AskDrSears - The Vaccine Book: New Study on MMR and Autism Fails to Show Any Useful Results

New Study on MMR and Autism Fails to Show Any Useful Results

Wednesday, February 13, 2008

A new study in England on 250 kids (98 of whom have autism) examined blood samples to look for evidence of measles infection in the bloodstream. They found no difference in blood antibody levels or the presence of the actual virus between neurotypical kids and kids with autism. They concluded that this study showed no link between the MMR vaccine and Autism.

While this may sound interesting and useful on the surface, these researchers failed to do a study they way it really needs to be done. The original researchers who demonstrated a possible link between MMR vaccine and intestinal inflammation, intestinal inflammation and autism, or a possible link between the MMR and autism (four separate studies – Thompson in The Lancet 1995, 345(8957):1071-1074; Wakefield in The Lancet 1998, 351:637-641; Uhlmann in Molecular Pathology 2002, 55(2): 84-90; Kushak in The Journal of Pediatric Gastroenterology and Nutrition 2005, 41(4): 508) actually looked at either inflammation or the actual presence of measles infections in the INTESTINES of their patients with autism. I give a detailed summary of each of these studies, as well as many studies that show NO LINK between MMR and autism, on pages 255 through 259 of The Vaccine Book.

This latest study only looked at blood samples. But that’s not where measles causes any sort of problem. So, in my mind, this latest study doesn’t really help us get to the bottom of this issue.

What type of study DOES need to be done? Well, someone from a large university or medical center needs to do a large study involving many hundreds if not thousands of children and duplicate Wakefield’s and Uhlmann’s research (which only involved about 100 children). Ever since Wakefield did his research, and a few years later Uhlmann duplicated it in a larger study, and Kushak added some more clues, no one else has actually done an intestinal study that disproves their findings. No one has come up with any intestinal research that contradicts them. The only studies that have been done are ones that look at MMR and autism from other angles, such as population statistics and blood samples. I summarize all of these studies in my book.

Would someone from a large, credible, and authoritative academic institution do some useful research on this subject so that parents and doctors can stop worrying about this issue? All that’s been done so far is to criticize Wakefield and others and attack them personally, but no one has re-done their studies to prove them wrong. If anyone does find any research before I do, please let me know.

27 Comments:

At February 13, 2008 11:22 PM , Catherina said...

Wakefield and Uhlman's results were based on a contamination of measles DNA they had in the lab as positive control. Have you not read the Autism Omnibus proceedings? It is very frustrating to see you propagate their claims that have been PROVEN to be false in the first place.
At February 14, 2008 11:00 AM , Dr. Bob Sears said...

Catherina, I've seen all of this and other articles written that attack Wakefield's work. And I don't buy a lot of those criticisms. Lab contamination simply isn't possible in this type of situation. I think most of the criticism is politically based with very little actual science. Wakefield and Uhlmann, working separately, couldn't have had the same contaminations. If there was so much contamination, why didn't the control patients show measles as well?

The easiest way for the English Government to discount Wakefield's findings would be to do their own study. Why haven't they done that?

Uhlmann did replicate Wakefield's work with 90 patients and 70 controls and found the same thing (page 257 of the book).

What I believe is that the English Government simply attacked Wakefield personally and professionally, got some of his co-researchers to recant (or face losing their jobs and getting kicked out of the country). What type of doctor wouldn't recant under that type of pressure?

Having said all that, I'm NOT saying that Wakefield and Uhlmann's work proves ANYTHING yet. what I'm saying is that no one has adequately DISPROVEN their work. Until someone does, with 2 or 3 studies, then I think the jury is still out.

It's not enough to just attack their studies. The English Government has to do their own studies.
At February 16, 2008 1:43 PM , Science Mom said...

I agree with Catherina on this and you have a far greater responsibility than to be perpetuating an unproven hypothesis that has been debunked repeatedly. Furthermore, by your own admission of not being a 'science-type' are not qualified to "(not) buy a lot of those criticisms".

Wakefield and Uhlmann did not independently replicate Wakefield's work and his methods were appalling. Dr. Bustin did demonstrate how that level of contamination was certainly present in Uhlmann's laboratory (OAP).

Wakefield and Uhlmann contend that they found measles vaccine-strain replicating in the guts of autistic children along with positive serology. With those findings, other investigators should be able to easily identify antibody and/or viral RNA in leukocytes or PBMCs. What you and other Wakefield hanger-ons fail to accept is that his and his cronies finds defy biological plausibility. If you still believe this then you have failed to critically evaluate Baird et al.s, Afzal et al.s and D'Souza et al.s studies that could not find any evidence of measles vaccine virus in autistic children.

As a physician you of all people should know that Wakefield violated medical ethics by performing unnecessary colonoscopies and blood sample collection on children. What you are asking for and which other investigators could not justify to an Internal Review Board is that autistic children get some holes punched into their intestines needlessly. I listed 3 studies and you have the Omnibus Autism Proceedings to go through, there is your better than 3 studies so the 'jury' should no longer be out.

Science Mom

http://pediatrics.aappublications.org/cgi/content/full/118/4/1664

http://www3.interscience.wiley.com/cgi-bin/abstract/112535802/ABSTRACT?CRETRY=1&SRETRY=0

http://adc.bmj.com/cgi/rapidpdf/adc.2007.122937v1

ftp://autism.uscfc.uscourts.gov/autism/cedillo.html
At February 17, 2008 10:10 AM , Anonymous said...

I can't believe you are actually backing Wakefield. Have you not done any reading at all on this? Even amongst anti-vaxers Wakefield is a laughingstock!
At February 17, 2008 11:56 PM , Dr. Bob Sears said...

All three of you are right. In the mainstream science world his work has been criticized and ultimately rejected. But I always like to consider both sides of every issue, and in my mind there are some things that need to be resolved:

1. Repeat the study using a large group of autistic children with inflammatory bowel disease who need colonoscopies anyway (to diagnose and treat their IBD) and run the study (including viral detection) up to the standards that are acceptable to the medical community. That way no unnecessary colonoscopies are done.

2. Have this study funded by parties that don't have a stake in the outcome, and run by researchers that have no conflicting interests.

I know that the scientific community does not believe Wakefield, but anonynous - you are wrong about anti-vaxers, especially those with children affected by autism. Many such families believe his work, and will continue to believe forever, and will continue to spread this belief. In my mind, the only way to prove this theory wrong once and for all and to rebuild everyone's faith in the MMR vaccine is to do the study.

Is that too much to ask? I would LOVE this to be proven wrong. I would love to make the vaccine schedule easier by grouping the MMR back together. But so many of my patients want it separated. A study of this type would go a long way to relieve these parents' worries.
At February 21, 2008 3:53 PM , The Vagabond said...

"... these researchers failed to do a study they way it really needs to be done."
I think you mean the way it really needs to be done.
At February 28, 2008 6:55 AM , Anonymous said...

Dr. I'm interested to read your views on the first conceded vaccine-autism court case. Regardless of how the court defined it, I sure hope its an acknowledgement of some link and a step in the right direction.
At February 28, 2008 12:08 PM , Anonymous said...

I think that I could read articles on both sides of vaccines until I was blue in the face. I wish someone would just finally do a study so that parents had a clear understanding about whether to vaccinate their kids, change the schedule of the shots, or skip them altogether. I don't even know what articles to believe anymore!!!! UUUGGGHHHH!!!
At February 28, 2008 12:55 PM , Anonymous said...

I think it's interesting that readers interpret Dr. Sear's comments to mean that he believes Wakefield et al. I got the opposite. He is calling for exactly what I would LOVE to see - a definitive study that would my mind at ease about vaccinating my little girl. I want to vaccinate her, but I am so frightened of what MIGHT happen. I really wish a really good study such as he has suggested would be done and we could all rest easy.
At February 28, 2008 1:16 PM , guesswho said...

First off, I do not want to see another study of Dr. Wakefields. This man is up on charges in the UK and facing prison time for the unethical testing conducted. I would not subject anyone else to that. And do some research. New England Journal of Medicine has found a genetic link with Autism, located in Chromosone 16. I find this to be a HUGE medical break through and am looking forward to futher reports. http://www.wusa9.com/news/local/story.aspx?storyid=67145
At February 28, 2008 1:40 PM , bharshr said...

I think Dr. Sears understands very well that by raising doubts in the minds of parents he can continue to promote and profit from his book and other ventures. His opinions would be more credible if he did not specifically reference and thus advertise his own book in the critique of this autism study. Perhaps he does not accept any money from the sale of his book so that he can truly offer an unbiased opinion.

He states that we need a study on "..a large group of autistic children with inflammatory bowel disease...". Where are all these children? U.S. Census data: 72 million under 18. 1 in 166 have autism = roughly 430,000 autistic children. Incidence of inflammatory bowel disease = 6.7 per 100,000. So autistics with inflammatory bowel disease = 29 children with autism and IBD. If IBD is far more prevalent in autistics then please reference this for me.

He continues to invoke innuendo with respect to government conspiracy: "...the English Government simply attacked Wakefield personally..". What about the U.S. government? The German goverment? The French? WHO? The rest of the world? Are these other parties colluding with one another to poison our children merely for the sake of protecting vaccine companies? Yet he states "Have this study funded by parties that don't have a stake in the outcome...". He should specify who this should be. A government? An autism organization? Geier and Wakefield?

Yes, Dr. Sears, it is one of the limitations of the scientific method that you can never accept the null hypothesis. In other words, you can never prove conclusively that Vaccine A does not cause disease B. Thus, you can always raise doubts in the minds of parents. However, the evidence has become so compelling that no other scientific organization even believes this to be an issue anymore. But then again, you are not a science-type guy.
At February 28, 2008 1:58 PM , Anonymous said...

Well, part of the problem is that many parents of children with autism don't realize their children have IBS, because many of the children cannot complain the way a non-affected child can.
I'm not stating all autistic children have IBS, just that it's been known that some autistic children have had digestive problems for years that have gone undiagnosed.

Also, the more I read about Autism, the more convinced I am we are still in the dark.
Why are we attacking people who call for larger studies, more studies, more specific studies??

I'm not a scientist, but I was a science teacher, and even I know the most baisc tenant is test, and then test again and again and again.

And to say that a pediatrician is trying to scare parents for profit is a very serious accusation! It shows no class and is uncalled for.
At February 28, 2008 2:15 PM , amy said...

Dr. Sears,
What would you do? Would you give your kids the vaccine?
At February 28, 2008 3:18 PM , Anonymous said...

I will start off by stating that I am not a scientist or a medical doctor but there is plenty of information available for any reasonably intelligent parent to be able to make their own decision concerning vaccinations. The fact that anyone would trust our government which is completely biased by big pharma's precious dollars is CRAZY!
At February 28, 2008 3:33 PM , Dr. Bob Sears said...

Anonymous and other comments - Thanks for your contributions to this discussion.

As for the autism court case, I am withholding comment until I see the information and details from an actual news source. If you know of one, let me know.

I don't disclose what I do with my own kids, but I agree with all of you that say you would like to see more research.

Thanks!
At February 28, 2008 8:44 PM , Erika said...

I don't understand why more scientists aren't looking more closely at everything that goes into a vaccine - including the preservatives. Clearly, there is an undeniable "coincidence" that children start exhibiting autistic behaviors after this particular vaccine is given at approx. 15 months. Something is not right. A larger study should be done on all of the components of the vaccine as well as the age at which each of the components of the vaccine can be better tolerated / processed in a child's body.
At February 28, 2008 11:23 PM , Anonymous said...

1. Didn't Wakefield fail to disclose an obvious anti-vaccine funding conflict of interest for his first article? When researchers do this, I lose all trust in them.

2. Meanwhile there is measles just south of you in San Diego and all the unvaccinated kids caught it in a pediatrician's office. Also there was a recent case of measles in Tucson where thousands may have been exposed in an ER and hospital ward.

3. I am very disappointed that you have any reservations about vaccines and give an credibility to autism being somehow causally related to vaccines.
At February 29, 2008 10:02 AM , Dr Tim G. Swift DC said...

Have you seen this survay?

Cal-Oregon Unvaccinated Survey

"We surveyed over 9,000 boys in California and Oregon and found that vaccinated boys had a 155% greater chance of having a neurological disorder like ADHD or autism than unvaccinated boys." -Generation Rescue, June 26, 2007

Methodology

Generation Rescue commissioned an independent opinion research firm, SurveyUSA of Verona NJ, to conduct a telephone survey in nine counties in California and Oregon. Counties were selected by Generation Rescue. Interviews were successfully completed in 11,817 households with one or more children age 4 to 17. From those 11,817 households, data on 17,674 children was gathered. Of the 17,674 children inventoried, 991 were described as being completely unvaccinated. For each unvaccinated child, a health battery was administered.

Generation Rescue chose to use telephone interviews with parents to gather data on children, so as to closely mirror the methodology the CDC uses to establish national prevalence for NDs such as ADHD and autism through their national phone survey of parent responses. Generation Rescue chose to focus on children ages 4-17 to match the age range used by CDC.

Are parent responses a reliable indicator of a child's diagnostic status? According to Dr. Laura Schieve, co-author of the CDC's national phone survey study, in discussing the CDC's two phone surveys on autism prevalence, "the consistency of prevalence estimates across the two surveys supports high reliability or reproducibility of parental report of autism and reliability is one important component of validity."

SurveyUSA is a well-known national opinion research firm with unique expertise in canvassing local communities. SurveyUSA has no vested interest in any outcome this or any survey might produce. You can see a copy of the questionnaire used in the survey here. The data the survey intended to capture included:

- Households with a child or children aged 4-17
- Whether or not that child had been vaccinated
- Whether or not that child had any one (or more) of the following diagnosis: ADD, ADHD, Asperger's, PDD-NOS, Autism, Asthma, or Juvenile Diabetes (the final two of which were added to consider other health outcomes).

The results of the survey allowed us to compare the prevalence (what percentage of children have a particular diagnosis) to see if there was any meaningful difference between unvaccinated and vaccinated children.

The most common way to measure prevalence differences is through a calculation known as relative risk or the Risk Ratio, where we compared prevalence amongst unvaccinated children to prevalence amongst vaccinated children. So, if 5% of unvaccinated children have asthma, and 10% of vaccinated children have asthma, that represents an "RR" of 2.0 (10%/5%), or a difference of 100%. We were also able to look at the data by gender, age, and county.

Results

SurveyUSA gathered data on 9,175 boys and 8,499 girls. Counties surveyed in California included:

San Diego
Sonoma
Orange
Sacramento
Marin

Counties surveyed in Oregon included:

Multnomah
Marion
Jackson
Lane

The results of the survey can be accessed as a pdf file here. This is the primary data we received from SurveyUSA and it can be used for anyone to independently analyze our results.

Generation Rescue analyzed the data provided by SurveyUSA, and a copy of our analysis can be found here. The most notable results of our survey are with the boys, which is not surprising considering boys represent approximately 80% of total cases of NDs. Namely:

All vaccinated boys, compared to unvaccinated boys:
- Vaccinated boys were 155% more likely to have a neurological disorder (RR 2.55)
- Vaccinated boys were 224% more likely to have ADHD (RR 3.24)
- Vaccinated boys were 61% more likely to have autism (RR 1.61)

Older vaccinated boys, ages 11-17 (about half the boys surveyed), compared to older unvaccinated boys:
- Vaccinated boys were 158% more likely to have a neurological disorder (RR 2.58)
- Vaccinated boys were 317% more likely to have ADHD (RR 4.17)
- Vaccinated boys were 112% more likely to have autism (RR 2.12)

(Note: older children may be a more reliable indicator because many children are not diagnosed until they are 6-8 years old, and we captured data beginning at age 4.)

All vaccinated boys, removing one county with unusual results (Multnomah, OR), compared to unvaccinated boys:
- Vaccinated boys were 185% more likely to have a neurological disorder (RR 2.85)
- Vaccinated boys were 279% more likely to have ADHD (RR 3.79)
- Vaccinated boys were 146% more likely to have autism (RR 2.46)

All vaccinated boys and girls, compared to unvaccinated boys and girls:
- Vaccinated boys and girls were 120% more likely to have asthma (RR 2.20)
- No correlation established for juvenile diabetes

All vaccinated girls, compared to unvaccinated girls:
- No meaningful differences in prevalence were noted for NDs (which may be due to the smaller sample size of the study because girls represent about 20% of cases.)
At February 29, 2008 12:25 PM , The Beast said...

I'm amazed that more of these types of surveys aren't done. I wouldn't call it conclusive evidence, but it certain provides food for thought.

I'd like to see a survey like this with a few more lifestyle questions, though. Are unvaccinated families less likely to eat foods with preservatives? Watch less television? Live in the country vs. the city? What are the professions of the parents? Any of these factors could contribute to autism.
At March 1, 2008 1:46 PM , Anonymous said...

With all of the controversy surrounding the MMR vaccine, why don't they make an inactivated MMR, like we have for the Polio vaccine?
At March 1, 2008 2:47 PM , Science Mom said...

anonymous, it was done, in the 1960's and didn't work, in fact caused atypical measles in the vaccine recipients because they were sensitised to the measles antigens and when subsequently exposed to wild measles developed more severe illness.

Great post bharshr, excellent points made.

SM
At March 1, 2008 3:36 PM , Anonymous said...

Oh goody, Science Mom is here! Yay!

Bharshr, stop referring to children with autism as "autistics." FYI, it's rude.
At March 1, 2008 3:36 PM , Anonymous said...

Oh goody, Science Mom is here! Yay!

Bharshr, stop referring to children with autism as "autistics." FYI, it's rude.
At March 1, 2008 7:15 PM , Anonymous said...

I have a friend in the UK who has a severley autistic now 18 year old son, a few years ago she had him scoped for IBD and they found live measels in his intenstines.........
At March 3, 2008 5:54 AM , Anonymous said...

The pharmaceutical companies are who pay to get these done and pay the people giving the results. It's always about the money. If there is truly a link found then the pharmaceutical companies would lose alot of money. I don't believe the results are true. I'm due with my first baby in a few months have have made an educated decision not to vaccinate her and just provide her with good nutrition. I put my faith in God alot more that I do in the pharmaceitical companies. Granted some meds are life saving, but there is a time and place for them.
At March 8, 2008 5:18 PM , anne marie said...

I'm gonna throw another log in the fire here.

Besides vaccines, our overuse of Rxs, our poor environmental conditions (food and air), and the possible genetic weaknesses one may have, we have also changed birth from a normal event into a medical one in the past 50 yrs or so*. Epidurals, Pitocin, IVs and many other interventions are the norm, and C sections are well over 30% nationally, in some areas as high as 50% (with a poor national showing of maternal and infant mortality to boot)! This means babies are drugged, the natural hormonal, biochemical balance is disrupted, and often babies are delivered too early. (The average gestation time of a first time mother, without intervention, meaning NATURALLY, is 41 weeks, 1 day. It's a couple days longer in repeat moms. That means, if it's an average, there are women at either end of that number. So women who are inducing at 40 wks or 39 or 38 for that matter could be delivering a baby a month early developmentally!)

So now you have possibly a baby who was born too soon, with drugs, from a mom who possibly ate poorly, into a world with bad air and food that is full of hormones/ pesticides/chemicals, who possibly isn't breastfed (one more step away from Mother Nature), getting a gazillion shots with god knows what in them all at once. I am no scientist, but, to my very core, my instincts tell me this can't be good. We have lost faith in our bodies, and have lost respect for our environment.

Everything can't be about medicine and lobbyists and big business. What happened to our INSTINCTS? What happened to us trusting the fact that our bodies were designed perfectly? We have handed so much over to other people who I would argue don't have necessarily my child's best interests in mind (maybe some of them are concerned about the masses, but that's not my child, the INDIVIDUAL that matters most to me).

I would venture to guess that women who choose natural (non medicated) childbirth are also concerned with eating organic, breastfeeding their babies and waiving vaccines. Not to say that women who have C sections or epidurals don't do the latter, but I would guess there is a connection with the non-medicated moms to carry that philosophy all the way through. It's a matter of getting educated on all these areas and again, trusting your real instincts, not our emotions that react to the fearmongering (which puts someone else in control) that we are constantly presented with. All moms want to do their best, no question. It's what is "best" that gets so confusing, and also to be honest, takes a lot of work to do the research to make our own decisions. And we moms are so busy that we rarely have time to do what's on the list for the day, let alone having the time to stop, breathe, and get reconnected with our highest selves so that our instincts are best honed.

My overall philosophy is that our health is reflected by our physical, spiritual, psychological and emotional selves. We must take responsibility in all those areas, do our homework, connect again with our true essence and get a different perspective on this.

Sorry got off on a tangent there, but I do believe all this stuff is tied together.

*(I just recently read an article that questions the decline of our SAT scores in relation to births getting more medical in the last half century. Doesn't surprise me a bit, and would seem to me to tie in with all the affected neurological conditions we are seeing now. AGain, I'm no scientist, but it makes sense to me.)
At March 11, 2008 3:57 PM , Anonymous said...

It seems to me that the same people who would choose to not vaccinate their kids would also choose to not use a diagnostic label such as ADHD or autism for their kids symptoms or might not be in a medical or educational environment where those sorts of diagnoses are used (i.e., a homeschooled child whose parents primarily use alternative medicine might not get the same diagnosis that a child in a traditional school setting who comes in for well child checkups with and MD might).

Also, there is not way to independently corroborate the data gathered by the parents. For this reason the California-Oregon study seems to me to prove nothing other than that people who reject vaccines also are more suspicious or intolerant of diagnosis such as these.