Vaccine Wars

        I'm just about over this ridiculous posturing by Chris Christie, Rand Paul, Jenny McCarthy et al. No sane, informed parent in their right mind could come to a conclusion that vaccines cause autism spectrum disorders. The problem is in the word "informed."  If your definition of "informed" consists of some talk show bimbo stating falsehood as fact, or some politician or pundit posturing to solicit votes, you are the victim, and your child may well become one without any recourse to common sense.

        I find it ludicrous that the same parents who will lobby their school board for "peanut free" cafeterias will, in turn, place the same child they believe they are protecting from the dreaded goober at equivalent or greater risk by eschewing vaccination against measles.  These persons are reacting to anecdotal and thoroughly disproved urban myths with their child's real physical welfare as the ante. Consider the "no vaccine " mom whose child contracts measles/rubella  while mom is incubating an unborn child. The birth defects which may eventuate are horrific. As bad as Autism spectrum disorder can be, (and it isn't caused by vaccines) , congenital Rubella syndrome is a nightmare, with effects that include blindness, microencephalopathy, and  all sorts of internal organ related pathological implications, just to name a few. Worse yet, the unvaccinated infected child may well be  asymptomatic but contagious for as much as 4 days.  Place this child in contact with another  who cannot be vaccinated for other health reasons and you may as well name him "Typhoid Harry!"

        The anti-vaccine Chicken Littles have absolutely no real medical evidence on which to base their indictment. The sole origin of this urban myth seems to be a study done in England by a  former doctor named Wakefield. I said former because when the real nature of his "study" and the damage done was realized, The Lancet retracted the  study and issued an apology, characterizing it (the study) as one of the "great medical frauds in history". Wakefield's license was revoked, but the damage had been done. So what exactly was the study, and what did it claim? Moreover, why has it been so thoroughly discredited? Finally, what have been the results in the UK, where it was published?

        First:  In 1998, an esteemed British medical journal (The Lancet, UK equivalent to the Journal of the AMA) published a paper with a startling conclusion: that the measles, mumps, and rubella vaccine (MMR) — administered to millions of children across the globe each year — could cause autism. This study, led by the discredited physician-researcher Andrew Wakefield, is where the current vaccine-autism debate started. It has since been thoroughly eviscerated: The Lancet retracted the paper, investigators have described the research as an "elaborate fraud," and Wakefield has lost his medical license. Public-health experts say that Wakefield's false data and erroneous conclusions, while resoundingly rejected in the academic world, still drive some parents' current worries about the MMR shot.   

       To begin with, Wakefield's association between the MMR vaccine and autism was based on a case report involving only 12 children. That's right just 12! remember that number when we cite later valid studies! "Case reports" are detailed stories about particular patients' medical histories. And, because they basically just stories — they are considered among weakest kinds of medical studies.

       In this case, many children have autism and nearly all take the MMR vaccine. Finding, among a group of a dozen children, that most of them happen to have both is not at all surprising and in no way proves that the MMR vaccine causes autism. (Wakefield also proposed a link between the vaccine and a new inflammatory bowel syndrome, which has since been called "autistic enterocolitis" and also discredited.)

        Don't stop with the retracted study. The totality of the evidence opposes this vaccine-autism theory. Large-scale studies involving thousands of participants in several countries (Japan, Finland, USA and others) have failed to establish a link between the MMR vaccine and  mental developmental disorder. As one of the most thorough studies to date showed, nearly half a million kids who got the vaccine were compared to some 100,000 who didn't, and there were no differences in the autism rates between the two groups.  Note - not 12, but groups of about half a million and 100,000  "This study provides strong evidence against the hypothesis that MMR vaccination causes autism," the authors wrote in The New England Journal of Medicine. Studies published in The Lancet, The Journal of Pediatric Infectious Diseases, PLoS One, and — among others — The Journal of Autism and Developmental Disorders have also found no association between the vaccine and autism.  

        A British investigative journalist, Brian Deer, rather just look at the numbers,  followed up with the families of each of the 12 kids in the study. He concluded, "No case was free of misreporting or alteration." In other words, Andrew Wakefield, lead author of the original report, manipulated his data. In The British Medical Journal, Deer spelled out exactly what he found, and it's mind blowing in light of his findings  that this study was ever published in the first place. You learn that the parents of many of the kids deny the conclusions in the study; some of the kids who Wakefield suggested were diagnosed with autism actually weren't; others who Wakefield suggested were "previously normal"  actually had pre-existing developmental issues before getting their shots.  Had The Lancet had access to this information, the study would never have seen the light of day.

       So, one might ask, what could possibly have been Wakefield's motivation to fudge the data and start all this brouhaha?   To start with, he  had financial conflicts of interest. While he was discrediting the combination measles-mumps-rubella vaccine, and suggesting parents should give their children single shots over a longer period of time, he was conveniently filing patents for single-disease vaccines. "For the vast majority of children, the MMR vaccine is fine," he said, "but I believe there are sufficient anxieties for a case to be made to administer the three vaccinations separately."

        Brian Deer's investigation further showed,  that, in June 1997, he (Wakefield) had filed a patent for a supposedly "safer" single measles vaccine. Deer writes, ".... his proposed shot, and a network of companies intended to raise venture capital for purported inventions — including 'a replacement for attenuated viral vaccines', commercial testing kits and what he claimed to be a possible 'complete cure' for autism — were set out in confidential documents." Follow the money! Wakefield has steadfastly refused to even attempt to replicate his research, styling himself as a martyr.

        Since the bogus study was published until 2013, incidence of measles in the UK has increased by a factor of 18. This year, for the first time MMR vaccination rates are again rising, as it becomes obvious that  Wakefield's scam has had vastly negative results. Meanwhile, here at home,  eye doctor Rand Paul,  pizza expert Chris Christie, talking head McCarthy (whose "autistic" child actually has something other than autism, it turns out) use their bully pulpits  to further the spread of anti-vaccine bullshit.

        The greatest generation once trumpeted the great scientific advancements of the post war era, today  science deniers and spreaders of urban myths symbolize regression to rumor and innuendo.  Oh, and as an added possibility, MMR means (as previously noted)  Measles, Mumps, Rubella. Let some unvaccinated dads contract mumps from their unvaccinated kids and lets' see how their attitudes change.