Help me make sense of MMR - hype or theory

[felicity10]

OK, so I've been through a few pages of previous posts, I must be missing something because I can't make sense of it!

DD is 1 and I've had a letter about the vacs from the GP. I've heard about the MMR in the news few years ago and about the link to autism, but I just would really value your views.

Single vacs with no mumps or the MMR? Can anyone point me in the direction of key MMR issues?

I just don't want to get to the gp's and then feel like I am getting bullied into having the mmr - it is normally very no nonsense nurses who barely speak english, so will be unlikely to give me a clear answer as to any risks.

I am amazed that we have this lack of clarity in the UK.

Many thanks in advance!

....and back to the fact that you are ignoring, or trying to dismiss, the inconvenient truth.

Ok well here is a novel idea...

How about we try to accurately calculate the risks, determine who is at risk from vaccination and who is at risk from infectious disease.

How about we then use that data to determine who can be safely vaccinated and who, unfortunately, cannot.

I would love to have children who react well to vaccines. It is a no-brainer - if I knew they reacted well to vaccines and could be protected from the potential risk of infectious disease I would vaccinate them tomorrow.

(Quite how the above makes me antivaccination I don't really know.)

Stata - what about exaggerating the risks of the diseases?

You agreed yesterday that the polio vaccine in the UK is probably not that necessary yet the majority of people fear polio like the plague! What about lumping measles, mumps and rubella into the same category as life-threatening childhood diseases when mumps and rubella are nothing of the sort? Do you think that type of exaggeration is ok?

I'm also really interested in why a medical community that has admitted that my eldest child does not react well to vaccines (or at least the DTP vaccine) is so keen to vaccinate her sibling with MMR.

DD2 does not need to be vaccinated against mumps and it is probably to her long term benefit not to be vaccinated against rubella.

And yet, I am 'antivaccine' for pointing these rather obvious facts out...

Also PMSL at our school doctor (we live in France where certain vaccines are obligatory for school entry).

Three years ago, said school doctor was berating me and threatening to report me to social services because my children had not received a BCG vaccination.

The following year she made no mention of BCG because it had disappeared from the list of obligatory vaccines for school entry.

Why had it disappeared I asked her? - answer; because it has been shown to have limited benefit versus risk ratio.

Well you don't say...

(Even the incredibly go-hung, pro vaccination, USA admit that the BCG vaccination is highly problematic.)

And this was a vaccine that school doctor was previously dead keen for my (documented) vaccine damaged child to receive.

You couldn't make this crap up.

i have read most of this thread. i still cannot make a decision about dd having the mmr. dh and i decided to delay in order to research (dd is 16 months so we are only 3 months behind and have allowed the jabs up to 12 months)

i am scared to give the mmr. i am scared not to.

Pertussis kills. Measles kills. They can still easily become endemic if we don't vaccinate.

Diptheria and polio can kill. Less likely to be infected but given the potential severity of the dz, not a bad idea. We may be able to drop polio soon if things go well.

Mumps - not as fatal. Nasty stuff though as you can get encephalitis which can lead to brain damage in addition to other stuff like deafness. Not for me or my children thanks.

We all know rubella is a community good. Saves unborn babies. Not all women know they're pregnant or have the nous to get their immunity checked before. Especially since I have girls, happy to protect my grandchildren and other people's babies.

Hep B - one of the safest vaccines we know. Sure, not much chance of a child getting it but vaccine so safe that no worries there.

Hib - absolutely. GOne down from incidence of about 40-100 per 100,000 children to 1.3 leading to decreased deaths from pneumonia and meningitis. Again, won't take my chances with nature, thank you.

sungirltan - what exactly are you scared of with the MMR?

You have plenty to fear from measles and mumps such as death, brain damage, blindness and deafness. Or just a stay in hospital on IV antibiotics for pneumonia.

The BCG vaccine hasn't got high risks. It's just not very effective.

"Hep B - one of the safest vaccines we know."

Really?

I have a friend who is a nurse who received several Hep b vaccines in so many years. She worked in three different countries over a period of 5 years and each time was required to have a full set of Hep B in order to gain her work permit.

She now has MS and has been compensated by the Swiss government as her condition as been accepted as being directly caused by over vaccination with Hep B vaccines.

Sucks - huh?

i am scared about the autism link even though i appreciate its rare/not even there. i am on the fence - as i explained dh and i are only delaying to research - not made a decison re the jab yet.

i have wasted lots of my time on antivax forums (not mn) where i find the posters to be so hystrical i can't digest their arguments and or being antivax is part of a wider parenting community where you have to tick all the boxes to fit in (bf/cloth nappies/blw blah blah). also they all default to the sherrie tenpenny website.

i would like to read some rational science against vaccines. i am not anit or pro i just want to be as informed as i can before we go ahead and jab/don't

There is no proven link between MMR and autism.

Wakefield's studies were falsified and publicly retracted. He has been struck off.

There are plenty of studies that have not demonstrated a relationship. There is not one study demonstrating a link.

I'm c and ping from an earlier post.

In 1999, Brent Taylor and co-workers examined the relationship between receipt of MMR and development of autism in an excellent, well-controlled study. Taylor examined the records of 498 children with autism or autism-like disorder. Cases were identified by registers from the North Thames region of England before and after the MMR vaccine was introduced into the United Kingdom in 1988. Taylor then examined the incidence and age at diagnosis of autism in vaccinated and unvaccinated children. He found that:
The percentage of children vaccinated was the same in children with autism as in other children in the North Thames region
No difference in the age of diagnosis of autism was found in vaccinated and unvaccinated children The onset of symptoms of autism did not occur within two, four, or six months of receiving the MMR vaccine.

One of the best studies was performed by Madsen and colleagues in Denmark between 1991 and 1998 and reported in the New England Journal of Medicine. The study included 537,303 children representing 2,129,864 person-years of study. Approximately 82 percent of children had received the MMR vaccine. The group of children was selected from the Danish Civil Registration System, vaccination status was obtained from the Danish National Board of Health, and children with autism were identified from the Danish Central Register. The risk of autism in the group of vaccinated children was the same as that in unvaccinated children. Furthermore, there was no association between the age at the time of vaccination, the time since vaccination, or the date of vaccination and the development of autism.
Subsequent studies have corroborated the findings that the MMR vaccine does not cause autism.

All these other studies corroborate these findings:

Dales L, Hammer SJ, Smith NJ. Time Trends in Autism and in MMR Immunization Coverage in California. JAMA 2001; 285:1183-1185.

DeStefano, R, Bhasin, TK, et. Al. Age at First Measles-Mumps-Rubella Vaccination in Children With Autism and School-Matched Control Subjects: A Population-Based Study in Metropolitan Atlanta. Pediatrics 2004:113:259-266.

Deykin EY, MacMahon B. Viral exposure and autism. Am J Epidemiol 1979;109:628-638.

Farrington CP, Miller E, Taylor B. MMR and Autism: Further Evidence Against A Causal Association. Vaccine 2001; 19:3632-3635.

Kaye JA, Melero-Montes M, Jick H. Mumps, Measles, and Rubella Vaccine and the Incidence of Autism Recorded by General Practitioners: A Time Trend Analysis. BMJ 2001; 322:460-463.

Peltola H, Patja, A, et. Al. No Evidence for Measles, Mumps, and Rubella Vaccine-Associated Inflammatory Bowel Disease or Autism in a 14-Year Prospective Study. Lancet 1998; 351:1327-1328.

Taylor B, Miller E, Farrington P, et al. Autism and Measles, Mumps, and Rubella Vaccine: No Epidemiologic Evidence for A Causal Association. Lancet 1999; 353:2026-2029.

Taylor B, Miller E, Lingam, et al. Measles, Mumps, and Rubella Vaccination and Bowel Problems or Developmental Regression in Children with Autism: A Population Study. BMJ 2002; 324:393-396.

thanks stata - i really appreciate the references - i will be looking them up tomorrow :-)

I have searched the thread - and other threads, and I cannot find a link to the papers detailing the replication of Wakefield's work.

Please cn somebody show mw where it is?

And I repeat, it's not because I haven't looked - I have. I just can't find it.

Here are some papers for you seeker -

I know Dr. Wakefield. He's not a liar. He is horrified by what has happened but has fought and will fight as long as he can afford to. I have spoken to many many parents who believe their DC was damaged by MMR. All recount a similar anecdotal story and it is very disturbing that so many have such a similar tale. The conduct of the GMC is this affair is worth serious scrutiny. I have never seen a single individual falsely accused of so many different things, so relentlessly for simply questioning the safety of a vaccine. His paper actually said they had not shown a link. It may be instructive that the only people NOT accusing him of behaving incorrectly are the parents.

Is the MMR safe? It appears, yes, for most but not all. Court cases in the US and Vaccine Damage verdict in UK acknowledge it can damage children. This in itself is not sufficient reason to avoid vaccination because the numbers are so small - somewhere on this thread are the most important comments. If it happens to your child the statistics don't matter. To deny that it happens is in itself a fraud. All my children had it.

The following peer-reviewed papers support Dr. Wakefield's original findings:

Furlano R, Anthony A, Day R, Brown A, Mc Garvey L, Thomson M, et al. "Colonic CD8 and T cell filtration with epithelial damage in children with autism." J Pediatr 2001;138:366-72.

Sabra S, Bellanti JA, Colon AR. "Ileal lymphoid hyperplasia, non-specific colitis and pervasive developmental disorder in children". The Lancet 1998;352:234-5.

Torrente F., Machado N., Perez-Machado M., Furlano R., Thomson M., Davies S., Wakefield AJ, Walker-Smith JA, Murch SH. "Enteropathy with T cell infiltration and epithelial IgG deposition in autism." Molecular Psychiatry. 2002;7:375-382.

Wakefield AJ, Anthony A, Murch SH, Thomson M, Montgomery SM, Davies S, Walker-Smith JA. "Enterocolitis in children with developmental disorder." American Journal of Gastroenterology 2000;95:2285-2295.

Ashwood P, Anthony A, Pellicer AA, Torrente F, Wakefield AJ. "Intestinal lymphocyte populations in children with regressive autism: evidence for extensive mucosal immunopathology." Journal of Clinical Immunology, 2003;23:504-517.

The following peer-reviewed papers replicate Dr. Wakefield's original findings:

Gonzalez, L. et al., "Endoscopic and Histological Characteristics of the Digestive Mucosa in Autistic Children with gastro-Intestinal Symptoms". Arch Venez Pueric Pediatr, 2005;69:19-25.

Balzola, F., et al., "Panenteric IBD-like disease in a patient with regressive autism shown for the first time by wireless capsule enteroscopy: Another piece in the jig-saw of the gut-brain syndrome?" American Journal of Gastroenterology, 2005. 100(4): p. 979- 981.

Balzola F et al . "Autistic enterocolitis: confirmation of a new inflammatory bowel disease in an Italian cohort of patients." Gastroenterology 2005;128(Suppl. 2);A-303.

These are the articles on treatment of gastrointestinal symptoms in autistic children:

Buie T, et al. Pediatrics. 2010 Jan;125 Suppl 1:S19-29. Recommendations for evaluation and treatment of common gastrointestinal problems in children with ASDs.

Buie T, et al. Pediatrics. 2010 Jan;125 Suppl 1:S1-18. Evaluation, diagnosis, and treatment of gastrointestinal disorders in individuals with ASDs: a consensus report.

And now for today's quiz. Who said this?

"Studies designed to evaluate the suggested link between MMR vaccination and autism do not support an association, but the evidence is weak and based on case-series, cross-sectional, and ecologic studies. No studies have had sufficient statistical power to detect an association, and none had a population-based cohort design."

Here's a clue: it was said in 2002 and so covers these studies as mentioned by Stata

Dales L, Hammer SJ, Smith NJ. Time Trends in Autism and in MMR Immunization Coverage in California. JAMA 2001; 285:1183-1185.

Deykin EY, MacMahon B. Viral exposure and autism. Am J Epidemiol 1979;109:628-638.

Farrington CP, Miller E, Taylor B. MMR and Autism: Further Evidence Against A Causal Association. Vaccine 2001; 19:3632-3635.

Kaye JA, Melero-Montes M, Jick H. Mumps, Measles, and Rubella Vaccine and the Incidence of Autism Recorded by General Practitioners: A Time Trend Analysis. BMJ 2001; 322:460-463.

Peltola H, Patja, A, et. Al. No Evidence for Measles, Mumps, and Rubella Vaccine-Associated Inflammatory Bowel Disease or Autism in a 14-Year Prospective Study. Lancet 1998; 351:1327-1328.

Taylor B, Miller E, Farrington P, et al. Autism and Measles, Mumps, and Rubella Vaccine: No Epidemiologic Evidence for A Causal Association. Lancet 1999; 353:2026-2029.

Thank you RPO - I'll read them this evening.

If you've got all those papers so easily available, hy on earth didn;t you post them at the beginninly og this debate? We've all wasted huge amounts of time trying to find them and asking for them - and you've wasted huge amounts of time being exasperated with people - can't understand why you don't seem to want to enlighten people. In your position I would be flooding them with all the peer reviewed studies, statistical evidence, academic papers and learned journal articlsa I had.

Oh dear Seeker: you don't understand. The papers I just posted are all copied and pasted from Stata. Unfortunately as I say: they are

"weak and based on case-series, cross-sectional, and ecologic studies. No studies have had sufficient statistical power to detect an association, and none had a population-based cohort design."

That's not according to me, by the way. That's according to the author of the study Stata likes to call "one of the best". So you can ignore them all quite happily.

I suggest you read thoughtaboutit's links. Read those.

Why don't I post links? A very good reason. People like Stata would love the debate to be based around "peer-reviewed research", however flawed, faulty, and weak. They would love it if people could just forget and ignore and dismiss the cases that contsitute a large part of the evidence of correlation.

Epidemiological studies are not the whole of the debate -- they are only part of it. There are plenty of people posting links, who'll join that debate.

I will continue to insist that the cases of children remain part of the evidence, that the link between natural disease and autism remains part of the evidence, that the testimonies of parents and immunologists remain part of the evidence, and that successful treatment protocols based on damage diagnoses remain part of the evidence.

You can choose to ignore that evidence. I will continue to insist that's what you're doing -- ignoring evidence.

Thoughtaboutit has the links you've been given before and are so keen to read.

I would just like to point out a couple of things.

Firstly I entirely agree with rightpissedoff about anecdote. This word is used in discussions about vaccines as though it is some sort of top trump.

If you think about it, a massive amount of evidence about vaccine safety is, in fact, anecdotal.

For instance when a vaccine is in the post marketing surveillance stage, parents are asked to fill out questionnaires and give anecdotal evidence of their child's reaction. The much touted Yellow Card scheme or the VAERS system in the US is purely anecdotal - people report their personal version of what happened to them or their children following vaccination. Much of the information that we have about vaccine safety is based on statistical analysis of anecdotal evidence.

Anecdotal evidence is very often the basis for establishing a hypothesis - it is also often the 'red flag' which leads to a drug being pulled from the market (Vioxx for example).

en.wikipedia.org/wiki/Anecdotal_evidence

"Anecdotal evidence can have varying degrees of formality. For instance, in medicine, published anecdotal evidence is called a case report, which is a more formalized type of evidence subjected to peer review.[6] Although such evidence is not regarded as scientific, it is sometimes regarded as an invitation to more rigorous scientific study of the phenomenon in question.[7] For instance, one study found that 35 of 47 anecdotal reports of side effects were later sustained as "clearly correct."[8]

Anecdotal evidence is considered the least credible among scientific information.[9] Researchers may use anecdotal evidence for suggesting new hypotheses, but never as validating evidence."

Of course nobody would claim that anecdotes prove anything - of course they don't, they are not the correct tool to do so. Patterns of anecdotes do however raise questions and allow hypotheses to be generated.

Ignoring, denying or dismissing patterns of anecdotal evidence is just as unscientific as relying on anecdote alone. Good doctors wouldn't dream of doing such a thing.

And lest we forget: this man Madsen, who says all the other studies were weak, produced a deeply flawed study which certainly wasn't exhaustive and certainly doesn't show "no correlation" between MMR and ASD diagnoses.

The youngest children were not studied for long enough and didn't have enough time to be diagnosed after vaccination and before the end of the study. They are therefore put in the group of "vaccinated, non-autistic". They might well have been diagnosed later, after the study ended, at the average age that autism diagnoses were made, between age four and five. They've been put in the wrong group, and counted as children unaffected by vaccination.

The authors will have known this.

Quite Beach.

Unfortunately Stata and co: do like to claim they've proved an absolute negative - and really do need to have it pointed out repeatedly that they have not done any such thing, and will never be able to do so with an epidemiological study, even if they devised a proper one.

OK now the other point.

Quite reasonably, people ask for solid scientific evidence about the MMR/autism issue.

Answering this reasonable request is quite complicated because we are dealing with a complicated, novel, little investigated phenomenon.

Autism is complicated and manifests in different people in different ways - as another poster always says, it is much more scientific to speak about autisms. Autism is not one thing.

Vaccines are complicated, or more correctly, vaccines act upon the human immune system which is a hugely complicated biological puzzle about which science continues to learn every day. The human immune system changes over a person's lifetime and varies enormously from one individual to another.

Science is complicated. Designing a study which will be effective in answering a scientific question is not easy - indeed it is probably impossible to answer the MMR/autism question with one study alone. (And it certainly won't be an epidemiological study!)

Nobody here can link to one study and say - there it is, there you go, that is the study which shows the link (or shows there is no link).

What we can do is link to the hundreds of studies and reports, which when examined as a whole, show the hypothesis of MMR being linked to gut disease, immune system deregulation and behavioural regression as being biologically plausible.

Then we can look at the hundreds of studies which show that the immune system is involved in some types of autism. We can also look at the studies which show that the wild diseases of measles, mumps and rubella have all been connected with autism. We can look at studies which show that measles can cause disintegrative psychosis - a condition which

"occurs when normally developing children show striking behaviour changes and developmental regression, commonly in association with some loss of coordination and bowel or bladder function." (sound familiar?)

We can look at the studies which examine the autoimmune aspects or the mitochondrial issues or the unusual myelin basic protein profile some autistic children present.

It is only when this information is looked at as a whole can we start to see what we are dealing with here. I think I've read a lot about this and I have probably only read 1% of the relevant studies (and it has taken me a very long time!).

Anyway - here is a link to the supporting research as gathered by Thoughtful House.

www.thoughtfulhouse.org/research/supporting-research-references.pdf

Here is a link to the 1998 Lancet report. I took the quote about disintegrative psychosis from there.

We are missing two very important studies in this issue;

1. A large (well designed) epidemiological study which examines levels of autism in vaccinated and unvaccinated populations. Ideally we need a study which factors in the parents vaccine status also.

1. A primate study which examines what happens to primates which are given a standard vaccine schedule and a control group which remains unvaccinated. (Actually, this study has been done but it has been censored.)

Which of course leads us to the political aspect of all this. That is probably another thread all of its own!

For anyone who is genuinely interested here is a video in which Dr Wakefield presents his theories and findings.

It is an hour long and very interesting. It is easy enough to follow as he is giving this lecture to laypeople.

I already posted this on another thread on MN - here was the comment I made about it;

"Try to have an open mind and put aside the image of moneyhungrycrazeddoctorexperiementsonkidsandparentsdon'tnotice (and neither do a whole research team).

Wakefield was considered one the leading gastrointestinal researchers in the UK until he found a potential problem with a vaccine.

Professor Walker Smith who has also been struck off by the GMC is considered the grandfather of paediatric gastroenterology and one of the most eminent scientists in the UK. The idea that he would act unethically is frankly laughable."

The Video