Fwd: Part 5 - REGRESSIVE AUTISM AND MMR VACCINATION

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http://www.redflagsweekly.com/yazbak/2003_nov01_5.html

 

REGRESSIVE AUTISM AND MMR VACCINATION

 

By RFD Columnist, F. Edward Yazbak, MD, FAAP.

 

TL Autism Research

Falmouth, Massachusetts

 

E-mail: tlautstudy

 

Part Four here

 

 

 

 

The Yazbak comments (November 2002)

 

It is more than likely that the CDC would not have supported a study in Denmark

without being assured, in advance, that the results provided evidence against an

MMR-Autism association.

 

My disagreement with the Madsen study was based on the fact, that whatever it

proved in Denmark, was not relevant to the situation in the United States.

 

The MMR story in Denmark

 

Based on a Medline search. (27)

 

§ Before the MMR was introduced in Denmark (The Campaign), 98% of Danish

children aged 9 were immune to measles.

 

§ Within two years from the beginning of the campaign, the Health

Authorities were concerned about acceptance already.

 

§ Almost HALF of the physicians questioned were neither certain about nor

comfortable with the MMR vaccine’s efficacy.

 

§ Parents were concerned about the adverse effects and efficacy of the MMR

 

§ “All practices expressed a positive attitude towards the usefulness of

MMR vaccination, but only 56% of the respondents expressed a whole-hearted

positive attitude. The average vaccination rate in practices with unreservedly

positive attitudes was 85%, compared with 69% in practices with more guarded

attitudes.”

 

Note: According to the authors of the study themselves, 18% of children born

between 1991 and 1998 did not receive the MMR vaccine. This is quite high. Only

3% of the children in the study had not received the HIB vaccine.

 

 

Vaccination Practices: USA & Denmark (1991-1998)

 

The Hepatitis B vaccine was not administered routinely to infants in Denmark

during the study period. In the USA, the first dose is often administered a few

hours after birth; the second at age 1 to 2 months and the third at age 6 to 12

months. Each dose of Hepatitis B vaccine, at the time, contained 12.5ug of ethyl

mercury. DTP (or DTAP) and HIB contained each 25ug of ethyl mercury per dose

 

During the period in question, infants in the USA potentially received 12

vaccines in the first six months of life: DTP (DTaP) x3, HIB x3, Polio x3,

Hepatitis B x3. [More vaccines are administered now and even more are planned.]

 

Infants in Denmark received 6 vaccines by age 6 months: DTP (DtaP) x2, HIB x2,

Polio x2 [The third series was administered at age 12 months]

 

The Potential Ethyl Mercury Load (ug.)

 

Age

 

USA

 

Denmark (1992)

 

1 day

 

12.5

 

0

 

1 month

 

12.5

 

0

 

2 months

 

50

 

0

 

3 months

 

0

 

0

 

4 months

 

50

 

0

 

5 months

 

0

 

0

 

6 months

 

62.5

 

0

 

 

The adult “safe” amount of mercury is 0.1µg/kg/day according to the

Environmental Protection Agency (EPA). In the United States, a 2-month old

infant (4-5 kg) who received the second dose of hepatitis B vaccine with DTP and

HIB would be getting 62.5 ug of ethyl mercury or 12-15 ug/kg that day. An infant

receiving 187 ug of ethyl mercury through vaccines over 6 months has had an

average daily exposure in excess of the EPA adult safe amount.

 

MMR Vaccination

 

The MMR vaccine was almost always administered alone, at age 15 months, in

Denmark. In the U.S., the MMR was administered at age 12 months, frequently

with the chicken pox vaccine and the last dose of HIB and Hepatitis B vaccines.

 

Again, both Professor Spitzer and I based our critiques (above) of the study

from Denmark only on information and data published by the authors in the NEJM

in November 7, 2002.

 

The Danish investigators reviewed information on a group of children born

between January 1991 and December 1998, and who would be therefore 5 to 12 year

old now.

 

They stated:

 

“ Results Of the 537,303 children in the cohort (representing 2,129,864

person-years), 440,655 (82.0%) had received the MMR vaccine. We identified 316

children with a diagnosis of autistic disorder and 422 with a diagnosis of other

autistic-spectrum disorders. After adjustment for potential confounders, the

relative risk of autistic disorder in the group of vaccinated children, as

compared with the unvaccinated group, was 0.92 (95 percent confidence interval,

0.68 to 1.24) and the relative risk of another autistic-spectrum disorder was

0.83 (95 percent confidence interval, 0.65 to 1.07). There was no association

between the age at the time of vaccination, the time since vaccination, or the

date of vaccination and the development of autistic disorder.

 

Conclusion This study provides strong evidence against the hypothesis that MMR

vaccination causes autism”.

 

The vaccine authorities widely publicized the results of the research and

reassured everyone that the “Danish Study” had proved that the MMR vaccine did

not cause autism, not only in Denmark but elsewhere also. Feeling that they had

won that battle and considering the subject closed, the researchers from Denmark

turned their attention to Thimerosal in vaccines and published a study on the

subject. They were immediately confronted by an informed group of parents who

found serious problems with their data.

 

While preparing this presentation, I decided to review any available autism

statistics from Denmark. The following important analysis is lengthy and

detailed; it is intended for parents as well as professionals. To the best of my

knowledge, this information has not been published to date.

 

Examination of the autism data from the Danish Psychiatric Central Register

reveals that there has been a serious increase in autism in children under 14 in

the last few years. (Graph II).

 

 

 

Graph II Incidence of Autism in Denmark by Age Group

 

Source The Danish Psychiatric Central

Register.

 

The MMR vaccine was introduced in Denmark in 1987. It has been estimated that

only 70% of the 15-month old children received the MMR vaccine in 1987-1988. The

percentage of vaccinated toddlers then reached and remained at 80 to 88% for

several years. It is estimated that in the last two to three years, about 95% of

the 15-month old children in Denmark received the MMR vaccine.

 

The present rise in autism in Denmark appears to have started 4 to 5 years after

the introduction of the MMR vaccine. It also appears to correspond with the

percentage of children who received the MMR.

 

The mean age at the time of diagnosis in Denmark is probably around 4.7 years

(“The mean age at diagnosis for autism was 4 years, 3 months, and for autistic

spectrum disorders 5 years, 3 months. " )

 

This would be compatible with the following analysis. Looking at the mean value

of autism incidence for 2002-2003, there are approximately

 

70 cases per 100000 among 5 to 9 age group

41 cases per 100000 among 0 to 4 age group

35 cases per 100000 among 10 to 14 age group

16 cases per 100000 among 15 to 19 age group

If all 4 age groups under the age of 20 are combined, there are 162

[70+41+35+16] individuals with autism per 100000. By computing the percentage

contribution of each age group we find that:

43% of cases of autism are diagnosed in the 5 to 9 age group

25% of cases are diagnosed in to 0 to 4 age group

22% of cases are diagnosed in the 10 to 14 age group

10% of cases are diagnosed in the 15 to 19 age group

 

 

 

When one looks for further validation at the percentages in 1998 (the last year

examined by Dr. Madsen), similar findings are noted:

39% among 5 to 9 age group

 

26% among 0 to 4 age group

 

19% among 10 to 14 age group

 

17% among 15 to 19 age group

 

 

In summary, using the 2002-2003 mean values (1st set of percentages above) we

find that about 25% (1/4) of autism cases in Denmark are reported under the age

of 5 and the remainder 75% (3/4) of affected children are reported when they are

5 to 19 years old.

 

 

The 2,129,864 person-years reported in the Madsen study divided by the number of

children 537,303 indicates that the average age of the children in the study is

less than 4 years (range 1 to 7 years). Those children would be 5 to 12 years

old in 2003. Because the mean age at diagnosis is 4.7 years in Denmark, the

Madsen study could NOT have detected many of the cases of autism that were

subsequently diagnosed when these children were older, thereby missing the

connection between MMR vaccination and autism.

 

The 0-4 year old group of children (Graph II, black) remains the lowest from

1980 to 1991, because autism was/is rarely diagnosed under the age of 4 in

Denmark. The prevalence of autism in that age group starts climbing after 1991,

4 years after the introduction of the MMR vaccine, to become the second highest

by 1993 but it always remains distinctly lower than in the 5 to 9 year old

group.

 

The 5-9 age group is the earliest cohort to first receive the MMR vaccine after

coverage has improved and is also old enough to be diagnosed. That group (red)

is the largest all along and the spread between it and the next older age group

increases with the passing years.

 

The 10-14 age group (dark green) represents the earlier cohort that first

received the MMR vaccine, but at lower coverage rates. . Those affected

children aged 10 to 14 in 2003 were aged 1 to 5 in 1994. They reflect the

startup of the autism increase associated with the startup and progression of

the MMR vaccination program.

 

The 15-19 age group (light green) were aged 1 to 5 in 1989; their number

increases but at a much slower rate than in the younger age groups.

 

Lastly, the 20-24 age group (brown) shows only a slight increase starting in

1994 possibly because few if any of this cohort received the MMR vaccine at a

vulnerable age.

 

Looking at data similar to that used in the Danish study, but with five

additional years added, appears to invalidate the conclusions of the Madsen

group and to support the hypothesis, that increases in autism in Denmark, may be

correlated with increases in percentage coverage and number of children

receiving MMR vaccination.

 

It is likely that in Graph II, the 0-4 year group of affected children

represents those who were not generally diagnosed earlier, that the 5-9 age

group represents the highest increase which occurred after wide-spread coverage

of the MMR vaccine and that the 10-14 age group represents the earlier cohort

that first received the MMR vaccine, but at a low coverage rate.

 

It is possible that the rate of autism will now level off at the higher rate

since children receiving MMR immunization have now saturated the age groups and

replaced individuals in the age groups that were previously unvaccinated.

 

Around 65,000 babies are born every year in Denmark. Graph II shows the early

slow ramp-up period due to low vaccination rates as my literature review had

suggested. (28). When MMR vaccination coverage improved beyond a certain level,

from 1993 to 2001, there was a steady and increasing trend in autism yearly.

That gradual rise leveled out after the entire cohort aged <10 was almost

completely vaccinated (vaccine coverage at >95%). One must keep in mind that

many of the children of the most affected 5 to 9 group, could have started with

symptoms as early as the second year of life.

 

The prevalence rate of autism in Danish children under the age of 14 has

increased by 729% from 17.67 per 100,000 Population in 1980 to 146.42 in 2002.

(Graph III)

 

 

 

Graph III Children with Autism under Age 14 In Denmark per

100,000 Population.

 

Source The Danish Psychiatric Central

Register.

 

The prevalence of autism in children and teens under the age of 14 in Denmark,

which was 131.42/100000 in the 7 years before the MMR vaccine, increased by 542%

to 843.73/100000 in the last 7 years. Indeed, the prevalence of autism in that

group was 11% higher (146.42/131.42) in 2002 alone than in the combined 7 years

before the introduction of the MMR vaccine.

 

Two doses of MMR are administered in Denmark, one at age 15 months, and one at

age 12 years. (29) The data suggest that the main concern is the vaccination

given at age 15 months.

 

The prevalence of autism in Denmark in the 0 to 14 year-olds leveled off in the

last 3 years, when toddler MMR coverage reached the 95-98% level. The reason why

this did not take place in the United States in the 90’s (Graph I) may have been

because pediatric vaccines in the US contained Thimerosal, further supporting

the argument that countries with strikingly different vaccination practices

should not be compared.

 

In summary:

 

I: The Madsen study, as designed, could NOT have detected an increase in Autism

in Denmark after MMR vaccination.

 

II: Autism HAS INCREASED in Denmark after the introduction of the MMR vaccine.

The rate ratio (incidence of autism after vs. before MMR vaccine) is 8.8 (95%

C.I., 6.3 to 12.1) among 5 to 9 year olds.

 

III. Honest, accurate and unbiased clinical studies are needed. Parents must be

interviewed and children must be examined and thoroughly evaluated. Looking at

databases is not the answer.

 

Questions and Parting Thoughts

 

There are two questions for Dr. Madsen

 

Why did an autism study involve an age group that was so young, when it was

well known that the majority of cases were diagnosed at a later age?

 

If the MMR vaccine is not responsible for the more than 700% increased

prevalence in pediatric autism in Denmark after 1992 then what is?

 

There is only one question for the CDC Director:

 

“When will the CDC sponsor and support clinical studies of autism?

 

* * *

 

The health authorities in Denmark should take a close look at the autism

situation. If autism is due to an autoimmune problem and if indeed a brain-gut

relationship exists, then delaying the diagnosis to age 4 or later is

unacceptable. Early strict diet management and intensive ABA have been clearly

associated over the years with improved outcomes.

 

It is clear that there are many problems with several anti-Wakefield studies. It

is unfortunate that so much faith was put in their conclusions. The Wakefield

hypothesis remains valid and ongoing results and replications are encouraging.

 

The blind acceptance of the anti-Wakefield studies has resulted in a dangerous

situation. The health authorities and the research community, by accepting their

conclusions at face value, are essentially saying that a vaccine-autism

connection does not exist and that scientists should stop looking. If the

authorities are wrong in their assumption and if Dr. Wakefield is correct, even

greater harm to our children may be occurring.

 

In the UK, believing these same flawed studies that deny an MMR-Autism link has

just resulted in the cancellation of legal aid funds necessary for a class

action suit. The research that would have been revealed in Court has thus been

snuffed. Only £10m ($15m US) more was needed to see the parents’ legal case

through to conclusion; this amount represents the approximate cost for lifetime

care for only four children suffering from severe autism.

 

The UK Government has been spending considerably more money on a propaganda

campaign to defend the MMR vaccine than it has on autism research. In January

2002 funds were promised for autism research as long as it did not involve the

MMR vaccine. To date, not a single study has been launched. At his annual report

on July 3, 2003, Sir Liam Donaldson, the UK Chief Medical Officer, did not even

mention autism His five priorities at present were the health risks of

second-hand smoke, West Nile virus, obesity, poor clinical performance by

physicians and the safe administration of intrathecal chemotherapy.

 

This year, the CDC has spent immensely more time discussing SARS in China than

it has looking at the causes of this true epidemic of autism.

 

Meanwhile a whole generation of beautiful children is being lost.

 

 

 

 

 

 

 

 

 

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