New MMR and autism study: no correlation

29 Dec

OK so its not the greatest idea to blog about just an abstract but I hope to have more to bring you soon.

This new study states (again) that there’s no correlation between MMR and autism. In fact, the abstract in its entirety reads:

The MMR vaccination coverage in Malopolskie voivodeship improved rapidly and finally reached a high level during last years. The number of new cases of autism spectrum disorders in children during that time revealed a slightly rising but not significant trend, while the number of childhood autism were stable. Ecological study showed no correlation between MMR vaccination and an increased risk of childhood autism and autism spectrum disorders in children.

Clearly they’re using the phrase ‘autism spectrum disorders’ to mean to everything autism related and the phrase ‘childhood autism’ to refer to what the medical community refer to as ‘severe’ or ‘low functioning’ type of autism.

Now, this study is Polish, written in Polish. I have written to the lead author asking if they have, or expect to have, an English translation and if so if I could have a copy.

But still – the message is clear – there is no correlation between autism and MMR. Neither at ‘general’ ASD level, nor at specific ‘severe’ level.

In 2005, The Cochrane Library performed a meta-analysis and systematic review on Vaccines for measles, mumps and rubella in children. Although it had some harsh things to say about the design of studies trying to track adverse events vs fulfilment of role of the vaccine it was also emphatic in its verdict regarding the MMR and autism:

Exposure to MMR was unlikely to be associated with Crohn’s disease, ulcerative colitis, autism or aseptic meningitis (mumps) (Jeryl-Lynn strain-containing MMR)

So why am I bringing this back up again? Well, because I want to ensure that I understand the role of the Cochrance Library and I want to explain why the term ‘systematic review’ _matters_ so much. For this, I am indebted, once again, to Ben Goldacre’s truly excellent Bad Science – the book.

A meta-analysis is a very simple thing to do, in some respects: you just collect all the results from all the trials on a given subject, bung them into one big spreadsheet and do the maths on that…

….

So, if there are, say, ten randmoised placebo-controlled trials looking at whether asthma symptoms get better with homoeopathy, each of which has a paltry forty patients, you could put them all into one meta-analysis and effectively (in some respects) have a four-hundred-person trial to work with.

Now, the good thing about meta analysis is that it excludes papers of poor quality. Here’s Ben’s example – with Homeopathy again:

A landmark meta-analysis was published in the Lancet….they found, overall, adding them all up, that homeopathy performs no better than placebo….The homeopaths were up in arms…they will tell you its a stitch up….what [the authors] did, essentially, like all negative meta-analysis of homeopathy was to exclude the poorer quality trials from their analysis.

All quotes, Bad Science, pages 54 to 57.

Sound familiar?

So, back in 2005, a meta-analysis was performed by the Cochrane Library on MMR and one of its results was that:

Exposure to MMR was unlikely to be associated with Crohn’s disease, ulcerative colitis, autism or aseptic meningitis (mumps) (Jeryl-Lynn strain-containing MMR)

So – where do we go now? Do we really need to keep on churning out results and studies until every last person on the earth gets the point? Or do we cut our losses, accept that there will always be some idiots who will never get it and…move on….to a research future where we can get back to thinking about autism, how we can help autistic people to live their lives and hopefully a future where children don’t die of vaccine preventable diseases.

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22 Responses to “New MMR and autism study: no correlation”

  1. kristina December 30, 2008 at 05:21 #

    One of my resolutions for the new year is to say, enough, let the AOA’s have the mercury/vaccine talk, and onward for those of us who know the question is settled.

  2. David N. Andrews M. Ed. (Distinction) December 30, 2008 at 05:54 #

    yet another study that fails to demonstrate a link.

    i doubt that the Mercury Militia will acknowledge defeat here.

    tough. they like to look like idiots? then let them.

  3. Jen December 30, 2008 at 11:27 #

    All of the studies in the world won’t convince some people…when you base your decision- making process on a premise that doctors, pharma, and scientists all have a vested interested in (falsifying results, making money, harming children- take your pick), then every study is only going to confirm those beliefs.

    It’s time to move on to things that are useful.

  4. Kev December 30, 2008 at 12:59 #

    Trouble is, it seems that vaccines are still the biggest topic associated with autism.

    Depressingly, I think its going to be awhile yet until we’re done with it.

  5. Harold L Doherty December 30, 2008 at 13:11 #

    In order to avoid wasting time on personal attacks let me say that I have never accepted that serious study and evidence proves a link between vaccines and PDD’s including Autistic Disorder.

    Having said that it is also true that “all of the studies in the world” have not been done. Dr. Bernardine Healy has stated that:

    “vaccine experts tend to look at the population as a whole, not at individual patients. And population studies are not granular enough to detect individual metabolic, genetic, or immunological variation that might make some children under certain circumstances susceptible to neurological complications after vaccination.

    ….

    There is no evidence that removal of thimerosal from vaccines has lowered autism rates. But autism numbers are not precise, so I would say that considerably more research is still needed on some provocative findings. After all, thimerosal crosses the placenta, and pregnant women are advised to get flu shots, which often contain it. Studies in mice suggest that genetic variation influences brain sensitivity to the toxic effects of mercury. And a primate study designed to mimic vaccination in infants reported in 2005 that thimerosal may clear from the blood in a matter of days but leaves inorganic mercury behind in the brain.

    The debate roils on—even about research. The Institute of Medicine in its last report on vaccines and autism in 2004 said that more research on the vaccine question is counterproductive: Finding a susceptibility to this risk in some infants would call into question the universal vaccination strategy that is a bedrock of immunization programs and could lead to widespread rejection of vaccines. The IOM concluded that efforts to find a link between vaccines and autism “must be balanced against the broader benefit of the current vaccine program for all children.”

    Wow. Medicine has moved ahead only because doctors, researchers, and yes, families, have openly challenged even the most sacred medical dogma. At the risk of incurring the wrath of some of my dearest colleagues, I say thank goodness for the vaccine court.”

    http://health.usnews.com/articles/health/brain-and-behavior/2008/04/10/fighting-the-autism-vaccine-war.html

    You can claim repeatedly and endlessly that ALL the studies have been done. Dr. Healy has exposed that type of claim as false. More research needs to be done as suggested by Dr. Healy. Only then will the autism-vaccine wars be ended one way or the other.

  6. Kev December 30, 2008 at 14:16 #

    Harold

    1) Healy’s statements were regarding thiomersal. This study is about MMR.

    2) Both epidemiological science AND clinical science has disproven the MMR link.

    3) Bernadine Healy has a history of symapthy for woo, reneges on promises and is a tobacco shill. If you think thats an acceptable history for someone calling for ‘more science’ then you go right ahead.

    What science falls under Healy’s ‘more research’ by the way? Does she know enough about the issue to be specific? Or is she just making specious noises to make her look good?

  7. B Campaigne December 30, 2008 at 15:02 #

    So?
    What causes Autism?

  8. Socrates December 30, 2008 at 15:25 #

    BC, largely genetics.

    Harold,

    “Science” has never claimed mercury to be harmless.

    I mean you can’t even by a mercury thermometer in the UK anymore.

    ‘Science’ has never claimed vaccines are harmless either.

    I’m sure that some autistics could react badly to vaccines, as do some NT’s. There might even be different/worse reactions. But…

    But this vaccines cause autism just thing has just lost its legs.

    Harold, how about I suggest that we reduce the number of autism cases by 80%?

    Interested?

    Well, help me ensure that all HFA’s get decent support, education, employment and housing and then we’ll all drop off the pathological end of the spectrum…

    Then we can all work together much more effectively for the welfare and future of the other 20%.

  9. Neuroskeptic December 30, 2008 at 15:47 #

    I think the time has come that studies like this shouldn’t even be worth mentioning. It’s like making a fuss about a new report that the Pope is Catholic…

  10. AutismRealityNB@gmail.com December 30, 2008 at 15:50 #

    Kev

    Kristina commented specifically on mercury and DNA MEdDistinction referenced the same obliquely with his reference to the mercury militia. You made no distinction in responding to their posts.

    Socrates

    I have been actively advocating, with other parents, here in New Brunswick, Canada, with considerable success for government funded pre-school intervention by autism trained therapists and for autism trained teacher aides and resource teachers in our schools. We also have been successful in advocating for accommodation of environmental requirements of autistic students in neighborhood schools based on their individual strengths and weaknesses. We have also continued to advocate for decent residential care for autistic adults a struggle which is much more challenging to date.

    I only began autism blogging when I realized it could be of assistance in the autism advocacy which for me,with the severity (yes the severity) of my son’s autistic disorder, will be a lifetime occupation.

    I encountered fierce criticism locally when, years ago, I published a reference on our local newsgroups to the BMJ article which began the reexamination of the Wakefield theory. Going the opposite route and arguing that further thought, discussion and study of vaccine issues should be closed down is misguided.

  11. Joseph December 30, 2008 at 16:42 #

    Having said that it is also true that “all of the studies in the world” have not been done.

    Harold, do you think “all of the studies in the world” should be done? (Whatever that means)

    Dr. Bernardine Healy has stated that:

    “vaccine experts tend to look at the population as a whole, not at individual patients. And population studies are not granular enough to detect individual metabolic, genetic, or immunological variation that might make some children under certain circumstances susceptible to neurological complications after vaccination.

    There are excellent individual-level studies, BTW. But she’s correct that even then, it’s not possible to prove a negative. A real effect can always hide in the risk ratio confidence interval, no matter how tight it is around 1.0. But it really becomes an article of faith at that point to cling to the possibility that a real effect still exists in individuals, undetectable by epidemiology.

    There is no evidence that removal of thimerosal from vaccines has lowered autism rates.

    That’s an under-statement. You make it sound as if they haven’t studied the rates enough to know. This is not an issue of maybe they did, maybe they didn’t. The data is there for all to see, and it’s quite clear. Thimerosal was removed and autism caseload trends did not even flinch a little.

  12. B Campaigne December 30, 2008 at 16:58 #

    Has the issue of coal fired plants been looked into as a potential carrier of mercury?

  13. Socrates December 30, 2008 at 17:48 #

    Yes, but this has nothing to do with autism.

    If mercury caused autism, then people exposed to lots of mercury would have lots of autistic kids. They don’t.

    Mercury is bad news for the body, but it doesn’t cause autism.

  14. Dedj December 30, 2008 at 19:47 #

    I find it rather interesting that none of the people who use Dr Healy as an authourity have managed to provide any rationale for her use as an recent and relevant authourity in this matter.

    If someone does provide a reason to listen to a semi-retired cardiologist over teams of relevantly qualified experts who are independantly reaching concordance, then she might get listened to.

    She wasn’t considered relevant to this issue (and was barely known outside the US) until she started making contrarian noises. Suddenly she’s an expert on something she wasn’t an expert on just a few years ago. What gives?

  15. Socrates December 30, 2008 at 20:06 #

    AutRealNB,

    I agree vaccinations should be subjected to the same kind of research as any other area of medicine.

    I do feel though, the vaccines-cause-autism thing will discredit by association any reasonable questions about vaccine safety.

  16. B Campaigne December 31, 2008 at 01:40 #

    Socrates,
    Your an idiot.

  17. JKW December 31, 2008 at 04:29 #

    B Campaigne: English much? Or are you just pulling a ironic funny?

    My bet – unintended.

    Thanks for the update, Kev. We have to hope that Wakers will give up the ghost and apologize soon. I’m not holding my breath, but it’s a nice thought for a new year’s resolution.

  18. Socrates December 31, 2008 at 09:27 #

    No BC, I am not an idiot. I am a genius.

  19. Chris December 31, 2008 at 09:35 #

    B Campaigne said “Your an idiot.”

    What a laugh! Did you mean to be so funny?

    http://www.amazon.com/Eats-Shoots-Leaves-Tolerance-Punctuation/dp/1592402038/

  20. Chris December 31, 2008 at 09:55 #

    B Campaigne said “Has the issue of coal fired plants been looked into as a potential carrier of mercury?”

    What does that have to do with the MMR vaccine? It does not have mercury (or aluminum), and measles, mumps and rubella are not jokes. Are you doing some comedy routine? Because bringing up stupid stuff with bad grammar that has nothing to do with the subject is not a good way to present an argument. Please try harder, and use some real science.

  21. Kev December 31, 2008 at 20:32 #

    B Campaigne – strike 1. OK?

  22. Prometheus December 31, 2008 at 20:53 #

    From B. Campaigne:

    So?
    What causes Autism?

    From the data available to us at present, it appears that the primary cause of autism is genetic.

    However, even if we don’t know “the cause” of autism, we have a lot of data showing that vaccines in general (and the MMR in specific) don’t cause autism. The same can be said about mercury.

    Now, at some future time, there may be a study that shows that a certain vaccine (or vaccines in general) cause a small percentage of the cases of autism – but that day hasn’t come and those data haven’t materialized.

    People may feel, in their guts, that vaccines have to be involved in autism in some way, but they haven’t got any data to support that “feeling”.

    I just wanted to make it painfully clear that saying “We don’t know what causes autism.” does not mean that we can’t eliminate certain things as “the cause” of autism.

    So far, vaccines and mercury are “out” as causes of autism. If you have access to data (real data, please, not anecdotes or parental insights) that show otherwise, this would be the time and place to show them.

    Prometheus

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