MMR at three? Or should I wait until booster age?

[SoBroken]

To cut a long story short, DS has had all his vaccinations except the MMR. After seeing mothers talk very passionately about the effects it had on their children, DH and I decided we didn't want to do it, and would get single jabs instead.

However, he lost his job and things have been very tight financially. We have never had a spare £300 to actually get it done.

Looking at DS starting nursery after xmas and I'm a bit worried about him catching measles or something while there.

The private clinic where they do the separate jabs told us there is no need to get separate boosters at five, as by then, the danger of autism has passed.

I just want to know at what age this passes? Should i go and get the MMR done now, or should I wait until he's five? Our financial situation is still too tight to get the separate jabs at the moment, at least while DH builds his business up a bit.

you cannot get all three separate jabs anyway, so do the MMR whenever you feel brave enough for it.

Or, just pay for a single measles jab for now.

Actually I know of reports of teenagers regressing with MMR. One report anyway. A 15-year-old.

Blueberties - link needed!

Not really. You'd treat it as a lie if there was one.

Blueberties Even with a scientific paper, some on MN would either treat it as coming to the wrong conclusions, or they'd say there are always some children who will be damaged by vaccines but the risks outweigh the benefits.

Tabitha: one could post two thousand personal stories of regression with evidence and you'd be told: here's an epidemiological study which say they're not true.

So what's the point?

In fact you could post your own story and link to medical records and you'd be told: here's an epidemiological study which says it's not true.

Never give up, Blueberties. I have friends who have fully vaccinated their children who seem not to know that there is even any controversy about it. Even just looking at the MMR, they keep telling me that Andrew Wakefield has been discredited, despite what's happened since then, with other studies backing him up.

Even if Andrew Wakefield had got it all wrong, I could never see the point in mass vaccinating everyone against mumps and German measles.

I found a website the other day, called WeSupportAndyWakefield or some such. It was full of personal stories of families who had been helped by his protocol and given fresh heart by the fact that he listened and took them seriously.

Needless to say, some very bad person has set up a mock website satirising, knocking down and generally taking the mickey out of the children and their parents. It's like the heavily sarcastic comments on here, but one step further. No stone of cruelty and ignorance must be left unturned against MMR families because they, and Wakefield, simply can't be seen to have the thinnest shred of credibility.

Some people don't seem to care how low they go.

www.wesupportandywakefield.com/
Possibly that one?
The book, Callous Disregard is supposed to be worth a read.
And Silenced Witnesses, but I can't find them in print anywhere (volume one and two).

I've got Callous Disregard. I think he's such a love.

and yes - that's the one

callous disregard definitely worth a read. whatever side of the debate you fall, it is always worth reading both sides, imo.

the silenced witnesses books are available via the cryshame website, I believe.

@Blueberties

You seem to value personal testimony over scientific method (or at least how it is applied through the science of epidemiology).

Other people, both here on MN, and elsewhere don't.

Can I ask why you do?

See?

Does personal testimony have no worth?

Am I misunderstanding the meaning of epidemiology? According to Wikipedia, epidemiologists have observation as one of their tools. Obvservation of what, then, if we ignore personal testimony?
It also says that epidemiology can only show that an agent could have caused a problem, not that it did. So, MMR wins everytime with epidemiology.

Please explain if I have got this wrong.

That's well expressed. I don't get the pearl-clutching. The normal response after reading personal testimony is not to clutch your pearls and say "my dear, how could you believe a word they say." Maybe DBennett hasn't read any though.

I don't think personal testimony has no worth.
But it is liable to logical fallacy and cognitive bias.

But I'll come back to that, if I may.

Wikipedia has 3 mentions of observation in it's epidemiology article.

The first is the title of a book published in 1662 by John Graunt.
With the second and third uses observation is part of the word observational and relates to the type of study design.

This study design is not defined by the collection of personal testimony.
Off the top of my head, I can't think of one which is designed like that.

Observational studies are studies which do not involve the investigator controlling the subject assignment, as in who is in the control group and who is the intervention group.

The Wikipedia article also has a section on causal inference.
This is the part of epidemiology which deals with moving from detecting correlation to demonstrating causation.

I think you accidentally truncated a sentence from there when paraphrasing and in doing so corrupted it's meaning.

You wrote:

"It also says that epidemiology can only show that an agent could have caused a problem, not that it did."

The closest to this is this sentence from the legal section (not really the best definition to use when talking about scientific terms but never mind):

"Epidemiological studies can only go to prove that an agent could have caused, but not that it did cause, an effect in any particular case."

That last bit (which I've put in bold) is fairly important when discussing causation.
Coupled with earlier parts of that section like Bradford-Hill criteria and discussion of "necessary, sufficient or probabilistic conditions" I think the Wikipedia strongly supports the idea that epidemiology can tell us about causation.

And examples of it doing so are myriad.
I'll mention only one to avoid this post getting even longer.

Smoking.
And it's relation to lung cancer, heart disease and macular degeneration.

I don't know whether those who doubt epidemiology believe these relationships to be real.
But it's the same methodology in use.

What worth do you think MMR personal testimony has? Have you read any? What did you think?

Why do you call it personal testimony when it is often backed up by video evidence, clinical evidence such as milestones being met and being failed, and temporal connection not in one or two cases, but thousands?

I think the methodology used in studies to disprove the link between MMR - vaccines and autistic disorder has often been found to be flawed. I don't know why you value these. Can you explain why you do? Can you explain why further methodology ought not to be treated with a sceptical eye when the weight of personal testimony and the epidemiology of autism - if there is such a thing with a non-notifiable disorder - is considerable?

Combined with Occam's Razor one has very good reasons for taking personal testimony more seriously than you, and there are many who agree with me.

But never mind - you will just say none of it is true.

"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."

Madsen et al 2002, New England Journal of Medicine

"But it is liable to logical fallacy and cognitive bias." This is a fancy way of saying: they're wrong or they remember it wrong. Don't pretend it's anything else.

You just think it isn't true, you base that on the epidemiology and a lot of the epidemiology is flawed.

Lots to talk about in your three posts.
And that's before we follow up on issues previously raised.

Lets take the quote you posted from the Madsen paper here.

You take that quote from the preamble to a one of the larger, more powerful studies investigating the suggested link between MMR vaccination and autism.

It perhaps would have been more representative of the source material to quote it's discussion section.
If internet etiquette will allow a longer block quote than I would prefer (to avoid mis-characterisation):

"This study provides three strong arguments against a causal relation between MMR vaccination and autism. First, the risk of autism was similar in vaccinated and unvaccinated children, in both age-adjusted and fully adjusted analyses. Second, there was no temporal clustering of cases of autism at any time after immunization. Third, neither autistic disorder nor other autistic-spectrum disorders were associated with MMR vaccination. Furthermore, the results were derived from a nationwide cohort study with nearly complete follow-up data."

Even if without any possibility of "rhetorical flourish" in the sentence you quoted, I think it's clear that the authors (an authority you brought in to the thread) think very highly of the science of epidemiology and it's abilities to access causation.

Less than 15mins before posting the Madsen paper quote you suggested that epidemiological methodology used to with regards to MMR vaccination and autism is often flawed.

Is the Madsen paper one that is flawed?
If so, how?

I'd also, if it's acceptable to broaden this post even further, question you use of Occam's Razor.
Even if Occam's Razor had anymore use than as a heuristic device in the scientific method (a framework with precious little respect for heuristics), when believing an association between MMR and autism you're not making one new assumption, you're making a number.

And few of them are new or untested, further distancing Occam's razor from anymore than superficial appeal.

Would it be rude to ask for a quick recap of your thoughts following my last post, do you still think that epidemiology is unable to investigate causation?

Yes, the Madsen paper is flawed.

The point is that ten years of epidemiological work in support of MMR, which was used to back advertising campaigns costing millions of pounds, and persuade people to have their children vaccinated in the middle of deep concern - ten years of that work dismissed in a paragraph. How do you feel about that?

The Madsen paper is flawed because of the difference between age of vaccination and age of austism diagnosis. If the average age of vaccination is 18 months and the average age of diagnosis is around 4.5 (the dates are in the study, I haven't read it this time) then at the end of the study there will be a three year gap.

That means that all children under the age of around four and a half who've been vaccinated will be counted as non-autistic because they havene't been diagnosed yet, and that obtains even if they're showing signs of autims, because all that counts for the study is the diagnosis.

That's a very large gap, like a three year gap, in such a study.

Can I ask you how much personal testimony you've read?

I can't believe you dismiss it as a "rhetorical flourish". If you don't like it, you just totally ignore it.

There's actually no point, you just ignore stuff, from MMR parents to the authors of pro-MMR studies. It just doesn't suit your argument so you ignore it.