A Quick Note on the MMR-Autism Controversy

Posted on January 18, 2011

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Earlier this evening, a guest contacted me regarding a comment I made recently about the Wakefield study’s fraudulent nature.  She said she “seriously [doubts] many parents based their decision on a study by Wakefield that covered 12 children.” That’s probably a true statement – I’d bet every cent in my bank account that the majority of the anti-vaccine movement hasn’t even read the Wakefield study.  However, what did influence these parents was the ripple effect the study caused, especially when it was picked up and propagated by certain celebrities.

She asked me for statistics on how many unvaccinated children develop autism, and I thought “I’m not aware of any studies that have examined this yet.”  However, attempts to locate credible research linking the MMR vaccine (or others) to autism yields the same results – there are none.  I would, however, like to provide two studies for this reader and other concerned parents, and also remind you that the results of the Wakefield study have never been replicated.

1)  Madsen et al, 2002:  “A Population-Based Study of Measles, Mumps, and Rubella Vaccination and Autism”

What’s important to note about this Danish study is that, with one of the most complete health records of any nation, researchers were able to accurately analyze data.

“This study proMMR vaccine autism relative riskvides three strong arguments against a causal relation between MMR vaccination and autism. First, the risk of autism was similar in vaccinated and unvaccinated children, in both age-adjusted and fully adjusted analyses. Second, there was no temporal clustering of cases of autism at any time after immunization. Third, neither autistic disorder nor other autistic-spectrum disorders were associated with MMR vaccination. Furthermore, the results were derived from a nationwide cohort study with nearly complete follow-up data.”

2)  Hornig et al, 2008:  “Lack of Association between Measles Virus Vaccine and Autism with Enteropathy: A Case-Control Study”

“This study provides strong evidence against association of autism with persistent MV RNA in the GI tract or MMR exposure. Autism with GI disturbances is associated with elevated rates of regression in language or other skills and may represent an endophenotype distinct from other ASD.”

At this time, I’d like to make a few additional points:

  • Autism, as a disease, is not new (though, autism as a diagnosis may be considered somewhat recent).  Its description dates back well before the solidification of the Germ Theory of disease, and thus, well before the advent of vaccines.  It may be that the observed increase in diagnoses is due to increases in certain environmental exposures, but it may also be due to how our understanding of, and thus criteria for, the disease has changed in recent years.
  • The claim that rates of autism are lower amongst the Amish is not a valid argument against the use of vaccines.  This is a population with drastically different lifestyles, and you can’t simply choose a single factor like vaccination rates while ignoring other important environmental & genetic factors. That’s not how evidence-based medicine works, (though it is sometimes how we generate hypotheses).
  • Parents who choose not to vaccinate their children based on ignorant propaganda are not themselves ignorant. They, in many cases, are well-meaning caregivers who have been mislead by others.  Many times, they have “done their research” – just not in the right places.  Look out for a post in the future about how dangerous it can be to have low scientific literacy (if I ever get around to it).
  • Herd immunity is important.  Not everyone can receive vaccines, and in order to protect the defenseless, it’s important that those who can are vaccinated.  Why do I get the flu shot? Certainly not because I’m afraid of getting the flu – but that’s not the point!  As someone who comes into contact with elderly and/or immunocompromised patients, I must be concerned about spreading illnesses that aren’t particularly dangerous if I myself contract them.  The long-term damage that the Wakefield study and its proponents have done, I believe, cannot be measured.

Thanks again for the reader input – it helps me direct the content of the blog (that is, when I’m not posting silly pictures).

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Posted in: Health, Medicine