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Dispatches. MMR: What They Didn't Tell You

BMJ 2004; 329 doi: https://doi.org/10.1136/bmj.329.7477.1293 (Published 25 November 2004) Cite this as: BMJ 2004;329:1293

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Abi Berger's sensationalistic tabloidesque MMR review not worthy of BMJ or other medical journal

Dear Abi Berger and BMJ:

Your sensationalistic review entitled "MMR: What They Didn't Tell
You" (November 27) unfortunately fell short of doing its homework. For
the sake of innocent children who may yet be damaged grievously by the MMR
vaccine, I must hope that you and Brian Deer are not misinforming loving
parents by allowing a pharmaceutical manufacturer or other entity with
similarly vested interests to do your homework for you.

My 6 1/2 year old son, who is diagnosed with autism, was scoped by
quite possibly the best pediatric gastroenterologist in this country. The
findings evidenced that my son's gastrointestinal tract pathology is
consistent with the findings of Dr. Andrew Wakefield. The work/findings of
Dr. Wakefield have been replicated by various parties. Elevated titers
corresponding with the antigens in the MMR vaccine may provide further
substantiation of an MMR reaction, as might my son's laboratory testing
showing an autoimmune reaction to brain tissue, which is consistent with
the work of Dr. Singh and his correlation with vaccine strain measles
virus.

Although you say that, "Large scale international epidemiological
studies have repeatedly failed to find any indication for his advice to
give single shots, or confirm the assertion of a causal link between the
MMR vaccine and autism," you fail to mention that the most-often quoted
study is the Danish MMR study, and that study has been refuted. In a
press release of September 1, 2004, we read:

"Goldman and Yazbak report association between start of MMR
Vaccination and Increase in Autism.

Based in part on a key Denmark study by K. Madsen in 2002, the
Institute of Medicine (IOM) recently concluded that no connection existed
between MMR vaccination and the increase in autism. During the period of
Madsen’s study, in the US, the MMR vaccine was usually administered at the
age of 12 months, often with two other vaccines (Hib and Hep B) that
contained Thimerosal–a mercury derivative. By contrast, in Denmark, MMR
vaccine was usually administered alone at the age of 15 months and by 1992
the thimerosal-containing pertussis vaccine had been phased out.

From 1992 to 2000, by the age of 6 months, infants in the U.S. had
been exposed to 12 vaccines and up to 187.5 micrograms of thimerosal,
compared to only 6 vaccines with no thimerosal in Denmark. Thus, Gary S.
Goldman, Ph.D. and F. Edward Yazbak, M.D. took the opportunity to
investigate the effect of the MMR vaccine on autism without the
confounding (complicating) effects of thimerosal.

Goldman and Yazbak estimate that a substantial increase in autism
occurred in Denmark after the introduction of the MMR vaccination in 1987.
Their results therefore oppose those of Madsen who selectively restricted
his review to the period between 1991 and 1998 and reported that a link
did not exist.

Goldman explains some of the flaws inherent to the Madsen study,
“Because autism is usually diagnosed at age 5 or older in Denmark, many
children born in 1994 and thereafter would not have been diagnosed by the
end of the study period.” He continues, “Since unimmunized children were
clustered in the earlier years of the study, ascertainment was more
complete in this cohort [group] than in those immunized a few years prior
to the end of the study period, when many cases were missed owing to
insufficient follow-up time to make the diagnosis.” Yazbak additionally
notes, “Madsen himself concedes in a manuscript published less than a year
later (Pediatrics-September 2003) that increases in autism occurred from
1991 to 2000 among children born after thimerosal had been discontinued.”

An MMR-autism link is supported by the fact that recently, measles
genomic RNA has been detected in both the gut wall and the cerebrospinal
fluid of some children with autism.

It has been suggested that increases in autism in Denmark were due to
(1) a change that occurred in the manner in which autism was diagnosed in
1993/94 and (2) the fact that outpatients were added to the Danish
registry after 1995. Goldman and Yazbak, however, avoided biases
associated with these events and were the first to strictly consider data
from 1980 to 1992, before the influence of these events. The results of
their analysis are strengthened by the fact that in both California and
North London, appreciable increases in the prevalence of autism occurred a
decade apart, shortly after the introduction and large scale use of the
MMR vaccine." You may read the full study in the Journal of American
Physicians and Surgeons, Fall 2004, Vol. 9, No 3.

According to Dr. V. Singh, speaking at the Institutes of Medicine
meeting in Washington, DC on February 9, 2004, "there was a positive
correlation (90% or greater) between MMR antibody and MBP [myelin basic
protein] autoantibody.... These findings led me to speculate that the
measles subunit of the MMR vaccine might trigger an autoimmune reaction in
a significant number of autistic children." If you would like a copy of
this transcript or other writings of Dr. Singh, please let me know.

A friend of mine has a son who never had shown a sign of autism, and
they have nurses in the family who might have detected such. Within 10
minutes of being injected with the MMR vaccine, he had a 104 degree fever
and commenced incessantly screaming and crying; this lasted 10 hours. The
next day he was "gone" -- that is, regressed into the condition called
autism. They did not give her next son the MMR vaccine, and he did not
become autistic. Unfortunately, her youngest son was accidentally given
an MMR vaccine by a practitioner; he developed a fever and started crying
6 hours after the shot, and he regressed into autism within 10 days.

Another friend of mine has twin boys who, after receiving their MMR
vaccines, also regressed into autism.

I hope that for the sake of tiny innocent children and their loving
parents, the BMJ will retract their sensationalistic libel against Dr.
Wakefield. You cannot attack the science, so you are attacking the man.
That is most uncivilized.

Teri Small
Delaware USA

Competing interests:
parent of child with medically documented gastrointestinal pathology consistent with damage attributed to MMR vaccination

Competing interests: No competing interests

12 December 2004
Teri Small
editor
Delaware USA 19808