Measles-Mumps-Rubella (MMR) Vaccine
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Similar proportions of case and control children were vaccinated by the recommended age or shortly after (ie, before 18 months) and before the age by which atypical development is usually recognized in children with autism (ie, 24 months). Vaccination before 36 months was more common among case children than control children, especially among children 3 to 5 years of age, likely reflecting immunization requirements for enrollment in early intervention programs.
Earlier in the video, Andrew Wakefield repeated crucial information that he also gave in a video news release issued by the Royal Free hospital in February 1998. In that video, he reveals that the initial plan was to study 10 children - which was the number specified in a contract from solicitors, financed by the Legal Aid Board. These statements contradict later statements, including one issued by the Lancet, where Wakefield claims that the legal contract was "separate" from the research published in the Lancet.
Those concerned over the ethics of research by Andrew Wakefield may find little comfort in an anecdote he told a parents meeting called by the Mind Institute in Sacramento on May 20 1999. He talked of how he collected blood at his son's birthday party - paying children as young as four £5 each. At the time, Dr Wakefield had a non-clinical teaching contract with the Royal Free's medical school. He gave no further details of the safeguards, consent procedures, children who he says fainted, etc.
There are three separate actions involving Andrew Wakefield and Brian Deer. One is between Wakefield and the Sunday Times, the other between Wakefield and Brain Deer personally (in respect of his website) and a third one (the one under discussion here) between Wakefield and Channel 4/Twenty twenty Productions... Its not looking good for Andrew Wakefield. He's now been exposed as a bully who likes to threaten with what he has no intention of pursuing. He's also looking like he's beginning to realise that he has no chance of escaping the GMC hearings unscathed. Hopefully all those who like to bandy around legal action as a threat will see that a hot head often gets regretted when the facts are examined.
The apparent increase in the number of children with autism has levelled out after peaking in 1992, reports a UK cohort study published last week. The results show that the rise in the number of cases reported previously may have been due to greater awareness of autism and to changes in diagnostic criteria, and the plateau in the prevalence of autism provides further evidence against an association with the MMR vaccination.
Susan Mayor, British Medical Journal
The current literature does not suggest an association between ASD and the MMR vaccine; however, limited epidemiological evidence exists to rule out a link between a rare variant form of ASD and the MMR vaccine. Given the real risks of not vaccinating and that the risks and existence of variant ASD remain theoretical, current policies should continue
Ten of the 13 authors of the research paper that first raised the possibility of a link between the measles, mumps, and rubella (MMR) vaccine and autism, resulting in a major fall in the number of children being vaccinated in the United Kingdom, "retracted" this interpretation of their findings in a statement published last week
The saga about MMR vaccination and autism illustrates the challenge to pharmacoepidemiologists to be able to investigate suspicions about the safety of drugs or vaccines in a timely and effective manner.
It is important to know that Wakefield's suggestion that MMR may increase risk of autism is an unproven theory, and that extensive research worldwide has failed to substantiate this proposed link.
href="http://www.neurodiversity.net
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Journal of Autism and Childhood Schizophrenia 1971 Jan-Mar;1(1):33-47
The increase in autism and autistic spectrum disorders in this part of Yokohama displays the same increase over time seen in other parts of the world. Here, though, the increase occurred even when the MMR vaccine was withdrawn. This destroys any possible causative link between use of the vaccine and autism... Whatever causes autism, it is not the MMR vaccine.
The lunacy over autism and the measles-mumps-rubella (MMR) vaccine probably wouldn't exist but for a tiny yet massively-publicized British study that turned out to have been paid for by trial lawyers who -- you got it -- were suing vaccine makers. In fact, some of the children in the study were their clients! When the news got out, the chief author was fired (he now works for the vaccine conspiracy nuts), the medical journal disavowed the study, and the co-authors also disavowed their participation. None of which mattered a bit to the conspiracy-theorists, who prize "real life" X-Files episodes over children's health and blasted me with more hate mail than I'd received on any other subject to date.
For lucky Westerners measles is not much of a problem but in developing countries poor nutrition and weak health care make it a killer. In a world where international travel has become commonplace, an increase in measles in the West heightens the risk of deadly epidemics in poor countries. So far, international health agencies have remained steadfast in their backing for MMR. But a UK survey showed that misleading coverage of the MMR scare meant only one in four people were aware that most studies showed no link between the vaccine and autism. Negative stories tend to stick and our increasingly networked world means they also tend to spread.
Mark Weston, Accra Daily Mail
A matched case-control study using data derived form the United Kingdom General Practice Research Database. Children with a possible diagnosis of autism will be identified from their electronic health records.
Liam Smeeth, Andrew J Hall et al
The MMRV vaccine provides a new option for reducing the number of injections required for the routine childhood immunization schedule. By combining two well established products, the manufacturer has created a new product that maintains a high level of seroconversion and is well tolerated. Additional data are needed, however, to confirm the clinical efficacy and safety of the MMRV vaccine.
Studies have shown that there is biological plausibility and epidemiological evidence showing a direct relationship between increasing doses of mercury from thimerosal-containing vaccines and neurodevelopmental disorders, and measles-containing vaccines and serious neurological disorders.
A recent Cochrane systematic review concluded that there was 'no credible evidence' of a link between the measles, mumps and rubella vaccine (MMR) and either inflammatory bowel disease or autism. The virtually unanimous verdict of the media was that this review, following a series of studies coming to the same conclusion, meant that the scare launched by Andrew Wakefield's now notorious Lancet paper in 1998 was finally over. Not quite.
Michael Fitzpatrick, Spiked Online
Visual images and vivid accounts of families living with children with autism are indeed distressing, anecdotes are not proof. On the other hand there could be no more heart-rending tragedy than a child damaged by a (preventable) disease.
National Institute for Communicable Disease, Zaire
After a 40-year effort, rubella is no longer endemic in this country. Late last month, officials from the Centers for Disease Control and Prevention announced that the transmission of the rubella virus rubella has been interrupted in the United States. This accomplishment is a result of intensive efforts to increase vaccination levels and eliminate the disease both here and throughout the Americas. Here is how the disease's vanishing act took place.
In light of encephalopathy presenting as autistic regression (autistic encephalopathy, AE) closely following measles-mumps-rubella (MMR) vaccination, three children underwent cerebrospinal fluid (CSF) assessments including studies for measles virus (MV)... Findings are consistent with both an MV etiology for the AE and active viral replication in these children. They further indicate the possibility of a virally driven cerebral immunopathology in some cases of regressive autism.
J.J. Bradstreet, J. El Dahr, A. Anthony, J.J. Kartzinel; A.J. Wakefield
Following Brian Deer's Channel 4 Dispatches investigative documentary on November 18 2004, visitors to this website had their say.
Because MMR vaccine is administered just before the peak age of onset of autism, a temporal relationship between vaccination and onset of autism is expected to be common.
A Scots family will launch a multi-million-pound lawsuit at the High Court in London today, claiming the MMR vaccine was responsible for causing autism in their child. The test case, which could open the floodgates to hundreds of similar actions, is set to reignite the fierce debate over the safety of the mumps, measles and rubella jab. The family, from Glasgow, is among nine suing the government in a joint action.
Andrew Wakefield, the doctor at the centre of the measles, mumps, and rubella (MMR) vaccine controversy, was criticised by a high court judge last week for trying to silence critics by warning them that he was suing for libel while at the same time failing to progress the case. Mr Justice Eady said that he was quite satisfied that Dr Wakefield, who now works in Austin, Texas, "wished to extract whatever advantage he could from the existence of the proceedings while not wishing to progress them or to give the defendants an opportunity of meeting the claims."
Clare Dyer, British Medical Journal
The uniformity of the intestinal pathological changes and the fact that previous studies have found intestinal dysfunction in children with autistic-spectrum disorders, suggests that the connection is real and reflects a unique disease process.
Presents an assessment of the evidence regarding a hypothesized causal association between the measles-mumps-rubella (MMR) vaccine and autism, an assessment of the broader significance for society. This is a full-length book.
Changes in the definition of autism, rather than use of the measles, mumps, and rubella vaccine (MMR vaccine), led to increased diagnosis of autism in the United States and probably in Europe, says a study from the Mayo Clinic in Rochester, Minnesota. Before the late 1980s and early 1990s, these children were diagnosed as retarded or having developmental delay, lead author William Barbaresi, a developmental paediatrician, told the BMJ.
Janice Hopkins Tanne, British Medical Journal
The incidence of IBD remained nil amongst 201 autistic children likely to have been exposed to the MMR vaccine, suggesting no particular association between Crohn's disease and autism among children immunised with MMR.
Whilst we are aware that there are a number of parents who feel that their children's autism has been caused in this way, there is to the best of our knowledge no conclusive scientific evidence to prove this at present.
National Autistic Society
Madsen and colleagues present data from a retrospective cohort study of more than 500,000 children born in Denmark between 1991 and 1998. No association was demonstrated between MMR vaccination and later development of autism.
In February 1998, the Lancet medical journal triggered a global scare when it published research claiming a possible link between the measles, mumps and rubella triple vaccine and autism. The researchers' leader, Dr Andrew Wakefield called for the vaccine to be "suspended". Six years later, an investigation by Brian Deer revealed that there was more here than met the eye.
For the past eight years, the campaign against MMR has been at best a distraction from the important issues in autism - scientific research and matters of education and care provision. At worst, for many parents, it has raised - and dashed - hopes of compensation and forced many more to carry an utterly unwarranted burden of guilt over giving their children MMR.
Michael Fitzpatrick, U.K. Guardian
Doctors at the Royal Free Hospital in London believe they have uncovered a new bowel disease in children that may be linked to autism and triggered by the measles, mumps, and rubella vaccine.
These findings provide no support for an MMR associated "new variant" form of autism with developmental regression and bowel problems, and further evidence against involvement of MMR vaccine in the initiation of autism.
Brent Taylor et al, British Medical Journal
The evidence available does not support a causal association between the MMR vaccine and development of autistic disorder, or autistic spectrum disorder. Earlier studies that reported a link between MMR and autism have been found to have significant methodological flaws and high potential for bias. The current search failed to identify any articles published since the systematic review that is appraised in this report.
Although the possible association with MMR vaccine has received much public and political attention and there are many who have derived their own conclusions based on personal experiences, the available evidence does not support the hypothesis that MMR vaccine causes autism or associated disorders or IBD.
Neal A. Halsey, Susan L. Hyman
This note - which has been put together by the parent of a child who became autistic after immunisation - sets out the concerns of parents whose children have degenerated into an acquired-autistic state after MMR or measles vaccines.
Parents of children with regressive autism will forever remain convinced that vaccines were responsible for drastic changes their previously normal, healthy children exhibited post-MMR.
A large survey of all children born in Denmark between January 1991 to December 1998 shows no difference in the incidence of autism between vaccinated and unvaccinated children.
Perhaps the most important lesson from the conference is that it is less about proving the lack of a link between MMR and autism, and more about finding the cause of autism and doing something about it.
The great expense involved in studying the possible role of MMR as a causative factor for autism is diverting resources away from research into other possible causes for the disease and its increased prevalence.
Michael E Allen, HealthWatch
Long the target of disease-causation theories, vaccines have come under extreme fire in the past decade for what some believe to be their propensity to cause autism in some children. Here in the U.S., anti-vaccination groups most commonly blame thimerosal, a vaccine preservative no longer in wide use. In Britain, the most frequently targeted immunization is the combination measles/mumps/rubella vaccine (MMR). In his book MMR and Autism: What Parents Need to Know, Michael Fitzpatrick, a general practitioner in London, explores the development of the scare over MMR and how it has affected public health in multiple countries, particularly in Britain.
A causal association between the administration of this vaccine and the development of autism has not been found in recent studies.
A large UK case-control study showed no association between MMR and subsequent development of autism. It also performed a meta-analysis of studies, which overall showed a non-significant reduction of autism rates in children receiving MMR vaccination.
It has been suggested that there is a new condition called Regressive Autism where a child seems to be developing normally but starts to show signs of autism between 1 and 3 years of age - where children lose skills like speech and actions, after MMR. This has been studied and it has been proved that the proportion of autistic children with regression is the same whether they have had MMR or not, and that there has been no increase in the proportion with regression after MMR was introduced.
For three months you've been telling the Science Museum your concerns about MMR - the measles, mumps and rubella triple vaccine. Armed with your questions, fears and arguments a team from the Museum set off to interrogate the major players in the controversy.
Author Dr Vittorio Demicheli said: "We conclude that all the major unintended events, such as triggering Crohn's disease or autism, were suspected on the basis of unreliable evidence." Recent statistics show the uptake of MMR vaccine among two-year-olds in England was 81 per cent in 2004/05 � up from 80 per cent. That is still below the 95 per cent recommended by the World Health Organisation.
It is pertinent that Dr Fletcher is an expert witness on behalf of parents of autistic children pursuing claims for compensation against manufacturers of the MMR vaccine. In common with Kenneth Aitken PhD, another expert witness on this subject, he seems to have sacrificed his scientific objectivity in favour of a subjective identification with the concerns of the parents. While it is easy to dismiss rogue scientists and in some cases point to a financial incentive for their roguery, the fact remains that there are a significant number of scientific and medical experts who are sufficiently persuaded by their contact with disaffected parents of autistic children to become passionate campaigners and abandon their previous commitment to dispassionate research.
A conspiracy of silence or paranoid scaremongering? Is the MMR vaccine a cause of autism -- or is it a vital health programme undermined by this medical maverick?
Robert Sandall, Times Online
Phillips presents material as experimental scientific research when it has never been published in a peer-reviewed academic journal and is not indexed in PubMed, the standard search tool for finding medical academic papers. The research she refers to has been published only in the in-house magazine of a rightwing US pressure group well known for polemics on homosexuality, abortion and vaccines. She says "autistic enterocolitis" is a "disease" and a "new syndrome" that has been "replicated in studies around the world". As a rough guide, the phrase "autistic enterocolitis" appears in only five PubMed-indexed academic papers, one by Wakefield and four others mostly doubting its status... It is self-evident to anybody who understands biomedical research, and if you don't get it then you have only two choices: you can either learn to interpret data yourself and come to your own informed conclusions; or you decide who to trust. Choose wisely.
Ben Goldacre, The Guardian
More media circuses about vaccinating children with MMR, and the "association" of MMR vaccination with autism and inflammatory bowel disease. Frightening stuff, but much heat and little light. One of Bandolier's informal team asked us to look out the evidence. There's much, mostly from exemplary public health work in Finland, and it shows conclusively that vaccination with MMR does not cause autism or bowel problems.
Goldman and Yazbak do not have data on vaccination status, and therefore cannot compare autism rates between vaccinated and unvaccinated individuals. They rely instead upon demonstrating that the population rate of autism was rising between MMR vaccination was introduced in 1988, 1990 and 1992 and therefore, since MMR vaccination must "logically" be the cause.
Matthew L. Grove, Adam Jacobs
While vaccine can be guaranteed to be without any risk, this has to be weighed against the huge advantages of protection against disease.
Angus Nicoll, David Elliman, Euan Ross
1294 cases and 4469 controls were included. 1010 cases (78·1%) had MMR vaccination recorded before diagnosis, compared with 3671 controls (82·1%) before the age at which their matched case was diagnosed. After adjustment for age at joining the database, the odds ratio for association between MMR and pervasive developmental disorder was 0·86 (95% CI 0·68�1·09). Findings were similar when restricted to children with a diagnosis of autism, to those vaccinated with MMR before the third birthday, or to the period before media coverage of the hypothesis linking MMR with autism.
It would be an unfortunate consequence of Dr. Wakefield's allegations regarding the safety of MMR vaccine if the rate of immunization declined and another outbreak of measles occurred.
Parents concerned that the measles, mumps and rubella (MMR) vaccine might lead to autism in vaccinated children can be reassured that absolutely no evidence has been found linking the vaccine to the disorder.
A major step in the right direction would be the establishment of a nationwide epidemiological register of children who have been diagnosed as having a disorder which lies within the spectrum of autism.
Its also worth noting that all of the co-authors of the original Lancet paper have rescinded their position leaving Wakefield standing alone. Next year he will face misconduct charges in the UK from the GMC. Its further worth noting that at the time he began to criticise the MMR and implicate it in autism causation, Wakefield also claimed he had found another, safer way to vaccinate kids which he duly filed a Patent application for. He later denied this on a website and through his solicitors, however Brain Deer unearthed Wakefield's Patent application for all to see. F. Edward Yazbak talks of bias. We have a saying in the UK Sir � 'people who live in glass houses shouldn't throw stones'.
Offering numerous resources on the subject.
Institute for Vaccine Safety
The unfolding of the measles, mumps and rubella (MMR) controversy reveals some of the key features of the cultural climate affecting matters of health and illness in contemporary society. A high level of anxiety around issues of health is reflected in a heightened sense of individual vulnerability to environmental dangers (such as atmospheric pollution, electromagnetic fields, bioterrorism) and in a general aversion to risk, particularly in relation to children. This mood has proved responsive to views sceptical, if not hostile, towards science and medicine and associated professionals, particularly in the sphere of immunization. The result is that uptake of MMR vaccination in the UK has fallen, from a peak of 92% in the mid-1990s to a national level of 82% in 2003 (at the age of two); in London uptake is now less than 75%�much less in some areas�causing a significant risk of outbreaks of measles. In the USA too, the proportion of parents opting out of regulations requiring immunization as a condition of school entry has increased significantly in some areas, though these controversies appear to have had little impact so far in continental Europe.
MMR: The Questions is a new and developing website. It will be used to present contributions from scientists, other professionals and parents who believe that there is sufficient evidence to warrant further research into the issue of whether exposure to measles-containing vaccine increases subsequent risk of a range of developmental disorders and/or gastro-intestinal problems.
This continuous upward trend in autism dating from the late 1970s or early 1980s has been seen before in a study from North Thames [3]. We now have three studies, all showing this inexorable rise irrespective of whether immunisation rates are high and uniform, or pretty high and getting higher. MMR has been available and been used for years. None of these studies supports, and all refute, that autism is caused by MMR vaccination, or that MMR vaccination is responsible for a major number of cases of autism.
The incidence of autism among 2 to 5 year olds increased markedly among boys born in each year separately from 1988 to 1993 while MMR vaccine coverage was over 95% for successive annual birth cohorts.
James A Kaye, Maria del Mar Melero-Montes, Hershel Jick
The data provide evidence that no correlation exists between the prevalence of MMR vaccination and the rapid increase in the risk of autism over time.
James Kaye, Maria del Mar Melero-Montes, Hershel Jick
Of the 535,544 children who were vaccinated, 199 were hospitalized for encephalitis, 161 for aseptic meningitis, and 352 for autistic disorders. In 9 children with encephalitis and 10 with meningitis, the disease developed within 3 months of vaccination, revealing no increased occurrence within this designated risk period. We detected no clustering of hospitalizations for autism after vaccination. None of the autistic children made hospital visits for inflammatory bowel diseases.
Dr. Brian J. Ward and colleagues from Montreal's McGill University report their findings in a paper in the October issue of Pediatrics. In it, they note that despite mounting epidemiologic evidence against an association between MMR vaccination and autism, several molecular investigations have been used to implicate MMR vaccination in the development of autism spectrum disorder in at least a subset of affected children... Dr. Ward's team attempted but failed to replicate the results reported by Kawashima and Uhlmann by applying their primer pairs to PBMCs isolated from children with autism spectrum disorder and developmentally normal controls.
The Committee on the Safety of Medicines' study examined medical records of 92 children with autism and 15 with Crohn's disease; the records had been passed to the committee by a firm of solicitors. Evidence of autism before vaccination was found in 36 cases, and another 28 showed family history of the condition. Eight autistic children and four with Crohn's disease seemed to have developed symptoms after MMR vaccination, but, the authors said, the small numbers and the fact that onset of autism frequently occurs around age 18 months meant that this is not enough to prove causation.
Hilary Bower, British Medical Journal
The study by Ulhmann et al. published recently [1] is the third empirical article from Wakefield and colleagues supposedly describing a new syndrome of which a form of autism might be a component. Thus, it was surprising that Ulhmann et al. article did not contain a proper Subjects section providing the necessary background clinical characteristics which are required both for a proper evaluation of the significance of the results and for allowing replication by independent research groups. The behavioral and diagnostic characteristics of the 91 'affected' children included as patients in the paper are totally lacking. Nowhere in the paper the word 'autism' appears nor do the authors refer to regression in the developmental course of these children. Patients are vaguely described as being 'affected' with 'developmental disorders' (what is meant by this is unclear unless the disorders in question are further qualified) and the qualification of 'pervasive' for these disorders is not even used.
The behavioral and diagnostic characteristics of the 91 'affected' children included as patients in the paper are totally lacking. Nowhere in the paper the word 'autism' appears nor do the authors refer to regression in the developmental course of these children. Patients are vaguely described as being 'affected' with 'developmental disorders' (what is meant by this is unclear unless the disorders in question are further qualified) and the qualification of 'pervasive' for these disorders is not even used.
BACKGROUND: A causal relationship between the measles, mumps, and rubella (MMR) vaccine and occurrence of autism spectrum disorders (ASD) has been claimed, based on an increase in ASD in the USA and the UK after introduction of the MMR vaccine. However, the possibility that this increase is coincidental has not been eliminated. The unique circumstances of a Japanese MMR vaccination program provide an opportunity for comparison of ASD incidence before and after termination of the program. METHODS: This study examined cumulative incidence of ASD up to age seven for children born from 1988 to 1996 in Kohoku Ward (population approximately 300,000), Yokohama, Japan. ASD cases included all cases of pervasive developmental disorders according to ICD-10 guidelines. RESULTS: The MMR vaccination rate in the city of Yokohama declined significantly in the birth cohorts of years 1988 through 1992, and not a single vaccination was administered in 1993 or thereafter. In contrast, cumulative incidence of ASD up to age seven increased significantly in the birth cohorts of years 1988 through 1996 and most notably rose dramatically beginning with the birth cohort of 1993. CONCLUSIONS: The significance of this finding is that MMR vaccination is most unlikely to be a main cause of ASD, that it cannot explain the rise over time in the incidence of ASD, and that withdrawal of MMR in countries where it is still being used cannot be expected to lead to a reduction in the incidence of ASD.
No evidence was found to support a distinct syndrome of MMR-induced autism or of "autistic enterocolitis." These results add to the recent accumulation of large-scale epidemiologic studies that all failed to support an association between MMR and autism at population level. When combined, the current findings do not argue for changes in current immunization programs and recommendations.
Eric Fombonne, Suniti Chakrabarti
The authors go on to point out that regression in autism is not a new phenomenon. In a review of the literature they demonstrate regression rates of 22% to 50% in studies between 1963 and 1998 (Table 2). The variation between studies is what might be expected by chance given the small numbers of some of the studies, but it is clear that regression occurred in children with autism long before MMR. In this study regression occurred in 18% of autistic children in a pre-MMR sample and in 16% of autistic children in a post-MMR sample.
Contrary to the findings of some earlier studies, measles virus genetic material was not detected in the blood of MMR-vaccinated autistic children with development regression, according to a report in the Journal of Medical Virology for May. A possible link between MMR vaccination and autism was first noted in a report released in 1998. Since then, several epidemiologic studies, conducted in various countries, have found no support for this association. However, in recent years, the controversy again surfaced as researchers reported finding measles virus genomic fragments in tissue samples taken from autistic children.
The real-time assays based on previously published primers gave rise to a large number of positive reactions in both autism spectrum disorder and control samples. Almost all of the positive reactions in these assays were eliminated by evaluation of melting curves and amplicon band size. The amplicons for the remaining positive reactions were cloned and sequenced. No sample from either autism spectrum disorder or control groups was found to contain nucleic acids from any measles virus gene. In the nested polymerase chain reaction and in-house assays, none of the samples yielded positive results. Furthermore, there was no difference in anti-measles antibody titers between the autism and control groups. There is no evidence of measles virus persistence in the peripheral blood mononuclear cells of children with autism spectrum disorder.
Yasmin DeSouza, Eric Fombonne et al
An analysis of data covering young children in California does not suggest any association between measles-mumps-rubella (MMR) immunization and an increase in the occurrence of autism. The authors point out that a similar lack of correlation between the trends in early childhood MMR immunization rates and autism occurrence has been noted in Great Britain and in Sweden.
A New study out of the UK looked for measles virus in bood samples taken from children vaccinated with the MMR who also had a diagnosis of autism. They were unable to detect the measles genome in any of the subjects.
Families who blame the MMR vaccine for their children's autism lost their final appeal for legal aid funding last week. But 11 families who claim the vaccine caused other conditions -- such as epilepsy, encephalitis, and deafness -- or who allege that their children were injured by earlier versions of the MMR vaccine which are now withdrawn, won funding to investigate the prospects of a claim against the vaccine's manufacturers.
Clare Dyer, British Medical Journal
Why do some people find measles virus RNA anywhere they look and then link the MMR to autism?? Hmmmm... A look at how bad PCR can fuel an MMR conspiracy theory.
The prevalence of pervasive developmental
disorder in Montreal was high, increasing in recent birth cohorts as found in most countries. Factors accounting for the increase include a broadening of diagnostic concepts and criteria, increased awareness and, therefore, better identification of children with pervasive developmental disorders in communities and epidemiologic surveys,
and improved access to services. The findings ruled out an association between pervasive developmental disorder
and either high levels of ethylmercury exposure comparable with those experienced in the United States in the 1990s or 1- or 2-dose measles-mumps-rubella vaccinations.
Dr Fletcher however simply invokes the spirit of these 'thousands of documents' and doesn't discuss them or what they contain at all. It may well be that he's hampered by the legal constraints of the case(s) in question but thats really besides the point. What we need to know is -- what can Dr Fletcher add to the debate? Both the epidemiology and the hard science have refuted the MMR link on more than one occasion. If Dr Fletcher has peer reviewed journal based evidence that contradicts or invalidates the science done so far then he should state it. At the moment he is simply repeating a fallacy of intuition, magical thinking and an argument to the future. None of these lend any scientific credence to making a case that supports the idea that the MMR jab caused or contributed to anyones autism. If there's evidence lets get it peer reviewed and published in a respected journal -- anything else is simply hearsay.
It has been suggested that vaccination against measles, mumps, and rubella (MMR) is a cause of autism. We conducted a retrospective cohort study of all children born in Denmark from January 1991 through December 1998. There was no association between the age at the time of vaccination, the time since vaccination, or the date of vaccination and the development of autistic disorder. This study provides strong evidence against the hypothesis that MMR vaccination causes autism.
Kreesten Meldgaard Madsen, Anders Hviid, Mogens Vestergaard, Diana Schendel, Jan Wohlfahrt, Poul Thorsen, Jørn Olsen, Mads Melbye
Seventy five of 91 patients with a histologically confirmed diagnosis of ileal lymphonodular hyperplasia and enterocolitis were positive for measles virus in their intestinal tissue compared with five of 70 control patients. Measles virus was identified within the follicular dendritic cells and some lymphocytes in foci of reactive follicular hyperplasia. The copy number of measles virus ranged from one to 300 000 copies/ng total RNA. The data confirm an association between the presence of measles virus and gut pathology in children with developmental disorder.
The prevalence of autism appears to have stabilised. There is no evidence for a new phenotype of autism ("new variant", or "regressive autism"). The claims that MMR vaccine is involved in the initiation of autism, and/or with regression, and/or with bowel problems associated with autism, are not supported by any credible scientific evidence, while there is compelling and increasing evidence showing no association.
R. Lingam et al, Archives of Disease in Childhood
I am free to keep an open mind and give other researchers a fair chance to show the merit of their work, but my mind doesn't have to be so open that I accept theory in the absence of full experimental research... I wonder sometimes if future epidemics of infectious disease will be triggered by a current epidemic of irresponsibility.
Ten articles that specifically evaluated the possible relationship between the MMR vaccine and autism were identified. Review articles, commentaries, and evaluations of a link between gastrointestinal symptoms in autistic children and MMR immunization were excluded. Based upon the current literature, it appears that there is no relationship between MMR vaccination and the development of autism.
We wish to make it clear that in this paper no causal link was established between MMR vaccine and autism as the data were insufficient. However, the possibility of such a link was raised and consequent events have had major implications for public health. In view of this, we consider now is the appropriate time that we should together formally retract the interpretation placed upon these findings in the paper, according to precedent.
Measles, mumps and rubella (MMR) are all preventable but infectious diseases caused by viruses. A particular study by Wakefield et al suggests that there are potentially adverse effects of having the triple MMR vaccine. This has been reported widely by the media and has caused alarm to parents of young children, probably contributing to the decline in its uptake. In order to provide the context for the debate regarding the single versus the triple vaccine, this paper briefly appraises firstly, the Wakefield et al research paper that has led to public health concerns and secondly, a more rigorous research study that contradicts the findings; the paper then explores the risks and benefits of the single and the triple MMR vaccine programmes, finally providing a short discussion on factors that might influence the decision-making process by parents when faced with the dilemma of not having their child vaccinated, or opting for either the single or triple vaccination programme.
When it comes to science reporting in the media there is often sensationalism and bias in the guise of "breaking news." Readers and watchers must remain initially skeptical of scientific "evidence" presented in the press. Don't believe everything you read, at least not at first.
An expert group's review of the use of the measles, mumps, and rubella (MMR) vaccine in Scotland has concluded that it is the best method of protecting children against these diseases. The group also rejected the use of single vaccines, after finding that they have no safety advantages and are likely to be less effective in immunising children.
There is now unequivocal evidence that MMR is not a risk factor for autism--this statement is not spin or medical conspiracy, but reflects an unprecedented volume of medical study on a worldwide basis. By any rational standards of risk/benefit calculation, it is an illogical and potentially dangerous mistake for parents to be prepared to take their children in a car on the motorway or in an aeroplane on holiday, but not to protect them with the MMR vaccine.
On February 18, 2004, serious allegations of research misconduct concerning an article by Dr Andrew Wakefield and colleagues published in The Lancet in February, 1998, were brought to the attention of senior editorial staff of the journal... We regret that aspects of funding for parallel and related work and the existence of ongoing litigation that had been known during clinical evaluation of the children reported in the 1998 Lancet paper were not disclosed to editors. We also regret that the overlap between children in the Lancet paper and in the Legal Aid Board funded pilot project was not revealed to us. We judge that all this information would have been material to our decision-making about the paper's suitability, credibility, and validity for publication.
My position on Dr Wakefield's role in the campaign against MMR is a matter of public record � it is well known to readers of spiked. He is a scientist in whom self-belief turned into self-delusion. When he could not substantiate his hypotheses to the satisfaction of his peers he found a responsive audience among scientifically naive journalists, lawyers and parents, who found his theories congenial to their own agendas... Though I have no great sympathy for Dr Wakefield in his current predicament, I still do not think he should be struck off the medical register and I am sceptical that any benefits will result from his appearance before the GMC. Though his work was crucial to the notion of an MMR-autism link, he cannot take all the blame for the scare, for which many others share responsibility.
Michael Fitzpatrick, Spiked UK
Results showed that 78% (1010/1294) of cases, who were diagnosed with pervasive development disorder, had been given the MMR vaccine, but a higher proportion (3671; 82%) of controls, without such a disorder, had been given the vaccine.
Susan Mayor, British Medical Journal
The country's largest measles outbreak in a decade was sparked when an unvaccinated teenager returned from a mission trip to Romania and attended a single church gathering with other unvaccinated children. Of the 34 people who became sick during the 2005 outbreak: 33 were members of the same northwest Indiana church, 32 had not been vaccinated against measles, and 28 were school-aged. Of the 28 school-aged children, 20 were homeschooled. The parents of most of the children who got sick said they had refused measles vaccination for their children because of fears about vaccine safety.
During the early part of 2005, Thoughtful House's plush blue-and-white website indicated that the 49-year-old British former gut surgeon and laboratory researcher, was establishing what appeared to be a facility to bring developmentally-disordered children from all over America, and possibly the world, to the lone star state's capital, for the purpose of undergoing endoscopy. This looked like good business, but recent developments suggest that something in Austin has changed. In late August 2005, the Thoughtful House website underwent dramatic reconfiguration. The "Mount Rushmore" line-up of Wakefield, Krigsman, Jepson and Granpeesheh, seen above, vanished from the welcome page. And previously extensive details of the Wakefield operation's clinical services were replaced with: "This page is under construction."
For the 1980-1994 birth cohorts, a marked, sustained increase in autism case numbers was noted, from 44 cases per 100 000 live births in the 1980 cohort to 208 cases per 100 000 live births in the 1994 cohort (a 373% relative increase), but changes in early childhood MMR immunization coverage over the same time period were much smaller and of shorter duration. Immunization coverage by the age of 24 months increased from 72% to 82%, a relative increase of only 14%, over the same time period. These data do not suggest an association between MMR immunization among young children and an increase in autism occurrence.
The safety of the MMR innoculation, the combination vaccine given to young children and widely supported by scientists, will be questioned again this week in a presentation that claims to provide proof of a link to autism. American researchers say that their study supports the findings of Andrew Wakefield, the discredited gastroenterologist who raised fears that the measles, mumps and rubella injection might be causing autism.
While we should certainly celebrate the success of the national immunization program in eliminating the domestic incidence of rubella, it and similar successes need to be viewed in context. Given that the risk of contracting rubella still exists and that the risk associated with receiving the vaccine -- as long as one is not pregnant -- is far less, parents should heed the advice of pediatricians and make sure their children continue to be properly immunized.
A scientific review of 31 select studies has found "no credible evidence" linking measles-mumps-rubella vaccinations to autism or Crohn's disease, the authors said... Although the review found an association between MMR and some adverse effects, such as febrile convulsions within two weeks of the vaccination, it concluded MMR exposure was unlikely to be associated with Crohn's disease, ulcerative colitis or autism.
Andrew Wakefield is soon to embark on a multi-city tour to promote his idea that the MMR vaccine causes autism. Media coverage surrounding this tour may increase parents' fears about the vaccine and parents may come to you with questions. This issue may be used as a resource for talking points. It provides a concise summary of: the studies used to support the hypothesis that MMR causes autism; the studies that refute this hypothesis; other investigations into the causes of autism.
MMR was associated with a lower incidence of upper respiratory tract infections, a higher incidence of irritability, and similar incidence of other adverse effects compared to placebo. The vaccine was likely to be associated with benign thrombocytopenic purpura, parotitis, joint and limb complaints, febrile convulsions within two weeks of vaccination and aseptic meningitis (mumps) (Urabe strain-containing MMR). Exposure to MMR was unlikely to be associated with Crohn's disease, ulcerative colitis, autism or aseptic meningitis (mumps) (Jeryl-Lynn strain-containing MMR). We could not identify studies assessing the effectiveness of MMR that fulfilled our inclusion criteria even though the impact of mass immunisation on the elimination of the diseases has been largely demonstrated.
We report on the validity of the computerized diagnoses of autism in a large case-control study investigating the possible association between autism and the measles, mumps and rubella vaccine in the UK using the General Practitioner Research Database.
Materials from a documentary investigation by Brian Deer for the UK's Channel 4 Television exposing the bizarre true story of British gut surgeon Andrew Wakefield and his strange crusade against a children's vaccine
With a few notable exceptions�such as Brian Deer, whose work for the Sunday Times and Channel Four helped to discredit Wakefield's Lancet paper�British journalists have a poor record on MMR and, indeed, on autism. While certain journalists have lionised Wakefield, real scandals -- such as the recent death of an autistic boy from Britain undergoing mercury chelation therapy in the United States, or the inadequacy of respite services revealed by the conviction of a 67 year old mother for killing her adult autistic son when she could no longer cope with his violent behaviour -- have largely been ignored (www.spiked-online.com). If children die from measles, the MMR scandal may indeed get worse.
Michael Fitzpatrick, British Medical Journal
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