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!

Stata - get that post deleted.

You can do your apologising for your crass you tube bullshit afterwards.

Well, I'll withdraw my posts if all you anti-vaxers withdraw all the libelous posts about the GMC, Richard Horton et al. lying. Because I'm very concerned about you posting such libelous comments anonymously on a website that others are responsible for.

And if you're that concerned about mumsnet, contact them yourself.

Okay. I will.

Never seen anyone get this low and this desperate before now. Ugh.

Hats off to the marvellous ladies.

Right, now that we have stopped splitting our sides at songs which mock and deny the existence of some very sick children, perhaps we could have a stab at having an adult conversation about the science.

I have been looking at the review which silverfrog linked to earlier. It is a very concise overview of the hypotheses to date and makes for very interesting reading. A lot of what is there will be known to some of us on this thread but it is very helpful to have it gathered together in one place in a concise document.

What is also very interesting about this is that it is authored by a mainstream scientist and published in a mainstream journal. Obviously one is able to discuss vaccines and autism in the US without ending up before a tribunal! (Perhaps that is because the US government was not so foolish as to grant indemnity to the manufacturers?)

Here are a few things that were of interest to me;

"However, there have been case reports of late-onset autism (DeLong et al., 1981; Gillberg, 1986; Gillberg, 1991) in individuals who were 11, 14, and 31 years of age and who previously had herpes encephalitis. Therefore, autism is not necessarily a developmental disorder."

I hadn't come across this info before. I'm interested in the clearly viral nature of the phenomenon.

"In 1988, two doses of MMR II were recommended to immunize those individuals who did not respond to the first injection. A spike of incidence of autism accompanied the addition of the second dose of MMR II. Also, in 1988, MMR II was used in the United Kingdom, which reported a dramatic increase in prevalence of autism to 1/64 (noted above). Canada, Denmark, and Japan also reported dramatic increases in prevalence of autism. It is important to note that unlike the former MMR, the rubella component of MMR II was propagated in a human cell line derived from embryonic lung tissue (Merck and Co.,
Inc., 2010). The MMR II vaccine is contaminated with human DNA from the cell line. This human DNA could be the cause of the spikes in incidence. An additional increased spike in incidence of autism occurred in 1995 when the chicken pox vaccine was grown in human fetal tissue (Merck and Co., Inc.,
2001; Breuer, 2003)"

Yikes - I haven't read about this before either.

"The human DNA from the vaccine can be randomly inserted into the recipient?s genes by homologous recombination, a process that occurs spontaneously only within a species. Hot spots for DNA insertion are found on the X chromosome in eight autism-associated genes involved in nerve cell synapse formation, central nervous system development, and mitochondrial function (Deisher, 2010). This could provide some explanation of why autism is predominantly a disease of boys."

Most intriguing.

"For example, one hypothesis of the cause of autism is that the pertussis toxin in the DPT vaccine causes a separation of the G-alpha protein from retinoid receptors in genetically at-risk children (Farfel et al., 1999; Megson, 2000). The pertussis toxin creates a chronic autoimmune monocytic infiltration of the gut mucosa lamina propia and may disconnect the G-alpha protein pathways, leaving some G-alphamodulated pathways unopposed. In turn, the non-specific branch of the immune system is turned on and, without retinoid switching, cannot be down regulated."

This is of special interest to me as my DD reacted to her DTPs (although she does not have autism).

"Infections/infectious agents that appear to be causally related to the development of autistic behavior include encephalitis caused by measles, congenital rubella, herpes simplex virus, mumps, varicella, cytomegalovirus, and Stealth virus(Chess,
1971; DeLong et al., 1981; Libbey et al., 2005). Rubella virus was the first known cause of autism (Chess, 1971; Ziring, 2001). In addition, measles and mumps viruses can cause encephalitis that can result in autism later in time (Chess, 1977; Ziring,
1997). The viral infections that cause encephalitis that result in autism often occur in utero. However, encephalitis caused by herpes viruses has been documented to cause autism in older individuals (mentioned above). Taken together, these
data show that some viruses can cause autism."

As I said before I have an interest in viruses - I'm also always gobsmacked by the notion that people will accept that the wild viruses can cause autism, but there seems to be a stubborn refusal that vaccination with these viruses could have the same outcome .

"Acetaminophen has also been suggested to cause autism (Schultz et al., 2008; Schultz, 2010). Children given acetaminophen after the MMR II vaccine were significantly more likely to become autistic than children given ibuprofen."

Again of personal interest to me considering how my DD reacts to paracetamol. Also I have heard this info before and think it is mindblowing that doctors still recommend paracetamol after a jab. (Although that may be changing as they have also found out the paracetamol use can affect vaccine efficacy. Somebody posted a link about that on another thread - will try to find it.)

Thanks silverfrog for posting the link.

Of course the differences in studies are not a question of semantics. In order to critically appraise research, you need to be aware of the different types of studies and what their advantages and disadvantages are. For instance, no-one would assume that anyone would perform a randomised control trial on vaccine safety in children. Such a study would simply be unethical. Therefore, the assertion that you use the word 'study' because that's what everyone was thinking is flawed from the start.

Of course you can shout that a study is flawed when you think that they type of study is just semantics. What I suggest you do is read up a little bit about how research is conducted. Johns Hopkins University has an excellent Here it is ocw.jhsph.edu/courses/FundEpi/syllabus.cfm It's a great learning tool.

I think once you up your critical appraisal skills, we'll have more opportunity to talk sensibly about what the epidemiological studies are saying and what their flaws/biases are.

A suggestion would also be to tone down the arrogant 'we know best' tone of your 'but you don't know the difference between a case series and a study' since it just exposes how little you do actually know and how much you need to try to make others look like they don't (eg the open university). An admission of error would also be nice but not expected.

And anyone who really wants to know what the overwhelming evidence says, I suggest you go to google scholar. Don't just google since you get all the whacky pseudoscience anti-vaxers - use google scholar. Search for things like 'vaccine' and 'autism' and just work your way down the literature having a look at the abstracts. I think that's a good objective way of doing things. ANyone can cherry pick but when the evidence is overwhelming, it comes across when you look at it in its entirety. scholar.google.co.uk/

Ok the reason I found the study thing funny is because the GMC is determined to make the 1998 Lancet paper out to be research when it is in fact a report of observations made during clinical investigation of symptoms.

I guess it was a bit of a political in-joke.

No, you were going to teach me about controls. And you've used it before to try to make out that people don't understand the difference between different types of study. Leonie put the anti-vax view about the different types of study beautifully 'it's all semantics'.

And a case series IS research and is subject to exactly the same standards. It's used to generate hypotheses. It's not inferential so it can't be used to confirm a hypothesis ie that vaccines have any effect on autism. Wakefield knew that.

You guys are making this up as you go along.

beachcomber - thank you for the full link

I thought it was interesting to read a review of how things stand - it certainly does make for easier reading to have it gathered in one place.

I had heard of the viral issues before (maybe saintly has previously linked?) and it was good to see them included here, alongside the more "typical" routes assumed.

the DNA/cell tissue stuff is both grimly fascinating and alarming.

the paracetamol link is very interesting.

dd1 also reacts badly to paracetamol. I agree that it is extraordinary that paracetamol is stil recommneded pre/post jabs (my last hv used ot recommned giving it half an hour before the appt, so that the child was nice and drowsy. goes back to the "ah, poor baby, don't wan tot hurt them with nasty ickle needles, do we" line I mentioned earlier.)

Stata: still debating the semantics, I see. not a word about the actual topic. speaks volumes in itself, tbh.

as for the case series/study thing - it is like the "anecdote" line you like to trot out. there is a vast difference between the actual definitions of these words/phrases, and the way in which you (and other hardline pro-vaxxers) use them. and the inference used by you, and the OU in that frankly risible course you linked to, is that the 1998 paper was a proper research project, which is then rpped ot shreds for not having a decent conclusion, raising more questions than it answered, etc.

it is useful, I htink, and important to keep the differences noted. there are differences, as you full know.

trying to conflate them is just muddying the waters - somethign you are very good at.

It is a common criticism of the 1998 Lancet paper that 'no controls were used'.

This is a stupid thing to say - the Lancet report was reporting on the gastroenterological inflammation found in the clinical examination of some ill children.

What was notable was that it was a type of inflammation that had not been observed before and that it presented in children with behaviour regression. That was why a report on the findings was written and published.

Controls were utterly irrelevant to the report.

Some studies were then designed in order to try to examine some of the questions raised by the case report (that was a result of standard clinical examination). At this point controls became relevant.

Gosh I do wish we could move on from this really basic old stuff and actually discuss some of the actual science. Whenever people have a go at Wakefield for a lack of controls (or link to documents which do so) I immediately think two things;

1. The person hasn't actually bothered to read the 1998 Lancet paper.

1. The person hasn't bothered to read anything else that Dr Wakefield has published.

I then wonder if the person has read the studies that claim to disprove Wakefield's hypotheses.

I then wonder why I am engaging very much with this sort of person when I could be having an interesting discussion with people who actually read the science and have a genuine interest in it and the children it is relevant to.

It is also a common criticism of the report that it was 'unethical'.

This is also stupid (even though the GMC say it).

Clinically indicated examination by clinicians does need ethical clearance from ethics committees.

Suggesting the report was unethical is to suggest that the children were not ill. Suggesting the report was unethical is to try to pretend that it was research when in reality is was a clinical report.

One doesn't have to be a rocket scientist to see how offensive and outrageous such a claim is.

And let us be very clear about one thing whilst we are on the subject;

to support the decision made by the GMC is to support the notion that the Lancet 12 were not ill.

• This is why the parents of the children campaigned outside the GMC with pictures of their children's colostomy bags, pictures of diarrhoea running out of very underweight children and pictures of the lesions in their children's diseased guts.

The GMC ruling and anyone who agrees with it or supports it, is claiming that such children are not ill.

Regardless of whether people think that MMR is responsible for that illness, they should at least have the humanity to acknowledge that these children's suffering is real. Supporting the GMC is to do the contrary. The only excuse I can think of for doing this would be ignorance.

Personally I tend not to voice strong opinions (and ridicule those of others) on serious matters about which I am ignorant.

The OP hasn't posted since 17th Feb. I wonder if they are feeling any clearer on the issue now...

Not ill? Isn't that one of the problems the ethics committee has with the whole thing? There was an out of court settlement from Wakefield because he caused 'life threatening complications'.
And part of the ethics committee conditions were that approval only covered children enrolled after 18 December 1996.
Yet
^"Professor Walker-Smith, after his assessment of Child 1 on 19 June 1996, concluded in his letter to Dr Barrow that Child 1 had the features of ?toddler?s diarrhoea? and planned to see Child 1 again in three months? time. However, Child 1 was admitted to hospital one month later. There were no apparent clinical reasons for this change in plan. Child 1 underwent a colonoscopy, MRI scan of his brain, an EEG and a variety of blood and urine tests. These were some of the investigations listed in the programme of the project. He was further admitted on 23 October 1996 for further investigations regarding the ?etiology of the autism?, again for no obvious clinical gastro-intestinal reasons.

During this admission, Child 1 underwent a barium meal and follow-through and a lumbar puncture. These were also the investigations listed in the programme of the project."^

Thanks for the links and the last few very clear posts.

It is one of the greatest injustices that it would actually have been unethical not to treat the children. But because a certain word was used on a certain form, the doctors are accused of behaving inhumanely? They were the only team to try to help the parents. What is unethical, and inhumane, is the fact that other children with similar symptoms and diagnostic history are now not being accepted, not being looked at, not being investigated, because consultants fear their careers may be endangered. I've read too many times that you can have your child's gut or bowel disorder treated so long as you don't mention autistic spectrum disorders, let alone MMR.

No where in the gmc ruling does it say they were not ill, nor does it say that they did not have autism or gut problems. It's the fact the autism and gut problems are not as recorded in the research paper ie symptoms did not appear with days of mmr, or the fact that most had developmental problems before the mmr etc.
The children were not treated they were investigated. Although one was experiemented on with the "transfer factor" that Wakefield and the child's father had set up a company to market.

I would also point out that Wakefield was forbidden under his contract with the Royal Free to treat patients.

Their conditions and symptoms were certainly investigated. That is what happens: how can you treat until you know what the children are suffering from? No one knew: it was a new condition. That's why the parents were with AW: no one could help them.

You don't treat cancer, or meningitis, or asthma, or lupus, or sinusitis, or any disease or disorder you might care to mention, until you know someone has it.

Bruffin have you read the research supporting AW's work? Plenty of links here.

It wouldn't have to say it : by finding that the investigation and attempts to isolate and treat symptoms were unethical, the clear implication of the GMC ruling is that they were unnecessary: and the clear implication of that is that they were not ill.

Bruffin, have you read the links supporting AW's work? plenty of links here.

Also have you noted that almost all the epidemiological evidence cited as "proof", if such a thing were possible, that there is no link between MMR in particular and ASD, has been accepted as weak by the scientific community? It's been accepted that these studies could not find any correlation even if there was one because they were poorly designed.

What do you think of that?

RPI only in your mind

There is nothing to research on Wakefields work, he falsified data to make money which is not libelous as it is all a matter for public record