MMR and Autism – 2007 is the year

This year, the Autism Omnibus hearing in the USA will examine the idea that MMR causes autism. They will do this by taking one of the plus 4,500 cases and looking at it as a ‘test case’. The case in question is the Cedillo family, mother Theresa (just a coincidence), father Michael and daughter Michelle.

The document above by the way establishes that they want the evidence they accumulate to be open to the other families but that they do not want the identities or the evidence of their expert witnesses to be made available online. I wonder why. If I may be so egotistical, it could have something to do with the fact that several bloggers have trounced both the data and the experts and they don’t want this happening any more.

Anyway. What do we know about the Cedillo’s?

We know that Michelle’s bioposies were examined by Professor O’Leary, one time colleague of Andrew Wakefield who went on to have his own results seriously questioned and who went to say:

Professor John O’Leary, who did the tests for solicitors representing the families of autistic children, said his scientific findings “did not support the MMR/autism hypothesis”.

We also know that Michelle was seen by Arthur Krigsman, who, despite claiming to replicate Wakefield’s discredited Lancet paper has had no papers on autism, or vaccines published at all. What he has had however, are numerous close calls with licensing bodies – in one instance he had to resign in order to escape official investigations into his conduct.

And what do the Cedillo’s believe has happened to Michelle?

We just found out the left hind foot bones in Michelle’s foot are deformed. Instead of being one on top of the other, they are growing side by side. Michelle is on pain meds nearly around the clock. She limps and walks with a side to side gait instead of forward like normal. This was caused by the Crohn’s associated arthritis (confirmed independely by 2 orthopedic spec and a ped rheumatologist AND Dr. Krigsman and Dr. Wakefield), which was caused by the Crohn’s disease caused by the vaccine strain measles RNA found in her bowel tissue from the MMR. Michelle gets periodic ocular inflammation – also from the Crohn’s disease. This gives her headaches.

Its terrible that such a young girl is in so much discomfort. But looking past that and concentrating solely on the science, we see that the Cedillo’s believe that Michelle contracted Crohn’s disease brought on by the measles element of the MMR.

So – Crohn’s _and_ autism? Searching VAERS, I find only seven cases that refer to ‘crohn’ and had the MMR vaccine. That’s pretty rare.

Even those who might be expected to support the MMR/autism hypothesis don’t. In an email to the Autism Biomedical Group on March 08, 2004, Vice President of SafeMinds Mark Blaxill stated:

epidemiological evidence (albeit from studies that have not carefully considered interaction issues), have not supported the broader proposition that “MMR causes autism.”

I will be very curious to see exactly who their experts are and what their evidence will be. If it really is, as I suspect, Andrew Wakefield, then they won’t be able to choose a worse time to invoke his ‘expertise’. Wakefield’s hearing at the GMC starts at about the same time.

Here’s a beginners guide to the MMR/autism hypothesis and what Wakefield claims to have found. The hypothesis states that the MMR vaccine, being a live vaccine, leaves bits of live Measles virus in the gut. Wakefield claimed to have found it there. This goes on to trigger autism.

No part of this hypothesis has ever been replicated and published in a decent journal. Wakefields closest colleague – Krigsman – has been unable to find a publisher for his ‘replication’ which indicates the quality of _his_ science. As reported above John O’Leary claimed to have replicated Wakefield’s work but it turned out there was a good chance his data was contaminated and he later stated none of his work showed a connection. Various epidemiological studies have also failed to find any link (as Mark Blaxill admits).

We also have two clinical science papers that demonstrate convincingly that Wakefield did indeed make a substantial error. One Paediatricsin Pediatrics was very damning:

The real-time assays based on previously published primers gave rise to a large number of positive reactions in both autism spectrum disorder and control samples.

Translation: We replicated Krigsman/Wakefield etc to their end point and there were lots of measles virus just like they said.

Almost all of the positive reactions in these assays were eliminated by evaluation of melting curves and amplicon band size.

Translation: We did the science properly just like they didn’t. When we did most, but not all of the positive reactions disappeared.

The amplicons for the remaining positive reactions were cloned and sequenced. No sample from either autism spectrum disorder or control groups was found to contain nucleic acids from any measles virus gene.

Translation: When we looked at the rest of the very small number of positives we had left we found no measles virus in any of them.

In the nested polymerase chain reaction and inhouse assays, none of the samples yielded positive results. Furthermore, there was no difference in anti-measles antibody titers between the autism and control groups

Translation: We double checked our methods and tools and there were now _no_ positive reactions at all. Further more, just for clarity – there were none in our non autistic people _or our autistic people_.

It’s going to be very, very difficult for the Cedillo’s to overcome this.

Now, closer to home (for me anyway), there are a couple of new papers that discuss what impact the MMR really _did_ have on people. Here’s some real evidence of harm.

In “Tracking mothers’ attitudes to MMR immunisation 1996–2006“, we hear the alarming statistic of how much damage Wakefield et al did to the UK MMR program:

The proportion of parents believing MMRto be a greater risk than the diseases it protects against has fallen from 24% in 2002 to 14% in 2006. The proportion of ‘hard-core rejectors’ of MMR vaccine remains stable at 6%. There has been a gradual and sustained increase in the proportion of parents across all social groups saying MMR was completely safe/slight risk rising from 60% in 2002 to a current level of 74%. There now appears to be a sustained move away from fears over MMR safety and belief in the unfounded link to autism towards a more positive perception of the vaccine.

It a relief that the authors believe there is a sustained move back towards a more rational state of mind regarding MMR but its incredible that 24% of people ever believed that MMR was more risky than the diseases it protected against.

Its no surprise then, that in the years 1997/98 – 2004/05, MMR uptake dropped by a massive 10%. Of interest, when comparing that _fall_ in MMR uptake is the epidemic rhetoric that claims autism is sweeping the UK too. Both things can’t be true. If MMR causes autism then however one paints the stats, there should’ve been a 10% fall in autism.

One group of people truly have suffered through this period. They have been the front line recipients of the bad science of Wakefield et al: parents of autistic kids.

In the new paper, “MMR: marginalised, misrepresented and rejected? Autism: a focus group study“, investigators interviewed parents of autistic kids:

Of the parents whose children received the MMR vaccine, many felt guilty that they may have caused or contributed to their child’s autism. Some parents felt frustrated by health professionals’ lack of understanding of the negative impact the MMR controversy has had on them. Some parents were anxious about subsequent MMR decision-making for their children.

This is the legacy of Andrew Wakefield. Parents who are guilt ridden and unsure who to turn to. The study conclusions state:

The controversy has had a negative impact on some parents of children with autism. This has implications for health professionals, who need to be particularly aware of the issues these parents face in future MMR decision-making for their affected child and younger siblings.

These focus group discussions produced moving and often emotional accounts of parents trying to come to terms with their child’s diagnosis of autism against a backdrop of widespread public speculation about the role of the MMR vaccine in the aetiology of autism.

As Jim Sinclair states in his essay ‘Don’t Mourn For Us’:

Some amount of grief is natural as parents adjust to the fact that an event and a relationship they’ve been looking forward to isn’t going to materialize. But this grief over a fantasized normal child needs to be separated from the parents’ perceptions of the child they do have: the autistic child who needs the support of adult caretakers and who can form very meaningful relationships with those caretakers if given the opportunity.

The parents in these focus groups (and remember these people were interviewed when the MMR conspiracy theory was still well underway) never had a chance to move past the natural adjustment period and on to acceptance. When the media and ‘scientists’ continue to express certainty despite having absolutely no evidence that MMR causes autism its hard to get past the guilt. I know. That’s how I felt as well.

Parents often spoke angrily about how the MMR controversy had impacted on their lives. Even parents who stated that their
child’s autism was entirely genetic in origin felt affected by the uncertainty about the causes of autism which were heightened
by the controversy. For example, one mother who thought her son had been born with autism nonetheless found the speculation surrounding MMR upsetting, and stated that: … it makes you feel pretty damn rotten. I feel as if at the time I did the best for my boy… I wouldn’t have put my child through anything that I think would harm him. (G1: P3)

Thanks again Andy.