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Tuesday, September 9, 2008
A multicenter study (Harvard, Columbia, Mass General, CDC, and the AAP) involving 38 children (25 with Autism and 13 without) was released today, Sept 3, 2008. Its purpose was to duplicate the original research done by Dr. Wakefield in 1998 that raised questions about a link between MMR vaccine and autism. Dr. Wakefield had found measles virus infecting the intestines of children with autism and chronic diarrhea and proposed that further research be done to see if the measles virus in the vaccine could be a trigger for intestinal inflammation, chronic diarrhea, and autism. Dr. Thompson had published a study in the Lancet medical journal in 1995 (three years before Wakefield) showing a strong association between inflammatory bowel disease and Measles vaccine in adults. Wakefield tried to study this association in children with autism.
Thousands of parents across the U.S. have described how their developmentally normal infant developed diarrhea and then regressed into autism between age 1 and 2 years. I have personally heard this same story from about 300 families in my own office. While many things in an infant’s life can trigger chronic diarrhea (like antibiotic overuse and milk/wheat allergies), because of Wakefield’s work many parents have suspected that the measles virus in the MMR vaccine (given at age 1) could be a trigger. In the last 10 years, many doctors have tried to discredit Wakefield’s research, without simply repeating his work to try to prove him wrong.
This new study is the first to try to do just that. Doctors from some of the most reputable medical institutions did intestinal biopsies on 25 children with autism and 13 children without, and found only one child in each group with measles virus in their intestinal lining. Wakefield, on the other hand, had found measles in most of his 12 autistic patients and only a small percentage of his non-autistic control patients. The authors of this new study conclude that their results provide “strong evidence against an association of autism with persistent Measles Virus RNA in the GI tract or MMR vaccine exposure.”
While the authors of this study don’t go so far as to conclude that their results completely prove that there can be no link between MMR vaccine and autism, their findings should allow parents to feel more comfortable giving the MMR vaccine.
What should parents do with this information?
It has been my practice to delay the measles part of the MMR vaccine until age 3 years (to bypass any possible connection between that vaccine virus and the susceptible age of regressive autism), and provide the mumps vaccine and rubella vaccine in separate doses at ages 1 and 2. This is one of the most controversial parts of my Alternative Vaccine Schedule. This recommendation was made based on Wakefield’s findings, and the fact that no other study had yet repeated his work and proved him wrong. In fact, Uhlmann published findings similar to Wakefield’s in Molecular Pathology in 2002, but in a much larger group of 91 kids with autism. His study was also discredited by most doctors and researchers.
Now, in light of this new and seemingly credible study, the need to delay the Measles vaccine and split up the MMR has come into question. I have always known that my MMR vaccine precautions were not based on any solid proof of a connection with autism. But I felt that until someone proved Wakefield wrong, delaying the Measles vaccine was a legitimate precaution.
So the question is, does this new study prove Wakefield wrong? Does it prove there is no connection between Measles vaccine and autism? The authors of the study put it this way: “This study provides strong evidence against an association of autism with persistent Measles Virus RNA in the GI tract or MMR vaccine exposure.” It isn’t absolute proof, but it certainly is a giant step in that direction.
I am not yet ready to throw out the precaution of delaying the measles vaccine and splitting the MMR. There may not be any good scientific evidence that is necessary to delay Measles vaccine or split the MMR in regards to autism prevention (in light of this new study), but in my mind there are other potential benefits to getting only one live-virus vaccine at a time. Live-virus vaccines (MMR, Chickenpox) mimic the natural infection. Since children don’t catch all 4 of these infections simultaneously in nature, why induce them all together with vaccines if we don’t have to? I know the immune system can handle exposure to many simultaneous diseases, but when it comes to major diseases of childhood, like Measles, Mumps, Rubella, and Chickenpox, I feel it’s safer to expose infants and children to just one of these at a time. I believe the vaccines may work better this way, and may create fewer side effects when separated.
What should parents do? Finding a doctor who is willing to split the MMR up is very difficult, and the separate Mumps and Measles vaccines are in short supply. Because we don’t really have any good evidence that the Measles vaccine should be delayed in order to bypass the age of regressive autism, I think it is fine to get the full MMR at age one if a parent can’t find the separate vaccines or can’t find a doctor to split them up. Parents should feel more confident giving their infant this shot at age one in light of this new study’s findings that the MMR or plain Measles vaccine probably does not have any relationship to autism.
However, any parent who has access to the separate MMR component vaccines and wants their infant to get the shots split up according to my schedule should continue to feel free to do so. I will continue to offer this service in my office. I will continue to take the position that parents should have the freedom to choose a vaccine schedule that they are comfortable with, even if it goes outside the customary government and medical recommendations.
Click here for a link to the new study: