Dr. Wakefiled and the MMR study

[Uwila]

"If found guilty, Mr Wakefield could be struck off the medical register."

\link{http://news.bbc.co.uk/1/hi/health/5070670.stm\MMR Doc to face charges}

Discuss, please.....

mrsnoah- quite a few problems have been associated with the men C. Jabs can give you more details if you google them. The problem you have is that afaik you either have to give the 5 in 1, or it's nothing (which irritates the hell out of me because it means ds2 and ds3 have to wait until they are 10 before they can get a single tetanus jab).

The Germans use a 6 in 1 (Infanrix), which, however, contains no Men C component (offered as an optional-yet-strongly-pushed extra - ds hasn't had it, but he has had the 6 in 1). Might be an option (if you can get it) if you're specifically worried about the Men C, but not, of course, if it's combined vaccines per se you're worried about.

Jim Jams is right about the trigger / causal difference. many people have hgenetic predispositions to something (eg heart disease) but a trigger is required to set it off- for example a long run, or weigyht gain. However, causal is when something is purely trqceable back- for example heart disease caused purely by furred up arteries.

JimJams, I am seeing the Pasediatrician July 4th, i will ask about Sam's gastrointestinal problems and report back. I have kept the bookmark you let me have for the specialista s well. They've never talken any inforkation on his gastro system (a useful way of not finding any link LOL), but most nights he complains of stomach pains that are quite severe, as well as his food intolerances.

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So Jimjamskeepingoffvaxthreads, you do see "triggered" as a form of cause. I fail to see why the rate of trigger should go in the opposite direction to the rate of the thing it triggers.

Forgive me, as someone who saw the "Cold Fusion" debacle at point blank range, I'm deeply sceptical of people who have secret sources of data.

I know more about Autism than you seem to think...
So you can imagine that I'm very unimpressed by the selective personal experience, and cloaked references to things I can't understand. Mysticism of any kind is not an argument.

But I'm not an expert in it's diagnosis. Where I have professional experience is various forms of statistical reasoning under uncertainty, none of which seems to make it to this debate.

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cloaked references and mysticism? has this thread taken a surreal turn somewhere?

What on earth are you talking about DC.

No mysticism, it's not my place to make public personal communications I have been asked to not say too much about until its been published in a peer reviewed journal. Anyway that was only one source of the 7%- there are other sources out there. Until then there is plenty you can read. Richard Lathe's book is the obvious one. He has no particular thesis - pther than the area of the brain that is damaged, he just pulls together the published work so far, and in the process gives a very good demostration of how complex the biology and physiology of autism is. I've also suggested Megson and Waring as starting points if you want to begin to read up on the biomedical aspects of autism. The point I was trying to make is that the biomedical aspects are extremely complex and you might like to read more before discussing it further. "I know more about autism than you seem to think"... oooh bit of mysticism there DC- what is is best friend's cousin is a bit odd and likes computers? You know very little about the biomedical aspects DC that is very clear form your posts.

What selective personal experience? I mentioned my son to say that his autism wasn't MMR triggered so I have not been media duped.

If you're such an expert on statistical reasoning under uncertainty then you should know that studies like Taylor et al and the Finnish study are useless as they completely failed to address the hypothesis that MMR is triggering autism in a subset of the autistic population. We all know MMR is safe for the majority.

Pruni, DC even knows I did Stats at Uni last year. He doesn't (yet) know I got an A though.

Not sure if he means me and Sam with the stomach stuff as personal experience, but if so I said I'll ASK abot a link. not exactly getting a causal relationship is it LOL!

JimJams, respect for not divulging research that's not yours to reveal.

Autism is So complex, even the individual syndromes that in part comprise the disroder are very comples in themselves. For my last Psychology essay I did semantic pragmatic disorder, usng recent research into other language aspects and also looking at other non-typical autistic behaviours (in particular aggression as this is the worst of sam's behaviours). There di seem to be lot of links in terms of areas that co-ordinate these things- for example, the area that relates to sarcasm isn't with the other language areas, but on the other side of the brain, close to the aggression centre. Theoretically, anything that damages certaina reas together would produce autistic symptoms: therefore autism could be described as a name for a group of symptoms, rather than any single caused syndrome. So with sam who had a bad PG and labour (pre-eclampsia and hyperemesis) but in other kids a reaction to MMR or whatever might trigger the same response.

however, I am now talking out my arse and cannot produce anything to back up the theory bar one paltry essay.

Peachyclair - a collection of syndromes is the current thinking - and the most obvious one, it's an idea that's here to stay. Various genes are being found to be involved, but all doing wildly different things so there may be multiple sub groups of autism- which of course makes finding a cause very difficult as there are almost certainly many. You need to make sure you have a discrete subgroup before you start looking at causes. Hypoxia is recognised as one, and interestingly often those with a history of difficult births don't seem to have the biochemical oddities found in other cases of autism.

The subgroup thing is interesting in terms of treatment as well. No point following a gluten free diet if your gut is intact. DS1 appears to have many similarities with the group that can successfully learn to type/use facilitated communication (although this group appear to never really leaern to speak, and aslo appear to remain very compulsive). Lucy Blackman for example, severely autistic, can't reallyspeak, but has an english degree and has written a book. She learned via facilitated communication, but that in itself is very contentious (worked in her case as she now types independently). Identification/recognition of various subgroups could be life changing if it meant targetted treatment. A severely autistic adult ds1 able to type, would have a lot more control over his life than a severely autistic ds1 unable to type. Really must email Lucy Blackman.

Interesting. Whereas Sam has a verbal age 4+ years ahead of his actual, but can't master writing and seems destined to go to special school after Infant school because of it. yet excels at maths / science, and can -verbally- make up the most beautiful poetry.

Incredibly interesting isn't it? haven't really read much and wish i was taking psychology again last year so could do more (doing Ethics instead, culdn't timetable both).

It's fascinating, agreed. Lucy Blackman's behaviour in public- is I believe very similar to ds1's. Still very compulsive. The behaviours she describes at each age are identical to ds1's. And I'm very grateful to her- as I now have some understanding of why ds1 won;t walk under trees for example. And despite her severity - a book and a degree - in English ffs when she isn't verbal!

If you ever get the chance (look out for it- she talks a lot) go and see Roz Blackburn. She is amazing. Severely autistic, cannot walk along the street alone (no road sense), still in nappies, cannot read or write, and yet can give the most amazing talks- devlivered as well as any speaker she shared the stage with - in fact better (I saw her at a conference). She spent a lot of the talk wondering why she was so unable to do anything unless it was aimed at the PMLD population.

now she sounds like Sam- not in nappies but have noticved youn only get a five minute warning or he has an accident.

will look out for her thanks.

Explain to me, (feel free to use pictures and short words), why this subset doesn't show up in the stats ?

Oh I'm sorry I thought you were a stats expert. I'm sure you don't need pictures.

Because the subgroup is so small. 1 in 15 (ish) children with ASD. ASD rates are what? currently 1 in 100 ish. Depending on the exact figure you take to achieve statistical validity you would need approx 1 million vaccinated versus unvaccinated. If you restrict analysis to the ASD population then you can get away with smaller study groups but you still need in the order of 6000 children.

It all starts getting rather silly, far better to actually look at the children clinically.

Can I just ask if anyone (jimjams?) knows if their is an age limit for regression? I have never given my 3.5 year old dd the mmr as the reasearch does worry me. I'm also worried because we think that my dp's father has undiagnosed aspergers and am worried about the genetic factor, dd is plainly not autistic or aspergers now but am worried that if she may have a genetic disposition the MMR may trigger it. I have thought about the single vaccines but can't afford them at the moment and want dd to be protected before she starts nursery in September. What i'm asking is for those of you who do belive there is a link between MMR and autism do you think that risk decreases with age? I'm sorry to sound ignorant but would be grateful on your thoughts?

There are a few cases of regression following MMR at 3 or 4. And obviously those cases are rather striking (would often get diagnosed as childhood disintegrative disorer rather than autism though- for an autism diagnosis you need certain deficits by certain ages). Not sure that Aspieness is a risk factor for MMR triggering autism though, the risk factors are more likely to be to do with the immune system and gut abnormalities

Thanks Jimjams.

Explain to me, (feel free to use pictures and short words'

How very rude, DC.

DC- Smeeth et al in a 2004 paper did emphasise the importance of isolating the subgroup (to my knowledge the first that diodn't just ignore it), however the design of their study (it was a matched design) meant that: "we were not able to separately identify the subgroup of cases with regressive symptoms to investigate the hypothesis that only some children are vulnerable to MMR-induced disease". So having highlighted the importance of it they then didn't do it.

Here we go more from Smeeth et al- this time 2002- but as I said they then didn't/couldn't do it. Do you still need pictures DC? Or have they used sufficiently short words?

??the key question is whether exposure to MMR vaccine ..is associated with an increased risk of this relatively rare [regressive] subtype of autism.

Epidemiological research has not addressed this question so far because the question was not previously posed, not because epidemiology itself is a blunt tool.

Research focusing on this subgroup of autistic children compared with a suitable control group will assess association and establish the temporal sequence between exposure to measles virus and onset of the disorder, thus addressing causality.?

Anyway- I think I've been helpful enough there, you can do your own research now. I'm off to do some work.

jimjams; thanks for your reply i will look into it.
Noted the comments about the risk factors for autism potentially being related to the gut and immune system.. Have there ever been studies done on breastfed/bottle fed links
(in that breastfeeding boosts the immune system?)

breast feeding probably plays a large role in providing lots of probiotics (these are often way out in autistic individuals, all sorts of weird things, and most biomedical treatment tackles this). Also viruses in general are known to be implicated in ASD so extra protection from those will have an influence.

The immune system problems themselves may be made worse by heavy metals etc though. Also many autistic children (although not necessarily the MMR group) have a history of frequent ear infections and antibiotic treatment, so that may negate the good cnotribution to the intestinal bacterial population that bfeeding would have provided.

Thanks for the clarification re Wakefield's vaccine, Jimjams. I was sure that that was what I had read.

I thought you may be interested to know that despite DSs gut profile not suggesting any problems with milk, we recently started him on goat's milk after reading about your DS3. Well, his comprehension and speech have clearly improved and he even sleeps better. Of course it could all be coincidental but we're sticking to it for now.

DC's comment 'I know more about autism than you think' reminded me of that NCT woman who told me that DS showed signs of autism at 9mths old because she knew 'lots of autistic children'!

Out of interest, do you think that the ARU would speak to me directly about Ds's profile even though we went through a private hospital for DS's sample (they sent it to UoS)? It's just that I'm a little nervous about their suggestion that we start to reintroduce gluten slowly after his second birthday if we are happy with his development and his gut. His profile said words to the effect of, 'you may find it beneficial to follow a gluten free diet'. Does this perhaps suggest he was just borderline?

Sorry to take up your time, and for the hijack.

I'm sure Paul Shattock would talk to you- he's a really lovely man. They'll only worry that you paid more for it than you should have- remember he's a parent as well, so he understands the emotions etc. The profile will always say "may be beneficial" for a positive result because the procedure etc is still experimental so they will never insist that you remove gluten iyswim. They're very cautious about how much they will say, but privately on the phone you'll get a lot of help.

The goats milk stuff is really weird isn't it? I haven't seen any studies on it at all, only complete suggestion from the A2 milk people, but ds3 changed dramatically within days.