Is there a vaccine-autism link? Is Andy Wakefield a crazy man? The gap I see, as a nutrition professional who has worked with children with autism for twelve years, is in a willingness to open our minds, to consider studies that corroborate Wakefield’s work. I am weary of doing the literature search over and over, handing out these links (below) again and again – the ones the media ignore so handily. Your pediatrician likely doesn’t know that Wakefield is not alone. I challenge physicians out there to pause, breathe, read the studies, and wonder. Think it through: What if he’s right?
I notice that most doctors, parents, journalists and bloggers who are shouting about what a fraud Dr. Wakefield is are more voyeurs on the autism controversy than anything else. Most often, they don’t see many patients with autism, don’t treat them for anything beyond prescribing Miralax or Abilify, or aren’t raising children with autism themselves. Or maybe I should say, they don’t see their poop, their growth charts, endoscopy reports, stool cultures, or food intakes. They don’t see how physically ill these children are, up close and stinky. How many autism diapers have they changed? You know, the ones with the explosive gold lumpy liquid that soars up the child’s neck and seeps down to his knees, six or eight times a day? How many toilets have they unclogged or replaced, after one too many enormous, stone-hard stools filled it? How many impacted colons have they cleared in young children with autism? How many failure to thrive children with autism have they worked with, to restore normal nutrition status and good health? This is what I’m mucking through at work on a regular basis as I provide nutrition care. Either in a child’s history, parent interview, or in a kid’s pants right in my office. Do I want to see it, mom asks? Why, yes I do, I always answer. And I want to culture it too. So off we go collecting that stool sample, right then and there. Let’s do something about it.
Let’s do something about the myths relentlessly repeated now about measles and Andrew Wakefield too.
First, there are fewer, not more, children getting measles in the UK since Andrew Wakefield voiced his concerns for the bundled MMR vaccine. See this analysis for data on measles cases pre and post Wakefield.
And, no, your child is not certain to die from measles if unvaccinated against it, unless he happens to be in profoundly weak status for vitamin A, iron, protein, and body mass index. Those nutrition parameters are strong predictors of how children manage most any infectious disease, and measles in particular. They are so strong, in fact, that protocols for using vitamin A to prevent and treat measles have long existed for UNICEF and the World Health Organization. A child in strong nutrition status typically passes through measles quickly with no lasting ill effect, and then has permanent immunity. This does not mean children never catch or die of measles. It does mean that measles is a highly survivable routine illness that healthy, well-nourished children overwhelmingly survived in the pre-vaccine era – just as my siblings did, who passed immunity to me.
Thirdly, I would also point out (groan, again) that Wakefield’s infamous original Lancet article was a case series. Which means, it did not test a hypothesis that MMR causes autism, nor did it intend to. It did not state this at all, as the media relentlessly hypes. I wonder how many MDs have actually read this original article, or even know the findings published there. The real tragedy is that the message of that original case series has been long lost in the sensationalist media cacophony. Again, think: What if he’s right? Would Pharma, CDC, FDA, AAP, ACIP, UK GMC, and NIH stand up and say – “Oops. We’re sorry.” Would the US go into even greater financial arrears, to pay the hundreds of thousands of injured families the billions they would be due?
These are colossally powerful, profitable entities. If there is trouble with bundled vaccines like MMR, what a tidy solution if Wakefiled is indeed a monster and a fraud. But I don’t think he is, after reviewing food intakes, GI sx, growth patterns, medical histories, and developmental histories on hundreds of children with autism.
Enough lamenting. I’m always asked, so here are some citations for the uninitiated. Wakefield has company. Can all these journals and authors be wrong as well? Here’s one that I can’t link to because it has vanished from PubMed (hmmm it was there two days ago), so here is the full citation:
Sheils O, Smyth P, Martin C, O’Leary JJ. Development of an ‘allelic discrimination’ type assay to differentiate between the strain origins of measles virus detected in intestinal tissue of children with ileocolonic lymphonodular hyperplasia and concomitant developmental disorder. J Pathol 2002; 198 (suppl): 5A.
Wakefield’s company includes other researchers, and other vaccines beyond the MMR. For example, hepatitis B vaccine at birth was found to triple risk for autism in this retrospective study http://bit.ly/rKeth A horrifying vindication for a book I published in 2002 When Your Doctor Is Wrong: Hepatitis B Vaccine & Autism.
This one shows a “hyperimmune” response to MMR in children with autism: http://bit.ly/fXmchZ
Oh alright, I will keep going…Here’s a 2010 chart review finding ileal or colonic lymphonodular hyperplasia in 73% of subjects with autism http://bit.ly/cr0HAL and this one saw a strong association between MMR vaccination and CNS autoimmunity in children with autism http://bit.ly/eTH7Vg and this one documents intestinal permeability (“leaky gut”) occuring 7x more frequently in subjects with autism compared to controls http://bit.ly/aYirdO ..Here’s a page with over twenty citations and analysis collected in one spot for MMR-autism: http://www.jabs.org.uk/pages/thrower.asp
Okay I’ll stop. There is more, you can keep going down this rabbit hole if you like. You’ll find Wakefield has plenty of company.
Lastly, we never hear much about this study, perhaps the most chilling of all. It is the only one to date that reviews the immunization schedule as it is given to human infants – something the FDA never required anybody to do before allowing our children to be given dozens of vaccines in a short time span, as many as twelve or fifteen in one day, as I have seen on my patients’ vaccine records. It was a prospective case controlled study with primates, the closest animal model to humans that we can use. Do you know the outcome? Read it and weep, for our children. They are not victims of Wakefield. They are victims of ignorance and greed. We owe them more research, solutions to the neurodevelopmental disorders and autism they now suffer in unprecedented numbers, and truth.
Liam – you claim Wakefield had a major conflict of interest in his findings and yet you fail to mention that Paul Offit has an even bigger conflict of interest in these arguments. Amazing how one can overlook this when it’s convenient for these debates.
Also, what about Poul Thorsen’s studies touted by the CDC? He’s been recently indicted on 13 counts of embezzlement and for filing FRAUDULENT STUDIES (including, but not limited, to this autism-isn’t-caused-by-vaccines claim).
Here’s a concise presentation of citations:
Peer Reviewed Papers Support Wakefield Findings – AGE OF AUTISM
http://www.ageofautism.com/2010/05/peer-reviewed-papers-support-findings.html
Great post!!!
Here is an excerpt from Dr Mercola’s interview with Dr Wakefield:
In the years after his initial controversial finding, linking the MMR vaccine to Crohn’s disease and autism, he published another 19 papers on the vaccine-induced disorder.
All were peer reviewed. However, strangely enough, none of these 19 papers are ever discussed in the media. The only study that keeps seeing the light of day is the original study from 1998, along with the original questions about conflicts of interest, which he explains in great detail in this interview.
This is very interesting indeed, because not only has he continued his own studies, but since then, a large number of replication studies have been performed around the world, by other researchers, that confirm his initial findings.
Says Wakefield:
“… it’s been replicated in Canada, in the U.S., in Venezuela, in Italy… [but] they never get mentioned. All you ever hear is that no one else has ever been able to replicate the findings.
I’m afraid that is false.”
For those of you who have swallowed this type of reporting hook line and sinker, here is a list of 28 studies from around the world that support Dr. Wakefield’s controversial findings:
1. The Journal of Pediatrics November 1999; 135(5):559-63
2. The Journal of Pediatrics 2000; 138(3): 366-372
3. Journal of Clinical Immunology November 2003; 23(6): 504-517
4. Journal of Neuroimmunology 2005
5. Brain, Behavior and Immunity 1993; 7: 97-103
6. Pediatric Neurology 2003; 28(4): 1-3
7. Neuropsychobiology 2005; 51:77-85
8. The Journal of Pediatrics May 2005;146(5):605-10
9. Autism Insights 2009; 1: 1-11
10. Canadian Journal of Gastroenterology February 2009; 23(2): 95-98
11. Annals of Clinical Psychiatry 2009:21(3): 148-161
12. Journal of Child Neurology June 29, 2009; 000:1-6
13. Journal of Autism and Developmental Disorders March 2009;39(3):405-13
14. Medical Hypotheses August 1998;51:133-144.
15. Journal of Child Neurology July 2000; ;15(7):429-35
16. Lancet. 1972;2:883–884.
17. Journal of Autism and Childhood Schizophrenia January-March 1971;1:48-62
18. Journal of Pediatrics March 2001;138:366-372.
19. Molecular Psychiatry 2002;7:375-382.
20. American Journal of Gastroenterolgy April 2004;598-605.
21. Journal of Clinical Immunology November 2003;23:504-517.
22. Neuroimmunology April 2006;173(1-2):126-34.
23. Prog. Neuropsychopharmacol Biol. Psychiatry December 30 2006;30:1472-1477.
24. Clinical Infectious Diseases September 1 2002;35(Suppl 1):S6-S16
25. Applied and Environmental Microbiology, 2004;70(11):6459-6465
26. Journal of Medical Microbiology October 2005;54:987-991
27. Archivos venezolanos de puericultura y pediatría 2006; Vol 69 (1): 19-25.
28. Gastroenterology. 2005:128 (Suppl 2);Abstract-303
Vitamin A intakes and status are indeed a concern in the US, and have been tracked in NHANES for decades – this is absolutely on the public health nutrition radar in this country. We do not see deficiency such as seen widely in underdeveloped countries, but we do see marginal status; intakes are inadequate in 44% of US population (see page 8 of this document): http://bit.ly/ef4QKH Page 9: “..prevalence of inadequacy was also high for magnesium, vitamin A, and vitamin C with 1/3 to 1/2 population having inadequate intakes from food.” This is in the US.Status of this nutrient will worsen further in those with inflammatory bowel diseases and/or malabsorption, such as the children Wakefield assessed. This dramatically heightens susceptibility to infection, and worsens duration and severity of infection.
OK I’m done with the elementary nutrition lesson. On your other points Liam we don’t agree. Thank you for posting.
I am well aware of the impact of vitamin A deficiency on respiratory disease in the developing world which serves to exacerbate the impact of measles infection. Vitamin A supplementation in such a situation is an excellent public health measure but does not reduce the transmission of the measles virus. The most effective approach is that recommended by the WHO, the use of vitamin A combined with vaccination ( http://www.who.int/vaccines/en/vitamina.shtml )
In the developed world vitamin A deficiency is not a major concern. In healthy people it is “highly survivable” as you say but that doesn’t help those who still develop encephalitis or the fatal SSPE. As people shun vaccinations it also puts those too vulnerable to be vaccinated at high risk. In the years following Wakefield’s paper the UK has had the first deaths from acute measles infection since 1992. Both were immunocompromised teenagers relying on herd immunity to protect them.
http://www.hpa.org.uk/hpr/archives/2008/news2508.htm#meas0805
Wakefield had a major conflict of interest, serious flaws in his methodology and even basic ethics, any evidence of a link has been disproved through epidemiological studies many times over and we now learn he falsified his original data. What grounds do you have to suggest that more of these deaths are acceptable?
Thank you Liam, See the link in the post to vitamin A protocols to answer your question. These dosages have been determined by WHO and UNICEF…. I would like to see data on vitamin A versus measles vaccine but we do not have this as far as I know. We have much data on vitamin A reducing morbidity and mortality in measles (example here http://www.ajcn.org/content/54/5/890.abstract ) and we have plenty of data touting benefits of vaccine; we also have data showing use of two together. But I know of none that actually compares nutrition status versus vaccine. Also, see data by Pelletier (1995) showing that much of the mortality burden worldwide from infectious disease in children is due to undernutrition – even mild to moderate undernutrition can cause more children to succumb to this virus.
AMAZING post!! THANK YOU!!!!
I think you’ll find that “highly survivable” is not considered a great measure of success in clinical trials. “Highly survivable” might be a great prognosis for a cancer, it is not a great option to give a parent. Vaccines are extremely safe and there has yet not been a shred of actual evidence to support Wakefield’s “theory”.
True, measles is a major killer in the developing world but noone is saying it is like rabies, which is 100% fatal without a vaccine. It does kill though, which is why I would like to ask, in your professional opinion, how much vitamin A would it take to cure SSPE?
Why do you think “The Wakefield Factor” uses 10 year averages? That seems a strange way to analyse incidence. Plot the data. You’ll see measles declining rapidly then picking up after the paper was released. If you want to be sure plot it against MMR uptake. Open your mind. You might be wrong on this one.