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February 4, 2002
News Morgue Search www.feat.org/search/news.asp
On Vaccinations And Autism by the Autism Society of
America
ASA Position Paper
[This is an excerpt of the document at the ASA
website, posted last
month.]
http://www.autism-society.org/
The question of a relationship between vaccines and autism
continues to be debated within the autism community and covered in the mass
media. While most studies to date do
not support a link between the MMR and autism, many, including the ASA, agree
that more research is needed.
“We do know that vaccines have significantly reduced
life-threatening diseases in children around the globe. What we don’t know is
if there is an issue regarding the amount, the timing, or the medium used to
deliver the vaccines that would result in a child developing autism or other developmental
disorders.
The Autism Society of America strongly supports research
to determine if, in fact, there is a correlation. Until that research is
performed and replicated, vaccines continue to be indicated.” This package is
intended to provide you with useful information about the current understanding
on vaccinations and to give you some background on the work the Autism Society of
America and other advocacy groups are doing to increase funding for research
into autism, including its cause or causes. Included in this package is a
compilation of informational sheets from both governmental and non-governmental
organizations on the issue of vaccines and autism.
The ASA has spoken with families who suspect that there
may be a link between vaccinations and the onset of autism in their children.
The ASA is taking a proactive approach to these concerns and is asking the same
attention be given to the issue from organizations such as the National Institutes
of Health (NIH) and the Centers for Disease Control and Prevention (CDC).
ASA is calling for more funds and consequently more
research in the areas of incidence and prevalence. Further investigation must
occur into the factors that may cause autism and related disorders.
We hope this information proves helpful. For specific
information or to request materials, please contact the organizations listed in
this document. If we can be of further assistance, please do not hesitate to contact
us.
The following article is reprinted with permission from
the National Immunization Program at the Centers for Disease Control and
Prevention VACCINES AND AUTISM: NO KNOWN RELATIONSHIP The following information
is being provided to help address concerns recently expressed in press reports about
a possible association between developmental disorders such as autism and
vaccines.
1. Is there any scientific evidence that provides a link
between autism and vaccines?
To date there is no convincing evidence that any vaccine
can cause autism or any kind of behavioral disorder. A suspected link between
measles, mumps, rubella (MMR) vaccine and autism has been suggested by some
parents of children with autism. Typically, symptoms of autism are first noted
by parents as their child begins to have difficulty with delays in speaking after
age one. MMR vaccine is first given to children at 12 to 15 months of age.
Therefore autism cases with an apparent onset within a few weeks after MMR
vaccination may simply be an expected but unrelated chance occurrence.
The only evidence that has been presented to suggest that
MMR vaccine may be associated with autism has been published by the Lancet
(Wakefield et al 1998 ). An editorial published in the same issue, however,
discussed concerns about the validity of the study (Chen and DeStefano 1998).
Based on data from 12 patients, Wakefield and colleagues speculated that MMR
vaccine may have been the possible cause of bowel problems which led to a
decreased absorption of essential vitamins and nutrients which resulted in developmental
disorders like autism. No scientific analyses were reported, however, to
substantiate the theory.
Whether this series of 12 cases represent an unusual or
unique clinical syndrome is difficult to judge without knowing the size of the patient
population and time period over which the cases were identified. If there
happened to be selective referral of patients with autism to the researchers’
practice, the reported case series may simply reflect such referral bias. Moreover,
the theory that autism may be caused by poor-absorption of nutrients due to
bowel inflammation is not supported by the clinical data.
In at least 4 of the 12 reported cases, behavioral
problems appeared before the onset of symptoms of inflammatory bowel disease
(that is, the effect preceded the cause). Furthermore, since publication of
their original report in February of 1998, Wakefield and colleagues have
published another study in which highly specific laboratory assays in patients
with inflammatory bowel disease, the posited mechanism for autism after MMR vaccination,
were negative for measles virus (Chadwick 1998, Duclos 1998). Other recent investigations also do not
support a causal association between MMR (or other measles-containing vaccines)
and autism or inflammatory bowel disease.
In one investigation, a Working Party on MMR Vaccine of
the United Kingdom’s Committee on Safety of Medicines (1999) was charged with
the evaluation of several hundred reports, collected by a firm of lawyers, of autism,
Crohn’s disease, or similar disorders developing after receipt of MMR or MR
vaccines. The Working Party conducted a systematic, standardized review of
parental and physician information. Although acknowledging that it is
impossible to prove or refute the suggested associations (because of variable
data quality, biased selection of cases, and lack of a control group), the
Working Party concluded that the information available “... did not support the
suggested causal associations or give cause for concern about the safety of MMR
or MR vaccines.”
A study by Taylor and colleagues provides population-based
evidence that overcomes many of the limitations faced by the Working Party and
by Wakefield and colleagues (Taylor 1999; DeStefano and Chen 1999). The authors
identified all 498 known cases of autism spectrum disorders (ASD) in certain districts
of London born in 1979 or later and linked them to an independent regional
vaccination registry. ASD includes classical autism, atypical autism, and
Asperger’s syndrome, but the results were similar when cases of classical
autism were analyzed separately.
The authors first showed that the known number of ASD
cases has been increasing since 1979 and there was no jump after the introduction
of MMR vaccine in 1988. Second, they found that cases vaccinated before 18
months of age had similar ages at diagnosis as did cases who had been
vaccinated after 18 months or not vaccinated, indicating that vaccination does
not result in earlier expression of autistic characteristics. Third, they
showed that at age two years the MMR vaccination coverage among the ASD cases
was nearly identical to coverage in children in the same birth cohorts in the whole
region, providing evidence of an overall lack of association with vaccination.
Finally, Taylor and colleagues showed that the first diagnosis of autism or
initial signs of behavioral regression were not more likely to occur within
time periods following vaccination than during other time periods.
A weak statistical association was found between MMR
vaccination and initial parental concern, but this appears to have been due to
parents’ difficulty in recalling precise age at onset and a preference for approximating
the age as 18 months.
A study of the population of children in two communities
in Sweden also found no evidence of an association between MMR vaccination and
autism (Gillberg and Heijbel 1998). That study found no difference in the prevalence
of autism in children born after the introduction of MMR vaccination in Sweden
compared with children born before.
2. Is there a theoretical possibility that there is a
connection between autism and MMR vaccine or any other vaccine?
If measles vaccine, or any other vaccine, causes autism
then it would have to be a very rare occurrence since millions have children
have received vaccines without ill health effects.
In January 1990, an Institute of Medicine committee
examining possible health effects associated with DPT vaccine concluded that
there was no evidence to indicate a causal relation between DPT vaccine or the
pertussis component of DPT vaccine and autism. Also, data obtained from CDC’s Monitoring
System for Adverse Events Following Immunization (MASAEFI) system, showed no
reports of autism occurring within 28 days of DPT immunization from 1978-1990,
a period in which approximately 80.1 million doses of DPT vaccine were
administered in the United States.
From January 1990 through February 1998, only 15 cases of
autism behavior disorder after immunization were reported to the Vaccine
Adverse Events Reporting System (VAERS).
Because of the small number of reports over an 8 year
period, the cases reported are likely to represent unrelated chance occurrences
that happened around the time of vaccination. The most frequent vaccines cited
in the reports were diphtheria, tetanus, pertussis (DPT), oral polio vaccine (OPV),
and MMR. Other vaccines reported as having a possible association with autism
were Haemophilus influenzae type B and Hepatitis B.
Recently, the National Childhood Encephalopathy Study
(NCES) was examined to see if there was any link between measles vaccine and neurological
events. Researchers in England found no indication that measles vaccine
contributes to the development of long term neurological damage, including
educational and behavioral deficits (Miller et al 1997).
3. What are the known side effects associated with MMR
vaccination?
Most persons have no reactions after receiving a MMR
vaccination.
About 5%-15% of vaccinees may develop a fever 5-12 days
after MMR vaccination and 5% may develop a rash. Central nervous system
conditions, including encephalitis and encephalopathy, have been reported with
a frequency of less than one per million doses administered.
As with the administration of any agent that can produce
fever, some children may have a febrile seizure. Most convulsions following
measles vaccination are simple febrile seizures, and they affect children
without known risk factors. An increased risk of febrile convulsions may occur
among children with a prior history of convulsions.
4. What is the federal government doing to protect the
health of persons who receive MMR vaccine?
There are no proven data to suggest that measles vaccine
will increase the risk of developing autism or any other behavioral disorder.
The CDC continues to recommend two doses of MMR vaccine for all children who do
not have a known medical contraindication; the first dose is recommended at 12-15
months of age and the second dose is recommended at either 4-6 years of age or
at 11-12 years of age. For more information about contraindications to MMR
vaccine see the Advisory Committee’s Recommendations for Immunization Practices
on MMR vaccine.
To assure the safety of vaccines, The Centers for Disease
Control and Prevention (CDC), the Food and Drug Administration (FDA), the
National Institutes of Health (NIH), and other Federal agencies routinely
monitor and conduct research to examine any new evidence that would suggest
possible problems with the safety of vaccines. Currently, CDC is conducting a study
in the metropolitan Atlanta area to further evaluate any possible association
between MMR vaccination and autism. Results of this study are expected sometime
in 2000.
Health Care providers that administer vaccines are
required to report to the Vaccine Adverse Event Reporting System (VAERS)
certain adverse health events that occur in persons who have received vaccines.
Some of these reports are related to vaccines and other reports are not related
but occur from other causes and happen around the time vaccines are given.
Anyone can fill out a report, you do not have to be a health care provider. The
Centers for Disease Control and Prevention( CDC) and the Food and Drug Administration
(FDA) collect and analyze these reports. If you wish to report a health problem
that followed vaccination you can do so by calling the Vaccine Adverse Event
Reporting System (VAERS) at 1-800-822-7967.
The National Immunization Program has established a
National Immunization Information Hotline to help answer questions people may
have about vaccines.
The following information is reprinted with permission
from the National Vaccine Information Center.
1. Is my child sick right now?
2. Has my child had a bad reaction to a vaccination
before?
reactions Convulsions or neurological disorders Severe
allergies Immune
system disorders
4. Do I know if my child is at high risk of reacting?
5. Do I have full information on the vaccine’s side
effects?
6. Do I know how to identify a vaccine reaction?
7. Do I know how to report a vaccine reaction?
8. Do I know the vaccine manufacturer’s name and lot
number?
VACCINATION DECISIONS FOR PARENTS Vaccination is a medical
procedure, which carries a risk of injury or death. As a parent, it is your responsibility
to become educated about the benefits and risks of vaccines in order to make
the most informed, responsible vaccination decisions.
1. Your doctor is required by law to provide you with
vaccine benefit/ risk information materials before your child is vaccinated.
Consumer groups, including the National Vaccine Information Center, worked with
government health agencies to develop parent information booklets on each
mandated vaccine. Ask your doctor for the booklet and take time to read it
before your child is vaccinated. You may also ask your doctor to show you the information
insert provided by the drug company, which manufactured the vaccine( s) your
child is scheduled to receive.
2. Your doctor is required by law to keep a permanent
record of all vaccinations given, including the vaccine manufacturer’s name and
lot number. Ask for a copy of the doctor’s record on vaccinations given to your
child to keep for your records.
3. Your doctor is required by law to report all adverse
events, including injuries and deaths, which occur within 30 days after
vaccination to federal health authorities. If your doctor refuses to report a
reaction following vaccination, you have the right to report to the government yourself.
4. If your child is left permanently brain damaged or dies
as a result of a vaccine reaction, you may be entitled to benefits under the
National Childhood Vaccine Injury Act of 1986.
By fall 1995, the federal vaccine injury compensation
program had compensated nearly 1000 families at a cost of $600 million.
DO: Become educated about childhood diseases and vaccines.
You have the ultimate responsibility for your child’s health and well-being and
you, not your doctor or state or federal health officials, will live with, and be
responsible for the consequences of your decision.
Ask your doctor to give your child a physical exam to make
sure your child is healthy before you permit vaccination. A sick child can be
at increased risk for having a vaccine reaction.
Write down your child’s personal and family medical
history listing major illnesses and diseases or medical conditions, especially
previous reactions to vaccinations, and have it included in your child’s
permanent medical records. Before permitting vaccination of your child, ask
your doctor if any of these conditions will put your child at risk for having a
vaccine reaction. A child who has had a previous severe reaction to a vaccination
can be especially at risk for even more severe reactions if more vaccine is
given. If you are not satisfied with the answers you are given, get a second
opinion.
Monitor your child closely after vaccination. Call your
doctor if you suspect a reaction. If your doctor is not concerned and you are,
take your child to an emergency room.
Obtain a copy of your state mandatory vaccination laws.
Become educated about state vaccine requirements, your rights and legal
exemptions to vaccination.
DON’T: Be intimidated by medical personnel and forced into
a vaccination decision before you are comfortable with your decision.
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The connection between vaccination and autistic behavior,
first reported in DPT: A Shot in the Dark (Coulter & Fisher, 1985) fifteen
years ago and now being discussed in the medical literature, has finally
entered the U. S. public arena after simmering for more than a decade. This
enhanced public awareness has been fueled by persistent reports by parents in
the U. S., Canada and Europe that their
children were healthy, bright and happy until they received one or more
vaccines and then descended into the isolated, painful world of autism marked
by chronic immune and neurological dysfunction, including repetitive and
uncontrollable behavior. Conservative estimates are that about 500,000
Americans are autistic but that number is growing daily, with new evidence that
perhaps as many as 1 in 150 children are suffering from autism spectrum
disorder that can include a range of neurological, behavior and immune system
dysfunction.
In 1999, as states revealed skyrocketing rates of autism
spectrum disorder among children and a congressional hearing was held in the U.
S. Congress, the media began to explore
the medical controversy in print and broadcast reports. At the heart of the
debate stand a few courageous physicians whose independent, multi-disciplinary
approach to investigating the possible biological mechanisms of vaccine-induced
autism is serving as a counterweight to the steadfast denials by infectious
disease specialists and government health officials defending current mass
vaccination policies. As scientific evidence reveals that a portion of autism
lies on the vaccine injury spectrum, parents determined to find help for their
children are turning to doctors exploring diet and immune modulating therapies.
Parents of now grown vaccine injured children, who warned pediatricians
and Centers for Disease Control (CDC) officials in the 1980’s that their once
healthy, bright children regressed mentally, emotionally and physically after
reacting to DPT vaccine with fever, high pitched screaming (encephalitic cry),
collapse/ shock, and seizures, are grieving with a new generation of parents
whose healthy, bright children suddenly regress after DPT/ DTaP, MMR, hepatitis
B, polio, Hib and chicken pox vaccinations. The refusal two decades ago by
vaccine manufacturers, government health agencies and medical organizations to
seriously investigate reports of vaccine-associated brain injury and immune
system dysfunction, including autistic behaviors, is reaping tragic consequences
today.
Now parents of old and young vaccine injured children in
the U. S. and Europe are joining with enlightened doctors in a rejection of the
unscientific a priori assumption that a child’s mental, physical and emotional
regression after vaccination is only coincidentally but not causally related to
the vaccines recently given. They are calling for credible basic science
research into the biological mechanism of vaccine adverse events to develop
pathological profiles which will separate health problems caused by vaccines
from those that are not; the development of screening techniques to identify
children at genetic or other biological risk of developing vaccine-induced
health problems; the institution of informed consent protections in vaccination
laws; re-examination of vaccine licensing standards; and an end to
one-size-fits-all vaccination policies.
This, while the U. S. government, the pharmaceutical
industry and international corporate interests announced on March 2, 2000 the
creation of a new multi-billion dollar alliance called the Millennium Vaccine
Initiative (MVI) to vaccinate all of the world’s children with existing and new
vaccines, including those being targeted for accelerated development for AIDS,
tuberculosis and malaria. According to the annual NIH Jordan Report, there are
more than 200 vaccines in various research stages. Dozens are under
consideration for childhood use. Even as the race to add new vaccines to the
routine child vaccination schedule rushes forward, parents, whose children
became autistic after receiving existing vaccines, are changing the direction
of autism research and the vaccine safety debate.
To read the entire report, which includes extensive
resources, go to
http:// www.909shot.com/NVICSpecialReport.htm
LEADING VACCINE SAFETY GROUP QUESTIONS INTERPRETATION OF
IOM REPORT ON
The National Vaccine Information Center (NVIC), a
non-profit organization representing families with vaccine injured children
have endorsed some of the conclusions of the report released yesterday by the newly
created Institute of Medicine (IOM) Immunization Review Committee on the
hypothesized link between MMR vaccine and autism. But the nation’s largest and
oldest vaccine safety and informed consent advocacy group is questioning
whether misinterpretation and misuse of the Committee’s conclusions will
compromise public health agency commitment to funding vaccine safety research.
The Institute of Medicine Committee concluded that “the
evidence favors rejection of the causal relationship at the population level
between MMR vaccine and autistic spectrum disorders” but also stated that “the proposed
biological models linking MMR vaccination to autism spectrum disorders,
although far from established, are nevertheless not disproved.” The Committee
also called for further scientific research on the occurrence of autism in
children following MMR vaccination.
“The Committee clearly acknowledged the biologic plausibility
that MMR vaccine could be a co-factor in causing autism in some children. But
the message this report may send out, in practical terms, is that there is absolutely
no association between vaccination and autism and that the case is closed. It
can be used by those in industry, government and medical organizations with a
vested interest in protecting the status quo.” said NVIC co-founder and
president Barbara Loe Fisher.
“This would be tragic because it could fatally compromise
the making of vaccine safety research a priority in our society and delay the
search for identification of biological markers that could predict which
children are more vulnerable to vaccine-induced neuroimmune dysfunction that
can, in some, take the form of autism.” NVIC has long advocated that scientific
research into vaccine-associated autism, learning disabilities, attention deficit
hyperactivity disorder, asthma, and other chronic neuroimmune disorders explore
the cumulative effects of multiple vaccines in genetically susceptible
children. In the past 30 years, as vaccine recommendations have increased
routine childhood vaccinations to 37 doses of 11 different vaccines, there has
been a dramatic rise in the numbers of chronically ill children in the US,
including a doubling of those with learning disabilities, asthma, ADHD and
diabetes. Autism is now affecting 1 in 150 children.
“The conclusion of the IOM Committee that current
scientific evidence favors rejection of a causal association between autism and
MMR vaccine should not be taken out of context. There has been limited
scientific research to date to investigate the relationship between vaccination
and autism and until a more rigorous examination is conducted, the case is
open, not closed,” said Fisher.
©Copyright 1996-01 National Vaccine Information Center 512
W. Maple Ave., Suite 206, Vienna, VA 22180 1-800-909-SHOT or (703) 938-DPT3
FAX:
938-5768 email: info@ 909shot. com
Autism Society of America
7910 Woodmont Avenue Suite 300
Bethesda, MD 20814-3067
301.657.0881 fax: 301.657. 0869 www. autism-society. org
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INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR
GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE
KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED
AS PROVIDING MEDICAL OR LEGAL ADVICE. THE DECISION WHETHER OR NOT TO
VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU
ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.