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January 06, 2011

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Interesting medical study. I think the viral strains on vaccines have an adverse effect on the fetus to which includes neural development.

This is my first visit to your blog - I'm ecstatic to have found you! As an RN and a mother, I am an advocate for vaccination: with whatever schedule you are comfortable with. I think that some physicians adhere so strongly to the current CDC recommended schedule because they can't be sure when a parent will decide to balk at vaccinating (hence the increasing number of shots kiddos get).

I can't wait to start scrolling through some of your other entries!

Kristen, so well handled with such interesting comments! When I saw the headline on the news, I felt a sinking in my stomach for all the parents who have worked so hard to show a link. I do think there may be a link for some kids---maybe certain combinations of vaccines react different with different body chemistries---it just sucks that some doctors may now brush aside parental concerns and insist on following the schedule hook line & sinker.

I was fortunate in that my pediatrician allowed us to delay vax, esp. MMR, until my kids were all past the age when signs of autism are most commonly seen---esp. my son who wasn't speaking well until about 3. We have always split things up and tried not to do a handful of shots as once.

And, yes, it pisses me off that this study was allowed to be held up as proof for this long before someone really looked at it hard and debunked it.

For me, as a researcher and a public health professional, the data is not lacking. After enormous amounts of research, there is no credible evidence that links autism with vaccines. Saying that autism is caused by vaccines, is like saying matches cause lung cancer.

Could it be that many important things in life are simply, out of our control?

I am grateful to vaccines for saving millions of lives, including quite possibly, my life and the lives of my children.

Thanks for mentioning Dr. Sears' schedule, Hannah. We loosely follow that one ourselves.

And I do agree that most people who do choose to delay and/or are selective about their vaccinations have done a lot of research.

In my own personal situation, it was not specifically due to the Wakefield study. My grad school research professors would have slapped my hand if I had done that.

It's based on a myriad reasons.

Thanks again for all the thoughtful comments everyone!

I wanted to clear some things up about the Wakefield study. This study never said the MMR caused autism. The paper says:
"We did not prove an association between measles, mumps, and rubella vaccine and the syndrome described.
Virological studies are underway that may help to resolve this issue."

Wakefield noted that parents of 8 of the 12 children stated their children regressed into Autism after they received the MMR vaccine. Wakefield never said it the parents did. The paper stated that all 12 were suffering from new form of bowel disorder called Illeal Lymphoid Hyperplasia - their gut was filled with the measeles virus.

The case report has actually been supported and replicated. A couple are listed below:
Furlano R, Anthony A, Day R, Brown A, Mc Garvey L, Thomson M, et al. “Colonic CD8 and T cell filtration with epithelial damage in children with autism.“ J Pediatr 2001;138:366-72.

Sabra S, Bellanti JA, Colon AR. “Ileal lymphoid hyperplasia, non-specific colitis and pervasive developmental disorder in children”. The Lancet 1998;352:234-5.

Torrente F., Machado N., Perez-Machado M., Furlano R., Thomson M., Davies S., Wakefield AJ, Walker-Smith JA, Murch SH. “Enteropathy with T cell infiltration and epithelial IgG deposition in autism.” Molecular Psychiatry. 2002;7:375-382

Gonzalez, L. et al., “Endoscopic and Histological Characteristics of the Digestive Mucosa in Autistic Children with gastro-Intestinal Symptoms“. Arch Venez Pueric Pediatr, 2005;69:19-25.

Balzola, F., et al., “Panenteric IBD-like disease in a patient with regressive autism shown for the first time by wireless capsule enteroscopy: Another piece in the jig-saw of the gut-brain syndrome?” American Journal of Gastroenterology, 2005. 100(4): p. 979- 981.

Also one has to question how Brian Deer, the journalist who started the inquiry with the GMC acquired the personal medical records of the 12 children. He works for the Sunday Times and the overall boss is James Muroch, who is also a board member of GlaxoSmithKline, MMR supplier. His role is to oversee “external issues that might have the potential for serious impact upon the group’s business and reputation“:[James Murdoch takes GlaxoSmithKline role - Chris Tryhorn The Guardian Monday 2 February 2009.

Some links if folks would like to read:
http://vactruth.com/2011/01/07/media-vultures-have-another-go-at-andrew-wakefields-research/
http://www.ageofautism.com/2011/01/cryshame-response-to-bmj-report.html

Also all the folks I know either personally or through online groups have never stated their reason to not vax was based on the Wakefield study. It was through research, hearing reports from parents whose children were injured or their own children were injured, and/or reading the vax inserts and ingredients.

I am a nurse who has administered vaccines for years. Both at a Public Health Department and in a Physician's office. I love Motherhood Uncensored but I have to admit that when I read the post I thought to myself "She just opened a HUGE can of worms with this one!"
It was a nice surprise to me when I read the comments and discovered that there were no rude comments and it didn't seem that anyone was picking a fight. I support vaccines myself and my children are immunized per the CDC schedule. I also support delayed scheduling and as a parent myself I can respect why parents chose this. Dr. Bob Sears has an alternative schedule many parents seem to like. It can be difficult to find a delayed schedule and his is easy to follow.
Whatever you decide to do it should be an educated decision that you as a parent are comfortable with. Do not let a healthcare professional talk you into (or out of) something you are not informed about, however big or small.
Good to see an open discussion on a worthy topic. And God bless the parents of autistic children. :)

I too am mystified as to why the media is picking this up now when it's been known for years. Fascinating. But I do have an answer as to why major journals publish stuff that's probably wrong. It is in fact important to do so. This is how science advances: by hypotheses being advanced, and then being disproved. In truth we can't prove *positives* - the positives are what's left after everything else is ruled out. So the big journals are eager to publish controversial hypotheses, as this spurs more research which can prove them wrong. Wolfgang Pauli once characterized some bad research as "not even wrong." Implying, of course, that good yet wrong is preferable to bad and 'right.' However, fraud is not supposed to be part of the system, so it is often hard to detect. Researchers are supposed to be ethical. But, of course, the vast sums of money floating around in biomedical/pharmaceutical research are powerfully tempting to the weak-minded.

@Gertie, I can't read that article without buying access, which I'm not inclined to do. It appears to be about the Pfizer-Wyeth merger. Is it arguing that Pfizer bought Wyeth to get into vaccines? At the time of the merger, the industry scuttlebutt was that, among other tings, they wanted Wyeth's strength in biomolecules- which is the use of proteins as direct therapeutics, not as vaccines. However, I just poked around a bit and found some articles arguing that the steady income stream from Prevnar was appealing to Pfizer (see, for instance: http://www.dailymarkets.com/stock/2009/02/02/pfizer-wyeth-merger-underscores-that-bigger-isn%E2%80%99t-better/). I'll buy that, but I still don't think those revenues come close to the revenues big pharma gets from drugs like Viagra and Lipitor- and if you read the article, neither do the wall street analysts.

I'm an industry insider (I work in biotech), so I know that most vaccine-haters think I'm in on the conspiracy. But, for the record, I've never had anything to do with vaccines as anything other than a consumer (both of my kids have gotten all of their vaccines on schedule, and we get our flu shots every year). My opinion is that if you want to see where pharma thinks the big money is, look at where they direct their research efforts. And that, for the most part, is not in vaccines.

And as an aside- the whole pharma conspiracy argument sorta makes me giggle, because it would require a huge number of PhD scientists to be in on the conspiracy. We can't, in general, even decide where to go to lunch. Thanks to all the mergers and layoffs in the industry, there is no love lost between the scientists and the business types who run the companies. If there were any evidence that vaccines caused harm, and the businessfolk in the pharma companies were trying to repress it- my money is on one of the scientists using the whistleblower laws and exposing the whole thing. We have kids, too, you know, and of all the parents I know in the industry, I can't think of a single one who hasn't gotten their kids vaccinated. I know one or two who have used a delayed schedule, but no one I know has skipped the vaccines altogether.

Kristen, I'm sorry I keep writing such long comments. I should write my own post on this, I suppose! Thanks for giving me the space here.

Paul Offit has a new book out: http://www.amazon.com/Deadly-Choices-Anti-Vaccine-Movement-Threatens/dp/0465021492/ref=sr_1_2?ie=UTF8&s=books&qid=1294425656&sr=8-2

And Kristen - I think we touched base about an article in Wired Magazine last year that did an in-depth interview and story on Dr. Offit and the anti-vax movement.

That said, we delayed the MMR for our son because we wanted to separate the vaccine from the average age of symptom onset. We discussed it with the kids' ped, and he was supportive of our decision. IMO, having a ped who listens instead of push one way or the other goes a long way toward keeping our kids healthy.

Just for the record, vaccines are big money makers for pharm companies....

http://online.wsj.com/article/SB10001424052748703545604575406892820210702.html

That being said, I don't think it is a smoking gun that vaccines are bad at all.

The thing that is most frightening about people skipping vaccines is that it puts holes in our community armor. If everyone is vaccinated we are strong, outbreaks are as unlikely as winning the lottery. But there are holes, for example, the mmr vaccine didn't "take" with me. I didn't find out until I was pregnant and they did a blood test. Then they gave me another series, and it took. But for 20 years I was unprotected. There are others like me. Those are the natural holes in the armor.
Then there are people who don't vaccinate for religious reasons. They widen the hole it's still a little more likely.
When the vaccine scare happened there were huge portions of entire communities that chose not to vaccinate. Then there were out breaks and the people to young, or that just didn't have the vaccine take for some reason, fell just as fast as those who chose not to vaccinate. It's not fair.
Drug companies are not out to get you. They are full of human beings, parents even, who want whats best for you and your kids. There's not a lot of profit in vaccines, that myth needs to be debunked. There is no "link" between them and the AMA conspiring to get the most money for your kids.
That being said I feel awful for the parents of children with autism who all this time thought a decision they made caused their Childs autism.

Thank you. You put into words what I couldn't yesterday. What I haven't been able to do since both my sons were diagnosed as being on the autism spectrum. I've never thought it was the vaccines in our case. They both showed signs since birth if anyone was looking. But like you said, I do think that yes, some kids' biology may react with some vaccines and there may be a correlation. We need more valid research to know more. It's such a shame that this one person has set the research on autism back so far.

Today, my 3 year old son had his first day at an all day autism program. I was sick to my stomach knowing if he were frightened, my son (who does not speak) would not even be able to tell his teacher, "I'm scared. I want my mom." I was sick knowing that if he were crying at school, my son (who cannot break free of his own world) would not be able to understand the words, "It's going to be okay. Don't cry. Mommy will be back."

My son did not develop autism b/c of the MMR vaccine b/c he hasn't received it thanks to a delayed schedule. However, immediately after he SHOULD have received it, he started showing signs that months later would lead to an autism diagnosis. Had he received that vax, I would be the first one shouting at the top of my lungs that vaccines caused my son's autism b/c before that he was fine.

To suddenly have a perfectly happy healthy typical child begin to falter for no apparent reason-- one can't help but search for one inciting incident that changed everything. For many parents, the only thing different is that one shot. Perhaps if the vax were scheduled later, many of these indicators would have already presented themselves and the vax might not be such an issue. Most signs show up around 15 months--the same time as the MMR shot.

I'm not arguing against vaccinations, I'm only saying that I UNDERSTAND why parents are frightened by them. The numbers are climbing. It's difficult sometimes not to see a link between the increasing number of vaccines and the increasing number of autism cases. While the CDC and research shows there's no connection, many moms who have lived through it say there is.

Most moms aren't skipping vaccines b/c of Wakefield or Jenny McCarthy, but b/c of their own gut fear that something might go wrong with their child. Yes, the research says everything will be fine after a vax, but then there's that mom, claiming everything was perfect until her child had that shot...

Is it selfish to endanger other people's children so one's own child can be safe? Yes. But I would happily throw myself in front of bus to save my children, but to be honest, I probably wouldn't do it for someone else's. Does that make me an asshole? Probably. But as horrible as it sounds, it's true.

I am a paediatric nurse and was taught to follow the vaccine schedule to the letter; I didn't second guess it. When my first child lost all of his words immediately after his 18-month MMR vaccine, it was the hardest thing I've had to deal with in my life. I didn't even realize the connection until I looked back in his baby book a few years later and saw it was the same week as his vaccinations.

As we've done years and thousands of dollars of appointments, therapies, evaluations, and research into his speech problems, I see time and time again, children who fell ill after their MMR vaccination. I was not looking for this information, just looking for things to help my child. This is one study that has holes in it. But we are not God, and we don't know the cause of autism, so just because one study says vaccines don't contribute to it, and another has holes in it, doesn't mean subsequent studies will never show that.

All I know, is my subsequent children are on a delayed vaccine schedule. I NEVER want to go through that again and don't wish what I've gone through on my worst enemy.

Kristen, I actually reacted to dTAP as a kid and had to get a modified schedule. I think the fact that some people have this problem makes it all the more important for the majority of people who don't have an unusually strong reaction to get the vaccine.

I didn't react at all to my recent booster, though, beyond a sore arm.

Cloud - In addition to the vax scare, there has been the most reactions (most being relative, I know - it's a very small percentage of people) with the DTaP and its many forms for many people.

It is one of the most reactive vaccines (speaking from my own personal experience - my own family and my husband's) so we've waited to get that one.

It's unfortunate, however, because we have the same outbreak here in Atlanta. And I actually had Pertussis (though I was vaccinated, I picked up a different strain when I lived overseas). I opted to get the TDaP when I was in the hospital after I had Bridget.

Initially, my understanding was that it was the Pertussis that was the most reactive part of the vaccination, but apparently it's the Diptheria (according to my pediatrician). I wish that they'd offer a TP vax (they do offer DT which doesn't do much good for Pertussis obviously) as I'd be more inclined to get it.

You know who I really feel for? The babies under the age of one who caught measles because other parents chose not to get their own children vaccinated.

When my oldest was about 11 months old, we had a measles outbreak here in San Diego. It was circulating in the neighborhood in which I lived, and I was scared, but we got lucky and my baby did not catch measles. The outbreak was started by a family who chose not to vaccinate their kids, traveled to Switzerland, came into contact with other people who chose not to vaccinate, and got measles. Then they came home, and spread it at the doctor's office, school, and swim school- not out of malice, but because measles is an incredibly infectious disease that can be spread before the telltale rash appears. Two little babies caught measles, which is a horrible, scary disease in babies. They both recovered, but I'm not sure I'd be able to forgive that experience if it had been my baby.

And the outbreak before this one, which was back in the 90s? In that one, kids died.

Now, my community is in the midst of a whooping cough epidemic, and again, it is babies too young to be vaccinated who are dying. DYING. Our vaccination rate on whooping cough is down, thanks to the trend to choose not to vaccinate. That vaccine is only about 70% effective, so we really need as many people to vaccinate as possible to help control the spread. (People- if you haven't gotten your pertussis booster yet: do it! Adults and older children need a booster.)

The pseudoscience spread by Jenny McCarthy and others like her has been thoroughly debunked many, many times. As far as I'm concerned, she has those innocent little lost lives on her conscience.

@Sherry, the required childhood vaccines are not big moneymakers for the pharma companies. They just aren't. Viagra, Lipitor- those are big moneymakers for pharma companies. There have actually been supply problems with some vaccines because pharma companies look at the risk to profit margin on making vaccines and conclude it isn't worth staying in vaccines. And studies have been done explicitly looking for a connection between vaccines and autism, and no connection has been found. I encourage anyone who wants a comprehensive review of the science to check out the page put up by the Science Based Medicine blog: http://www.sciencebasedmedicine.org/reference/?p=1

Sure, do your research. But a google search isn't necessarily good research. Make sure you are reading good information. Be skeptical- but be skeptical about the information from the people arguing against vaccines, too. So the pharma companies are making some money off of vaccines. But ask yourself, how much money do the people writing anti-vaccine books make from this? Are you sure their motives are pure?

What's amazing is that the news has been out there for quite some time that Wakefield was a fraud and the sheep that follow Jenny McCarthy STILL DON'T CARE. I wish the autism activists could put their money and energy into finding the real cause and/or an effective treatment for autism.

You can't *prove* a negative, but the research is pretty clear that vaccines and autism are not linked.

I'm also baffled as to why people think vaccines are a profit center for pharma companies. They focus their research and advertising on expensive lifestyle and long-term drugs like Viagra and blood-pressure medications.

I agree Julie. Indeed - signs and symptoms do tend to emerge near the time that the MMR is given.

I don't think that it's surprising that folks latched onto Jenny McCarthy. Not just because she had a loud voice and a wide forum, but because she was a mom. The voice of someone relatable, as opposed to a dr. in a white coat, is pretty powerful.

I need to start using my voice to make Ryan Reynolds the next keynote speaker at the conference in my bedroom.

Heh.

Melissa - You bring up SUCH a good point about FMLA.

I agree with Julie that routine vaccines are given at the same sort of age as the symptoms of autism start to show. But, like other commenters, I also wouldn't want to 'rubbish' others who had this happen. We don't know for sure whether the two are linked or not. This is where the research should be.

Well done to those who made their decisions according to what was right for them. It can be very hard to take a different route than the one considered normal.

The thing I really worry about with the loss of herd immunity is what happens to the less fortunate among us. If my daughter got pertussis now (almost 3), it'd be uncomfortable and awful. But I am a professional with good medical insurance, sick and vacation leave, and some savings so I could take FMLA.I could take several weeks to nurse her back to health, as could my husband.

What about the mom who works retail and has no worker protections? What happens when her too-young-to-be-vaxed kid gets pertussis or measles from someone in the community? What happens to her family when she needs to quarantine her kid?

I feel like I have a responsibility not only to my family but to my neighbors (some of whom are immuno-compromised) and fellow parents to do my part in keeping all our kids healthy.

I'm skeptical of some vaccinations. But as someone in public health I am acutely aware of how very, very important some vaccines that might be less necessary for my kid (e.g. Hep A, Gardasil for now) save many lives in areas where medical care is unavailable or in very short supply.

First, that the study was seriously flawed isn't news, though for some reason the media is picking up on it now. This has been well known amongst researchers for some time.

How did such a flawed study get published? Why wasn't it picked apart? I too have had papers picked to peices and gone through the revision process - like you, not in the top journals like Lancet, but not far down the list. Take a good look at studies published in the 'top' journals. Sure, mostly they're great articles. However it's no secret that those journals are cliquish, and that they're eager to publish 'sexy' peices, and that there's stiff competition out there (ie Nature vs Science). Take the latest NASA one in Science, I believe it was, about bacteria that use arsenic instead of phosphorus? Bad science. Remember cold fusion, also in Science I think, a few years back? If a top journal thinks a piece is big news, they'll push it through despite serious flaws.


But what it comes down to, unfortunately, is that there are flawed studies out there that get published. I was taught in my undergrad, thankfully, to never believe a published result until I'd read the paper and critically thought about the premise, background, methodology, and conclusions. But your average Joe or Jane who hears on the news that there's a new study that shows a link between X and Y not only don't necessarily have access to the full article, but they also don't have the background to fully evaluate the claims.

Okay, there's my geeky response :) And I should note that even though I knew that study was flawed, even though I know there's no link, I still was nervous about vaccinations for my son, and I still did a delayed vaccination schedule for some vaccines (not all -- the early ones esp H.flu you need to have done on schedule, there's a reason behind the timing of them). The fear of autism, of anything happening to our precious children, is a very strong motivator.

Thank you for your work with kids on the spectrum and thank you for this post. My son is 4 with mild autism, but there were signs/red flags from the very beginning. We've delayed our younger son's vaccines and have spaced them a considerable amount, and I don't doubt that choice a single minute.

Parents of kids on the spectrum don't get the luxury of a magic bullet so we try everything hoping desperately something will stick. A delayed vaccine schedule is just one line in a litany of therapies, diets, etc. Whatever it takes.

I am not a doctor, nor have I read the studies. I'm also unabashedly a firm believer in medical science. That said, let me just add:

1. It's possible that children shows signs of autism after vaccinations because the age of those vaccines correlate with when the first signs of autism might appear.

2. The information that vaccines were not linked to autism has always been available, even right alongside the Wakefield research. People see what they want to see and disregard the rest.

3. People who speak loudest tend to be heard. The anti-vaccine group was, for some reason, VERY vocal. Just like some other *advocates* we can all think of. The danger here, of course, is that you get a butt-load of people who follow the words of a Jenny McCarthy-like figure, instead of going to speak to a real medical professional.

Like you said, the hard thing is that we just don't know. It is hard to see that studies like this can even get published--it reminds us that it is impossible to know which studies to trust, especially when it comes to our kids' health.

We've made the well-researched and doctor-supported decision not to vaccinate our kids, at least for now. We're always continuing to read new information and re-evaluate our situation. None of my kids is yet in daycare or school, which is a major factor in our decision at this point. We may choose to selectively vaccinate before our oldest starts school (in the fall), or we may not.

I have a cousin who is severely autistic (he is now in a group home, at the age of 18), whose parents swear his symptoms started immediately after his 18 month vaccinations. Like you, I cannot totally dismiss what my aunt and uncle claim. I think the real problem comes down to a general lack of thorough, long-term safety testing in vaccines, making it very difficult to trust claims of safety or lack thereof.

Thanks for such a well written piece.

I believe in vaccinating my little one, but that conclusion came after much research and deliberation.

I'm glad the truth about this fraudulent study is finally in the fore front of the autism discussion.

I do think, however, that some individuals have reactions to vaccines, and that it is tragic and sad that it causes problems short or long term.

The perfect example is my dad and brother. They are deathly allergic to penicillin-it is dangerous to them. Just because it is dangerous to them, however, does not mean in anyway I am stupid enough to claim that it will be dangerous for everyone, and we should stop it's use across the board.

Since my mom delayed getting me a vaccine when I was little and my sisters and I ALL got measles, mumps and chicken pox at the same time I am a little anal retentive about my girls getting their shots.

Being quarantined at age 6 will do that to you!

Also, I had a boy in my elementary school that had a severe reaction to one of the shots they give right after birth and he ended up in a wheel chair with severe disabilities. So I understand the hesitancy about vaccines but I ALWAYS ask my doctor. She has 3 kids of her own after all.

When we got our daughters they were 2 yrs old and 11 months old and had never had a single vaccination. We played catch up but only one or two shots at a time, slowly letting them adapt to all the big changes their bodies and lives were going through. The one that bothered me the most was the flu vaccine, to the point that I refused it for the past few years. I don't know why that one was such a big issue to me, I just didn't want to do it for me or my kids.

This year I finally gave in and got them both the flu shot. My littlest had been fine earlier in the day and ended up with a 103 degree fever, shaking and vomiting and sick. I know the flu vaccine was likely not the cause. I know that logically. But still. My baby got a shot and then my baby got terribly sick. It's hard not to want to blame the vaccination. It's not as serious as autism - she recovered a few days later after some quality time at the ER - but I can see how those parallels are tempting to an overwhelmed, scared parent.

I don't know the answers. But I'm furious that something this important was all a lie.

Well said. I too believe strongly that not enough research has been done and just because this one study was debunked doesn't mean that there aren't cases of autism where there could exist a link between it and vaccinations. Furthermore, I think a little research needs to be done on the relationship between drug companies and the American Academy of Pediatrics and the AMA. My personal opinion is that there's a "link" between the amount of vaccines that are 'required' and the money the drug companies make from them.

My largest frustration is that a lot of energy was spent fighting vaccinations that could have been spent working on getting therapies covered and other research done. Something I think is a lot more important in the long run.
My parents delayed my vaccinations, but I also grew up in the country in a time when travel wasn't nearly so common. We delayed vaccinations for M, but only a little given that we live in a city with a larger possibility of transient unvaccinated population. When we were going to travel somewhere with a measles outbreak, we did her MMR.
I understand the concern, but hate to think that someone made a decision based on that study, and that their kid was one of the many who got sick because they were unvaccinated. It just makes me sick to my stomach.

Bravo. Thanks for getting this out there. Its actually been known he's a fraud for years but its not common knowledge.

Also I applaud your decisions on vaccination. Not like "hey you did the right thing, good for you!" but rather that you did what was right for you and your kids. People often forget to research and make informed decisions.

Awesome.

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