to be cross my ds has measles because other parents didn't vaccinate their children

[snickersnack]

He's 11 months old, poor little thing . Fortunately he's going to be ok - he got off quite lightly, I think - but it was scary and he was really poorly for a day or so. Spent 10 hours in A&E yesterday while he had chest x-rays, blood tests, IV fluids etc. Now we're just waiting to see if his sister,who's 2, gets it - she's had one dose of MMR already so fingers crossed she's immune.

We live in an area where immunisation rates are among the lowest in the country. Now I have to go and tell all parents of the other babies he's met recently that their children might be at risk as well...

Not at all parents that do not vacinate are very selfish and can be seriously putting in jeopardy the health of their ds and others

Message withdrawn

I was immunised against measles as a child get caught it last year, my children who have not had the MMR caught measles from me as they started showing signs a week after I did. All of us were unwell for a few days and I also suffered a mid trimester miscarriage while I was ill with measles. I don't blame anyone for me and my girls catching measles and certainly don't begrudge parents who had decided not to give their children the MMR.

It's crazy that people still trust these studies actually. Why don't they look at the 1500 children whose parents have evidence of regression after vaccination?

Basically they're saying: well it didn't happen to all those other children so it didn't happen to you.

Going for three: I'm so sorry about your pregnancy.

Message withdrawn

Suey2 said;

"wakefield quite rightly has had his reputation put through the mangle! 12 patients FFS! and he had a huge conflict of interest. the article was exceptionally irresponsible. Particularly as many people cannot read scientific articles with a critical eye. This was in no way a scientific article. Look at the denmark epidemiological study- half a million people! That's more like it

IMHO pushing for this research is like mohammed al fayed banging on about his conspiracy theories relating to the dodi/di crash. There is no basis on which to perform this research because all of the epdemiological studies have shown no link!"

I really disagree with you here Suey2. Firstly I think it is unacceptable that Dr Wakefield's reputation has been smeared in such a cheap way. His science stands unchallenged. To attack his personal and professional reputation is a desperate and cynical measure. Unfortunately this sort of method works as people believe what they read in the papers and most don't bother to try to find out the truth for themselves.

Could you please expand on the 'huge conflict of interest'. Are you refering to the Legal Aid Fund or the patent?
The Legal Aid Fund was not paid to Dr Wakefield but to the Royal Free Hospital and so far according to what is happening in the GMC case, the charge about this so called C of I is completely unfounded. If you are refering to the patents for transfer factor (much touted as a single measles vaccine by the press), this accusation is also unfounded. The patent is held by the Royal Free and Dr Wakefield and is for a transfer factor not a competing vaccine. This is also briefly touched upon in the GMC trial and more than one person from the Royal Free Hospital has testified on the matter.

Could you also please expand on how Dr Wakefield and his collegues paper was 'in no way scientific' when it was signed by 12 doctors, peer reviwed, published in the Lancet, praised by the editor and others, and remains unchallenged today?

You refer to the Danish study. The Danish study is a lot of tosh. See here for why.

Danish study is a load of tosh

Manipulated, flawed, epidemiology cannot 'prove' that there is no autism/MMR link. You accuse Dr Wakefield of conflict of interest but you want to look into the the studies you cite. From the above link about the Danish study;

"The study authors were conflicted, and the conflicts were not reported in the study, as they should have been. Of the seven co-authors of the study, three had received direct funding from the CDC on vaccine-safety related projects. One of the authors, Poul Thorsen, was a CDC employee. And, two of the authors were employees of Statens Serum Institute, a Danish vaccine manufacturer. Here's SSI's Annual Report. Interestingly, page 28 shows that sales of vaccine products to the U.S. were particularly high in 2002. None of these conflicts are mentioned anywhere in the study."

From the same site this is very interesting

Suey do you understand the difference between epidemiology and clinical study? You scoff at the Lancet paper because it examines 12 children. This is called a case study and is a common scientifc method for creating a hypothesis. 12 cases is plenty to come to a cautious conclusion suggesting further investigation. You cite the (fatally flawed and discredited) Danish study and its half a million subjects as thought that is somehow better than 12 clinical case studies. The two do not compare.

to beachcomber what do you think of this study?:

MMR Vaccine Not Linked to Autism in Virologic Case Control Study CME/CE
News Author: Marlene Busko
CME Author: Laurie Barclay, MD
Disclosures

Release Date: February 11, 2008;
Authors and Disclosures
Marlene Busko
Disclosure: Marlene Busko has disclosed no relevant financial relationships.

Laurie Barclay, MD
Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.

Brande Nicole Martin
Disclosure: Brande Nicole Martin has disclosed no relevant financial information.

February 11, 2008 ? No differences in measles virus or measles antibody concentrations were detected between children with autism spectrum disorders (ASD) and controls, whether they had received 1 or 2 measles, mumps, and rubella (MMR) vaccinations, in a study from the United Kingdom.

The investigators did not find any evidence of a persisting immunologic response in children with ASD, whether these children also had regression in words, social skills, or behavior, and they did not find increased enterocolitis (bowel disorders) in children with ASD and regression.

The study, led by Gillian Baird, PhD, at Guy's Hospital, in London, England, is reported in the February 5 Online First issue of the Archives of Disease in Childhood.

"This is one of three virological case-control studies [and the largest of the three] that have failed to demonstrate any association between measles vaccination and ASD, using well-validated techniques," the group writes.

Are Vaccines to Blame?

A 1998 report of a study in 12 children suggested that MMR vaccination might be linked to the development of ASD, and a subsequent study postulated that the vaccine might be associated with enterocolitis, the group writes. Subsequent epidemiologic studies, however, discredited this research and failed to demonstrate an association between MMR vaccination and ASD. Despite these subsequent findings, parental concerns have led to a decrease in MMR vaccinations in the United Kingdom from 92% to 80%.

The investigators of the current study aimed to test the hypothesis that measles vaccination was involved in the pathogenesis of ASD, by looking for raised levels of the measles virus or measles antibodies in children with ASD who had been vaccinated with the MMR vaccine vs control groups of vaccinated children.

The subjects were derived from a community-based sample of vaccinated children, aged 10 to 12 years, from a population of almost 57,000 children born between 1990 and 1991 in southern England.

The study sample was made up of 98 children with ASD and 2 control groups: 52 children with special educational needs but no ASD, and 90 typically developing children.

Blood tests were performed to detect the presence of the measles virus and to test for measles antibody levels.

No difference was found between cases and controls for measles antibody response or for enterocolitis, regardless of whether the children showed regression.

The children with ASD or with special educational needs were, however, less likely than the typically developing children to receive the second MMR vaccination (MMR2).

Need to Look Beyond MMR Vaccine

This case-control study used a complementary approach to the epidemiologic studies that demonstrated that the rates of autism prevalence did not decrease after the removal of the vaccine preservative thimerosal, Eric Hollander, MD, from Mount Sinai School of Medicine in New York, who was not involved in this study, told Medscape Psychiatry.

"From this study, it's clear that persistence of the measles virus or the antibody response doesn't occur in patients with autism compared to typically developing individuals or to children in special education, irrespective of the number of doses of the vaccine," he noted.

Research shows that very early childhood experience or environmental factors can play a role in modifying the expression of certain genes and the development of autism, which suggests that it is important to look for environmental factors, he added.

Focusing on the MMR vaccine or mercury as potential environmental factors is not warranted, however, given the negative research findings. "I would say at this point, it would be much more fruitful to invest resources...into looking at other potential environmental factors that could play a role," Dr. Hollander believes.

"Autism places more stress on parents than any other illness," he added, "and it's not unusual for families to seek what may have caused this particular problem in a child that seemed to be developing normally and then all of a sudden regressed, and sometimes people may seize on things that seem to co-occur at the same time.

"It's important to move past anecdotal observations and do more systematic studies to either prove or disprove certain [them], and I also think it's important...to be able to incorporate new data and modify hypotheses to most effectively find out what the real underlying causes of autism are, to have major breakthroughs," he concluded.

The study was funded by the Department of Health, the Wellcome Trust, the National Alliance for Autism Research, and Remedi. Two of the study authors have given unpaid advice to lawyers in MMR and MR litigation. Two other study authors have acted as expert witnesses for the diagnosis of autism and in the matter of MMR/MR vaccine litigation. One other study author has received royalties from diagnostic assessments used in the study. The remaining study authors have disclosed no relevant financial relationships.

Arch Dis Child. Published online February 5, 2008.

Clinical Context
The estimated prevalence of ASD based on recent studies ranges between 6 and 12 per 1000, depending on the strictness of criteria used for diagnosis. A 1998 report of an uncontrolled case series of 12 children suggested a link between MMR vaccination and subsequent development of ASD, and a larger case series described "autism enterocolitis" thought to be associated with MMR vaccination and regression in autism.

However, several epidemiologic studies later found no association between MMR vaccination and ASD. The present analysis used a new, geographically defined study of ASD prevalence (Special Needs and Autism Project [SNAP]) to examine the hypothesis that the measles vaccine was involved in the pathogenesis of ASD.

Study Highlights
The goal of this case-control, community-based study was to test the hypothesis that measles vaccination was involved in the pathogenesis of ASD.
Evidence for that hypothesis was defined a priori as signs of a persistent measles infection or abnormally persistent immune response shown by circulating measles virus or raised antibody titers in MMR-vaccinated children with ASD and with a history of regression vs controls.
The study sample consisted of a community sample of 98 vaccinated children aged 10 to 12 years in the United Kingdom with ASD and 2 control groups of similar age: 1 group of 52 children with special educational needs but without ASD and 1 group of 90 children with typical development.
Participants underwent testing for measles virus and serum antibody response to measles.
Cases and controls did not differ in measles antibody response or in measles virus, whether the children had received the first, second, or both MMR vaccinations.
There was no dose-response relationship between autism symptoms and antibody concentrations.
Measles virus nucleic acid was amplified by reverse transcriptase?polymerase chain reaction in peripheral blood mononuclear cells from 1 patient with autism and from 2 children with typical development.
Response to measles virus or to the measles component of the MMR in children with ASD, with or without regression, did not seem to differ from that in children in the control groups who had either 1 or 2 doses of MMR.
Clinical symptoms of possible enterocolitis occurred in none of the cases and in only 1 child from the combined control group.
Based on these findings, the investigators concluded that there was no association demonstrated between measles vaccination and ASD.
Limitations of the study include subjects in the typical development group not randomly selected from the whole population; parents being informed that the study was about MMR vaccination may have led to response bias; satisfactory blood samples not obtained in 100 children, both ASD cases and control group with special educational needs; and lack of gut mucosal samples for ethical reasons.
After diagnosis of a developmental problem, children were less likely to receive the MMR2, which the investigators suggested may reflect parental concern about vaccination after a diagnosis of a developmental abnormality.
Both ASD cases and the control group with special educational needs had lower uptake of MMR2 and, hence, less exposure to the measles virus.
Only 29% (20/70) of children diagnosed with ASD received MMR2 vs 50% (14/28) of those who were not diagnosed with ASD.
Pearls for Practice
The investigators concluded that there was no association demonstrated between measles vaccination and subsequent development of ASD. Cases and controls did not differ in measles antibody response or in measles virus, there was no dose-response relationship between autism symptoms and antibody concentrations, and clinical symptoms of possible enterocolitis occurred in none of the cases.
After diagnosis of a developmental problem, children were less likely to receive the MMR2, which the investigators suggested may reflect parental concern about vaccination after a diagnosis of a developmental abnormality. Only 29% of children diagnosed with ASD received MMR2 vs 50% of those who were not diagnosed with ASD.

oh, and i do know the difference between a single case study and an epidemiological one, thanks.

Single case studies are normally published when they show an interesting case. They are normally (IME) a question to other practitioners whether they have found the same thing and whether the finding is an interesting 'one off' or worthy of further investigation. They do not usually make any conclusions, being only one case and therefore too small a study to make any conclusions. A study of 12 patients of which only 8 show what you were looking for, is not powerful research.

Epidemiological studies are usually flawed and therefore seen as poorer research because, as they are retrospective, they cannot accurately match the patient groups for age, sex etc, as you would need a very large group of patients to 'iron out' any differences in the population. Half a million patients, however, is a very large sample.

Comparative studies in general are much more powerful than non- comparative ones. The danish study was comparative, the original wakefield article was not.

My main beef with wakefield's original piece was that he was deliberately looking for a link when he started, that would 'prove' MMR caused autism. I havent read the article for a while, but i understand that he did not disclose that he was acting on behalf of the parents of these children (thus the conflict of interest). Thus researcher bias. Now, i'm not saying that researcher bias does not exist in other studies, but to publish a report like this, which was always going to result in widespread reporting being such an emotive issue, you really have to at least disclose all of your influences. I am not saying that wakefield is alone in being culpable, but he was the research leader. He had a responsibility to those parents to conduct the research without bias. How difficult would it have been to examine a few biopsies of children (who were otherwise having a colonoscopy) who had not had the MMR? Then at least there would have been some comparison. As it is, there has been a similar finding in children without the mmr (seen in the study below, sorry for the cut and pasting), which AFAICS completely rubbishes this initial finding.

The original piece mentioned MMR several times. The fact is that we still don't know what causes autism, but that current thinking based on the research is that it lurks dormantly and presents after an environmental trigger. (NOT cause) Think of it like MS.

The original piece also stated that in 8 of the patients the parents had linked onset of symptoms to the MMR. BUT, as i recall, the onset was between 1 and 14 days after the MMR. Given my previous point that autism is usually diagnosed at 14 months with the MMR given at around 13, i still say that the link is likely to be coincidental. It may have been rather different if in every case (remember only 8!) the symptoms had manifested after the same amount of time, eg the same day or 2 days later, like exposure to a different kind of virus would.

My main beef with wakefield's original piece was that he was deliberately looking for a link when he started, that would 'prove' MMR caused autism>>

Not sure I understand this. What he 'wanted' to find is something that went on inside his head so I don't know how you could know.

What he was 'looking for' may have been a link, but that is surely normal? Don't cancer researchers look for causes of cancer? If all the people in a restaurant fall ill don't they look for salmonella in the kitchen?
Should they all just take blood tests and stare at them dreamily in case something occurs to them?

if one person in the restaurant got sick with 30 people eating the same meal then on the balance of probabilities, it would not have been a problem in the kitchen.

by all means look for a link, but disclose your motivation for doing so and that you're approaching the study on this basis and include a few non-autistic children for comparison.

How offended would you be if the evironmental health checked the restaurant anyway to be on the safe side?

Science IS looking for links. You sound like it was rude of him to consider it without proof. That's how you find proof.

And once again 'motivation' is something that goes on inside the head so I don't know where you are getting your information from. However I'm sure most scientists are hoping at least a bit that their latest hypothosis is correct.

Show me proof that he faked the evidence. The government couldn't find any. That's why everyone's been sifting through his past saying things like "aha! he once sat next to someone who later in life made a sandwich for a man who had done so and so." Just like the Mccarthy Era

Also I don't recall him saying it was proved. I understood that it was more like "an indication that a preexisting condition combined with a bad reaction to MMR might in a very small number of cases..... etc"

Hi Suey 2, I'd really appreciate your thoughts on the in-build flaws to the much hailed Danish study (the one that was authored in part by vaccine manufaturers who then went on to sign a lucrative order for the US market). I'm still interested in what exactly you meant by Dr Wakefield's C of I and by is work being 'in no way scientific'. When you have time, thanks.

With regards to the above study.

1. This is not the first study to pretend to try to replicate the Royal Free's research. Unfortunately yet again curious design flaws mean that the study does not directly replicate Wakefield's work. Therefore it cannot scientifically be used to challenge Wakefield's hypothesis.

1. In your cut and paste you fail to give us some vital information about the study;

Taken from here for anyone who wants the full story.

"Clinical symptoms of possible enterocolitis occurred in none of the cases and in only 1 child from the combined control group."

This is very revealing. Wakefield's hypothesis only applies to children who present both regressive autism and enterocolitis. By failing to include any children with one of the two defining criteria they are not replicating the Lancet study and therefore cannot challenge it. Wakefield has never claimed that children with no bowel problems are damaged by MMR. This study appears to be trying to refute something that he never said. Curious.

"Limitations of the study include subjects in the typical development group not randomly selected from the whole population; parents being informed that the study was about MMR vaccination may have led to response bias; satisfactory blood samples not obtained in 100 children, both ASD cases and control group with special educational needs; and lack of gut mucosal samples for ethical reasons."

I would be interested in what was unsatisfactory about the excluded blood samples but I can't seem to find details on this.

More importantly the study failed to examine gut mucosal samples. One of the key factors to autistic enterocolitis in MMR damaged children is that they have persistent measles infection in the gut. So this study has taken children with normal guts and then not examined their guts. How the fark were they expecting to draw any useful conclusions from that?

However they then have the gall to go on and say this;

"Based on these findings, the investigators concluded that there was no association demonstrated between measles vaccination and ASD."

Excuse me, did I read that right? That's a mighty sure sounding conclusion to make for people who appear to have deliberately excluded subjects from their study who present the symptoms they are supposed to be studying and who fail to look for what they are meant to be studying in the place they are most likely to find it.

Again, I seem to be asking myself are these folks imcompetent or are they doing this on purpose?

1. Even worse, this is not the first time that this lot have had a bash at this. They have had a previous attempt in the study commonly refered to as the Baird study. Here again they failed to include children who presented the bowel condition Wakefield studies and only examined blood samples not gut mucosal samples. See here for the Thoughtful House response from which I have taken the following quote;

"As a general observation, this paper contributes nothing to the issue of causation, one way or another. Case definition alone is likely to have obscured the relevant group of autistic children. The study tells us nothing about what actually happened to the children at the time of exposure. We are increasingly persuaded that measuring things in blood many years down the line tells us very little about the initiating events in what is, in effect, a static (non-progressive) encephalopathy unlike, for example, subacute sclerosing panencephalitis, which is a progressive measles encephalopathy. The gut is a different matter, and analysis of mucosal tissues has been very informative, since here, in the relevant children, active ongoing, possibly progressive4, inflammation has been identified."

Seems like the government's clincal experts aren't much more use than their epidemiological ones. See here for some comments from people who know a lot more about this than I do.

Suey2 although it is useful to cut and paste parts of a study so that we can all have a look at it, I think it is always a good idea to add a bit of commentary. You don't say why you are including the study in our debate, nor do you give your opinion of it. I'm interested in why you posted it.

X posted with Suey2, I don't have time to respond to your latest posts right now but will get back to you.

is the BBC impartial enough very basic but a good summary for lay people
conflict of interest??

Does anyone know of a study looking at wild type measles and autism or has it only been looked at with the MMR? I would guess that measles itself should be just as likely to cause autism as measles vaccine in which case there is less of an arguement for no MMR as you would then be at high risk of catching measles and therefore having exactly the same problems.

Beachcomber, I'm sorry, I haven't got time to read through everything that's been said, so apologies if this has already been mentioned, but if MMR damaged children have persistent measles infection in the gut, if these same children had not been vaccinated, and had then caught measles, would they not then have measles in the gut with the same result? I have no medical background; it's a genuine question.

x-post fleximum!

Macdoodle, Yeah fair enough. I'll accept that article as fair reporting.

An analysis of the same data by experts, published in the Journal of American Physicians and Surgeons, concluded children who received the triple jab were more likely to develop autism than those who were not given it. >>

I still say science is/should be more than counting heads. Let them look at how it would do it.

this is also interesting.

Aaah the Japan study, much touted, much flawed. I don't have time to expand just now but will try to later on.

Will also give my thoughts on midnight's question re wild measles versus vaccination in suseptable children developing ASD.