragedy.
References
1. An Autism ALERT
http://autismautoimmunityproject.org/A.L.E.R.T..htm
2. The US Autism Epidemic
http://autismautoimmunityproject.org/shame.html
3. 2001-2002 Autism figures (97,847 701% nationwide increase)
http://www.ideadata.org/tables25th/ar_aa3.htm
4. 2002-2003 Autism figures (118,602 870% nationwide increase)
http://www.ideadata.org/tables26th/ar_aa3.htm
Competing interests:
Founder of The Autism Autoimmunity Project and father to Eric Gallup who has regressive autism with myelin basic protein antibodies, elevated measles antibody titers, T-cell abnormalities, and colitis
Competing interests: No competing interests
The author starts by stating that the results of a recent study
published in Pediatrics (1) “show no relation” between the MMR vaccine and
the development of autism when in fact the DeStefano study only showed
that children diagnosed with autistic disorders in Atlanta Georgia
received their MMR vaccination at about the same age as a control group of
non-affected children.
Next, the author refers to the 2001 meeting of a special committee of
the US Institute of Medicine (IOM) but fails to mention that the committee
also stated that “the conclusion does not exclude the possibility that MMR
vaccine could contribute to ASD in a small number of children.”
Interestingly, the Vaccine Safety Committee of the IOM met again on
February 9, 2004. The following are quotes from 3 presentations:
“Mind you, half of Dr. Wakefield’s theory has been proven correct and
accepted in the medical community. Hundreds of children with regressive
autism and GI dysfunction have been scoped and clinicians are seeing the
inflammatory bowel disease he first described. The NIH is finally funding
an attempt to repeat Dr. O’Leary’s findings of measles RNA in Wakefield’s
biopsy specimens, though I am disappointed it has taken this long”. US
Representative Dave Weldon, Florida, 15th District, a physician
"Based upon our experimental research, it is plausible to postulate
that an atypical measles infection that does not produce a typical measles
rash but manifests neurological symptoms might be etiologically linked to
autoimmunity in autism. The source of measles virus could potentially be
MMR vaccine or a mutant measles strain, but more research is necessary to
establish either of these two possibilities…Fundamentally, I tend to think
that autistic children have a problem of their immune system, which is the
“faulty immune regulation.” Hence they have abnormal immune reactions to
measles virus and/or MMR vaccine” Vijendra K. Singh, Ph.D., Research
Associate Professor of Neuroimmunology, Utah State University, an expert
in the autoimmune causes of autism.
“In light of encephalopathy, presenting in children as autistic
regression closely following MMR vaccination … The findings confirm a
highly significant statistical association between the presence of MV RNA
in CSF and autistic regression following MMR vaccination.” Jeff
Bradstreet MD, Director, International Child Development Resource Center,
Melbourne, Florida.
Dr. Bernard Rimland, Founder of the Autism Society of America,
President of the Autism Research Institute and a full-time professional
research scientist in the field of autism for 45 years has stated “Late
onset autism, (starting in the 2nd year), was almost unheard of in the
‘50s, ‘60s, and ‘70s; today such cases outnumber early onset cases 5 to 1,
the increase paralleling the increase in required vaccines.” (2)
This directly contradicts the following statement by the author
“Because autism is usually diagnosed during the toddler years…”
Lastly, MMR does not contain Thimerosal and the majority of pediatric
vaccinations are given in the first year of life.
A relatively simple study would be to compare the age of onset of
autistic symptoms in affected children in Atlanta who received the MMR
vaccine at 15 months with those vaccinated at 30 months of age. I believe,
from my own research, that such a study will show that autistic behavior
follows MMR vaccination and that fewer and milder cases will be noticed in
the cohort vaccinated at 30 months, since vaccination at a younger age is
more damaging. Another reasonable study would be to compare Measles, MMR
and Myelin Basic Protein antibody titers of children who developed autism
shortly after MMR vaccination in Atlanta to an equal sample of normal
children similarly vaccinated.
Obviously there is an inherent risk with these studies; they could
prove that regressive autism after MMR vaccination is not a coincidence.
References
1. DeStefano F. et. al. Age at First Measles-Mumps-Rubella
Vaccination in Children With Autism and School-Matched Control Subjects: A
Population-Based Study in Metropolitan Atlanta PEDIATRICS Vol. 113 No. 2
February 2004, pp. 259-266
2. The Autism Epidemic is Real and Excessive Vaccinations Are the Cause
A Statement: Bernard Rimland, PH.D.July 14, 2003
Available at: http://autismautoimmunityproject.org/Rimland.htm
(accessed February 17, 2004)
Competing interests:
Grandfather of a child with autism who happens to have evidence of Measles Genomic RNA in his intestinal biopsy.
Competing interests: No competing interests
Perhaps I didn’t explain my position sufficiently clearly so that I
could avoid being misunderstood.
Frank Noos states that I believe that there is a connection between
MMR vaccination and autism. I never made any such claim. I merely stated
that if MMR vaccination does have some causal connection with autism, and
if it only causes autism in a very small fraction of MMR vaccinated
children, then there must be some other undiscovered factor in play that
causes only a very rare MMR vaccinated child to develop autism. Whether
that undiscovered factor is inherent in the MMR vaccine, or a factor
associated with the vaccine, or rather a singular, but rare,
predisposition in a susceptible child – I have no idea. I simply labelled
that unknown factor (if it exists) an “autistic factor”. Because that
theoretical “autistic factor” must be extremely rare (considering that
autism is so uncommon relative to the number of children who get MMR
vaccination), then one cannot search for its presence by looking at a
small sample of children vaccinated early rather than late, because if it
actually exists, there is no guarantee that it would be distributed
proportionally (equally) in a small population sample of children
vaccinated early versus a small population of children vaccinated late.
The same analogy of an undiscovered “causal factor” exists in the
relationship between cigarette smoking and the development of coronary
heart disease (CHD). Statistically, there is a definite association
between cigarette smoking and an increased likelihood of developing CHD.
However, only a small percentage of cigarette smokers develop premature
CHD. Therefore, there must be some undiscovered “causal factor” in play (?
genetic) that causes smoking to cause CHD in a particular (susceptible)
individual. If one studied a small sample of 100 smokers, versus a small
sample of 100 non-smokers, and then compared the ten year incidence of
CHD in smokers versus non-smokers, one may not necessarily find a strong
causal association between smoking and CHD -- if by chance that
undiscovered “causal factor” just didn’t occur as frequently in that small
sample of 100 smokers as it does in the general population of smokers. The
same analogy applies to searching for an unknown (if it exists) “autistic
factor” in a small sample of MMR vaccinated children. If that “autistic
factor” actually exists, then there is no guarantee that it is distributed
as frequently in a “particular” small sample of vaccinated children as it
does in the general population of vaccinated children. Therefore, a small
study involving a few hundred, or a few thousand patients, may not be
large enough when one is dealing with a clinical situation where a
postulated accessory (but necessary) “causal factor” occurs very
infrequently.
Competing interests:
None declared
Competing interests: No competing interests
I found Mr. Mann's argument to be specious. He agreed that the
Gottlieb work found no causal connection between MMR vaccination and
autism, but goes on to say that he "believes" that such a connection
exists, probably because of some "autistic factor" that Gottlieb did not
control for. This in spite of the fact that dozens of other trials, here
and in Denmark, have found no connection between vaccines and autism, and
despite the fact that no one has ever seen evidence suggestive to an
objective mind of an "autistic factor." As the father of a son profoundly
handicapped by autism, I share the evident frustration of Mr. Mann over
the inability of the medical community to find a cause for autism.
However, it's in no ones best interest to substitute "beliefs" for real
scientific evidence. Gottlieb's conclusion that there was no link between
MMR vaccination and autism is an objective fact; Mr. Mann's belief that it
showed the opposite, and his "belief" that there is an "autistic factor"
are just that: beliefs, similar to religious beliefs. There is a place
in our hearts for "beliefs" about our autistic loved ones, but let's not
confuse those beliefs with scientific evidence.
Competing interests:
None declared
Competing interests: No competing interests
Re: Re: Re: Complete and total confusion in the population
I wish there were grounds for Liam Farrell's confidence.
Unfortunately, I have read the press release of Rep. Dave Weldon in
response to the Institute of Medicine (IOM) report Tuesday before last (18
May) endorsing the safety of MMR and Thimerosal (so far unreported here).
In case there is any doubt about Rep. Waldon's professional credentials or
political bias it ought to be pointed out that he is both a medical doctor
and a Republican. Here are some extracts [1]:
"Today's report is premature, perhaps perilously reliant on
epidemiology, based on preliminalry incomplete information, and may
ultimately be repudiated...Unfortunately, this report will lead many
clinicians to believe that thimerosal is safe and there is no problem with
MMR; however, it will do nothing to allay the concerns of thousands of
parents of autistic children. It will only drag the IOM under the cloud of
the controversy that has currently engulfed the CDC. This concern is what
lead me earlier this year to request that Dr. Julie Gerberding delay the
meeting and the report."
He goes on:
"In 2001 the IOM stated that it is "unclear whether ethylmercury
[from vaccines] passes readily through the blood brain barrier...". The
IOM recommended several biological and clinical studies to answer this
question and whether this mercury could cause developmental problems.
These studies were in large part never done...The IOM's scope of
investigation was severely narrowed for this review...This raises
suspicions that this IOM exercise might be more about drawing pre-designed
conclusions..."
Rep. Waldon goes on to say:
"unfortunately, the epidemiology studies that the IOM bases its
findings on are not immune from conflict or controversy. Many of the
authors have conflicts of interest including funding from vaccine
manfacturers, employment by manufacturers, or conflicts in that they
implemented vaccine policies that are now being investigated. Futhermore,
the studies were designed to examine entire populations and would miss
subgroups of genetically susceptible populations...The IOM report is based
on studies examining populations in the United Kingdom, Denmark, Sweden
and the United States - all of whom have different vaccines, vaccine
policies, and mercury exposures. Study results are only as reliable as the
design of such studies. Relying on these studies to draw conclusions is
shaky ground."
Turning specifically to MMR he writes:
"...the IOM review of this matter is totally premature; the NIH is
only now attempting to duplicate the work of Dr. Andrew Wakefield. Half of
Dr Wakefield's work has been demonstrated to be correct. Attempting to
draw "conclusions" at this time is counterproductive. Statistical studies
of this matter are of little benefit, only clinical pathological study
will lay this issue to rest."
Dave Weldon concludes:
"Lastly, I am also troubled by the lack of liability or
accountability by these decision-makers should they be proved wrong. I
want more than just a "sorry" from them should their conclusions be found
erroneous a few years down the road. Two many lives are at stake."
Well, Dr Farrell?
[1] News from Dave Weldon, May 18, 2004, contact:
Jaillene.Erickson@mail.house.gov
Competing interests:
Parent of a child with autism. Pro safe vaccination.
Competing interests: No competing interests