Archive by Author

Minnesota funds Somali autism prevalence study

3 May

From the Minnesota Daily: U to research rate of autism in Somali community.

Parents and others in Minnesota’s Somali community are concerned about the prevalence of autism in children. Now, for the first time, state funds will go to researching autism in that community.

The health and human services omnibus bill Gov. Mark Dayton signed Friday allocates $200,000 to the Minnesota Department of Health to work with the University of Minnesota on the research.

The Somali community in Minnesota has been discussed a great deal online due to the apparently high prevalence rates there.

Parental socioeconomic status and risk of offspring autism spectrum disorders in a Swedish population-based study.

2 May

In many autism prevalence studies, higher socio-economic status (SES) for the parents is correlated with higher autism rates in the children of those families. While a conclusive reason for this has not been shown, it has been conjectured that the SES variability could be due to social influences such as access to care.

A recent study from Sweden shows the opposite. In this study, lower income families and children of parents with manual occupations show higher autism prevalence:

OBJECTIVE:
Epidemiological studies in the United States consistently find autism spectrum disorders (ASD) to be overrepresented in high socioeconomic status (SES) families. These findings starkly contrast with SES gradients of many health conditions, and may result from SES inequalities in access to services. We hypothesized that prenatal measures of low, not high, parental SES would be associated with an increased risk of offspring ASD, once biases in case ascertainment are minimized.

METHOD:
We tested this hypothesis in a population-based study in Sweden, a country that has free universal healthcare, routine screening for developmental problems, and thorough protocols for diagnoses of ASD. In a case-control study nested in a total population cohort of children aged 0 to 17 years living in Stockholm County between 2001 and 2007 (N = 589,114), we matched ASD cases (n = 4,709) by age and sex to 10 randomly selected controls. We retrieved parental SES measures collected at time of birth by record linkage.

RESULTS:
Children of families with lower income, and of parents with manual occupations (OR = 1.4, 95% CI = 1.3-1.6) were at higher risk of ASD. No important relationships with parental education were observed. These associations were present after accounting for parental ages, migration status, parity, psychiatric service use, maternal smoking during pregnancy, and birth characteristics; and regardless of comorbid intellectual disability.

CONCLUSIONS:
Lower, not higher, socioeconomic status was associated with an increased risk of ASD. Studies finding the opposite may be underestimating the burden of ASD in lower SES groups.

I haven’t been able to view the full study yet, so I am not sure what influences the authors may be implicated. What they do suggest is that the autism prevalence in lower SES groups may be underestimated in many prevalence estimates. I don’t think this will come as a surprise to many who consider the lower prevalence in the lower SES groups to be an indication of social factors at play.

Twitter Chat with autism experts Wednesday at 1 p.m. ET

2 May

USA Today has an article discussing an autism chat on Twitter scheduled for tomorrow (Wednesday) at 1pm Eastern Time. The article is copied below (with apologies to USA Today): Chat with autism experts Wednesday at 1 p.m. ET.

Questions about autism science, causes, support? Join our live chat with health reporter @LizSzabo as she talks with experts, families at 1 p.m. Wednesday May 2.

The USA’s top experts will weigh in, including: Dr. David Amaral of the University of California-Davis MIND Institute; Dr. Sarah Paterson of Children’s Hospital of Philadelphia; Dr. Sarah Spence of Children’s Hospital Boston; Alison Singer of the Autism Science Foundation, Dr. Alycia Halladay, Autism Speaks‘ Director for Environmental Research, and Lisa Goring, Autism Speaks’ vice president of family services.
Bring your questions and follow #autismchat.
New to Twitter chatting?
Here’s how to get started.

1) Create an account at Twitter.com.

2) Search for our reporter under @LizSzabo and start following the account.

3) On Wednesday at 1 p.m. ET, visit Twitter.com and search for #autismchat. Save your search and you will be able to view real-time results of the chat.

4) To join the conversation, tweet your question or comment and include the hashtag #autismchat in your tweet. Make sure the entire question or comment, including hashtag, is 140 characters or less.

5) Refresh your page. You will be able to see your question appear in the conversation.
Want to get your question in early? Tweet @LizSzabo using #autismchat anytime before the chat.

Jenny McCarthy, less brash but the same message

1 May

Jenny McCarthy and her organization, Generation Rescue, have toned down on the vaccine message in the past few years. Gone is the Generation Rescue “favorite” vaccine schedule (which left kids unprotected against most vaccine preventable diseases). It’s been four years since the “Green Our Vaccines” rally, and there isn’t even a discussion of a followup. Mostly, there hasn’t been that much vaccine talk from Ms. McCarthy in the press for the past few years. Autism Awareness month (April) was for three years running the launch date for Jenny McCarthy autism books.

From the article “Jenny McCarthy: ‘I’m Taking Baby Steps’ with New Romance” in Parade:

The biggest hurdle is the CDC not recognizing it as an epidemic. There is no such thing as a genetic epidemic. I know there is an environmental trigger that they won’t agree with right now but time will tell. I am just ready for them to call it an epidemic so people can take it seriously.

“I know there is an environmental trigger that they won’t agree with right now…” Not quite the old days with Jenny McCarthy shouting “Bullshit” at the head of the AAP on the Larry King show. Or telling a crowd at a TACA picnic where Barbara Walters can put her microphone (hint, it wasn’t a polite suggestion). It’s more of a “wink and a nod” now. But does anyone have a doubt as to what the “environmental trigger” Ms. McCarthy is referring to?

Ms. McCarthy is in the news for another topic: botox. In Jenny McCarthy: Botox Helps Maintain Youthful Look, ABC news had a single picture with the caption: Jenny McCarthy isn’t afraid to admit she uses botox to keep her youthful glow. McCarthy told Life & Style magazine that ‘I get Botox in my forehead. I just have my doctor do a little shot.’

Yes. Botox. From Wikipedia: “Botulinum toxin is a protein produced by the bacterium Clostridium botulinum and is the most powerful neurotoxin yet discovered”

Don’t worry. She just gets “a little shot”.

The MA State Senate: Please Stop Painful Electric Shocks on Students at JRC in Massachusetts!

30 Apr

A petition is hosted on Change.org: The MA State Senate: Please Stop Painful Electric Shocks on Students at JRC in Massachusetts! The Judge Rotenberg Center uses electric shocks as part of their program for some of the students in their care. The JRC is not allowed to use these aversives on new students, but still continues with students whose programs included them before the order (see Left Brain/Right Brain story: Judge Rotenberg Center banned from shocking new admissions)

The Change.org petition was created by a former JRC employee.

Hi, my name is Gregory Miller. I used to work at a school in Massachusetts named The Judge Rotenberg Center (JRC) where we used powerfully painful electric shock devices (45 – 91 milliamps, at 66 volts) on students to control their behaviors. These devices are much stronger than police stun guns (1-4 milliamps). Unlike stun guns, the electrodes most commonly used at school are spaced 3 – 4 inches apart so that the electrical volts passing through the flesh create the maximum amount of pain with those amps and volts. The United Nations is aware of JRC, has called these shocks at JRC “torture”, and says that “The prohibition of torture is absolute.” Please see the attached video of a student named Andre getting shocked at JRC, covered by Fox News.

Historically, the JRC has been very careful about what information is allowed to be seen by outsiders. Case in point, the video included in the court case which is reported in the video Mr. Miller references (and embedded below). The JRC fought to keep that video from being used in court (see Left Brain/Right Brain story Judge Rotenberg Center: Teen tied and shocked for hours; mom calls it “torture”).

Here is the news video mentioned above. Be forwarned: it is painful to watch. Nothing like what Andre McCollins had to go through.

Mr. McCollins was strapped down, face down, and repeatedly shocked while screaming repeatedly “no” and “help me”.

You can hear the attorney say, “that was shock number 16 or 17, out of 31 that day”. You can see the JRC attorney explaining that “the treatment plan was followed”. Is that really justification for what went on? Not for me. At about 2:10 into the video, you can see him shocked again while at a workstation. The shocks have been called equivalent to a bee sting by JRC personnel. That doesn’t seem like an accurate description to what happened to Mr. mcCollins.

Pharmacologic Treatment of Repetitive Behaviors in Autism Spectrum Disorders: Evidence of Publication Bias.

27 Apr

I had hoped to read this article and have a good review in place when the embargo lifted. Time is working against me and I just haven’t had the resources to apply to this. But I shouldn’t let that stop me from highlighting this study: Pharmacologic Treatment of Repetitive Behaviors in Autism Spectrum Disorders: Evidence of Publication Bias. The full paper is available free on the Pediatrics website.

Selective serotonin reuptake inhibitors (SSRIs) are a class of drugs used most often to treat depression. They are also used off-label for treating anxiety and, also, autism symptoms. A study carried out in 2009 showed that one drug frequently prescribed to autistics, Citalopram, was no different than placebo in reducing repetitive behaviors (Lack of efficacy of citalopram in children with autism spectrum disorders and high levels of repetitive behavior: citalopram ineffective in children with autism.) The study results came as a bit of a surprise to many and was a minor news story for that week.

Publication bias “is the tendency of researchers, editors, and pharmaceutical companies to handle the reporting of experimental results that are positive (i.e. showing a significant finding) differently from results that are negative (i.e. supporting the null hypothesis) or inconclusive, leading to bias in the overall published literature.”

A recent study looked at previous publications (and one unpublished study) and claims that there is publication bias involved in reporting on SSRI’s and repetitive behaviors in autism:

OBJECTIVE:
The goal of this study was to examine the efficacy of serotonin receptor inhibitors (SRIs) for the treatment of repetitive behaviors in autism spectrum disorders (ASD).
METHODS:
Two reviewers searched PubMed and Clinicaltrials.gov for randomized, double-blind, placebo-controlled trials evaluating the efficacy of SRIs for repetitive behaviors in ASD. Our primary outcome was mean improvement in ratings scales of repetitive behavior. Publication bias was assessed by using a funnel plot, the Egger’s test, and a meta-regression of sample size and effect size.
RESULTS:
Our search identified 5 published and 5 unpublished but completed trials eligible for meta-analysis. Meta-analysis of 5 published and 1 unpublished trial (which provided data) demonstrated a small but significant effect of SRI for the treatment of repetitive behaviors in ASD (standardized mean difference: 0.22 [95% confidence interval: 0.07-0.37], z score = 2.87, P < .005). There was significant evidence of publication bias in all analyses. When Duval and Tweedie's trim and fill method was used to adjust for the effect of publication bias, there was no longer a significant benefit of SRI for the treatment of repetitive behaviors in ASD (standardized mean difference: 0.12 [95% confidence interval: -0.02 to 0.27]). Secondary analyses demonstrated no significant effect of type of medication, patient age, method of analysis, trial design, or trial duration on reported SRI efficacy.
CONCLUSIONS:
Meta-analysis of the published literature suggests a small but significant effect of SRI in the treatment of repetitive behaviors in ASD. This effect may be attributable to selective publication of trial results. Without timely, transparent, and complete disclosure of trial results, it remains difficult to determine the efficacy of available medications.

Autism Science Foundation to host online chat with Jill Locke tomorrow (Friday)

26 Apr

Jill Locke is a researcher (a post-doc) at the Center for Autism Research at the U. Pennsylvania. Here is her biography from the CAR website:

Dr. Locke is a post-doctoral research fellow at the Center for Autism Research. She completed her doctorate degree in Educational Psychology at the University of California, Los Angeles. Jill worked with Dr. Connie Kasari at the UCLA Center for Autism Research and Treatment where she contributed to multiple randomized controlled treatment trials that examined the effects of targeted social skills interventions on the peer relationships and social networks of elementary-aged children with autism in the Los Angeles public schools. She created a social skills assessment tool using the Q-Sort methodology for her dissertation that investigated the differences in teachers’ and classroom aides’ perceptions of social competence in children with and without autism spectrum disorders as well as how these perceptions related to teacher-student and peer relationships.

Jill’s research interests are in social skills training and friendship/relationship development in children and adolescents with autism. She is also interested in exploring the ways in which treatment gains in intervention programs are generalized and sustained over time as well as the delivery to and sustainability of evidence-based practices in community settings.

She will be participating in a live chat on the Autism Science Foundation’s Facebook page tomorrow (Friday, April 27) at 12 noon Eastern time.

If you want an idea of what these online chats look like, transcripts are online for last week’s chat with Stephen Shore, Marcus Center Autism Research Dr. Celine Saulnier, and Yale Autism Scientist Dr. Kevin Pelphrey.

Todd W., running for a good cause

26 Apr

Todd W. of Harpocrates Speaks is a frequent author of articles and commenter in online discussions involving questions of vaccines and vaccines and autism.

In his article, Help Me, Interwebz! You’re My Only Hope!, he tells us that he is participating in a run to raise money for medical research. In specific, he’s helping to raise money for a new type of vaccine adjuvant:

The VIC is researching the use of a laser as a vaccine adjuvant. Basically, adjuvants allow vaccines to use fewer antigens by increasing the body’s immune response. In the U.S., we use aluminum salts (e.g., aluminum hydroxide, aluminum phosphate, and aluminum potassium sulfate) as adjuvants. Because there are some individuals who question the safety of these adjuvants (largely based on false information), the laser adjuvant may induce a similar boosted immune response without the concerns associated with aluminum. It also has the potential to reduce even the current minor side effects associated with aluminum adjuvants, like local soreness and swelling. The VIC researchers have completed animal studies and are ready to move on to human trials. Although the initial research focuses on influenza and hepatitis B vaccines, there is potential for this technology to be applied to a much wider range of vaccines. In the end, this could hopefully make for more effective and safer vaccines, as well as improve overall immunization rates among those worried about ingredients like aluminum.

Todd W. has details on how to contribute in his article, but if you want the short version:

You can be a part of this innovative research by supporting my flight through the zombie-infested wilderness of Amesbury by going to this page and making a donation. If you would rather make a gift by mail, make your check payable to:

Massachusetts General Hospital
Development Office
165 Cambridge Street, Suite 600
Boston, MA 02114

Make sure to put “Todd’s Zombie Run” in the memo line or in a note with your donation. All gifts will go to support these two projects and are 100% tax deductible.

Congressman Dan Burton: It is time to re-engage on the autism epidemic

25 Apr

Dan Burton is a U.S. Congressman, a legislator elected to represent the state of Indiana to the U.S. House of Representatives. Mr. Burton was once a frequent name in the discussion about autism. His grandson is autistic and Mr. Burton championed the idea that mercury, in specific the vaccine preservative thimerosal, was a possible cause of autism. Mr. Burton hosted congressional hearings on the matter which fueled the discussion. Much of this is documented in David Kirby’s 2005 book Evidence of Harm: Mercury in Vaccines and the Autism Epidemic: A Medical Controversy.

When Congressman Burton was holding meetings In the early 2000’s, there was not a great deal of scientific data on the idea that mercury could be behind an autism epidemic. There was correlation–autism prevalence estimates by various sources showed rising rates coincident with the increased exposure from infant vaccines during the 1990’s.

But this isn’t the early 2000’s. A lot has been learned since Mr. Burton held his hearings. And the knowledge gained points away from thimerosal as a cause if autism Mr. Burton himself is set to retire this year. Yesterday Mr. Burton wrote about his previous efforts and a new initiative he has proposed in a blog article: It is time to re-engage on the autism epidemic. And by epidemic, Mr. Burton appears to mean the failed mercury-induced-autism-epidemic. From his article:

Unfortunately, a great deal of misinformation has been thrown around in public and private about the Committee’s focus on mercury in medicines as a possible factor in the autism epidemic. I’m not a scientist, but the Committee heard from many credible scientists and experts who are convinced that mercury is a contributing factor; and the theory is no less worthy of exploration than the theories being propounded today that the pregnancy weight of the mother or the age of the father at conception influences whether a child becomes autistic. When you have no idea what is causing a disease, policymakers and scientists should never be afraid to investigate any plausible theory. In fact, researching possible environmental factors is a central component of today’s research on autism.

Mr. Burton’s attempt to compare the mercury hypothesis to recent results falls flat. For one thing, there is evidence that factors such as parental age may increase the risk of autism. Multiple studies indicate increased risk. On the other side, there is no real evidence to suggest that mercury increases the risk of autism, and a great deal of evidence to the contrary.

As already noted: a lot has been learned since Mr. Burton held his hearings 10 years ago. But today, as it was 10 years ago, scientists and policymakers are not afraid to investigate the hypothesis that mercury caused an autism epidemic. We’ve seen paper after paper come out of those efforts. Accepting results is not fear. Far from it.

Mr. Burton states:

The other issue we dealt with is how do we help the millions of individuals and families afflicted with this disease. Autism has no cure and it is not a life-threatening disease. That means that the autistic children of today will be the autistic adults and autistic seniors of tomorrow. Our nation is ill prepared to deal with the complex challenges posed by a generation of autistic individuals.

It strikes this reader that the leadership of the past, which certainly includes Congressman Burton, was afraid to tackle a basic question: what is an accurate count of the number of autistic adults? The autistic children of yesterday *are* the autistic adults of today. How many are there? What do their living conditions look like? What successes and failures can we learn from the lives of those autistics, and the way the rest of society supported them? What health issues are there for autistics as they age?

The sad fact is we don’t really know.

Some researchers in the U.S. have looked for, and found, misdiagnosed autistics in some populations. The U.S. has mounted a project to explore autism prevalence and other issues in older cohorts, but that work has just begun. Researchers in the U.K. have delved into the questions of adult prevalence and living conditions, five years ago.

The U.S. is ill prepared, and precisely because of the leadership Mr. Burton offered. Instead of accepting even the possibility that there were misdiagnosed or undiagnosed adult autistics, attention was focused on asking the same question again and again: is mercury behind the rise in autism prevalence? Time and again the answer came back no.

And, now, we are going to ask yet again. Mr. Burton mentions in his article a bill he sponsored: H.R. 3489: White House Conference on Autism Act of 2011. Yes, a bill from last year. It was introduced to committee on Nov. 18th of last year and has had no action since. In other words, a bill which is all but dead.

The bill calls for a conference. A meeting. To generate a report. The conference has no charge other than this. It is reminiscent of Mr. Burton’s hearings. People gathered. People were selected specifically to speak based on their views that mercury could cause autism. Reports were generated. This is action? Leadership?

Who will be a part of this conference? Mr. Burton’s bill spells out who should be a part of this committee:

(1) at least 1 shall be a parent or legal guardian of individuals with autism or other pervasive developmental disorders;

(2) at least 1 other shall be knowledgeable about autism intervention programs and systems, including complementary and alternative therapies;

(3) at least 1 other shall be knowledgeable about programs specifically designed to meet the unique educational needs of children and adults with autism;

(4) at least 1 other shall be knowledgeable about programs specifically designed to meet the unique housing needs of children and adults with autism;

(5) at least 1 other shall be knowledgeable about programs specifically designed to train and educate law enforcement and criminal justice officials to respond to the unique needs of children and adults with autism; and

(6) at least 1 other shall be knowledgeable about environmental or toxic exposure of adults and children as it relates to the development of autism.

A lot has changed since Mr. Burton held his first hearings on autism. One thing that has changed: autistics have rightfully fought for and won the right to be represented in autism discussions. Mr. Burton’s bill does not represent that shift.

Mr. Burton’s words do not acknowledge that the question of whether there was a mercury-induced-epidemic of autism has been answered.

Let’s put it simply. Mr. Burton: the answer is no. Thimerosal didn’t cause an autism epidemic.

The combined measles, mumps, and rubella vaccines and the total number of vaccines are not associated with development of autism spectrum disorder: The first case-control study in Asia.

24 Apr

A paper from researchers in Japan studies the questions of whether vaccines cause autism. In this study, The combined measles, mumps, and rubella vaccines and the total number of vaccines are not associated with development of autism spectrum disorder: The first case-control study in Asia, the authors use a case-control method. The study is moderate in size, 189 autistics and 224 controls.

OBJECTIVE: The aim of this study was to investigate the relationship between autism spectrum disorder (ASD) and general vaccinations, including measles-mumps-rubella (MMR) vaccine, in Japanese subjects, a population with high genetic homogeneity.

PATIENTS AND METHODS: A case-control study was performed. Cases (n=189) were diagnosed with ASD, while controls (n=224) were volunteers from general schools, matched by sex and birth year to cases. Vaccination history and prenatal, perinatal, and neonatal factors from the Maternal and Child Health handbook, which was part of each subject’s file, were examined. To determine the relationship between potential risk factors and ASD, crude odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated, and the differences in mean values of the quantitative variables between cases and controls were analyzed using an unpaired t-test. Moreover, MMR vaccination and the effect of the number of vaccine injections were investigated using a conditional multiple regression model.

RESULTS: For MMR vaccination, the OR was 1.04 (95% CI, 0.65-1.68), and no significant differences were found for the other vaccines. For all of the prenatal, perinatal and neonatal factors, there were no significant differences between cases and controls. Furthermore, regarding the presence of ASD, MMR vaccination and the number of vaccine injections had ORs of 1.10 (95% CI, 0.64-1.90) and 1.10 (95% CI, 0.95-1.26), respectively, in the conditional multiple regression model; no significant differences were found.

CONCLUSIONS: In this study, there were not any convincing evidences that MMR vaccination and increasing the number of vaccine injections were associated with an increased risk of ASD in a genetically homogeneous population. Therefore, these findings indicate that there is no basis for avoiding vaccination out of concern for ASD.

The authors confirm multiple previous studies that the MMR vaccine does not increase the reisk of autism. They also present results that the number of vaccine injections also does not increase the risk of autism.

The authors also find that the number of injections is does not increase the risk of autism.

The MMR vaccine was used in Japan from 1984 to 1993, and the study includes children born from April 1984 to April 1992. Controls were selected according to these criteria:

One to two controls were selected for each case, matched by sex and year of birth and recruited as volunteers from general schools in the Kanto area, the same area where YPDC patients reside. Consent for participation in the present study was obtained from the parents (or legal guardians) of the students. Students who had previously been recognized as having developmental problems and were already receiving care were excluded, as were those whose records in the MCH handbook were missing or illegible and those with a history of vaccination in another country.

The team had a pool of 354 autistics to work from in this geographic region and time period. They were unable to obtain controls for all of these 354, so 189 autistics were randomly selected as cases.

Among the patients who initially consulted the clinic between April 1997 and March 2011, 1875 cases of ASD were identified. Of these, 89 cases were excluded because the MCH handbook was missing or the vaccination record in the handbook could not be read, and 3 were excluded because they had received MMR vaccination overseas. Of the remaining 1783 cases, 1429 were born before March 1984 or after May 1992, leaving 354 cases (males: n = 286, 80.8%) born between April 1984 and April 1992, the possible time period for MMR vaccination. The ASD group consisted of 280 subjects with Autistic disorder (79.1%), 27 subjects with Asperger disorder (7.6%), and 47 subjects with Pervasive developmental disorder not otherwise specified (13.3%).

MMR was not universally given in Japan during this time, and here are the vaccination rates for the cases and controls:

The vaccination rates in cases and controls were as follows: MMR, 24.9% of cases and 24.1% of controls; Measles, 66.7% and 62.9%; Mumps, 58.2% and 49.1%; Rubella, 57.1% and 53.6%; DPT, 97.9% and 97.8%; Polio, 97.4% and 98.7%; B-encephalitis, 88.4% and 92.0%, and BCG 96.3% and 97.3% (Table 1). The mean times of each vaccine injection in cases and controls were as follows: DPT, 3.8 times of cases and 3.7 times of controls; Polio, 1.9 times and 2.0 times; B-encephalitis, 1.7 times and 1.8 times (Table 2).

The authors note that this is the fourth case-control study on autism and the MMR, but that those studies relied upon more genetically heterogeneous populations:

The three previous case–control studies focused on the relationship between ASD and MMR. Specifically, the investigation of DeStefano et al. was based on the Metropolitan Atlanta Developmental Disabilities Surveillance Program [31]; Smeeth et al. used data from the UK General Practice Research Database [32]; and DeWilde et al. examined the association using the UK Doctors’ Independent Network Database [33].

As a side result, the authors tested whether maternal hypertension was associated with autism. They found an odds ratio of 2.4, but that this result was not statistically significant. This is in contrast to a recent study from the U.C. Davis MIND Institute.

Here is table 1 from the study, giving the odds ratios for MMR and other vaccines (click to enlarge):

Criticisms will include: the moderate size of the group, the selection criteria, the fact that the controls were volunteers and might therefore have some selection bias, the fact that not enough controls were recruited to include all the autistics, and the fact that most children who did not get the MMR received the measles, mumps and/or rubella vaccines as individual vaccines, the fact that vaccine uptake is high in Japan, the lack of a “vaccinated vs. unvaccinated” structure to the study and more.

Taken alone, yes, this would not be convincing evidence that the MMR vaccine doesn’t increase the risk of autism. This doesn’t mean this isn’t a good study. Further, it is well worth noting that this study does *not*stand alone. Multiple studies have shown that the MMR does not increase the risk of autism.

Also worth noting is that by looking at the total number of injections, this study in essence considers the question of whether “too many too soon” is a cause of autism. Based on these results, within the limitations of the study, the answer is no.

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