The vaccines debate - seriously
Joelle - a Practical Parent Tuesday, March 9, 2010 at 12:00PM The New York Times reports that 1 in 4 parents link autism to vaccines inspite of the consistent scientific evidence that there is no such link. Autism diagnoses are up radically in the last 30 years and it's reasonable for parents to want to know the cause of this increase. Because of the timing of vaccination and the timing of autism diagnoses (and often onset), it was a reasonable hypothesis that the two are related.
There's just no science to support it.
In fact, the study that started the anti-vaccination movement has been thoroughly discredited.
Autism is a rough road. I'm lucky that I'm not on it so I cannot speak to how rough it actually is. I was impressed by the writing of autistic adults who emphasize that just because they are different does not mean anything except that they bring different perspective to society. And interventions to help autistic children interact with society have some amazing results. But it's still a rough road.
To be clear, blindness, deafness, cardiovascular disease, encephalitis, meningitis are also really rough roads some of which can lead to death. All are potential impacts from contracting a disease that is preventable through vaccinations. And not being vaccinated increases the public health risk for all of us.
As parents, we have to balance different risks. Our instinct to protect our children is wonderful, but sometimes very uninformed. Newsweek published a long article on the many benefits of vaccines in December - it's worth a read. There are arguments that vaccines are big-pharma making a lot of money. I guess that's possible, but the public health benefit has been tremendous. Vaccines and hygeine have saved millions of children.
There are a lot of potential causes for autism. I hope we research as many as we can to help parents prevent exposure if it's a preventable thing. The first step in good research is letting go of the theories that didn't pan out so you can put resources at finding a more viable answer.
My children are vaccinated and we also did H1N1 flu vaccines this year because we estimated it was a better risk after researching the science and talking with our doctors.
What do you think about the continual emphasis on the autism:vaccine link?
Joelle - a Practical Parent
I applaud Allison's passion - and there are articles about the Homefirst medical practice and the Amish community stating that they have no incidence of autism. The issue is establishing causality - and making a very dangerous conclusion - since vaccines prevent life-threatening diseases that have ravaged society in the past.
Homefirst and the Amish have other differences with the general population beyond vaccination. I don't know that any of them are causal either.
That said, a reader on MotherJones (a very progressive publication) did share a lot of studies that aggressively looked for links between the vaccines, thimerisal and autism - and didn't find any. Another reader pointed out that the rise in autism corresponds to the rise in nutrasweet. I'm sure other people can suggest other correlations. The vaccine correlation has been studied extensively and never found statistically relevant. The power of vaccines for prevention of serious disease is proven.
Here are the studies (from ttamiesor on MotherJones):
From http://pediatrics.aappublications.org/cgi/content/abstract/113/5/e472
"Review of 2 major textbooks on autism and of papers published between 1961 and 2003 yields convincing evidence for multiple interacting genetic factors as the main causative determinants of autism.” “These studies fail to confirm that immunizations with the measles-mumps-rubella vaccine are responsible for the surge in autism."
From http://www.ncbi.nlm.nih.gov/pubmed/16818529?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=2&log$=relatedarticles&logdbfrom=pubmed
"A statistically significant linear increase in pervasive developmental disorder prevalence was noted during the study period. The prevalence of pervasive developmental disorder in thimerosal-free birth cohorts was significantly higher than that in thimerosal-exposed cohorts (82.7 of 10000 vs 59.5 of 10000). Using logistic regression models of the prevalence data, we found no significant effect of thimerosal exposure used either as a continuous or a categorical variable. Thus, thimerosal exposure was unrelated to the increasing trend in pervasive developmental disorder prevalence”
From Journal of the American Medical Association
http://jama.ama-assn.org/cgi/content/abstract/290/13/1763
"During 2,986,654 person-years, we identified 440 autism cases and 787 cases of other autistic-spectrum disorders. The risk of autism and other autistic-spectrum disorders did not differ significantly between children vaccinated with thimerosal-containing vaccine and children vaccinated with thimerosal-free vaccine.” “Conclusion The results do not support a causal relationship between childhood vaccination with thimerosal-containing vaccines and development of autistic-spectrum disorders."
From:
http://www3.interscience.wiley.com/journal/119919937/abstract?CRETRY=1&S...
"There is no support for the hypothesis for a role of either MMR or thimerosal in causation, but the evidence on the latter is more limited."
From
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T1B-4D974DV-1...
"Findings: 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. Interpretation: Our findings suggest that MMR vaccination is not associated with an increased risk of pervasive developmental disorders."
From
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T1B-4D974DV-1...
“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.”
ttamiesor says s/he went through 30 abstracts, and found zero to support the theory the MMR and/or thimerosol shots had any statistically significant relationship to autism.
Again - it's about risk management - and looking for the research rather than opinions.
Health
Reader Comments (6)
Anyone who doesn't think that autism has something to do with vaccines should take a good hard look at the unvaccinated communities in our nation. Examples include an entire medical practice in Chicago (30,000 patients) and the Amish community, both who don't vaccinate. You know what you find? Almost zero autism rate. Isn't that the best control group to determine if vaccines cause injury? The vaccinated vs. non-vaccinated. And how come that hasn't been done? Because no entity, be it pharmaceutical companies, the gov't, nor pediatricians want to be held accountable for the incredible rise in autism in the past 20 years.
The debate is particularly frustrating because the diseases against which vaccination protect children can cause death or long-term health problems. Not vaccinating children puts other children at risk and every year increases the risk of an "outbreak" that will mutate and result in a childhood disease for which we have no vaccine, causing more death and heartbreak.
What about the fact that 1 in 6 children today have some form of neurological disorder? In some parts of the country it's 1 in 4. That's a far cry from what when we were growing up. There are big risks both way, and it's hard to be a parent in 2010 and know you are making the right decisions for your kids.
That's kind of the point I was making - it's not just about *your* kids or *my* kids, it's about *all* kids and what's best for all of them. And I hardly think vaccines are to blame. What about the fact that a large number of women are waiting until their mid-to-late 30s to have children when it's proven that the risk of defects in children increases as the mother ages? That's more likely to be the cause than external influencers that have been proven unrelated.
As far as my children go, scientific research and decades now of clinical observation says vaccines do more good than harm. I would not want to see my child - or any other child - die of a preventable disease. They have all been vaccinated and will continue to be so.
Exactly - there is a difference between causality, correlation and observation. The vaccine:autism debate is not grounded in causality or correlation - but observation. Observation is unreliable because it is not statistically significant.
This is a very hot topic and one in which parents feel very passionately. My husband and I were terrified with our first child and had anxiety leading up to the dreaded MMR, until we took the time to read the research, of which there was nothing that could correlate the two.
Sure, we still have it in the back of our minds, but would we risk one of our children getting polio (which has made a comeback in San Francisco where we live) to pass on the vaccine because we are worried about a link to autism that has not been proven? Absolutely not.
I completely agree with Lori above - what about the correlation between aging mothers and autism? It's just a physiological fact that women are born with all of the eggs that they will have in their lifetime and as those eggs age, they are more prone to developmental issues. There is also a school of thought that believes that the symptoms of autism have only recently (10 years) been defined and as a result, many children were being misdiagnosed as mentally retarded. Now that we as a community (including doctors, school couselors, therapists, etc.) are more educated about this disorder, we can make better diagnoses. This also needs to be considered.