Vaccines and Autism
Vaccines and Autism
The measles, mumps, and rubella (MMR) vaccine is used to immunize children against diseases that can cause major disabilities and fatal illnesses. In 1994, the vaccine was mandated for all school children and since then a spike has been seen in the diagnosis of autism. Many of those diagnosis falls within a few months of the MMR vaccine and in 1998, Andrew Wakefield published a study indicating a relationship between the MMR vaccine and autism (Rudy, 2009).
Intense media coverage followed and many parents refused to give their children the MMR vaccine, believing their children would develop autism. The study was later retracted due to the lack of evidence but many children are still not receiving the MMR vaccine. The public health field has tried to raise awareness about the benefits of the MMR vaccine but many are still skeptical about the vaccine. Efforts have now been focused towards increasing awareness about the vaccine and trying to encourage parents to get their children vaccinated.
In February 1998, The Lancet published an article entitled “Ileal-Lymphoid-Nodular Hyperplasia, Non-Specific Colitis, and Pervasive Developmental Disorder in Children,” which suggested that the measles, mumps and rubella (MMR) vaccine could contribute to the development of autism. Dr. Andrew Wakefield, a gastroenterologist, suggested the link between the MMR vaccine and autism. Wakefield proposed that the virus could “have a negative impact on a child’s immune system, lead to persistent infection in the gastrointestinal tract and lead, in the long run, to possible brain damage and autism” (Rudy, 2009).
Eight of the twelve children had severe intestinal inflammation, with symptoms emerging six days after receiving the MMR vaccine. The vaccine had damaging effects on the intestines and caused serious inflammation, “allowing harmful proteins to leak from the gut into the bloodstream and from there to the brain, where they damaged neurons in a way that triggered autism” (Begley, 2009). Wakefield’s study was later called fatally flawed due to the fact that Wakefield was studying children who had pre-existing gastrointestinal problems.
The group size was also very small, 12 children, and “no proof was offered that the measles virus found in autistic children’s’ guts was causally connected to their autism” (Rudy, 2009). The researchers lastly suggested that the MMR vaccine caused bowel problems in children which lead to autism. In the children studied, symptoms of autism appeared before the symptoms of the bowel disease, proving that the bowel symptoms, as a result of the MMR vaccine, did not cause autism.
In 2004, The Lancet published a retraction submitted by 10 of the 13 original authors that stated that there was no connection between the MMR vaccine and autism: “We wish to make it clear that in this paper no causal link was established between MMR vaccine and autism, as the data were insufficient. However, the possibility of such a link was raise” (Immunization safety review vaccines and autism, 2004). There were many things found flatulent with the Wakefield study.
Details of the medical histories of all the children used in the study were later revealed to the public and journalist Brain Deer interviewed several parents whose children participated in the study. Deer outlined major problems with the study including that the children were not randomly selected for the study and one came from as far as California when the study was conducted in the United Kingdom. All of the children were found to be recruited through anti-MMR vaccine campaigners (DeNoon, 2011).
Wakefield was a paid consultant to a lawyer who was suing MMR vaccine makers for damages caused to children who contracted autism months after the vaccine. Wakefield received a sum of about $668,000 to publish the study from the lawyers and was published biased results. Five of the children had evidence of developmental problems before receiving the MMR vaccine and this is a significant number of children since only twelve children were studied. Only one of the children had regressive autism, despite the fact that the studied reported nine of the children had the condition.
Three of these nine children were never diagnosed with autism (DeNoon, 2011). “At least five were clients of an attorney who was working on a case against vaccine makers alleging that the MMR caused the children’s autism” (Begley, 2009). Lastly, all twelve children’s medical records and parent’s accounts contradicted the case descriptions in the study. All of these discrepancies proved that Wakefield deliberately faked the study and was paid to publish these false, biased results. Wakefield had multiple conflicts of interest, had manipulated the evidence, and broke numerous ethical codes (DeNoon, 2011).
Wakefield defamed his reputation and later had his medical license revoked, no longer able to practice medicine. There is no evidence that links the vaccine to autism and the overall benefits outweigh the risks. Wakefield’s theories have raised controversy due to the fact that autism arises around age two to three, the exact same age children receive the MMR vaccine, the chicken pox vaccine, and other shots (Rudy, 2009). Some parents state that their children respond with autistic regression after receiving the MMR vaccine.
Other research has correlated the MMR vaccine with brain injury, making parents more wary about giving their children the vaccine. In 1998, Dr. Vijendra Singh and Dr. Victor Yang correlated the MMR vaccine to brain injury. Their findings suggest “that exposure to the measles virus may trigger an autoimmune response that interferes with the development of myelin… If myelin in the brain doesn’t develop properly, nerve fibers won’t work as they should. This could be one way that the brain abnormalities associated with autism arise” (Rudy, 2009).
Many studies have been conducted proving that autism is not a direct result of the MMR vaccine including the 1999 study conducted by Taylor, “Autism and Measles, Mumps, Rubella Vaccine: No Epidemiological Evidence of for a Causal Association. ” The study showed that the number of autism cases has increased since 1979, but no significant increase since the introduction of the MMR vaccine in 1988 (Autism and the MMR Vaccine, 2001). Children exhibiting symptoms of autism were diagnosed with autism at the same age of the onset of the symptoms.
This is important because if the MMR vaccine really did result in autism, the children who were vaccinated would show symptoms before and after the vaccination, not just after like the 1998 study concluded (Begley, 2009). The vaccination rate for children with autism was at the same rate for children who did not have autism. If the MMR vaccine resulted in autism then the vaccination rate for children with autism would be higher than the rate for children who do not have autism; there would be a greater percentage of children with autism who received the MMR vaccine than children who do have autism.
Lastly there is no definitive time frame for the onset of the symptoms of autistic behavior. The symptoms can occur at any given time and are not more likely to occur after the MMR vaccine (Autism and the MMR Vaccine, 2001). The Wakefield study resulted in large longitudinal effects across the globe. After the study was published, MMR vaccination rates decreased in the United Kingdom, Europe, and in the United States. MMR vaccine peaked in 1996 at 92% and after the study was published the MMR vaccination dropped in the United Kingdom to 84% in 2002 (Miller, 2009).
By 2006, the MMR vaccine was only given to 85% of children aged 24 months. In London, the rate was estimated at 61% in 2003, far below the expected rate for the vaccination (Miller, 2009). The study continues to have merit in those parents who believe the vaccination results in autism. Despite the fact that the study used twelve children, it led to widespread fear regarding the vaccine. After the study was published, measles became endemic in the United Kingdom and vaccination rates dropped sharply, leading to an increased incidence of measles and mumps (DeNoon, 2011).
This in turn led to more deaths and injuries from measles and pumps and physicians have made statement tying this study to various epidemics and deaths. In 1998 there were 56 cases of measles in the United Kingdom and by 2006 there were 449 cases in the first five months (Does the MMR Vaccine Cause Autism, n. d. ). Each of these cases occurred in children who did not receive the vaccination due to widespread fear evoked from the Wakefield study. Mumps also began to rise in 1999 and by 2005 there were 5000 cases within the first month in the United Kingdom. Measles and mumps continued to rise and in 2006 rates were 13 to 37 times higher than the 1998 levels” (Does the MMR Vaccine Cause Autism, n. d. ). In the United States there was a sevenfold increase in measles outbreak (Begley, 2009). This study had widespread consequences and in 2000 an Irish outbreak lead to three deaths and 1,500 cases which occurred due to a decrease in the vaccination rates of the MMR vaccine following the Wakefield study (Does the MMR Vaccine Cause Autism, n. d. ).
Lastly in 2008, measles was declared an endemic in the United Kingdom due to the high rates of the disease. The Wakefield study has had serious repercussions, even after its retraction, and many parents are still convinced that there is a link between the MMR vaccine and autism. After the publication of the Wakefield study parents became very skeptical about the effectiveness of the MMR vaccine. The perceived risks of the vaccination outweighed the risks and parents refused to give their children the vaccine out of fear.
The one shot approach was also very fearful since it was thought that children’s immune systems were too young to receive the vaccine in one dose. Concerns regarding the MMR vaccine were never a large issue; it was the fear of autism as a result of the vaccination that led parents to reject the MMR vaccine (Shan, 2011). Parents look to the internet for reliable information and any parent coming across the Wakefield study would be wary about allowing their children to receive the vaccine.
The media is a major contributor to the public’s opinion and the public listens to the media regarding risks and what to avoid. Since the retraction of the study more parents are opting for the MMR vaccine but more needs to be done to raise the vaccination rates. Educating the public regarding the benefits of the MMR vaccine is crucial to increase vaccination rates; this is where the public health sector is needed (Shan, 2011). Educational efforts are needed to increase MMR vaccination rates and parents need to be educated about the MMR vaccine to increase overall rates of vaccination.
The decreased vaccination of MMR in children following the Wakefield study has occurred due to a decrease in public confidence in the safety of the MMR vaccine. This has resulted from the incorrect assertions that the vaccine results in autism, as demonstrated in the fraudulent study conducted by Wakefield. No credible evidence supports the claim that MMR causes autism and more than 20 studies have been conducted since the Wakefield study that found no evidence that links the MMR vaccine to autism (Poland, 2011).
The media’s role in fostering fear in parents has led to an overall decrease in vaccination which is detrimental to children who have an increased risk of developing life-threatening diseases. Autism is now a public health concern that must be addressed by “enhancing research funding and directing that funding toward studies of credible hypotheses of causation” (Poland, 2011). Money needs to be funded in an attempt to disprove the connection between the MMR vaccine and autism and money needs to be funded for studies that provide information on the benefits of the MMR vaccine.
Another important public health concern is to insist on “responsible and scientifically informed media reporting” (Poland, 2011). Widespread fear occurs when conspiracy theories and other misinformation is given to the public. Uninformed reporting increases fear and mistrust about vaccines, leading to parental confusion and reduced vaccination to children. It is the responsibility of the public health sector to ensure reliable information is given and to continue funding scientific research regarding the MMR vaccine and autism (Poland, 2011).
The reluctance of parents to immunize their children has become a public health threat in that it can lead to vaccine-preventable diseases such as measles. Viruses spread quickly among children who are not vaccinated and it is a threat to the public health when children are not receiving the appropriate vaccinations. Measles is a life-threatening disease and parents are putting it off due to fear. Vaccines are the foundation in the public health field as “vaccines are one of the greatest achievements of biomedical science and public health” (Miller, 2009).
The reduction of any vaccination is of major concern to the public health arena and in response to the reduction in the MMR vaccine the CDC examined the major safety issues regarding the vaccination. The CDC rejected the link between the MMR vaccine and autism based on the following, “a lack of epidemiologic evidence linking autism and MMR vaccine, case reports of children with autism and bowel disorders that did not address causality, and a lack of biologic models linking ASD and MMR vaccine” (Miller, 2009).
Vaccine phobias become a public health threat and it is the responsibility of the public health arena to educate the public on the benefits of such vaccinations (Grant, 2010). There is an urgent need for research on the causes and treatment for autism as well as better support services for families caring for an autistic child. “One in 110 American children are considered to fall somewhere along the autism spectrum, a stunning 57% increase in prevalence since 2002” (Park, 2009).
Autism is a significant public health concern and researches continue to discover new information linked with the condition. Public health officials need to make available more services and knowledge regarding autism in the schools, families, and community (Park, 2009). Public health experts endorse the safety of the MMR vaccine and advise parents to give their children the MMR vaccine. Since 1995, the Department of Health and Human Services has increased its focus on ASDs (Autism Spectrum Disorders). From 1995 to 2001, “research funding for autism has quintupled from $11 to $56 million.
At the same time, both the CDC and the National Institutes of Health (NIH) have developed new initiatives, building a federal foundation for the public health response to autism” (Newschaffer, 2003). Autism now includes a broad spectrum of affected individuals and more individuals have been seeking “educational, medical, and social services to help confront the formidable challenges of autism” (Newschaffer, 2003). The Center for Disease Control supports ASD surveillance projects to provide accurate information regarding risk factors of autism.
The Disabilities Education Act also provides funding for screening and early intervention to infants and toddlers. Early detection is important to the public health and a new emphasis is now placed on providing training and consultation to physicians about detection and diagnosis of autism. Resources are more being directed towards assessment of autism and has led to a more informed public health response to autism. Making the decision to not immunize children with the MMR vaccine due to fear places children at great risk and is an irresponsible decision.
When fewer people are immunized, diseases begin to increase in numbers and in order to protect everyone the population must be immunized. Regardless of the overwhelming data, parents still continue to refuse vaccinating their children. Parents are ill-informed and because signs of autism arise around the same time as children receive the MMR vaccine, some parents link the MMR vaccine to the development of autism. The current research provides evidence that the MMR vaccine is safer than not getting vaccinated and the CDC agree that the MMR vaccine is not responsible for the onset of autism.