The vaccine-autism debate is far from over. If anything, it is just getting started.
As the following comments, funding decisions, research priorities and published papers suggest, the U.S. government and many scientists will be researching and discussing this topic for years to come. Here are some reasons why:
I) Federal Health Agencies Endorse More Research
The federal government's four leading health entitites dealing with vaccines and/or autism have all reached consensus: More vaccine safety research is required to fill gaps in knowledge, especially in the context of susceptible subpopulations, mitochondrial impairment, long-tern effects of vaccine-induced fever, seizures and brain injury, and other factors. Millions of dollars will be spent investigating these factors, and not because health officials somehow caved in to parental pressure. Mercury in vaccines, for example, was designated as one of the CDC's "high priority" autism research issues, following an "extensive review of the literature, based on how strongly they seemed to be associated with ASD."
Centers for Disease Control and Prevention Office of Immunization Saftey
The CDC will study autism "as a possible clinical outcome of immunization" as part of its new 5-year research plan. It will also study mitochondrial dysfunction and the risk for "post-vaccine neurological deterioration," and will convene an expert panel on the feasibility of studying health outcomes, including autism, among vaccinated and unvaccinated children.
Centers for Disease Control and Prevention Study to Explore Early Development
NOTE - THIS WEBPAGE WAS RECENTLY ALTERED BY CDC TO REMOVE REFERENCES TO VACCINES, MERCURY AND AUTOIMMUNITY - THE ARCHIVED PAGE IS HERE:
The CDC is currently looking at environmental, genetic and socioeconomic risk factors for ASD, including vaccines and mercury. "We chose to look at vaccines and other types of medical procedures that may have mercury exposure," the CDC says. The agency "designated these factors as high priority" following "an extensive review of the literature, based on how strongly they seemed to be associated with ASD." Selected mercury exposures include "vaccines that the mom received during pregnancy, the child's vaccine exposures after birth and specific other factors such as RhoGAM treatment in pregnancy if the mom has developed an immune response against the fetus that can harm it."
Interagency Autism Coordinating Committee (IACC) -- Includes CDC, HHS, NIH etc.
The nation's leading autism research entity, the IACC, recently announced funding for studies of environmental factors for ASD, such as toxic exposures and "adverse events following immunization (such as fever and seizures), and mitochondrial impairment." It will also fund studies to determine if some subpopulations are "more susceptible to environmental exposures (e.g., immune challenges related to infections, vaccinations, or underlying autoimmune problems)," and will continue to coordinate with the National Vaccine Advisory Committee on "public concerns regarding a possible vaccine/ASD link." The IACC has also concluded that existing population-based vaccine-autism studies are "limited in their ability to detect small susceptible subpopulations."
National Institutes of Health Early Autism Risk Longitudinal Investigation
A network of NIH agencies and affiliated sites are following some 1,200 pregnant women who already have a child with autism to identify the earliest potential causes and "possible environmental risk factors and their interplay with genetic susceptibility during the prenatal, neonatal and early postnatal periods." Researchers are reviewing each child's medical records, including vaccination history. They are also asking about mercury exposures through flu shots during pregnancy, ambient air pollution, seafood consumption, dental amalgams, and thimerosal exposure through contact lens solutions and other OTC products.
U.S. Dept of Health and Human Services National Vaccine Advisory Committee
The nation's leading experts on vaccine safey recently endorsed the study of adverse events following immunization (e.g., fever and seizures) to see if they increase autism risk. The NVAC also supports an expert committee to consider examining outcomes in unvaccinated, vaccine delayed and vaccinated children, including autism. The Committee recommends more study of "the possible occurrence of ASD in a small number of children subsequent to MMR vaccination" especially given "recent research around the incidence of mitochondrial dysfunction in children with an ASD phenotype."
The NVAC also recommends studying adverse vaccine reactions in subsets of ASD children, given "recent developments around mitochondrial dysfunction," and because some children "may be at elevated risk of reduced neurological functioning, possibly including developing ASD, subsequent to vaccination."
U.S. Dept of Health and Human Services Vaccine Injury Compensation Program
The so-called Federal "Vaccine Court" has asked an Institute of Medicine committee to consider adverse events from the DTaP and MMR vaccines, including autism and autism spectrum disorders. The IOM committee will will consider vaccine-associated "secondary" autism or autistic features arising from chronic encephalopathy, mitochondrial disorders and/or other underlying disorders. The vaccine injury program has asked the committee to consider "primary autism" in light of "recent theories of neuro-inflammation and hyper-arousal/over-excitation of the immune system via multiple simultaneous antigenic stimulation" (several vaccines at once).
Scientists Call For More Studies
Today, more scientists and research institutions are supporting further inquiry into the role of environmental toxins in the onset of autism spectrum disorder. While many of them doubt that vaccines are responsible for the dramatic increase in autism incidence, they point to knowledge gaps concerning susceptible subgroups that may have been missed in large population studies of MMR vaccine, thimerosal and ASD.
David Amaral, PhD, Director of Research, University of California, Davis M.I.N.D. Institute. PBS, April 2011:
In general, vaccines are not the culprit, (but) there may be a small subset of children who may be particularly vulnerable to vaccines if the child was ill, if the child had a precondition, like a mitochondrial defect. Vaccinations for those children actually may be the environmental factor that tipped them over the edge of autism.
Duane Alexander, MD, former Director of the National Institute of Child Health and Human Development (NICHD), current Senior Scientific Advisor to NIH's Fogarty International Center. Interview, October 2009:
One question [is] whether there is a subgroup in the population that, on a genetic basis, is more susceptible to some vaccine characteristic or component than most of the population, and may develop an ASD in response to something about vaccination. The trigger could be some adverse or cross-reacting response to a vaccine component or a mitochondrial disorder increasing the adverse response to vaccine-associated fever.
Geraldine Dawson, PhD, Chief Science Officer, Autism Speaks. July, 2009:
It remains scientifically plausible that the challenge to the immune system resulting from a vaccine (or other immunological challenges) could, in susceptible individuals, have adverse consequences for the developing brain. Evidence does not support the theory that vaccines are causing an autism epidemic. However, it is plausible that specific genetic or medical factors that are present in a small minority of individuals might lead to an adverse response to a vaccine and trigger the onset of autism symptoms.
Story Landis, PhD, Director of the National Institute of Neurodevelopmental Disorders and Stroke (NINDS), former member, IACC. Statement, October 2009:
It is important for autism researchers to study the children who have been most profoundly affected by their response to vaccines.
Julie Gerberding, MD, former Director of the Centers for Disease Control and Prevention, current President of Merck Vaccines. CNN, March 2008:
If a child was immunized, got a fever, had other complications from the vaccines. And if you're predisposed with the mitochondrial disorder, it can certainly set off some damage. Some of the symptoms can be symptoms that have characteristics of autism... I think we have to have an open mind about this.
Martha Herbert, MD, PhD, Assistant Professor of Neurology at Harvard Medical School, Pediatric Neurologist at Massachusetts General Hospital. PBS, April 2011:
I think it's possible that you could have a genetic subgroup. You also might have an immune subgroup. There are a variety of subgroups. But the problem with the (vaccine-autism) population studies is they don't... they aren't necessarily designed to have the statistical power to find subgroups like that if the subgroups are small.
Autism Speaks, Official Statement. February 2009:
We will continue to support authoritative research that addresses unanswered questions about whether certain subgroups of individuals with particular underlying medical or genetic conditions may be more vulnerable to adverse effects of vaccines. While large scale studies have not shown a link between vaccines and autism, there are lingering legitimate questions about the safety of vaccines that must be addressed.
III) Recent Papers and Future Study
Studies that refute an autism-vaccine association tend to get widespread coverage in the media, but studies suggesting that more research is needed tend to get overlooked. The following are just a few recently published papers, some from foreign journals. They are not presented here as evidence of an association between immunization and autism, but rather to demonstrate the types of investigations that researchers might pursue in the years to come.
Mitochondrial Impairment and Lead Found in Saudi Children with ASD -- Vaccines May Trigger Metabolic Stress and Regression in Mild Impairment Cases
"Plasma fatty acids as diagnostic markers in autistic patients from Saudi Arabia"
Lipids in Health and Disease, 2011 Apr 21;10(1):62.
This small study found that "fatty acids are altered in the plasma of autistic patients," and the differences were related to "oxidative stress, mitochondrial dysfunction and the high lead concentration previously reported in Saudi autistic patients." Taken together with three related Saudi studies, the authors "confirmed the impairment of energy metabolism in Saudi autistic patients, which could be correlated to oxidative stress." Vitamin E and glutathione were "remarkably lower" in ASD patients vs. controls. Saudi ASD children "are under oxidative stress due to GSH (glutathione) depletion," the authors said. "This confirms that oxidative stress and defective mitochondrial energy production could represent the primary causative factor in the pathogenesis of autism." And they added, "There may be an initial period of normal development and function before decompensation in association with metabolic stress or immune activation, such as fasting, illness or vaccination."
Vaccine-Induced Fever Caused ASD Regression in Four Chidren with Mitochondrial Dysfunction
"Fever plus mitochondrial disease could be risk factors for autistic regression"
Journal of Child Neurology, 2010 Apr;25(4):429-34.
Researchers looked at 28 children with ASD and mitochondrial disease and found that 17 of them (60.7 percent) had gone through autistic regression, and 12 of the regressive cases happened following fever. Among the 12 children who regressed after fever, a third of them (4) had fever associated with vaccination, as was the case of Hannah Poling v. HHS.
Birth Dose of Hepatitis-B Vaccine Associated with Increased ASD Risk in Boys
"Hepatitis B vaccination of male neonates and autism diagnosis, NHIS 1997-2002"
Journal of Toxicology and Environmental Health 2010;73(24):1665-77.
This cross-sectional study used weighted probability samples from National Health Interview Survey 1997-2002. It findings "suggest that U.S. male neonates vaccinated with the hepatitis B vaccine prior to 1999 had a threefold higher risk for parental report of autism diagnosis compared to boys not vaccinated as neonates."
Thimerosal may contribute to infant neurodevelopmental disorders, including autism.
"Lasting neuropathological changes in rat brain after intermittent neonatal administration of thimerosal"
Folia Neuropathologica 2010;48(4):258-69.
This study found that "numerous neuropathological changes were observed in young adult rats treated postnatally with thimerosal," and that "These findings document neurotoxic effects of thimerosal, at doses equivalent to those used in infant vaccines or higher, in developing rat brain, suggesting likely involvement of this mercurial in neurodevelopmental disorders." The authors concluded that thimerosal is "possibly contributing to pediatric neurodevelopmental disorders, including autism."
Risk of Neurotoxicity from Thimerosal is Plausible, at Least for Susceptible Infants
"Making sense of epidemiological studies of young children exposed to thimerosal in vaccines"
Clinica Chimica Acta, International Journal of Clinical Chemisty, 2010 Nov 11;411(21-22):1580-6
Although this review did not look autism, it compared eight epidemiological studies conducted in the U.S., UK and Italy on "neurological issues and thimerosal-containing vaccines (TCV)" and found the data were "insufficient to establish non-toxicity for infants and young children." The review identified "ambiguity" in some of the studies, likely caused by confounding variables.
"The risk of neurotoxicity due to low doses of thimerosal is plausible at least for susceptible infants," the author concluded. "There is a need to address these issues in less developed countries still using TCV in pregnant mothers, newborns, and young children. Developing countries should intensify campaigns that include breastfeeding among efforts to help prime the central nervous system to tolerate exposure to neurotoxic substances, especially thimerosal."
Dominique Browning: Fetal Rights: The Right to Life Case Against Air Pollution
Increases in autism as well as ADD, ADHD, asthma and autoimmune diseases have risen right along with the vaccine schedule. In 1989 the recommended vaccine schedule was 12 shots for 5 diseases for our 5 year olds. In 2010 the recommended vaccine schedule for our children was 32 shots for 16 diseases! That's a 3 fold increase! I am not a rocket scientist but I see a pattern here.
In the US, child vaccines are mandatory, overruling any parental concerns. At the same time, litigation costs, associated with medications proven to be harmful, are rising exponentially. Last year GlaxoSmithKline, (which also manufactures vaccines), reported an unusual part year loss due to Avandia compensation claims. Recently the US supreme court indemnified vaccine manufacturers against litigation claims.
What recourse do parents have if they suspect their own children have been vaccine damaged? Very little, particularly if the child develops autism and or another 'unseen' condition like bowel disease, but has no other obvious damage. Vaccine compensation boards are bureaucratic and only compensate the worst cases. Even then, the parents must prove the vaccine was responsible. The official stance is very unyielding:- "vaccines DON'T cause autism" so that's that!!!
An official statement that vaccines can cause brain damage, does not acknowledge autism as brain damage, even though it is a recognised 'neurological' condition.
Unfortunately the evidence does not support a record of robust safety ...
Dramatic Jump Found in Medication-Related Deaths
http://pn.psychiatryonline.org/content/42/19/8.full
"The growth of prescription-related deaths in recent years illustrates the need to devise strategies that will improve the way that medication risks are managed.
Serious injuries, disabilities, and deaths related to the use of prescribed medications nearly tripled in recent years, according to research based on Food and Drug Administration (FDA) data.
The total annual incidents of these events rose from 34,966 in 1998 to 89,842 in 2005, a 2.6-fold increase ... A total of 467,809 such incidents were reported over that eight-year period to the FDA's Adverse Event Reporting System (AERS)."
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What is worrying for parents and carers of children with ASD is the following ...
"...the antipsychotic clozapine was the most frequent drug suspected in death and serious nonfatal outcomes, with 3,277 such cases reported over the eight years.
...antipsychotic risperidone, which was the suspect drug in 1,093 deaths or serious injuries during the study period. "
Both are advocated in the treatment of autism ....
http://www.medicalnewstoday.com/articles/26879.php
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC167190/
How many more children will have to be harmed before it's all over?
Thank you David Kirby for your unrelenting pursuit of the truth about environmental hazards in this country - from the needle to the stable.
The point is, HuffPo, you are being alarmist and perpetuating a potential public health nightmare by encouraging people to be ignorantly afraid of vaccines. You all don't remember what it was like for your family members to have polio, or whooping cough, or even the measles. I'm not saying you shouldn't question what you put in your body. But help people make *good* decisions-don't just use sensational scare tactics.
I am not sure where David Kirby is supposed to have said any of this information is secret. What it is is neither publicised or widely reported - so he is reporting. Nor is it clear why the vaccine programme and its safety is the one area of public policy that we are not allowed to have free and open discussion about in the mainstream arena. Why the taboo? Why cannot we discuss the many settlements in the vaccine injury compensation scheme (which include encephalopathy induced autism) or the frank admission by Julie Gerberding, present head of Merck's vaccine division, when she was director of the CDC that vaccines can cause autism?
http://childhealthsafety.wordpress.com/2010/06/30/vaccination-causes-autism-%e2%80%93-say-us-government-merck%e2%80%99s-director-of%c2%a0vaccines/
Are ordinary people not to be trusted with the all-too messy reality, with mandated vaccine schedules, and doctors and vaccine companies shielded from any liability? What unmitigated arrogance!
There are plenty of people who would be prepared to dispute with you the truth of the allegations against Wakefield:
http://childhealthsafety.wordpress.com/2011/01/08/the-big-lie-brian-deer-dr-wakefield-the-british-medical-journal/
but this is just a distraction here.
http://blogs.plos.org/thepanicvirus/2011/05/05/pre-mature-optimism-about-a-huffington-post-shift-away-from-anti-vaccine-rhetoric/
He seems to have a supporter here.
I'm not quite sure what you are trying to say in your post.
"Do you understand that it often takes months if not years to successfully attain funding for studies, and then it takes years to conduct the studies and even more time to analyze the results and then get them published in peer-reviewed journals?"
Shouldn't drug and vaccine surveillance be a natural extension of the medical system ? Be funded adequately and be flexible enough to respond quickly and robustly to any safety issue raised.
"many of the studies referenced in this article, including the recently published works, were funded before Andrew Wakefield's gross guilt of fabrication was completely revealed."
As the apparent allegations have not been tested independently by any other body I think we should lay them to one side.
Further as I haven't seen any independent corroborative evidence either, after some 100+ days it leads one to suspect the authenticity and robustness of the allegations.
"HuffPo, you are being alarmist and perpetuating a potential public health nightmare by encouraging people to be ignorantly afraid of vaccines."
So the way to balance the arguments presented is to introduce your own 'scare' campaign.
Are you suggesting that modern medicine is incapable of delivering a solution to a disease outbreak ?
That it has been unable to design and deliver better medications and strategies that would result in a negligible impact, if indeed there was an outbreak of measles ?
As you correctly note: "Studies that refute an autism-vaccine association tend to get widespread coverage in the media, but studies suggesting that more research is needed tend to get overlooked."
In fact, nobody has ever proven that vaccines do not cause autism - nor that they do. We are in a big gray area.
As all these scientists say, what we need is serious, objective research that honestly tires to discern the truth. There has been a little of that, largely unpublicized, and lots of PR about neutral studies that don't show anything one way or another, and many of those studies were done or funded by those with a vested interest in a particular outcome.
While Sonic may raise important issues there cannot really be any excuse for his/her attitude. You can't really compensate in a literal sense, but there are two fundamental points. One is the bit that doesn't need to cost money, which is the acknowledgement the that something untoward has happened (rather than all the usual BS), and the other is the incredible cost to people's lives of disability.
On top of that there is the dangerous problem of lack of liability, or sanction against manufacturers for making unsafe products (which can only encourage negligence).
More relevant here is that although the 'autism is all genes' argument has long ago in reality collapsed research funding and institutional sentiment continues to be in favour of more genetic research rather than environmental: for that reason it is very good and important to see attitudes softening and the balance just beginning to even up.
I don't think any sane scientist has ever claimed "autism is all genes", so that argument is already moot.
You start off on two specious hominems
1) You are a talking about people who trusted their children to the vaccine programme at the beginning and are asking for reform.
2) It all something to do with money, as if people had some improper concern for it.
In my opinion both lines of attack were snide and gratuitous.
Whatever, and sane or insane scientist ever claimed environmental research, medical interest in the health of the cases has been sidelined and even persecuted.
Finally, I wanted to make these points in a place where they could be seen, not buried in a hole at the bottom. I really don't see the point of the HuffPost layout, where you have to comb through hundreds of posts to find out what's new. Compare Guardian CiF, where comments appear in order of submission,but it is perfectly easy to refer back to earlier ones.
Infant mortality rates regressed against number of vaccine doses routinely given: Is there a biochemical or synergistic toxicity?
"The infant mortality rate (IMR) is one of the most important indicators of the socio-economic well-being and public health conditions of a country. The US childhood immunization schedule specifies 26 vaccine doses for infants aged less than 1 year—the most in the world—yet 33 nations have lower IMRs."
So when the independent researchers looked further...
"...statistically significant differences in mean IMRs were found between nations giving 12–14 vaccine doses and those giving 21–23, and 24–26 doses. A closer inspection of correlations between vaccine doses, biochemical or synergistic toxicity, and IMRs is essential. "
http://het.sagepub.com/content/early/2011/05/04/0960327111407644
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It's one of those studies that raises some very interesting questions ...primarily are we getting the outcomes we thought we would ?
Obviously further investigation is needed and this very complex situation worked out ....
It goes with other research .... here
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Randomized trials to study the nonspecific effects of vaccines in children in low-income countries.
http://www.ncbi.nlm.nih.gov/pubmed/20431383
"evidence has accumulated that some EPI vaccines may have nonspecific effects that increase or decrease mortality from subsequent infections with other unrelated organisms....."
They suggest clinical trial relating specifically to MMR and DTP.
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Longitudinal studies would be suggested.
Seeing as how the USA achieves a 90% uptake, that means the number of recommended vaccines given is actually 10% lower than the schedule suggests.
Pity the researchers were so incompetent they couldn't even get some basics right.
I must admit I haven't come across such 'dogged dogma' before ... I think any reasonable person would acknowledge the questions raised by these studies and pursue them further, even if the results were not entirely in line with one's current thinking.
I note you have not responded to my criticism, but instead you have attacked me, accusing me of doing something I did not do.
Where exactly in my post did I indicate I am resistant to research into vaccines?
If anything my post indicates I am in favor of properly done research.
Maybe there isn't an autism increase after all?
If we are to believe this study although there are some serious flaws in its presentation. Then it is clear evidence that the UK medical profession has 'missed' diagnosing one of the most severe and debilitating neurodevelopmental disorders of the 20th and 21st centuries.
As the study presents a rate of 1% of the population then one should ask what have they been doing in the last 50 years ?
It might then follow - Why would we expect the UK medical to have a robust understanding of the complexities in the aetiology of autism ?
In fact if they haven't been able to identify autism ...why would would expect them to be able to identify sometimes subtle and complex medical conditions as Severe Adverse (SAE) from vaccinations.
Very interesting, there has been discussion about lead poisoning and it's impact on children in journals, but not a lot makes it into the media. Today an article came out stating that lead poisoning in children costs $50.9 Billion dollars annually, while autism is at $7.9 billion. http://www.sciencedaily.com/releases/2011/05/110504183411.htm
It would be interesting to find out if children with lead poisoning are more likely to have issues with vaccines.