MMR vaccine and Autisim...more research says NO LINK!

I wonder if this news will be broadcasted as loudly as the initial suspected vaccine link was. I do hope that if it turns out to be true that this was faked, or even if the truth was stretched, that the individuals involved are prosecuted to the maximum degree.

The time and focus devoted to this issue has taken the focus away from getting real, usable information out to parents who may suspect that their child is on the spectrum. The one thing that is showing up over and over in the research is that early intervention is imperative, and the longer people think, "well, he's a late talker because he's a boy, it can't be autism because we skipped the shots" the longer it takes to get a diagnosis - which then gets the ball rolling.

It would also be nice to have that time back to study other potential causes or contributing factors. What a shame if this person deliberately misled so many people.

Dr. Andrew Wakefield, 2/19/98 suggested in British medical journal study that MMR was source of autism through bowel disease. He made it up. Twelve kids in study. Data fudged, data omitted.

Source: Olbermann, 2/10/09

Thanks to those who responded to my question about the routine schedule. My kids were never unusually cranky with the routine schedule. I have the Dr. Sears book and I'll see what his arguments are about spreading it out more. I'd guess that more children are vaccinated on the CDC schedule than on the modified one, and since there aren't more stories about the problems the routine schedule causes, it's just a matter of taste.

My kids weren't pre-mature and I understand that logic. Thanks all.

JB- thanks for the UMDNJ link. Excellent stuff.

I read an interesting "theory" a few years ago regarding the autism uptick that has always stuck with me. Basically it proposed that a genetic predisposition was exacerbated by the societal shift towards technology. All those "weird" kids we knew (or were!) growing up now have an increased opportunity to meet other similarly gened people and procreate. Geek is the new cool!

In other words, nonrandom mating. I think there's a certain amount of evidence that like is attracted to like, but that's always been the case.

What makes more sense to me is that the autism genes travel with other genes that confer certain kinds of intelligence. For example, mathematical intelligence.

There are probably different kinds of autism and different ways to acquire autism; we just don't know much about it at this point.

:deleted:

In my view, the increase in the prevalence of autism is mostly due to detection bias. If you look for a disease you will find it. There are similar increases for other diseases as detection becomes possible. HIV is a simple example, where the disease existed prior to discovery but no one could be diagnosed prior to discovery and the number of cases explode once a test is available.
Autism has become a basket diagnosis where any mental, social or intellectual issue can be lumped in. 50 years ago kids with autism may have been labeled mentally retarded or slow. Mental retardation has a stigma that is now socially unacceptable and is no longer a diagnosis. Autism does not have a similar stigma, so now kids are often given the diagnosis of autism.
Finally, autism diagnosis goes hand in hand with state funding. I think NJ has one of the highest rates of funding for autism assistance, so it also has the highest number of cases per capita. I would have to look again but I think Alabama has the least funding and also the fewest cases. Physicians will give a diagnosis so the parents can get state help with the problem.
I don't believe there is any proof that the number of cases have increased, I think we just have something different to call it.

State funding and its relationship to number of cases in a given state may not be entirely due to "hunting for a diagnosis", but rather partly due to people getting a diagnosis in a poorly funded state, researching and then moving to a better funded state. NJ got in the game early with private and publicly funded ABA programs, and has a good reputation for being a place where you can find quality services.

I have to disagree with Autism not having a stigma

I agree, adiosmaplewood, and I don't think it's a bad thing. I just spoke with a woman on my street who told me about her kid with Aspergers and the help he gets at school. There's training on reading social cues, playing a game and not being a sore loser, and so much more. We could all benefit from this! Maybe we wouldn't have been such misfits when we were growing up.

Autism and mental retardation may co-exist. Not all mentally retarded kids have autism though. You may want to review the diagnostic criteria for autism spectrum before you claim that it's kind of a dumping ground for everything else.

I do agree that state funding probably influences a child study team to some extent if there is a choice between autsim spectrum diagnosis and something else that gets less funding. OTOH I think this is probably far less important than the existence of social skills programs, ABA programs etc that are in district and ready for kids with identified needs.

Also, not that I really want to reopen the vaccine conversation, but I did want to point this out:

Measles encephalitis can result in autism (through brain damage). These kids usually have other impairments as well such as hearing loss, blindness, etc. IIRC a measles epidemic in the 50s or 60s resulted in a couple of thousand cases of autism.

Posted By: lurkerMeasles encephalitis can result in autism (through brain damage). These kids usually have other impairments as well such as hearing loss, blindness, etc. IIRC a measles epidemic in the 50s or 60s resulted in a couple of thousand cases of autism.

And since the advent of the measles vaccine, the occurrence of measles-related encephalitis in the US population is now vanishingly small.

Posted By: lurkerAutism and mental retardation may co-exist. Not all mentally retarded kids have autism though. You may want to review the diagnostic criteria for autism spectrum before you claim that it's kind of a dumping ground for everything else.

Did you check out the

Yes, that was my point. Should have made that clearerl. The MMR vaccine wasn't around in those days, so you'd get measles epidemics which were often quite terrifying for parents.

I think people tend to take vaccines for granted.

My own mother would get teary eyed over Jonas Salk.

with you terp.

Boy do I understand your mother's reaction, lurker. I could be having a memory issue, but I think I got both the Salk injectible (we lived in New York state in 1959/60) and then later Sabin oral vaccine as a kid in NJ. A little later in life I came across some young adults with polio (one a professor who got it on his honeymoon in Mexico) -- just accident of a couple of years' timing that they hadn't been vaccinated.

Just thought I'd excerpt Shattuck's response to Newschaffer in its entirety:

I am grateful to the editor of Pediatrics for selecting my article on diagnostic substitution in US special education for comment and doubly honored that Dr Newschaffer,1 an esteemed epidemiologist and autism researcher, rendered that commentary. Newschaffer explores some of the limitations of my analyses including reliance on aggregate-level associations to make the case for diagnostic substitution, the inability to disentangle cohort effects in these data, and an incomplete discussion of the magnitude of association between changes in autism prevalence and corresponding changes in the prevalence of other categories. I have acknowledged and explored most of these limitations in my discussion and will not reiterate those points here. However, there are 2 comments to which I would like to briefly reply.

First, although the article perhaps can be fairly criticized for neglecting to detail the magnitude of effects in some of the regression models more thoroughly, it would be a mistake to conclude that the magnitude of effects in any given model is negligible. In fact, the magnitude of association between growing autism prevalence and the corresponding decrease in the prevalence of other categories is quite substantial. One of the ways to evaluate the adequacy of a model such as this is to compare observed values against values predicted by the model. For instance, the 2003 autism prevalence predicted by the mental retardation (MR) model in Table 2 of the article is 2.9 per 1000 (based on analysis of the residuals), whereas the actual observed autism prevalence in the same year was 3.1 per 1000, representing a very close match between observed and predicted outcomes. Regression models aside, one can also consider the actual magnitude of change in prevalence for one category as compared with another, as I did for examining the difference between changes in combined autism, other health impairments, traumatic brain injury, and developmental delay prevalence versus changes in combined learning disabilities and MR prevalence from 1994 to 2003. A similar comparison can be made between just autism and MR. The observed aggregate MR prevalence among 6- to 11-year-olds in special education declined by 2.8 per 1000 from 1994 to 2003, whereas autism prevalence increased by 2.6 per 1000. This indicates that, in the aggregate, total decline in MR prevalence could have offset the total increase in autism prevalence almost 1-for-1. Of course, this nationally aggregated calculation masks variability among states and cohorts.

Second, Newschaffer concludes with a plea to turn from the intractable, and perhaps unanswerable, question of whether autism's true prevalence has increased over the past 2 decades toward a greater prospective focus on conducting epidemiologic and genetic research related to autism. I agree that we may never be able to fully understand the dynamics behind historical changes in autism prevalence and of course agree that we need more research into etiology. However, autism diagnosis is based on observing behavior rather than clearly identifiable biological markers, diagnostic agreement among clinicians is not perfect,2,3 black children tend to be identified later than white children,4 and clinicians have reported a willingness to give a diagnosis of autism for children with ambiguous symptoms if they know it will result in the child obtaining more services.5 Therefore, I also believe that we need to continue complementing research into etiology with careful examination of the sociopolitical context wherein processes of identification, referral, diagnosis, and intervention occur for children with autism and their families. Questions related to equity, efficacy, effectiveness, quality, and efficiency in services for children are important in their own right.

Maybe the reason New Jersey has so many more ASD cases than Alabama is that New Jersey dads are significantly older than Alabama dads. An Israeli study (see a summary here http://archpsyc.highwire.org/cgi/content/abstract/63/9/1026 ) seems to indicate this. See also this article in Scientific American (http://www.sciam.com/article.cfm?id=the-father-factor). This could also be the reason for such an increase in recent years in ASD as paternal age has increased.

Public health has been one of the great governmental success stories of the last 100 years. Clean water, vaccinations, antibiotics and food safety laws have led to drastically lower levels of childhood mortality than 100 years ago. Also, to accept the idea that the government can't require vaccinations for children entering day care programs, preschools or elementary schools is to drastically cut back on the commonly understood general police power of the state. If a disease is contagious and could be prevented by a vaccine, the government CAN tell you that you have to get the vaccine. Why isn't that obvious.

New Jersey has more cases per capita because it attracts cases. Services are good here compared to the rest of the country. No one would move to Alabama to get services for their kids, but they would and do move to New Jersey.

I also suspect that NJ is richer in diagnostic resources: psychologists, psychiatrists, better child study teams, etc, etc. So the diagnosis is made more often.

There must be some good things about Alabama, but education and social services aren't among them.

http://abcnews.go.com/Health/AutismNews/wireStory?id=6862798

Court Says Measles Vaccine Not to Blame for Autism
Special court rules against families who claim measles vaccine caused children's autism
The Associated Press
WASHINGTON



A special court has ruled against parents with autistic children, saying that vaccines are not to blame for their children's neurological disorder.

The judges in the cases said the evidence was overwhelmingly contrary to the parent's claims — and backed years of science that found no risk.

More than 5,000 claims were filed with the U.S. Court of Claims alleging that vaccines caused autism and other neurological problems in their children. To win, they had to show that it was more likely than not that the autism symptoms were directly related to the measles-mumps-rubella shots they received.

The court still has to rule on separate claims from other families that other vaccines played a role.