Vaccination and Autism
In February, 1998, an article was published in a well-regarded British medical journal, the Lancet, about a relationship between autism and the measles, mumps, and rubella (MMR) vaccine. The paper, written by Dr. Andrew Wakefield, alleged that the MMR vaccine caused autism, as well as intestinal disorders. Dr. Wakefield called the developmental condition “regressive autism,” reporting that children could start to lose language and other skills within 14 days of receiving the vaccine and get progressively worse. He also noted the presence of measles-virus RNA in the intestinal tissue of these children.
This became front page news in Britain as well as the United States. Autism is a difficult diagnosis for parents to accept and understand. They naturally want to know why their children are autistic. Autism is usually diagnosed between 12 and 18 months of age. The MMR vaccine is given at 15 months of age. Consequently, there are many children who are found to be autistic within weeks or months of an MMR vaccine. It makes sense, at least temporally, that a vaccine given at that time could cause the problem.
What was lost, even in the beginning of this debate, was the fact that Dr. Wakefield's article presented information on only 12 children. Even if these 12 children developed autism after getting their MMR shot, that is not enough information to come to the conclusion that firstly, the MMR vaccine caused their autism and secondly, that other autistic children became so because of the MMR vaccine. What this should have been was a call for research into the possibility. What was needed, and what was eventually done, were studies looking at this connection among large groups of children, as well as research into what could possibly be the cause and effect.
Parents on both sides of the Atlantic latched on to the simple idea that the MMR caused their children's autism. Not only did this give them the answer to the question why, but it also gave them someone to blame. Allegations were made and lawsuits were filed, all based on the one article.
This diverted energy and money away from trying to help children and their families deal with autism, as well as mandating research into the possible connection, which began quickly.
This news was not just important to parents of autistic children, but to all parents of small children. People began to refuse the MMR vaccine for their children. Enough refused that eventually there was a pool of children without immunity to measles, mumps, and German measles. These diseases had not disappeared. Children began to come down with them.
Mumps can cause sterility in boys. German measles is a mild illness in children that can cause tremendous fetal damage if a pregnant woman catches it. An epidemic of measles started in Britain. Measles can be very dangerous and cause brain damage and death. In 2006, the first death in the UK from measles in 14 years was reported – a 13-year-old boy.
The anti-vaccination furor spread to other vaccines. People started refusing DPT shots – diphtheria, pertussis, and tetanus. Pertussis (whooping cough) reappeared.
Large studies were published that completely refuted Dr. Wakefield's claim. No one else could find an association between the MMR vaccine and autism. Japan stopped using the MMR, and the rates of autism rose, which was reported in 2005. Other investigators replicated Dr. Wakefield's research and did not find the same results.
Dr. Wakefield's study was scrutinized. The paper had presented evidence of 12 children that had come to attention because of their developmental and other disorders, which is when he discovered the connection. In fact, these children were recruited, brought in from various parts of England and even one from the United States. Dr. Wakefield had apparently been employed by a solicitor who wanted to create a case against the vaccine. This is how the children were recruited.
Dr. Wakefield was paid for his work. He also filed for a patent on a single measles vaccine. He advocated separating the vaccine into its three parts, and if the story had played out the way he imagined, he would have received financial gain from the change. He also violated multiple ethics rules.
The information in the article was not just misrepresented in terms of how Dr. Wakefield found the patients. All of the parents already blamed the MMR, and the children's medical histories were taken from the parents' memory. In fact, signs of autism had appeared in some of the children before the vaccine; some did not have autism. As the scientific evidence was reviewed, it was found that even the facts were wrong. Dr. Wakefield's paper stated that evidence of the measles virus had been found in the children. That was simply not true.
It took many years for all of this to come out. British journalist Brian Deer spent many years digging for the truth. There was litigation by multiple parties, including Wakefield who filed libel charges. However, he was forced to leave his hospital job in England, winding up in the United States. As data came in disproving claims that the measles component of the MMR was to blame, focus shifted to a preservative in the vaccine called thimerosal. Since the MMR was not the cause, it could not be the thimerosal any more than the vaccine itself.
On the legal front, in February of 2009, a US Federal court rejected three, large, test cases (some 5,000 families) against the MMR. In January 2010 in England, the GMC (General Medical Council) panel rendered judgments of misconduct against Wakefield, finding him guilty of nearly three dozen charges.
During this time, the editor of the Lancet apologized for the article. Other doctors whose name appeared on the original Lancet article withdrew their support. In February of 2010, after the data had been reviewed and all the information brought to light, the Lancet withdrew the original paper.
Although the Lancet article has been completely disproven and many good studies have shown no association between the MMR and autism, there are people who still believe that the MMR, and possibly all vaccines, or the number of vaccines children are given, causes autism. The thimerosal connection has been investigated. Thimerosal, which contains mercury, is no longer in the MMR vaccine or most vaccines given to children under 6 years of age.
At the current time, most in the medical and scientific community, like the American Academy of Pediatrics, are convinced that there is no association between vaccines or their components and autism. There are probably environmental factors that interact with a genetic tendency toward autism, and research continues to examine these possibilities.
The American Pediatric Association stated in 2009, “While it is likely that there are many environmental factors that influence the development of autism, vaccines are not the cause of autism. We know this because many careful and repeated studies show no link between vaccines and autism. Specifically, numerous studies have refuted Andrew Wakefield's theory that the MMR vaccine is linked to bowel disorders and autism. Every aspect of Dr. Wakefield's theory has been disproven.”