Once again, the powers-that-be have released a study claiming to
vindicate the MMR re: autism, with most of the mainstream
media dutifully waddling behind, rubber-stamping and disseminating
And once again, many of us are responding with
It does seem some things never change. Once again we must
contend with the misuse of limited, epidemiological data to promote
wide-ranging, unwarranted conclusions, conclusions which either ignore
or dismiss contrary data, as if one study could ever do that. And, as
seems to be the usual result, general acceptance of that misuse.
This most recent study,
published in the New England Journal of Medicine (NEJM) and based on
data from Denmark, alleges to show that MMR could not be related to
autism. It concludes that there are no differences between those
vaccinated and unvaccinated against MMR as to incidence of autistic and
"other autistic-spectrum" disorders. (Never mind that there is no
genuine control group, that is, unless no vaccine but MMR could
possibly be involved.)
Maybe this study says something about autism in Denmark; maybe it
doesn't. However, the important question for those not living in
Denmark is, does the Danish study say anything about what is happening
The incidence of autism reported in the Danish study cohort appears
to be considerably lower than what has been recently reported in the US
and other countries - an incidence of 1 out of 727 (or 738 out of
for instance, to an incidence as high as 1 in 86 among primary school
children in the UK and around 1 out of 150 children in the United
States. Is that because there are real differences in incidence
between Denmark and these other countries? If not, is the Danish
study missing hordes of autistic children? Or are we instead
overestimating the numbers occurring in the U.S. and other places?
A recent M.I.N.D. Institute study
revealed the increase in autism in California to be real and
alarming. Are we to accept the Danish results and ignore what is
happening in our own country which may contradict them?
If there are real differences in incidence between the US and
Denmark, why might that be? One reasonable possibility relates to
thimerosal use in Denmark - it has been reported
that Danish children did not receive vaccines containing
thimerosal. If that is true, and if, for instance, it is
of thimerosal and MMR which leads to autism, there might well be
indication of problems with MMR in Denmark, but evidence of
considerable involvement of MMR in the US and other countries where
thimerosal has been used.
Thus even if MMR alone does not cause autism, the NEJM study in no
way acquits MMR in combination with other co-factors. Why are
they acting as if it does?
To the contrary, if the incidence of autism in Denmark is actually
lower than in the US, and thimerosal wasn't used in childhood vaccines
during the study period, this study actually raises a red flag about
the possibility that MMR and thimerosal acting together are responsible
for the epidemic of autism in some countries, since an important
potential co-factor was missing in Denmark. At least it suggests
the need for further study.
Another disturbing trend is the rejection of biological evidence in
favor of weak epidemiological evidence (e.g., see my
review of one IOM report). Why are the study authors behaving
as if their study results justify dismissing or ignoring the growing
biological evidence that MMR and autism are related? It
is only a retrospective epidemiological study, after all. Why are
they trying to use it to trump solid biological mechanisms data?
Moreover, if Danish children did not receive thimerosal, why
wasn't the absence of it in this population noted, given its obvious
import and relevance to any study concerning autism?
The NEJM study raises far more questions than answers. And it begs
the questions, "Why aren't better studies being done?" and "How might
such studies be designed?"
I can't say why better studies aren't being conducted. But
were they to be done, they would be long-term and prospective. They
would be large enough to allow comparison of all vaccination and other
possibly relevant combinations, including a "never vaccinated" control
group. They would track study participants from birth or
before. All aspects of health and other history would be
recorded. Confounding factors would be controlled for by matching
As clues to the possible cause(s) of autism emerged, investigation
into possible biological mechanisms would follow. Just as
others have done.
Make no mistake about it, though - I'm sick and tired of hearing how
better studies are
difficult to manage. I don't care how hard it is to find
never vaccinated children. I don't care how much it costs to
follow large numbers of children, to prospectively track all adverse
vaccine reactions, to study biological mechanisms in a way that
translates into meaningful human data.
(And if you're thinking money is the problem, note the following
statement by Congressman Shays, made in the
hearing on government funding of autism research: "Let me just say
something, just so I can put this on the record. I don't fault
administrators when we in Congress don't appropriate the money, but
where administrators become responsible is when they see a need and
they can fill a need, they don't request the money, and then we in
Congress don't respond. I am getting the sense that in
the last years this has been mostly generated by Congress kind of
pushing NIH and others to treat this as a more important effort. I may
be wrong, and I am happy to be corrected." Is Congressman Shays
wrong? If not, why aren't NIH and the CDC treating this situation
I also don't care that confidence in vaccines might be undermined
were studies to be designed properly. All public confidence has been
based on the understanding that such studies had already been
conducted. That confidence has now been thoroughly shaken.
I simply don't care about any of the excuses which are keeping
well-designed epidemiologic and biological mechanism studies from being
The public has been told the MMR vaccine is safe and that is why
they have used it. All the public cares about is getting
information it can trust and Public Health owes it nothing less.
Until and unless the hard work of properly designing and conducting
studies is done, I and
others will continue to question and challenge MMR vaccine study
results, and question and challenge MMR vaccine use.
Sandy Mintz, M.A.