MMR Vaccine and Autism
Wakefield’s Study
In early 1998, a British gastroenterologist by the name of Andrew Wakefield, along with several colleagues, published a paper in The Lancet. The paper acknowledged 12 individual cases of autism that arose within children approximately one month after they received their Measles Mumps Rubella (MMR) vaccination. After undergoing an endoscopy, it was revealed that the majority of these children had gastrointestinal symptoms. Due to this, Wakefield hypothesized that the vaccination was the cause of these gastrointestinal issues. Thus, this led to the displacement of typically nonpermeable peptides to the bloodstream, which made their way to the brain, thus affecting the development of the children. (Plotkin et al, 2009)
Inconsistencies
Within the study, there were several major flaws within its infrastructure. Of these, the first flaw within the study was the fact that Wakefield did not utilize control subjects. Due to this, it is difficult for experts to discern whether these cases of autism were a result of the MMR vaccine or if the cases were simply coincidental. (Plotkin et al, 2009) Another fault within their study was the fact that autism and vaccinations are both essential aspects of early childhood, therefore although these children did receive vaccinations and then their children developed autism, there were many other children around the country receiving vaccinations and being spared from development of autism. By simply highlighting this fact, it appears more so that this was simply a false scenario of causation. (Andrade, 2011) Approximately 50,000 British children were receiving vaccinations monthly around the time this study took place, cases of Autism were bound to occur due to the large sample size. (Plotkin et al, 2009) A third issue was of ethical nature. Much of Wakefield’s work was funded by lawyers who represented clients engaged in lawsuits with vaccine producing companies. Because of this, Wakefield’s credibility took a massive downturn, thus resulting in his data and statistics being scrutinized at an even higher level. Because of his personal vestment within this association between the vaccine and Autism existing, it was possible that Wakefield framed the data in a way in which it provided support to his hypothesis. (Andrade, 2011) A fourth issue with Wakefield’s study was the fact that his data and statistics were not systematically collected nor were very organized. This further diminished Wakefield’s credibility and posed less evidence in favor of his hypothesis. (Plotkin et al, 2009)
Controversy
Due to Wakefield’s supposed findings and his attempt at uncovering a link between the MMR vaccine and Autism, a major global controversy arose, leading to decreases in vaccinations and the reemergence of several deadly diseases. Fears arose among the parental community, who were concerned that vaccines may have actual causation of the development of Autism. These concerns were especially fueled by the extensive media coverage, stirring the fears of parents. This fear carries on in much of the population today and has spurred constant debate regarding how safe vaccinations really are. Prior to Wakefield’s controversial study, skepticism for vaccinations were low. Although there still existed individuals who questioned the safety of vaccinations, it was nearly a universally accepted fact that vaccinations were safe and of the best intentions. Post Wakefield study, however, this idea has fallen dramatically. The rate of individuals questioning the link between vaccinations and Autism has increased steadily. Websites and books revolving the controversial subject have emerged, which in turn have influenced others of the supposed link between vaccines and Autism. Due to this fall in vaccinations, outbreaks have emerged steadily. One such example is the reemergence of Measles. Considered to have been eradicated in the early 2000’s, Measles has steadily been remerging and infecting communities. Per the CDC’s official website, 2008 witnessed an increase in Measles cases among communities of unvaccinated individuals. In 2008 alone, there were three massive outbreaks of Measles that took place. Of these, an estimated 131 cases took place in the span of January to July of that year. Compared with an average of 63 cases per year from 2000-2007, this was a dramatic increase of Measles cases. (CDC, 2008) In the year 2011, more than 30 countries reported an increase of Measles cases. In 2013, the United States has a total of 11 outbreaks, 3 of which reported more than 20 cases. This number increased in 2014, which had a total of 23 measles outbreaks. One of these outbreaks reported 383 total cases, of which the majority occurred within unvaccinated Amish villages. By simply observing the data, one can note that the number of Measles cases have risen steadily. (CDC, 2018) Could this be the result of Wakefield’s falsified study? Since his study, not only have Measles reemerged from its prior eradication, other diseases have begun to reemerge and wreak havoc on communities across the globe. Such examples include various forms of the flu, such as Swine and Bird, the West Nile Virus, among various other diseases and viruses.
Retraction
This study was retracted by the scientific and medical communities years later, and eventually retracted by The Lancer themselves. Due to the parental fears that arose because of Wakefield’s publication, several epidemiologic studies took place in order to examine his hypothesis. Utilizing sophisticated data gathering systems, these studies utilized several features of large-scale vaccination programs. Not only were these studies equipped with large sample sizes, thus providing a more accurate representation of the population as a whole, they were also provided with detailed vaccination histories, medical records, vaccination records, and accurate analyses of outcome data. The outcome data also provided these studies with the means to compare cases before and after vaccinations. Utilizing these methods, these groups concluded that there was no relationship between the MMR vaccine and Autism. (Plotkin et al, 2009) The second retraction that took place was when 10 of the original 12 co-authors of the paper refuted the data themselves and stated: “no causal link was established between MMR vaccine and autism as the data were insufficient.” (Andrade, 2011) Also, they revealed the financial interests of Wakefield, which as stated prior, diminished his credibility greatly and led to a higher level of scrutiny regarding his data. The third retraction of the paper took place in February of 2010, when The Lancer themselves admitted the presence of several erroneous elements within the paper that directly contrasted findings of the prior investigation. The fourth and final retraction of the paper occurred when Wakefield and his conglomerates were guilty of deliberate fraud and were found to have picked certain data in order to strengthen their hypothesis, as well as falsifying facts. The British Medical Journal published several articles, discussing how the actions of Wakefield were directly correlated with his desire for financial gain. (Andrade, 2011) Due to these above factors, the case of Wakefield’s was completely retracted and concluded to be false.
History of Autism
Autism, as defined by the Merriam-Webster, is “a variable developmental disorder that appears by age three and is characterized by impairment of the ability to form normal social relationships, by impairment of the ability to communicate with others, and by repetitive behavior patterns.” (Merriam-Webster) Autism was first utilized in 1908 to describe subsets of schizophrenic patients who possessed characteristics of Autistic individuals in contemporary society. This included being withdrawn and self-absorbed. (Sole-Smith, 2014) Although utilized as a descriptive term in 1908, the term itself began to branch out and classify more individuals in 1943. Utilized in his medical paper, psychiatrist Leo Kanner examined 11 children who possessed a high level of intellect but also displayed a strong tendency for solitude and a persistent desire for repetition. He later classified their condition as “early infantile autism.” (Sole-Smith, 2014) A year later in 1944, German scientist Hans Asperger built on Kanner’s work and discovered a milder form of autism. This milder form came later to be called “Asperger’s Syndrome.” (Sole-Smith, 2014) Major breakthroughs as to why Autism occurs came about in 1977, after research done on twins revealed that Autism is primarily due to genetics and biological differences in brain development. This finding led to “infantile autism” being officially separated from childhood schizophrenia by the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1980. (Sole-Smith, 2014) Seven years later, infantile autism is replaced with a more inclusive definition of “autism disorder,” and a checklist for diagnostic criteria is released by the DSM. In 1994, Asperger’s Syndrome is officially added to the DSM, thus expanding the umbrella of Autism and expanding the spectrum to include milder cases. Eventually in 2013, all subcategories of Autism are grouped under one umbrella diagnosis referred to as “Autism Spectrum Disorder (ASD).” Along with this, two categorizing characteristics of Autism emerge. These include: “1) The aspect of impaired social communication and social interaction. 2) The act of repetitive behaviors and often time restrictive actions.” (Sole-Smith, 2014)
Association between MMR and Autism
Disproved by a plethora of studies, the association between MMR and Autism is non-existent. There are several factors solidifying the assertion that this link is non-existent. The first of these factors involve how Autism comes to develop within individuals. Although there are several factors that lead to the development of Autism, they can be summarized as follows: Genetics and environmental factors. When mentioning environmental factors, it is helpful to note that these include pregnancy and birth complications, as well as an advanced (elderly) parent age. (Autism Speaks, 2018) Vaccinations have no altering effect on these various aspects. The MMR vaccination is merely a tool used to build immunity up towards Measles, Mumps, and Rubella, decreasing the individuals risk of attaining these diseases. A second supporting factor is the plethora of studies conducted examining the relationship between the MMR vaccination and Autism. One such study occurred in Atlanta. The study utilized data from a developmental surveillance program and compared autistic to non-autistic children. They then obtained vaccination records and noted that the time at which an Individual received a vaccination had no correlation with the development of Autism. (Plotkin, 2009) A second study conducted in Denmark utilized a registry and compared Autistic and non-autistic children. They separated those that had been vaccinated from those that had not been vaccinated and concluded they had found no difference in the risk of developing Autism between the groups. These two studies provide conclusive evidence that Autism and the MMR vaccination have no correlation. There have been numerous other studies as well, examining the various components of the MMR vaccination and studying their effects on individuals, and have failed to provide any relevant information linking vaccinations and Autism. By simply selecting samples of a population and submitting them to various tests, no relevant link between Autism and vaccination has been uncovered by any study thus yet.
Works Cited
• Wakefield, AJ et al. (Feb 28, 1998). Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. (Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/9500320)
• Plotkin, Stanley et al. (Feb 15, 2009). Vaccines and Autism: A tale of shifting hypotheses. (Retrieved from: https://academic.oup.com/cid/article/48/4/456/284219)
• Sole-Smith, Virginia. (2014). The History of Autism. (Retrieved from: https://www.parents.com/health/autism/the-history-of-autism/)
• Merriam-Webster. (2018). Autism. (Retrieved from: https://www.merriam-webster.com/dictionary/autism)
• Rao, T.S. (Apr, 2011) The MMR vaccine and autism: Sensation, refutation, retraction, and fraud. (Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136032/)
• MMWR. (Aug 22, 2008) Update: Measles — United States, January – July 2008. (Retrieved from: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5733a1.htm)
• Centers for Disease Control and Prevention. (March 6, 2018) Measles Cases and Outbreaks. (Retrieved from: https://www.cdc.gov/measles/cases-outbreaks.html)
• Autism Speaks. (2018) What causes autism? (Retrieved from: https://www.autismspeaks.org/what-autism/learn-more-autism/what-causes-autism)