Autism : Is there a vaccine connection? Part I.
Vaccination after delivery.
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Copyright 1999
F. Edward
Yazbak, MD, FAAP.
Note: The information on this
website is not a substitute for
diagnosis and treatment by a qualified, licensed professional.
The
routine administration of a live virus vaccine booster,
during the postpartum period, to previously vaccinated women who have
remained rubella-susceptible, should be reconsidered.
It is
likely that continued rubella susceptibility in these women, is not due
to a problem with the vaccine, but with the woman herself, and therefore
it seems reasonable not to attempt to correct it by the administration
of more boosters.
Some
re-vaccinated mothers are developing unusual problems, and many remain
rubella-susceptible. Their children also appear to have an inordinate
number of difficulties of their own. Twenty out of twenty five families
(80%) in this study have children with autism
Large-scale independent investigations on the possible link between live
virus vaccines, MMR, and autism should be undertaken.
An epidemic
increase in the incidence of autism nationwide has been noted in the last
few years and was described in “Autism 99, A National Emergency”(1). This
increase is still ongoing and indeed accelerating.
Many parents have
suspected that such an increased incidence may be due to the
administration of certain vaccines, a view vehemently denied by the
vaccine authorities. Mothers who themselves were re-vaccinated in
adulthood with live virus vaccines have also wondered if by receiving such
vaccines, they could have in any way compromised their children’s immune
system, and predisposed them to adversely react to their own vaccinations.
Andrew Wakefield
in an impressive study (2) published in The Lancet last year,
reported remarkable and original findings, in a series of twelve cases at
the Royal Free Hospital, London. He made it clear that his findings only
raised questions, and that more studies on the possible relationship
between Mumps-Measles-Rubella (MMR) vaccination and autism were
needed. His research was immediately criticized, and the vaccine
"establishment" viciously attacked him personally.
Brent Taylor and
associates (3), also from the Royal Free Hospital, published their own
study this past June in The Lancet and reported no increase in
autism in the UK after the introduction of the MMR vaccine in 1988.
Their research,
which was financed by The Public Health Laboratory and the Medicines
Control Agency, was hailed by the vaccine authorities, world wide, as the
absolute proof, and the final word, that indeed there was no MMR/Autism
link. However, parents of children with autism were not convinced, and
many researchers rejected Taylor’s methodology and conclusions. No
large-scale independent studies have been carried out in the United
States.
A study was
therefore initiated to examine any connections between the administration
of the MMR vaccine or any of its components to a woman in the childbearing
age and the development of autism in her children.
Methodology
Members of
vaccine and parent groups were contacted via e-mail, and notices were
included in newsletters in the UK, Australia, and US. The study outline
and questionnaire were also posted in a well-known web site. (4)
Over 280 replies
were received in 120 days. Of these, 240 were complete and accepted.
The discovery of
unexpected and alarming findings in twenty five families where the mothers
received a live virus vaccine shortly after delivery, prompted the release
of this information at this time, because of its serious implications.
Review of present
recommendations
The following are
statements of the vaccine manufacturer and the Centers For Disease Control
and Prevention, relative to the administration of live virus vaccines
after delivery (the postpartum period):
Ø
“It has been found convenient in many instances to vaccinate
rubella-susceptible women in the immediate postpartum period”. (5)
Ø
“Recent studies have shown that lactating postpartum women immunized with
(rubella) live attenuated vaccine may secrete the virus in breast milk and
transmit it to breast fed infants. In the infants with serological
evidence with rubella infection, none exhibited severe disease; however,
one exhibited mild clinical illness typical of acquired rubella. Caution
should be exercised when Meruvax II is administered to a nursing mother”.
(6)
Ø
“It is not known whether measles or mumps vaccine virus is secreted in
human milk. Recent studies have shown that lactating postpartum women
immunized with live attenuated Rubella vaccine may secrete the virus in
breast milk and transmit it to breast-fed infants.
In the infants
with serological evidence of rubella infection, none exhibited severe
disease: however, one exhibited mild clinical illness typical of acquired
rubella. Caution should be exercised when MMR-II is administered to a
nursing woman”. (7)
Ø
“Excretion of small amounts of the live attenuated rubella virus from the
nose or throat has occurred in the majority of susceptible individuals
7-28 days after vaccination. There is no confirmed evidence to indicate
that such virus is transmitted to susceptible persons who are in contact
with the vaccinated individuals. Consequently, transmission through close
personal contact, while accepted as a theoretical possibility is not
regarded as a significant risk. However, transmission of the vaccine virus
to infants via breast milk has been documented. There are no reports of
transmission of live attenuated measles or mumps viruses from vaccinees to
susceptible contacts” (7)
Ø
“Although vaccine virus may be isolated from the pharynx, vaccinees do not
transmit rubella to others, except occasionally in the case of the
vaccinated breast feeding woman. In this situation, the infant may be
infected, presumably through breast milk, and may develop a mild rash
illness, but serious effects have not been reported.
Ø
Infants infected through breast-feeding have been shown to respond
normally to rubella vaccination at 12 -15 months of age. Breast feeding is
not a contraindication to rubella vaccination and does not alter rubella
vaccination recommendations.”(8)
Ø
“Rubella vaccine recommendation: Prenatal screen with postpartum
vaccination.”(9)
Descriptions of
cases
All mothers
received postpartum boosters because they were rubella-susceptible.
Case 1:
Mother received MMR in 1994, few hours postpartum. She had no miscarriages
prior to 1994 and has had three since. The child, a boy, was normal till
he received his MMR vaccine at age 13 months. Autistic symptoms were noted
1-2 months later. A maternal aunt has also remained rubella-susceptible in
spite of multiple vaccinations.
Case 2:
Mother who was fully immunized received MMR boosters in 1983 and 1991.
She was again given another MMR in 1993, 4 hours postpartum. The child, a
boy, was breast-fed and was well until age 15 months when he received an
MMR vaccine. He developed autistic symptoms within the month, and also
has gastro-intestinal (GI) problems (2).
Case 3:
Mother had measles and mumps as a child. She received rubella vaccine in
1985, two days postpartum. She did not breast feed because the child had a
harelip and cleft palate. The child, a boy, received an MMR at age 15
months. He had gradual onset of autistic symptoms, and is now severely
affected. He has received a course of IVIG infusions, and has elevated
measles and rubella titers. He is also positive for Myelin Basic Protein
Antibody (MBP). A younger sister is normal
and immunized.
Case 4:
Mother was fully immunized and received two MMR boosters. She was given a
rubella vaccine in the immediate postpartum period. She has developed
asthma and “immune problems” lately. The child, a boy 18 months of
age is still breast-feeding, has allergies, and recurrent ear infections,
but no evidence of autism to date.
Case 5:
Mother, who was fully immunized, received an MMR vaccine in 1989 shortly
after the birth of her 3rd child. This child, a girl, is not
autistic, but has had frequently recurring ear infections and required a
T&A. Two older brothers born in 1981 and 1987 are normal. So are the
younger two sisters born in 1991 and 1997. The mother has had two
miscarriages, one at 12 weeks in December 1996 and the other at 14 weeks
in January 1999. Family history is positive for immune disease.
Case 6:
Mother, who previously had been fully immunized, received an MMR booster
24 hours after she had a normal uncomplicated delivery. The child, a boy
is now 13 years old. He had an uneventful newborn period, and breast-fed
well. He remained fine till age 4 months when he received his second DPT,
after which he developed a high fever and screamed for a long while. He
then became extremely listless and difficult to arouse, breast-fed poorly,
and started with gastro-esophageal reflux (which progressed and eventually
required fundoplication). The boy went on to develop athetoid movements,
and was later diagnosed with cerebral palsy. He is severely affected, has
serious problems with interpersonal communication and at times “tunes
out the world, and does not respond”. His first MMR vaccination was
delayed because of his neurological impairment. A younger brother is well
and immunized.
Case 7:
Mother, who had been previously immunized, received a rubella vaccine
immediately after the birth of her first son in November 1989. She
remained rubella susceptible, and was given another rubella vaccine three
days after the birth of her second son. She is still rubella susceptible.
The oldest boy,
born 11/6/1989, was breast-fed for a very short period. He was routinely
immunized, and seems to be normal.
The second son,
born 5/31/1991 was breast fed for one month, and received all his
immunizations on schedule. At age 2 ½ he started exhibiting autistic
symptoms. He was diagnosed as PDD-NOS at Stanford at age 3. He was
re-evaluated at UCSF a year later, and a diagnosis of autism was made.
He seems to have autistic entero-colitis (2) and complains of itching,
earaches and headaches. The third child, a girl, has verbal apraxia.
Case 8:
Mother received rubella vaccine booster 8 weeks postpartum in 1983. That
child, a boy, breast fed for one month, was immunized and seems intact.
The second child, a boy was born in 1991. Mother reports that her delivery
was difficult and that the baby was treated for meconium aspiration.
This boy received
his first MMR vaccine at age 14 months, started exhibiting autistic
symptoms around age 3, and was diagnosed as Asperger’s Syndrome.
Case 9:
Mother had a severe reaction to the measles vaccine at age 5. She was
given an MMR booster on 9/11/1993, a few days after she delivered a
daughter. That daughter, born September 6, 1993, was breast-fed for five
months. She was routinely immunized in the first year of life. She “was
sociable, but was not talking and had some OT issues” at 16 months,
when she received her first MMR vaccine. She developed autistic
symptoms “within days” of the vaccine, and was diagnosed with
autism. She also had symptoms of autistic entero-colitis (2).
A younger
daughter born 11/20/1997 was nursed for sixteen months.
According to her
mother: “She has some autistic symptoms but not all: she has a sensory
integration disorder, and severe speech and language problems.
She has the same
digestive difficulties as her sister, and has been on casein and
gluten-free diet since birth. She has not been vaccinated.”
Case 10:
Mother received rubella vaccine two months after the delivery of her first
child, a girl who was born on 5/20/1992 and is well and immunized. The
following child, a boy, born 1/14/1994 was breast-fed for six months. He
received his first MMR around age 15 months in April 1995.
He started
exhibiting autistic symptoms in July of that year, and lost more skills as
time went by. He is positive for MBP, and has high measles titers.
The third child,
a boy, age 2, is normal.
Case 11:
Mother received rubella vaccine in 1991, immediately after the birth of
her second child, a boy, whom she nursed for seven months.
Mother states: “my
health problems began after his birth”. The boy ”was happy and
talking until his MMR at 15 months. He has leaky gut symptoms (2),
digestive difficulties and candida.”. This boy was diagnosed with
autism and has received 12 monthly infusions of IVIG, with good clinical
results reportedly. His rubella titers were elevated initially, but came
down towards normal after the infusions.
The oldest boy,
born in 1990, is in good health and has been immunized.
Case 12:
Mother received rubella vaccine postpartum “while in the hospital”.
She is now “starting with arthritis.” Her only child, a boy, born
May 1996, was breast fed for 13 months. He has severe reactions to most
foods, and needed a rotation diet. He has not been immunized and shows no
signs of autism.
Case 13:
Mother received rubella vaccine in 1993, at the six-week postpartum
check-up, while she was breast-feeding. She is now 35, and claims to be
“extremely arthritic in my legs, have been since the vaccine”.
The child, a
girl, born May 1993 has received all her immunizations and does not appear
to be autistic.
However, she has
been diagnosed with Mc Cune Albright Syndrome and presented with
precocious puberty, hyperthyroidism and a cystic ovarian tumor. Her right
ovary and tube were surgically removed.
A second
daughter, born 6/94 was diagnosed with Kawasaki Syndrome, three
weeks after her 15 months immunizations. She was treated with IVIG
infusions but went on to develop an aneurysm of her left descending
coronary artery. She has “slow motor skills” and attends a special
early childhood program.
Case 14:
Mother received an MMR booster on 12/18/1991, two days after the birth of
her first child, a girl, whom she only breast fed for 3 to 4 days.
Thirteen months
later, she became pregnant with her second child. This boy was breast fed
for two days only, and was routinely immunized. He received his first MMR
at age 12 months, started with symptoms between 16 and 20 months, and was
later diagnosed with autism. He is due for his second MMR vaccine. The
mother claims that she has developed an immune disorder, and that she has
a positive ANA. The older girl is well and has been immunized.
Case 15:
Mother had
MMR vaccine in 1993. She failed to develop adequate rubella titers, and
was given another MMR booster in 1997, shortly after she delivered her
second child, a daughter, who has been immunized and seems normal to date.
The oldest child,
a boy born 12/7/1993, received one hepatitis B vaccination, and all his
scheduled HIB, DPT and polio vaccines, as recommended, and without
apparent immediate reaction. He received his first MMR at age 15 months.
Mother reports that he started developing symptoms suggesting autism at
the age of 18 months, and that his symptoms progressed, and became more
marked, till the diagnosis of autism was confirmed. He has not received a
second MMR.
Case 16:
Mother received a rubella vaccine booster three days after the birth of
her first child, a girl born 2/22/1992, who is well. The subsequent child,
a boy, was not breast fed. He received his first MMR vaccine at 14 months
of age, and his second at age 4 ½ years. He has autism and his symptoms
reportedly started at age 22 months.
Case 17:
Mother was given a rubella vaccine booster shortly after the delivery of
her first child who was born April 5, 1993. This girl has been immunized
and is well. The following child, a boy, born 10/19/1994, was not
breast-fed. He was routinely immunized and seemed well. At age 18 months,
he received his first MMR vaccine. Parents noted unusual symptoms starting
age 20 months, and the child has now been diagnosed as PDD/NOS. The third
child, a daughter, born 7/28/1997, is well and has been immunized.
Case 18:
Mother received a rubella vaccine booster shortly after delivering a son.
This young man born 2/18/1986 has been diagnosed as having Asperger’s
Syndrome (AS).
Case 19:
Mother
received an MMR vaccine on 1/6/1991, two days after the birth of her first
son who is healthy, has no developmental problems and has been routinely
vaccinated. A second son, born 9/2/1992 was normal until the age of 18
months when he received his first MMR. He reportedly started with autistic
symptoms within two months and the diagnosis of autism was later
confirmed.
Case 20:
Mother
received an MMR booster in 1982 when she resumed her college education.
In 1991, she was still rubella-susceptible and was given another MMR
booster in January 1991, after the birth of her first child a boy who is
being treated for Attention Deficit Disorder but who according to the
mother has some autistic traits. Her second boy born in December 1992
received his first MMR vaccine at the age of 18 months, and was diagnosed
with autism around the age of 33 months. A younger sister is
developmentally normal but has allergies and eczema. The mother was found
to be immune to rubella in 1992 but was told she was again
rubella-susceptible in 1994.
Case 21:
Mother, who is a physician, received a rubella vaccine immediately after
the birth of her first child in 1989. She acquired rubella immunity and
the boy seems developmentally normal.
A second son born
in 1993 was diagnosed with autism at the age of three.
Case 22:
Mother received an MMR vaccine shortly after she delivered her first
child, a girl who is in good health and seems neurologically intact. The
next child also a girl, who was conceived eight months after the mother’s
vaccination, exhibited autistic symptoms before her first birthday, and
has been diagnosed with autism.
Case 23:
Mother had a rubella titer of 9.2 during her first pregnancy. She
delivered prematurely on October 1, 1993 and because her titer was below
10, she was given an MMR vaccine on October 3, 1993. The child, a girl,
stayed in the nursery for 34 days but has developed normally and is doing
well.
A second daughter
was born 3 to 5 weeks prematurely on 1/15/1996. She was breast-fed for 6
months. She uttered a few words before her first birthday. On January
20, 1997 she received the MMR, HIB and Varicella vaccines. Her speech
was noted to be quite delayed by the age of 18 months, and she soon
thereafter developed severe behavioral difficulties. A diagnosis of autism
was confirmed in October 1998.
The mother’s
rubella titer in July 1995 was 12.3
Case 24:
Mother, who
had been previously vaccinated, received a rubella vaccine booster on
8/15/1989, less than 24 hours after the birth of her first child. This boy
was not breast-fed. He had G-E reflux, needed several formula changes and
was constipated, but he appeared to be developing normally in the first
year of life. He received his first MMR on 11/16/1990. According to the
mother he appeared to interact much less with his surroundings by the time
he was eighteen months old. His speech decreased and he was diagnosed with
autism.
The second child
a girl is 8 years old and is sensitive to gluten and Casein. She has
several educational issues and is being evaluated for ADD.
Case 25:
Mother received a rubella vaccine in 1979.
She delivered her
first child in 1986 and received a second rubella vaccine.
In 1992, she
delivered a second child and was given yet another rubella vaccine. This
last child was noted to have speech and other problems and was diagnosed
as having Asperger’s Syndrome.
Discussion
Methodology
A prospective
study of the general population is not feasible, and credible
retrospective studies would have to compare matched groups:
ü
With and without autism
ü
With and without maternal re-vaccination
ü
With and without children’s vaccinations
ü
And
any variations thereof.
Identifying,
selecting, and contacting such large groups would require a huge
organization without any assurance of a large-scale response. The
methodology used was the only one possible under the circumstances. In
any case, the findings are impressively meaningful by themselves and in
spite of any possible statistical bias.
General
Discussion
In a very short
time, and with limited research, twenty five families were identified,
where the mothers were vaccinated in the postpartum period. Fourteen
mothers received the rubella vaccine and eleven the MMR vaccine. Twenty
cases were from the United States, four from the United Kingdom and one
from Australia.
Twenty of the
twenty five families (80%) report having children with autism, AS or PDD.
One of these families, (Case 9), has two affected children, and the
younger child, who is less affected, has not received the MMR vaccine. In
another family (Case 20) there is one diagnosed and one suspected
child with autism.
In nine cases,
the child born immediately before the mother’s booster developed autism.
In ten others, that particular child was spared but the following child
was diagnosed with the disease and in one case it was a previous child who
was affected.
If there was a
mother to child vaccine virus transmission in cases 3 & 24, it was
not through breast milk, and it could have been through direct
contact.
In two instances
(Cases 16 & 17) where the mother did not breast-feed, the child
born just before the maternal booster was normal. However the following
child has autism.
In five families
(Cases 4, 5, 6, 12, and 13) the children who were not diagnosed
with autism report unusual problems, and in one (Case 6), the child
seems to have autistic tendencies. In another (Case 12), the intact
and only child has not received any MMR vaccine.
The first girl in
case 9 who was born just before mother’s vaccination was much more
affected with the disease, than her younger sister born four years later.
Several mothers
did not develop rubella antibodies in spite of repeated vaccinations.
Symptoms of
immune diseases have been reported in many families.
Gender
distribution.
(10)
Of the children
born just before mother’s vaccination and who developed autism seven were
males, one was a female and in one case, the sex of the child was not
listed.
Among the ten
cases where it was the subsequent child who developed autism, there were
eight males and two females.
Cases 5, 10, 13,
14, 15, 16, 17, 22, 23
represent
situations where the children, all girls, whose births immediately
preceded a maternal live virus vaccine booster, did not exhibit symptoms
of autistic spectrum disorders. However some of them have developed
immune, educational or unusual problems.
In cases 10,
14, 16, and 17 the subsequent male child was diagnosed with autism.
In cases 5 and
13, the girls who followed did not develop autism, while in cases
22 & 23, they did.
In case 15,
it was the preceding child, a boy, who had the syndrome.
Conclusions
In spite of it’s
statistical imperfections, this small study reveals new findings, which
can not and should not be all blamed on coincidence and /or sample bias.
It is hoped that it will prompt the vaccine manufacturers and the
regulatory agencies to review this situation and their present
recommendations with an open mind.
The routine
administration of a live virus vaccine booster during the postpartum
period to women who have previously been vaccinated, and yet have remained
rubella-susceptible, should be seriously reconsidered.
It seems that
women, who do not develop protective titers to rubella, after their
initial vaccination and booster, have some immune difficulty of their own,
which they may transmit to their children. It is most likely that their
continued rubella susceptibility is not due to a problem with the vaccine,
and therefore it seems reasonable not to attempt to correct it by the
administration of more boosters.
In this study,
re-vaccinated mothers seem to be developing unusual problems, and many
have remained rubella-susceptible.
Their children
also seem to have an inordinate number of difficulties.
Twenty out of the
twenty five families have at least one child with autism.
Autistic symptoms
often started shortly after the children were vaccinated.
Health providers
should clearly explain to mothers that at least the rubella vaccine virus
would be excreted in their nose, throat and breast milk, when obtaining
“informed consent”,
Serious research
on whether measles vaccine virus is passed from mother to infant through
breast milk should be undertaken.
The postpartum
vaccination of women with live virus vaccines should be promptly and
thoroughly reviewed.
Independent
research looking into all possible causes of autism is imperative.
Click here for "Autism :
Is there a vaccine connection? Part
II"
* * * * * * * * *
* *
A second study,
Part II on Intrapartum Vaccination with attenuated live virus vaccines is
also being published at this time (11).
References:
1.
Yazbak, F.E. : http://www.garynull.com/Documents/autism_99.htm
2. Wakefield AJ,
Murch SH, Anthony A, et al: Ileal-lymphoid hyperplasia, non-specific
colitis, and pervasive developmental disorder in
children.
Lancet
1998:351:637-41
3. Brent
Taylor, Elizabeth Miller, C Paddy Farrington, Maria-Christina Petropoulos,
Isabelle Favot-Mayaud, Jun Li, Pauline A Waight : Autism and measles,
mumps, and rubella vaccine: no epidemiological evidence for a causal
association. Lancet
1998:353 # 9169
4.
http://www.garynull.com/issues/MMRstudy.htm
5.
PDR 1999, p. 1833
6.
PDR 1999, p. 1834
7. PDR 1999,
p. 1820
8.
Epidemiology and Prevention of Vaccine-Preventable Diseases,
(CDC) 5th edition, January 1999, p. 185
9.
Epidemiology and Prevention of Vaccine-Preventable Diseases,
(CDC) 5th edition, January 1999, p 187
10. Lang-Radosh,
K.L., pers. comm. A review of male susceptibility to autism spectral
disorders (in progress).
11. Yazbak, F.E.
: Autism, Is there a vaccine connection? Part II. Vaccination during
pregnancy.
Some
of the above statements may not represent the views of organizations to
which I belong.
This study is dedicated to all the
wonderful mothers of children with autism. FEY
E-mail address:
TLAutStudy@aol.com
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