Will Current Media Frenzy Attacking Possible Autism Vaccine Links Be Counter Productive?

Will the current media frenzy unleashed with the BMJ-Brian Deer fraud allegations (unproven in a court of law) against Andrew Wakefield, followed up with another Paul Offit big media tour, and a star celebrity turn by Bill Gates yelling "LIARS" in his very loud voice finally result in an increase in vaccinations or will it be counterproductive?    Feel free to register your vote on the poll at the top of the sidebar. 

A Dose of Controversy Breezes Over Most Autism Vaccine Issues But Was Fair to Wakefield

I was actually pleased with the Matt Lauer/NBC coverage of the Wakefield/Deer and MMR/Vaccine Issues in A Dose of Controversy. I thought he was fair to Dr. Wakefield, giving him an opportunity to address allegations made against him. The program didn't go after Brian Deer for some of the allegations against him. While the program did give Paul Offit a free run to say what he wanted about vaccines and autism I thought he, of all people involved in the program, looked the most emotional and overwrought.

The coverage of vaccine-autism issues was light and glossed over many important issues including the "science disproving vaccine autism causal connections". The show did give Dr. Healy a brief spot to point out what is my main concern with the vaccine autism war - the obvious attempt to stifle scientific inquiry on vaccine autism issues that has been going on expressly since the IOM 2004 Report and the insufficiency of the scientific investigation to date of these issues. I don't know if Dr. Healy's sensible observations will make any impact on important audiences like IACC members but you never know.

A major criticism is the continuation of the characterization of parents as desperate, hysterical, dangerous, ignorant and unable to understand the issues or the science. It is a belief genuinely held by figures like Dr. Paul Offit and Dr. Thomas Insel and it is a belief which prevents them from being able to make their case persuasively to parents.

These criticisms aside I was pleased that NBC tried to air both sides of the Wakefield/Deer MMR war instead of following recent trends and simply giving a one sided account based totally on the medical establishment position.

autism

Mississippi Establishes Division of Autism Spectrum Disorders

The autism news has been dominated, until recently, by the professional misconduct hearings of Dr. Andrew Wakefield and the "vaccine court" proceedings in the US and now the exciting Cold Spring Harbor Laboratory study offering a unified theory of autism causation. A less dramatic but interesting autism public policy development has taken place in the State of Mississippi where that state has established an Autism Spectrum Disorders division of its Mental Health department. This sounds mundane beside the dramatic developments mentioned above but it seems to show a real commitment by the State of Mississippi to address the autism health crisis in that state. Such a demonstration of commitment should not go without recognition.

In New Brunswick Canada our province does not have a separate Mental Health Department let alone an Autism Spectrum Disorders division of its Health Department. New Brunswick did have an interdepartmental review of its existing autism services which completed its efforts and published a report in 2001. There have been some very positive developments in pre-school interventions since then in New Brunswick. Education is now just beginning to provide a real education to some autistic students, but adult residential care and treatment remain abysmal. But many of the recommendations of that 2001 interdepartmental autism report in New Brunswick were literally ignored. Some them are now outdated.

The fundamental promise of the 2001 IDC Autism Report in New Brunswick, a commitment to provision of evidence based services is not fully respected even, unfortunately, in the provision of preschool autism interventions in New Brunswick. The consequences of that failure will not be borne by the interest groups that stubbornly insist on implementation of non-evidence based interventions in New Brunswick or the public servants and politicians who defer to those groups. The consequences will be borne by the autistic children who could have benefited from evidence based effective autism intervention but were denied the opportunity.

The chance of seeing a stand alone Mental Health department in New Brunswick is slim to none let alone an Autism Spectrum Disorders division of such a department. But it would be of great benefit to autistic children in New Brunswick if the 2001 commitment to evidence based intervention were honored and prevailed over ignorance and vested interests.

In the meantime the State of Mississippi is providing some interesting organizational lessons that might be worthy of study by the Province of New Brunswick and other Canadian provinces.



http://www.clarionledger.com/apps/pbcs.dll/article?AID=/20070723/NEWS/70723033

July 23, 2007

Division of autism established at DMH

The Clarion-Ledger

The Mississippi Department of Mental Health (DMH) recently established a new division concentrating on autism in Mississippi. The Division of Autism Spectrum Disorders will initially focus its work around the newly formed Caring for Mississippi Individuals with Autism Task Force.

DMH was designated as the lead agency in HB 1267 which created the task force. The bill charges the group with reviewing the current state of services and practices and in turn filing a report making recommendations to the Legislature on its finding by Dec. 1, 2007. The recommendations made by the task force will address the areas of medical, educational and early interventions services. Further attention will be given to services across the lifespan of an individual and the preparation of professionals in the field for future service delivery.

Once the task force has made its recommendations, the Division of Autism Spectrum Disorder begins its long term function creating a Mississippi support system capable of serving Mississippians. This work will address the needs of individuals from birth throughout their life. The Division will work with other agencies to help improve existing services and create new ones.

Autism is the second most common developmental disability in the country second only to mental retardation. It is four times more common in boys than girls and present data has been offered by the Centers for Disease Control and Prevention stating that 1 out of every 150 children born is affected by an autism spectrum disorder. Autism is a neurological disorder. There is currently no known cause and no known cure. Autism knows no racial, ethnic, social boundaries, family income, lifestyle, or educational levels and can affect any family, and any child.

Autism Surging but Why? The Jury is Still Out

Lost in the hoopla over the Wakefield hearing in the UK and the "Vaccine trials" in the US are the increases in reported cases of autism in various parts of the world. The US reports have increased to 1 in 150 and the UK reports, by no less an authority than Simon Baron-Cohen himself, a 1 in 100 incidence of autism. Obviously some of those numbers are attributable to the changes in the DSM and in better awareness, diagnosis and reporting. But while everyone is aware of those factors no serious study or report actually attributes the entire increases in the incidence in autism to these factors alone, Baron-Cohen's opinion, and that of Neurodiversity bloggers notwithstanding.

The graph from the California Department of Developmental Services shows that reported incidence of autism increased by five times in the ten year period from 94 to 04. Undoubtedly the DSM change would be a substantial factor in that startling increase along with better awareness, diagnosis and reporting. But do environmental factors contribute to the increasing incidence of autism and if so to what extent? This is a serious question which is not answered by self assured opinions from Baron-Cohen. The medical tribunal will soon report its verdict on Mr. Wakefield and the US "Vaccine Court" may offer some insight on vaccines and thimerosal but as to environmental factors generally the jury may well be out for some time to come.

Autism-Vaccine Link Continues to Erode - LA Times

Autism discussions often provoke heated, intense discussion, debate and worse. Neurodiversity advocates condemn parents for seeking to cure or treat their own children, Dr. Ivar O. Lovaas, who has in fact done so much to help generations of autistic children, is painted as an evil mad scientist, but some of the most intense verbal warfare has been spawned by the belief that the MMR vaccine and thimerosal, a mercury based vaccine preservative have caused the dramatic rise in numbers of autism diagnosis in recent years. This belief has led to ome parents refusing to vaccinate their children in some countries. Here in Atlantic Canada we have recently experienced a mumps outbreak which some medical people have traced back to the United Kingdom and areas of lower vaccination rates resulting from the MMR Autism scare. As the following article from the online edition of the LA Times summarizes the science to date just does not support the existence of a vaccine autism link.

Link to autism continues to erode
Study after study dispels an earlier theory that the vaccine triggers the disease.
By Mary Beckman, Special to The Times
June 18, 2007


Last week, the U.S. Court of Federal Claims began hearing arguments about whether a childhood vaccine that protects against measles, mumps and rubella caused autism in a 12-year-old (Cedillo versus Secretary of Health and Human Services). Here is a look at the studies behind the controversy.

In 1998, a gastroenterologist named Dr. Andrew Wakefield, then at the Royal Free Medical School in London, examined 12 children with bowel problems. Nine had autism, a disorder that affects 1 in 150 youngsters. The parents of eight recalled that the symptoms started soon after the children received a vaccine against measles, mumps and rubella (the MMR vaccine). Wakefield postulated in an article in the Lancet that the vaccine might cause autism.

"Then he held a press conference and went a bit further," says Rachel Casiday of Durham University in the United Kingdom, who studies peoples' attitudes toward MMR and autism. Wakefield recommended the United Kingdom's Department of Health provide the three vaccines separately. The department refused, due to scientific, logistical and economic reasons. Casiday said this response probably made people think the government wasn't taking the issue seriously, and some parents of autistic children began to wonder.

Autism researcher David Mandell, of the University of Pennsylvania School of Medicine in Philadelphia, says the U.S. government made similar mistakes, with discussions about the potential link being held behind closed doors at the Centers for Disease Control and Prevention in Atlanta. "That gave off the appearance of impropriety," he says.

In 2004, 10 of 12 coauthors of Wakefield's paper retracted the claims in it.

Because of the public's concern, various governments investigated the possible autism-vaccine link with more rigorously-designed studies. Researchers focused on two vaccine components: thimerosal, a mercury-based preservative, and the killed virus that provides the immunization against measles.

Scientists started with studies that looked at how many children were being vaccinated and how many new cases of autism were diagnosed, to see if there was a link between the two, says epidemiologist Craig Newschaffer of Drexel University School of Public Health in Philadelphia. A 2001 study in California, for example, found that between 1980 and 1994, the number of MMR vaccines administered every year rose about 14%, but the autism rates rose 373%. Thus, vaccine administration could not account for the rise in cases of autism.

A 2005 Japanese study of children in Yokohama between 1988 and 1996 found that MMR vaccination rates dropped over that time, but autism rates rose, even after vaccinations stopped in 1993.

But the best evidence compares rates of autism in children who received the vaccine with rates in children who did not, Newschaffer says. A 2002 Denmark study of more than 537,000 children — 440,000 of whom had received the vaccine — between 1991 and 1998 found the same autism risk in vaccinated and unvaccinated children. No link was found between vaccination date and onset of autistic symptoms.

Wakefield had proposed the measles virus hid in tissues and induced the immune system to cause autism. But a 2006 report found that autistic children had no more measles virus in their blood cells than other children. Also, no connection has been found between children contracting measles, and autism.

Still more studies have found that autism rates continued to rise after thimerosal was removed from vaccines.

"Those studies just kept piling up that showed no association between MMR or thimerosal exposure and autism," Newschaffer says. To date, he says, about a dozen studies have investigated autism's link to one or the other, and none has found one. "Among the scientific community, it's pretty generally accepted that there is no link."

Newschaffer says researchers can't rule out a small percentage of highly susceptible individuals that the vaccine might affect, and so the search is still on for a possible link between either measles or mercury and the disease. The idea is not unreasonable, Newschaffer adds, but finding susceptible individuals is difficult.

Another unresolved issue is whether autism is actually increasing or physicians are getting better at diagnosing it. "It is extremely, extremely hard to tell the difference," Newschaffer says.

Mandell says he sympathizes with parents who see their toddlers all of a sudden lose the skills they've acquired. "It's human nature to search for an answer: 'Why does this happen?' " he says.

But regardless of where the disease is coming from, most people still get their children vaccinated. "There wasn't a wholesale revolt against the vaccine," Casiday says. "And in the last few years, it's been on the rise." And that, she says, is good news for the public welfare.

Evidence of Harm - The Sequel

In recent years theories that autism increases have been caused by either the MMR vaccine itself or thimerosal, the mercury based vaccine preservative, once more widely used, has dominated much public discussion of autism - despite an almost total lack of support for the vaccine causes autism theories amongst the world scientific community. But the controversy generated by the Wakefield study and the David Kirby/Robert Kennedy Jr anti-mercury campaigns has had an impact - on famlies already stressed by the realities of their children's autism and on a decline, at least temporarily, in the numbers of persons getting their children vaccinated against serious, dangerous diseases. Evidence of harm? You bet. Not the kind Kirby and Company rant about on the Huffington post though.

http://www.news-medical.net/?id=22732


Study reveals impact of the MMR controversy on parents of children with autism
Medical Studies/Trials

Published: Thursday, 29-Mar-2007

Researchers have found that the MMR controversy caused parents of children with autism feelings of stress, guilt and frustration. Their study is published in Archives of Disease Childhood.

In the course of 10 focus group discussions across the UK between 2003 and 2005 involving 38 parents of children with autism, scientists from the Medical Research Council (MRC) discovered the effects of the uncertainty caused by the MMR controversy on these parents. Their aim was to assess how the parents had been affected and identify their specific needs to inform how these might be met in future debates around immunisation.

In 1998, Andrew Wakefield and his colleagues published an article in which they claimed to have found a link between the MMR vaccine and the onset of autistic spectrum disorder, although most of his co-authors subsequently disassociated themselves from the suggestion that there was a link between the vaccine and autism.

The controversy that followed affected parents' decision-making with regards to MMR vaccination. The Health Protection Agency's figures show immunisation rates across the UK population fell from 92% before the controversy, to 80% by 2003/04 (http://www.hpa.org.uk/infections/topics_az/vaccination/cover.htm). Vaccination rates have since started to increase again as parental confidence in the vaccine has begun to recover. However, until now no research had looked at the impact of the MMR controversy on the parents of children with autism.

Dr Shona Hilton and her colleagues at the MRC Social and Public Health Sciences Unit in Glasgow found that many parents of children with autism have come under great stress and pressure as a result of the scare.

Dr Hilton found that some have experienced agonising uncertainty as to whether the MMR vaccine may have provoked their child's or children's autism. Many have wondered whether they are to blame for their child's condition or felt they had "let their children down" by deciding to vaccinate. Even those who felt that their child's autism was not linked to the MMR vaccine, either because of family history or because they had avoided vaccination, had suffered as a result of the ambiguous advice they felt that they had received.

The discussions also showed that most parents found it extremely difficult to make subsequent decisions about further vaccination for their children with autism and later children. Many parents felt let down by health professionals and health visitors as well as GPs. This appeared to be a result of the lack of clarity and consistency in what they were told. It may also have been a result of the perceived lack of empathy with and understanding of the realities of caring for a child with autism.

Dr. Hilton said: "It is clear from a review of the literature that there has been a lack of follow-up of the impact of this health scare on those likely to be most directly affected - those living day in and day out with children with autism. These parents in particular have been under a huge amount of stress about the possible impact of their decision to vaccinate or not. Often, those they turned to for guidance and advice, their health visitors and GPs, were not able to provide them with the support they needed.

Dr Hilton added "we are planning to conduct further research into whether health professionals feel that they are well-enough equipped to deal with parents during such health controversies, and how they can be better-supported. We hope to be able to develop new information materials and to identify other support that health professionals need in the difficult task they face of communicating with parents at the height of any future health controversies."

http://www.mrc.ac.uk