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Measles: Europe sees record number of cases and 37 deaths so far this year

BMJ 2018; 362 doi: https://doi.org/10.1136/bmj.k3596 (Published 20 August 2018) Cite this as: BMJ 2018;362:k3596

Response to David Oliver II (Risks of Vaccines)

Editor

This is the second part of my response David Oliver [1, 2] regarding the rise in autism and the safety of vaccines.

Absence of evidence, of course, is not evidence of absence. A Centers for Disease Control paper by LeBaron in 2006 found that 6% of toddlers receiving MMR developed a temperature of 39.5C or higher, but typically there was no follow up after 4 weeks so we have no idea of the long term effects [3]. Three times Cochrane reviewers reported [4,5,6]:

"The design and reporting of safety outcomes in MMR vaccine studies, both pre- and post-marketing, are largely inadequate."

In fact, despite the plain language summary, the 2005 review was particularly scathing about the six autism related studies [7], and by implication it poses the problem what might the studies have found if their execution had been “adequate”. Notably, it predicted the unravelling of the paper De Stefano which ultimately led to its dramatic repudiation by co-author William Thompson in 2014 [7,8]:

“The conclusion, however, implied bias in the enrolment of cases which may not be representative of the rest of the autistic population of the city of Atlanta, USA where the study was set.”

The unusual way in which vaccines are trialled was recently highlighted in the paper by Jørgensen on HPV vaccines [9] but in case of MMR there do not seem to have been any pre-marketing studies: all the studies reviewed by Cochrane were in fact post-marketing. In 1992, however, two brands of MMR were withdrawn in the UK after reports of them causing mumps meningitis [10].

Can vaccines cause autism? This has indeed been acknowledged the US government at various times. The HHS HRSA told journalists Sharyl Attkisson and David Kirby on separate occasions [11,12]:

"The government has never compensated, nor has it ever been ordered to compensate, any case based on a determination that autism was actually caused by vaccines. We have compensated cases in which children exhibited an encephalopathy, or general brain disease. Encephalopathy may be accompanied by a medical progression of an array of symptoms including autistic behavior, autism, or seizures."

And CDC director Julie Gerberding admitted to CNN following the Hannah Poling settlement [13]:

"Now, we all know that vaccines can occasionally cause fevers in kids. So if a child was immunized, got a fever, had other complications from the vaccines. And if you’re predisposed with the mitochondrial disorder, it can certainly set off some damage. Some of the symptoms can be symptoms that have characteristics of autism…"

An investigation into US vaccine injury court in 2011 found 83 cases of compensated vaccine injury in which autism is mentioned, but which because they are sealed cannot be used as precedents [14].

Vaccines with aluminium adjuvants (present as well in HPV vaccines) and mercury preservatives have also been implicated in autism [15]. In a recent paper by Morris et al it is stated [16]:

"Also detailed are several mechanisms whereby significant quantities of aluminium introduced via immunisation could produce chronic neuropathology in genetically susceptible children. Accordingly, it is recommended that the use of aluminium salts in immunisations should be discontinued and that adults should take steps to minimise their exposure to environmental aluminium."

Another paper by Mold detected high levels of aluminium in the brains of autistic people. [17]

I agree with Oliver that vaccines can be effective in suppressing diseases but it is less certain that they have benefits to overall health and longevity [18]. It seems unlikely that vaccines are a major player in the differences in mortality rates between the developed and the developing world, while recently MEPs complained that cost of vaccinating a single child had risen by 68 times between 2001 and 2014 [19], and is likely much higher now. On the other hand, Mawson et al reported in their admittedly small vaccinated versus unvaccinated study of American homeschool children [20]:

"The vaccinated were less likely than the unvaccinated to have been diagnosed with chickenpox and pertussis, but more likely to have been diagnosed with pneumonia, otitis media, allergies and NDD. After adjustment, vaccination, male gender, and preterm birth remained significantly associated with NDD. However, in a final adjusted model with interaction, vaccination but not preterm birth remained associated with NDD, while the interaction of preterm birth and vaccination was associated with a 6.6-fold increased odds of NDD (95% CI: 2.8, 15.5). In conclusion, vaccinated homeschool children were found to have a higher rate of allergies and NDD than unvaccinated homeschool children. While vaccination remained significantly associated with NDD after controlling for other factors, preterm birth coupled with vaccination was associated with an apparent synergistic increase in the odds of NDD. Further research involving larger, independent samples and stronger research designs is needed to verify and understand these unexpected findings in order to optimize the impact of vaccines on children’s health."

In the end it is as much as anything a matter of good faith. Every day we hear more about these very unpleasant people called “anti-vaxxers”, who need to be silenced at all costs although mostly they have had their children vaccinated. Unless “the powers that be” can start listening to reports of harm and become less dictatorial – in fact make a return to basic medical ethics - they will not be seen as honest brokers, they will not have a scientific foundation for action and many young people will be injured.

[1] David Oliver, 'Re: Measles: Europe sees record number of cases and 37 deaths so far this year' 24 August 2018, https://www.bmj.com/content/362/bmj.k3596/rr-7

[2] John Stone, ‘Response to David Oliver I (The Indisputable Rise in Autism)’

[3] Charles W. LeBaron, Daoling Bi, Bradley J. Sullivan, Carol Beck, Paul Gargiullo, ‘Evaluation of Potentially Common Adverse Events Associated With the First and Second Doses of Measles-Mumps-Rubella Vaccine’, Pediatrics, October 2006, VOLUME 118 / ISSUE 4, http://pediatrics.aappublications.org/content/118/4/1422

[4] Jefferson T, Price D, Demicheli V, Bianco E ‘Unintended events following immunization with MMR: a systematic review’ , Vaccine. 2003 Sep 8;21(25-26):3954-60. https://www.ncbi.nlm.nih.gov/pubmed/12922131

[5] Demicheli V, Jefferson T, Rivetti A, Price D, ‘Vaccines for measles, mumps and rubella in children’ Cochrane Database Syst Rev. 2005 Oct 19;(4):CD004407, https://www.ncbi.nlm.nih.gov/pubmed/16235361

[6] Demicheli V, Rivetti A, Debalini MG, Di Pietrantonj C, ‘Vaccines for measles, mumps and rubella in children’ Cochrane Database Syst Rev. 2012 Feb 15;(2):CD004407. doi: 10.1002/14651858.CD004407.pub3., https://www.ncbi.nlm.nih.gov/pubmed/22336803

[7] John Stone, ‘Re: Evidence is not bullying’ 18 September 2009, https://www.bmj.com/rapid-response/2011/11/02/re-evidence-not-bullying

[8] Statement of William W Thompson PhD, https://legislature.vermont.gov/assets/Documents/2016/WorkGroups/House%2...

[9] Lars Jørgensen, Peter C Gøtzsche, Tom Jefferson, ‘The Cochrane HPV vaccine review was incomplete and ignored important evidence of bias’ BMJ Evidence-Based,Medicine Epub ahead of print doi:10.1136/bmjebm-2018-111012
[10] BMJ Medicopolitical Digest 26 September 1992, https://www.bmj.com/content/305/6856/777

[11] Sharyl Attkisson, ‘Vaccines, Autism and Brain Damage: What's in a Name?’, https://www.cbsnews.com/news/vaccines-autism-and-brain-damage-whats-in-a...

[12] David Kirby ‘A new theory of autism causation’, Huffington Post 29 March 2009, https://www.huffingtonpost.com/robert-f-kennedy-jr-and-david-kirby/vacci...

[13] House Call with Dr Sanjay Gupta, 29 March 2009, http://transcripts.cnn.com/TRANSCRIPTS/0803/29/hcsg.01.html
[14] Mary Holland, Louis Conte, Robert Krakow and Lisa Colin, ‘Unanswered Questions: A Review of Compensated Cases of Vaccine-Induced Brain Injury’, Pace Environmental Law Review, vol. 28, no. 2, 2011, https://digitalcommons.pace.edu/pelr/vol28/iss2/6/

[15] World Mercury Project: science library; vaccines: https://worldmercuryproject.org/research_category/vaccines/

[16] Gerwyn Morris, Basant K. Puri, and Richard E. Frye, ‘The putative role of environmental aluminium in the development of chronic neuropathology in adults and children. How strong is the evidence and what could be the mechanisms involved?’ Metab Brain Dis. 2017; 32(5): 1335–1355. Published online 2017 Jul 27. doi: 10.1007/s11011-017-0077-2, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5596046/

[17] Matthew Mold, Dorcas Umar, Andrew King, Christopher Exley, ‘Aluminium in brain tissue in autism’, Journal of Trace Elements in Medicine and Biology Volume 46, March 2018, Pages 76-82, https://www.sciencedirect.com/science/article/pii/S0946672X17308763

[18] Written evidence from John Stone (Age of Autism), House of Commons Health and Social Care Committee Inquiry into Anti-Microbial Resistance, http://data.parliament.uk/writtenevidence/committeeevidence.svc/evidence...

[19] http://www.europarl.europa.eu/news/en/press-room/20180319IPR00021/health...

[20] Anthony R Mawson, Brian D Ray, Azad R Bhuiyan, Binu Jacob 'Pilot comparative study on the health of vaccinated and unvaccinated 6- to 12- year old U.S. children', Journal of Translational Science, 24 April 2017, http://www.oatext.com/Pilot-comparative-study-on-the-health-of-vaccinate...

Competing interests: No competing interests

28 August 2018
John Stone
UK Editor
AgeofAutism.com
London N22