|Vaccines as a Factor in Autism: Focus on the MMR Vaccine|
Autism - like cancer, heart disease and most of the other big killers - is a "complex" disorder, probably caused by a complicated mix of multiple genes and environmental factors. There is no single and clear cause. Autism is manifested in unique combinations of symptoms and varying degrees of handicapping conditions in each individual. It now seems that some people are predisposed by inheriting a complex combination of genes. Autism, as a neurodevelopmental disorder, may be triggered in these individuals by a type of food, a drug, exposure to a chemical, or an infection. The complexity of autism means that there is no quick fix or treatment strategy to suit all.
Autism was first identified in the early 1940s, but it is thought there have always been people with the symptoms of autism. Studies of the incidence of autism in the 1960s, in various parts of the world, found that 4.5 of every 10,000 childred had classic autism. An enormously increased prevalence of autism in the 1980s and 1990s has been reported. A new study in a region of England has found that one child in 175 has autism, an elevenfold increase over the rate of classic autism in the 1960s. California has seen an increase of over 1,000 per cent over a 20-year period. Similar increases have been reported in New Jersey, the Middle East, and Asia. These increases cannot be explained simply as the result of greater awareness or better diagnosis.
So what explains the increase? According to Dr Bernard Rimland of the Autism Research Institute in California, the most plausible cause of the increase may be changes in vaccination programs, such as the following:
a) The extraordinary increase in the number of vaccines given to children from birth to age two - from 8 in 1980 to 22 in 2000;
b) The amount of extremely toxic mercury, used as a preservative in many vaccines; and
c) The combination of three vaccines, Measles, Mumps, Rubella, previously given singly, into one, the MMR.
During the year 2000, the possible role of vaccines in triggering a form of autism has become a very contentious issue. The MMR, or combined Measles, Mumps, Rubella dose given to children at 15-18 months, and again, usually at 4-5 years, has been the main focus of controversy. The Internet has become a vaccine battleground.
The following are some headlines about vaccines and links to web-based information that OAARSN has posted in its Autism in the News feature since April 2000—especially those that provide comprehensive information. Please note OAARSN’s disclaimer. In this area, as elsewhere on our site, we try to provide balanced information about various theories and points of view, to help you keep an open and inquiring mind.
Dr Andrew Wakefield, a gastroenterologist at the Royal Free Hospital in London, first published his theory of a possible connection between autism and a viral infection associated with the MMR vaccination in The Lancet in February 1998. His research suggests that a subset of autistic people may suffer brain inflammation resulting from infections that began in their intestines after they were inoculated with the measles-mumps-rubella (MMR) vaccine. He considers that MMR could be linked to a syndrome called autistic enterocolitis and insists that the vaccine should never have got a licence. Wakefield had been approached since 1996, by parents who told him their children had been developing normally until given the vaccine for measles, mumps and rubella (MMR). The parents said they then witnessed regression in their children's behaviour and speech, as well as the onset of an unpleasant bowel disorder. Presented with similar accounts by numerous sets of parents, Wakefield decided to investigate. What he discovered has provoked a bitter vaccination controversy. Fears about vaccine side effects have given rise to a fledgling social movement, which calls itself "pro-choice" on vaccines and other medical decisions.
Hearings by the US Congress Committee on Government Reform in Washington were reported. Some parents and professionals have brought evidence to support their hypothesis that the multiple vaccine for measles, mumps and rubella, now routinely administered at 15-18 months, may trigger immune-system dysfunction, enterocolitis and the behavioral symptoms typical of autism in some young children. Among those testifying were Professor John O’Leary of Ireland and Dr Andrew Wakefield. The US Government’s official position, as reported by the Center for Disease Control, was to downplay or dismiss the hypothesis and to affirm that the general good of the whole population is best served by continuing routine administration of multiple vaccines to young children.
LATE AUGUST 2000
The vaccine controversy is featured in a series of articles from The Congressional Quarterly Researcher about the links among autism, vaccines, mercury and pharmaceutical companies. The CQR claims to be widely recognized as the number one authoritative news source on Congress and national politics for more than 50 years.
a) The Issues 1: a survey of key questions about the benefits and risks of vaccinations.
b) The Issues 2: a commentary on the reporting and interpretation of "vaccine adverse events" and the ethical issues of interests of scientists and doctors in pharmaceutical companies.
c) Background: A survey of the history of vaccination to the mid-1990s
d) The Next Step: Recent history of vaccines.
e) Is Your Child Getting the Right Vaccine?
may be found in the FEAT Archives by clicking on:
Top scientists at a conference sponsored by the National Vaccine Information Center in Arlington, Virginia, challenged the quality and quantity of scientific research on vaccine adverse events and will question the actions of pharmaceutical companies marketing vaccines and federal health agencies making vaccine policy. Prominent pediatric neurologists, microbiologists, molecular and cell biologists, epidemiologists, gastroenterologists, immunologists, and pediatricians presented new research into the biological mechanisms of vaccine injury and death and the relationship of vaccines to chronic illness such as learning disabilities, ADHD, autism, mental retardation, epilepsy, arthritis, asthma and diabetes. Clinicians discussed innovative therapies to treat the vaccine-injured, and legal experts discussed vaccine licensing and safety standards, product liability, conflict of interest and informed consent issues concerning vaccines for DPT, MMR, hepatitis B, HIB, polio, Lyme disease, pneumococcal disease, and anthrax.
Vaccine Information Center, "Autism & Vaccines, a comprehensive
DECEMBER 2000-FEBUARY 2001
A storm of controversy blew up about the MMR vaccine, most fiercely in Britain and Ireland, with echoes among the autism community in the United States, but very little in Canada.
One lightning rod was the publication (announced in advance) of "Measles, Mumps, Rubella Vaccine: Through a Glass, Darkly" by Dr Andrew Wakefield, reporting the latest research about the safety of the trivalent MMR vaccine. He has identified nearly 170 cases of a new syndrome and his team is testing the hypothesis that the measles virus from the vaccine can lodge in the gut of susceptible children. He notes that in almost every case of testing the vaccine, observation periods were too short to include the time of onset of delayed neurological or other adverse events...and too few patients were followed up. Published in Adverse Drug Reactions 2000,19(4) 1-19. Authors: Andrew J. Wakefield FRCS, Scott M Montgomery PhD.
text, search FEAT Archives: http://www.feat.org/scripts/wa.exe?S1=featnews
During January, widely publicized charges and rebuttals were exchanged between supporters of the MMR vaccine and those who worry about the dangers for some children. Significant numbers of parents of young children due for their triple vaccine demanded the option of single vaccines.
On the establishment side, there is strong support for total vaccination of the child population against all infectious diseases, based on success in eliminating smallpox, polio and tuberculosis from developing countries. Supporters can point to dramatic decreases in cases of almost all childhood diseases, including the deaths that used to follow complications. They dismiss theories of any links between the MMR vaccines and autism by pointing out that autism had been identified long before there was any MMR vaccine, and suggest that increased numbers of autistic children in the past 20 years may simply reflect better diagnostic skills and tools.
Examples of the case for MMR vaccination:
1. By David Salisbury, head of immunisation, UK Department of Health http://www.independent.co.uk/news/UK/Health/2001-01/for220101.shtml
2. A Rebuttal to Wakefield By Mike Watson the medical director of Aventis Pasteur MSD, one of the companies responsible for the MMR vaccine.
3. Editorial in the British Medical Journal, reviewing the controversy and concluding that "current concerns are idiosyncratic: most reviews have confirmed the vaccine's safety." BMJ 2001;322:183-184 (27 January)
On the other side, parents have reported their youngsters, who seemed to be developing normally, suddenly regressing disastrously after being given the triple vaccine. Numbers of children identified as autistic have increased enormously during the period that the MMR vaccine has been in use. Some specialists have found evidence of gastrointestinal disorders in young children with autism that seem to implicate the measles portion of the vaccine. Growing numbers of health professionals have become wary of administering the triple vaccine to all children after looking more closely at the documentation of how thoroughly the MMR and other vaccines have been tested. Doubts have been cast on the Finnish tests of the MMR vaccine, after these had been regarded as proof of the vaccine’s safety. Close links between drug companies and many health scientists and administrators and university researchers have been criticized.
Examples of the case against the MMR triple vaccine:
A critique, by TL Autism Research of Falmouth, Massachusetts, pointed out that this study never looked at autism, the word autism was never mentioned, and the authors could not have found any cases of autism because of the study inclusion criteria.
If the MMR Does Not Cause Autism, What On Earth Does?
The case against the MMR vaccine is not yet proven, though many parents and physicians have decided to be cautious. The controversy is one factor that has drawn wider attention to what parents of children with autism have been hearing for more than 30 years: "The causes of autism are not yet known and there is no medical cure." It is another impetus to increased research on the causes of autism.
For one example, the US Congress has ordered the Institute of Medicine to investigate the alleged link between childhood vaccinations and autism, as well as the likelihood of an alternative hypothesis.
U.S. National Institutes of Health on 13 February 2001 released a document, Grants for Research on Autism and Autism Spectrum Disorders, which is accessible in full at:
Specific areas of interest for research grants include (but are not limited to): epidemiology, early identification and diagnosis, genetic studies, brain mechanisms, communication skills, cognitive neuroscience, psychosocial (behavioral) interventions, pharmacological and other biological interventions, and services.
Internet Sites and Pages for Vaccine Information
a) U.S. Centres for Disease Control, National Immunization Program. http://www.cdc.gov/nip/
b) National Network for Immunization Information (NNii) is sponsored by the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, the American Academy of Pediatrics and the American Nurses Association. It is dedicated to providing the latest scientific information on immunizations to the public, health care providers, policy makers and the media, and does not accept any donations or grants from the pharmaceutical industry. The site's portal for parents offers downloadable schedules for childhood vaccinations as well as suggestions for vaccinations for adults.
Vaccine Information Center offers Autism & Vaccines, a comprehensive
d) National Vaccine Injury Compensation Program. http://www.hrsa.dhhs.gov/bhpr/vicp/
e) Pro-Vaccine Reform Findings: Measles Under Glass: an ongoing, updated report on the science surrounding measles, measles vaccine and autism by Laura J. Ruede, M.L.S., Editor, Autism Autoimmunity Project Newsletter. Reprinted from issues of AAPN and from "’The ABCs of MMRs and DTPs: Is There an Association Between Vaccination and Autism’ By Eric London: A Bibliographic Essay," by Laura J. Ruede,
f) Vaccine Adverse Event Reporting System, VAERS, http://www.fda.gov/cber/vaers.html
g) Vaccine Information and Awareness, VIA, San Diego, CA http://www.access1.net/via/
h) Vaccinations and Autism, part of a series of detailed summaries of Theories of Autism, written and maintained by Lewis Mehl-Madrona, M.D., Ph.D., Medical Director of The Center for Complementary Medicine. Other summaries are also available at the website, as are the detailed references.
http://www.healing-arts.org/children/ [click on Autism]
i) A review by Dr Bernard Rimland of the Autism Research Institute. "Garbage science," Brick Walls, Crossword Puzzles, and Mercury