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HEALTH & SCIENCE

Doubt cast on causal link between MMR
vaccine and autism

 No change is called for in administering the current
 measles, mumps and rubella vaccine, a new IOM report
 concludes.

By Susan J. Landers, AMNews staff. May 14, 2001.
Washington -- A new Institute of Medicine report has failed
to find any apparent link between the measles, mumps and rubella
vaccine and autism.

The evidence reviewed by a 15-member committee "favors
rejection of a causal relationship at the population level between MMR
vaccine and autistic spectrum disorders," said committee Chair Marie
McCormick, MD,ScD, professor and chair of Harvard's Dept. of Maternal and
Child Health. The committee released its findings April 23.

However, Dr. McCormick left open the possibility that the
MMR vaccine could, "in rare cases," contribute to the development of
autism in a small number of children.

   "We do not have epidemiological data or tools precise
enough to assess rare occurrences of such a response to MMR, if it occurs at
all," she said. The committee recommended that current MMR immunization
procedures continue to be followed.

 The IOM report is not alone in failing to find a link
between the MMR vaccine and autism, notes Bruce Gellin, MD, executive
director of the National Network for Immunization Information.

                 In addition, Medical Research Council in Great Britain
released a report and the American Academy of Pediatrics is set to release
another report, both discounting a link between the vaccine and autism.
It is this growing body of scientific evidence that will affect what people
do, Dr. Gellin said.

 Concerns still exist

 But the findings do not put to rest parents' concerns that
a link exists between the MMR vaccine and autism. Parents say their
children develop normally until they are vaccinated at 15 to 18 months.
Shortly afterwards,parents say, they notice pronounced regression in their
child's speech and behavior that ultimately leads to a diagnosis of autism.

Members of one parent advocacy group, the National Vaccine
Information Center, express fear that only part of the IOM report would
be heard by policymakers and others.

"The committee clearly acknowledged the biologic plausibility that MMR
vaccine could be a cofactor in causing autism in some
children," said Barbara Loe Fisher, the Center's president. "But the
message the report may send out in practical terms is that there is
absolutely no association between vaccination and autism, and the case is
closed."

The group has pressed for scientific research into the
possibility that vaccines are associated with not only autism but also
learning disabilities, attention-deficit/hyperactivity disorder, asthma and
other chronic neuroimmune disorders.

Fueling the belief that the MMR vaccine may trigger cases
of autism has been a dramatic increase in the number of children who have
been diagnosed with autism since the vaccine was first introduced.

Pediatricians have called for continued and aggressive
research into the causes of autism, said AAP President Steve Berman, MD.
Autism is a very serious but poorly understood condition that could be
related to a number of factors, he said.

At the same time, he said, "current scientific evidence
indicates that vaccines are not the cause."

AAP continues to recommend that parents fully vaccinate
their children to prevent the spread of potentially dangerous diseases, Dr.
Berman said.

The MMR vaccine, which contains three vaccines in a single
shot, has virtually eliminated measles, mumps and rubella in the
United States, Dr.  McCormick noted. Measles cases have dropped from more
than
400,000 per year in the pre-vaccine era to only 100 in 1999.

In reaching its conclusion, the IOM committee considered
the debate in a broader social context, according to Dr. McCormick. "If
left unchecked, infectious diseases like measles, mumps and rubella could
cause considerable sickness and death," she said.

Public health officials feared a repeat of a 1970s
situation in which concerns about the safety of the pertussis vaccine caused
many to forgo immunization, Dr. McCormick said. The result was a rebound of
pertussis cases.

"Similarly devastating disease outbreaks could easily occur
again, if immunization rates were to decline as a result of fears
regarding MMR," she said.

Dr. McCormick also testified about the report's conclusions
before the House Government Reform Committee. The April 25 and 26
hearings were held by Committee Chair Dan Burton (R, Ind.) to examine
increasing autism rates.

Burton held similar hearings in the previous Congress.

The congressman's grandson, who is now autistic, was
developing normally until receiving his vaccines, Burton said. The hearings
have been an attempt,he said, to uncover the cause: whether it was the MMR
vaccine, elevated levels of mercury in the vaccine or something else
entirely.

Dr. McCormick told the panel that scientists generally
agree that most cases of autism result from events that occur prenatally or
shortly after birth. But the MMR vaccine is administered in a child's second
year, she said, about the same time that autistic symptoms become apparent.

She also told the panel that to evaluate the hypothesis
connecting the MMR vaccine and autism, her committee reviewed all published,
peer-reviewed scientific and medical literature and held an open
scientific meeting that included a broad group of researchers and vaccine
safety advocates. In addition, a working group of the committee conferred
with
the parents of autistic children and vaccine safety advocates to discuss
their concerns.

                 Weblink

                 Summary of IOM report, "Immunization Safety Review:
                 Measles-Mumps-Rubella Vaccine and Autism."

(http://www.iom.edu/IOM/IOMHome.nsf/Pages/MMR+Autism+Summary/)



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