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Peter E. Tanguay, M.D., F.A.C.P. - PETER E. TANGUAY, M.D., F.A.C.P. has shared the following information related to autism as part of his interview with StorkNet members. Please click here to read his interview.

Autism & The MMR Vaccine

Peter E. Tanguay, M.D.

In February 1998, an article in Lancet by Wakefield and colleagues at the Royal Free Hospital and School of Medicine in London, reported that eight children who had received MMR (measles, mumps and rubella) vaccine developed symptoms of "autism spectrum disorder" between one day to two weeks after vaccination. the children also all developed inflammatory bowel disease (IBD). They suggested that MMR vaccination led to IBD, resulting in malabsorption, neurological damage and "autism." An accompanying commentary in Lancet, followed by many letters-to-the-editors, pointed out that shortcomings in Wakefield's methods could well have led to misleading results. MMR vaccination is given around the same time when most cases of autism are first suspected. Wakefield's patients were not a random sample: he and his colleagues interest in supposed MMR-induced autism was already well known, and cases were being referred to them on that basis. There were no control groups, no double-blinding and no independent observers or diagnosis. Several writers argued that chronic non-specific colitis, as described by Wakefield, is a common form of non-infective colonic inflammation in this age group. Wakefield replied to these letters, claiming that his critics were misinformed or had misinterpreted his statements. He did not directly address the methodological problems of his study and continued to argue that MMR vaccine could cause autism. Subsequently, Wakefield's claims were given wide coverage in the English press.

In March 1998, an article in the British Medical Journal recalled a similar situation which had happened in the early 1970s, when anecdotal reports linked pertussis vaccination with infant brain damage. Again it was an example of a temporal link between a vaccine and a devastating childhood condition whose natural peak onset was at a time when most children routinely received the vaccine. A national study eventually showed that while there was a temporal association with encephalopathy, any risk of lasting damage from the vaccine was so rare as to be unquantifiable. Following the initial report, however, parental and professional anxiety had soared, and national immunization rates fell from 80 to 30 percent. The number of susceptible children rose, and in the twelve years after 1976 three major pertussis epidemics occurred, resulting in 300,000 cases and 70 deaths

In 1998 and 1999 two studies appeared (both in Lancet) which did not support Wakefield's beliefs. Peltola and his colleagues reported a follow-up study on MMR vaccination in Finland, involving three million doses, in which 31 children developed mild gastrointestinal disorders and none developed autism. In a reverse approach, Taylor and his colleagues at the University College Medical School in London, identified 498 cases of autism from the disability registers of eight North Thames health districts in England. They found no temporal association with autism within one to two years after vaccination with MMR. They concluded that if such cases occurred, it was so rare as not to be identifiable in this size of sample. The Journal of Pediatrics reported Taylor's findings under the headline, "New research demolishes the link between MMR vaccine and autism."

Despite the lack of scientific support for the MMR-autism link, it continues to have its advocates. Wakefield, for one, remains convinced. At a congressional hearing convened by Representative Dan Burton last April [this was written in 2000], he testified that he has now studied 150 children with "autistic entercolitis" (Note that now it even has its own specific name) and that he expects to publish a detailed analysis of his cases. The Internet reverberates with accusations of cover-ups by the proponents of MMR vaccination. It is not unlike what happened some years ago with cold fusion. Despite the fact that cold fusion has been shown to violate fundamental laws of physics as well as to have no evidence in its favor, there are still small groups of physicists and other supporters who gather annually to proclaim its truth and to argue that if only the "right" experiments could be done, cold fusion would be vindicated. All of us want to prevent autism, and there is a human propensity to interpret chance association with cause. Before we think about stopping vaccinations, we should not forget the 70 preventable pertussis deaths in England between 1970 and 1990.

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