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“Healing Autism: No Finer a Cause on the Planet”

March 7, 2001                     Search  www.feat.org/search/news.asp

 

Time Trends in Autism and in MMR Immunization Coverage in California

Loring Dales, MD; Sandra Jo Hammer, RN, PHN; Natalie J. Smith, MD, MPH

[The following is the abstract to the above paper being widely reported today in the media.  Included are excerpts of quotes made in response as reported in various newspapers.]

Context

Considerable concern has been generated in the lay and medical communities by a theory that increased measles-mumps-rubella (MMR)

immunization among young children may be the cause of an apparent marked

increase in autism occurrence.

Objective

To determine if a correlation exists in secular trends of MMR immunization coverage among young children and autism occurrence.

Design, Setting, and Participants

Retrospective analyses of MMR immunization coverage rates among

children born in 1980-1994 who were enrolled in California kindergartens

(survey samples of 600-1900 children each year) and whose school

immunization records were reviewed to retrospectively determine the age at

which they first received MMR immunization; and of autism caseloads among

children born in these years who were diagnosed with autism and were

enrolled in the California Department of Developmental Services regional

service center system.

Main Outcome Measures

Measles-mumps-rubella immunization coverage rates as of ages 17 months

and 24 months and numbers of Department of Developmental Services system

enrollees diagnosed with autism, grouped by year of birth.

Results

Essentially no correlation was observed between the secular trend of

early childhood MMR immunization rates in California and the secular trend

in numbers of children with autism enrolled in California’s regional service

center system. For the 1980-1994 birth cohorts, a marked, sustained increase

in autism case numbers was noted, from 44 cases per 100 000 live births in

the 1980 cohort to 208 cases per 100 000 live births in the 1994 cohort (a

373% relative increase), but changes in early childhood MMR immunization

coverage over the same time period were much smaller and of shorter

duration. Immunization coverage by the age of 24 months increased from 72%

to 82%, a relative increase of only 14%, over the same time period.

Conclusions

These data do not suggest an association between MMR immunization among young children and an increase in autism occurrence.

JAMA. 2001;285:1183-1185

In Their Own Words: A Bad Conclusion

http://jama.ama-assn.org/issues/current/rpdf/jbr00284.pdf

From excerpts of the research paper itself, the authors acknowledge

the insufficient quality of the data for purposes of drawing conclusions

based on the reported rates of autism.  They give six different reasons for

this.

Then, contradicting themselves, they go ahead and draw a conclusion

anyway (see below).

“Difficulties in interpreting the increasing numbers of autism cases

are highlighted in the California Department of Developmental Services 1999

report, which repeatedly stressed that its data cannot be interpreted as

measuring trends in the actual incidence of autism. It is unknown how many

children with autism have not enrolled in the system and as the system

expanded and matured over time, the proportions of children enrolling in the

system who were born outside of California may have changed over time.

“Recommendations have been made for a detailed investigation into the

apparent increases in autism cases, carefully evaluating the extent to which

apparent increases in autism are real as opposed to artifact, as well as

evaluating factors that may have contributed to any true increases including

immunizations. Such investigations are in progress (Robert Byrd, MD,

University of California Davis Medical Center, Department of Pediatrics,

written communication, November 1, 2000).

“The data presented herein have some limitations. It would have been

useful to examine individual immunization and autism records on the same

children, however, these could not be linked. Further, the childhood

immunization coverage data used in the study do not provide precise

quantification of the percentages of children who received the combined MMR

vaccine product vs separate injections of the measles, mumps, and/or rubella

components.”

But an improperly drawn conclusion is made anyway:

“However, the issue here is, assuming that the secular trend noted in

the report represents a true increase in autistic disorder incidence, what

is the evidence that MMR immunization may be associated with this trend?. .

.”

 

How can they assume the report represents a true count when they just

gave six reasons above, why it cannot?  Then based on this false assumption,

they draw this conclusion:

“The lack of correspondence between the trends in MMR coverage and

numbers of autistic disorder cases does not support the hypothesis that

increasingly widespread MMR immunization of young children is associated

with the marked secular trend of increasing numbers of autism cases enrolled

in the California Department of Developmental Services regional service center system.”

What could be the real purpose for this misleading exercise, if not as

for propaganda?   -LS

 

* * *

 

Media Quotations in Response

In the LA Times:

. . .Dr. Bernard Rimland of the Autism Research Institute in San Diego

argues that it is not the vaccine—known as MMR—alone that triggers autism,

but the entire burden placed on the immune system by the 22 separate vaccines that are now given to children between birth and age 2.

“By focusing on MMR, these guys are missing the boat,” he said. “It’s

much too early to dismiss the [vaccine] hypothesis.”

http://www.latimes.com/news/state/20010307/t000020117.html

In the St. Petersburg Times:

“None of us are anti-vaccine. We all want the very best for our kids,”

said Rick Rollens, co-founder of Medical Investigation of Neurodevelopmental

Disorders, a research center at the University of California at Davis, who

blames the autism of his son, Russell, on immunizations he got as an infant.

“But I think the vaccine manufacturers and the public heath community

have failed in providing us with proof that these vaccines don’t cause

problems.”

http://www.sptimes.com/News/030701/TampaBay/Study_answers_autism_.shtml

In the San Francisco Chronicle:

“Quite frankly, something that appears in a journal that is controlled

by the American Medical Association, which is one of the world’s No. 1

promoters of vaccine policy, needs to be taken with a grain of salt,” said

Rick Rollens of Sacramento. He is the father of a 10-year-old autistic son

and has been vocal in asking for research into the possible link between

vaccines and autism.

http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2001/03/07

/MN152164.DTL

In the San Jose Mercury News:

Some parents of autistic children, however, remain convinced that the

vaccine may have caused the disease, in part because the vaccine typically

is first given at 12 to 15 months, slightly before parents usually first

detect the problems that characterize autism. A second dose is recommended

at 4 to 6 years.

Lenny Schafer, whose 12-year-old son is autistic, still believes the

MMR vaccine could have played a role.

“Parents are just desperate for hard science on this,” said Schafer,

who is based in Sacramento and helps run a financial-support organization

for parents of autistic children. “This study is not going to convince the

average parent one way or another. It’s just going to make things really

confusing. Parents are real gun-shy on vaccines and they’re getting more

so.” http://cgi.mercurycenter.com/premium/local/docs/vaccine.htm

In the Sacramento Bee:

In Sacramento, the MIND Institute, part of the UC Davis Medical

Center, was established in 1999 to try to solve the mystery. Two parents who

helped found the institute said Tuesday that they want to see more studies

before they’ll believe MMR isn’t a culprit.

Rick Rollens feels strongly that vaccines (although not MMR) had a

hand in the development of autism in his son Russell at 7 months of age.

Russell is 10 now.

“Until we get good independent science research into this question,

the spin control that the public health community continues to put out on

this issue just doesn’t pass the smell test,” Rollens said.

Another Sacramento father of an autistic son, Chuck Gardner, was likewise

suspicious of the state Department of Health Services as a source of unbiased research.

“Three words,” he said: “Conflict of interest.”

Dr. Robert Byrd, a pediatrician at the MIND Institute who was not

involved with the state autism study, said he did not see any flaws in the

study’s methodology.

“Irrespective of who’s doing the study, if MMR were to be the prime

reason, we’d see a different curve (in the data),” said Byrd, who is doing

his own epidemiological study of autism in California, trying to figure out

the factors behind the rise.

http://www.sacbee.com/news/news/local03_20010307.html

 

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ALL 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.