Vaccines and autism

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Extensive investigation into vaccines and autism spectrum disorder [1] has shown that there is no relationship between the two, causal or otherwise, [1] [2] [3] and that vaccine ingredients do not cause autism. [4] The American scientist Peter Hotez researched the growth of the false claim and concluded that its spread originated with Andrew Wakefield's fraudulent 1998 paper, and that no prior paper supports a link. [5]

Contents

Despite the scientific consensus for the absence of a relationship [1] [2] and the retracted paper, the anti-vaccination movement at large continues to promote theories linking the two. [6] A developing tactic appears to be the "promotion of irrelevant research [as] an active aggregation of several questionable or peripherally related research studies in an attempt to justify the science underlying a questionable claim." [7]

Claimed mechanisms

The claimed mechanisms have changed over time, in response to evidence refuting each in turn. [8] The CDC published updated statistics on autism in children for the year 2020. It states that in the year 2000, there were 1 in 150 children who were born in 1992 diagnosed with autism. [9] In 2020, they found 1 in 36 children born in 2012 were diagnosed with autism. [9] Anti-vaccination groups believe this to be the increased number of vaccines in children. Although there has been an increase in vaccines, there has been an increase in autism screenings. It is clear from the literature and the CDC the increased number of children diagnosed with autism is due to the increase in ways to diagnose it. The anti-vaccine groups credit ingredients in the vaccines to be the connection to autism. Some of the most mentioned ones are thiomersal, aluminum adjuvants, and formaldehyde. The MMR vaccine will be explained as well. Celebrity and social media involvement seem to play a role in the anti-vaccine movement.

Autism screening history

Vaccine-derived measles virus

The idea of a link between the MMR vaccine and autism came to prominence after the publication of a paper by Andrew Wakefield and others in The Lancet in 1998. This paper, which was retracted in 2010 and whose publication led to Wakefield being struck off the United Kingdom medical register, has been described as "the most damaging medical hoax of the last 100 years". [12]

Wakefield's primary claim was that he had isolated evidence of vaccine-strain measles virus RNA in the intestines of autistic children, leading to a condition he termed autistic enterocolitis (a condition never recognised or adopted by the scientific community). This finding was later shown to be due to errors made by the laboratory where the polymerase chain reaction (PCR) tests were performed.[ citation needed ]

In 2009, The Sunday Times reported that Wakefield had manipulated patient data and misreported results in his 1998 paper, thus falsifying a link with autism. [13] A 2011 article in the British Medical Journal describes the way in which Wakefield manipulated the data in his study in order to arrive at his predetermined conclusion. [14] An accompanying editorial in the same journal described Wakefield's work as an "elaborate fraud" which led to lower vaccination rates, putting hundreds of thousands of children at risk and diverting funding and other resources from research into the true cause of autism. [15]

On 12 February 2009, a special court convened in the United States to review claims under its National Vaccine Injury Compensation Program ruled that parents of autistic children are not entitled to compensation in their contention that certain vaccines caused their children to develop autism. [16]

The Centers for Disease Control and Prevention (CDC), [17] the IOM of the United States National Academy of Sciences, [18] and the National Health Service [19] have all concluded that there is no link between the MMR vaccine and autism. A systematic review by the Cochrane Library concluded that there is no credible link between the MMR vaccine and autism, that the MMR vaccine has prevented diseases that still carry a heavy burden of death and complications, that the lack of confidence in the MMR vaccine has damaged public health, and that the design and reporting of safety outcomes in MMR vaccine studies are largely inadequate. [20] Further, an epidemiology study concluded that even children labeled high risk for autism, due to an older autistic sibling, that received the MMR vaccine resulted in no causal connection between the vaccine and autism or the increased risk of being diagnosed with autism. [21]  The assumption that MMR vaccines cause autism is not isolated to the United States. A seven-year study was done in Denmark from 1991 to 1998 following children who received the MMR vaccine. The results of the study found that when comparing the vaccinated children to the unvaccinated children, the risk of autism in the vaccinated group was 0.92. [21] Also, the risk of another autism disorder was 0.83. [21] The study concluded there was no association between the MMR vaccine and autism. [21] The result held even when exploring the age of the child when the vaccine was given, the vaccination date, or the amount of time after the vaccine. [21]

Thiomersal

Thiomersal is an antifungal preservative used in small amounts in some multi-dose vaccines (where the same vial is opened and used for multiple patients) to prevent contamination of the vaccine. [22] Thiomersal contains ethylmercury, a mercury compound which is related to, but significantly less toxic than, the neurotoxic pollutant methylmercury. Despite decades of safe use, [23] public campaigns prompted the CDC and the American Academy of Pediatrics (AAP) to request vaccine makers to remove thiomersal from vaccines as quickly as possible on the precautionary principle. Thiomersal is now absent from all common United States and European Union vaccines, except for some preparations of influenza vaccine. [24] (Trace amounts remain in some vaccines due to production processes, at an approximate maximum of 1 microgramme, around 15% of the average daily mercury intake in the US for adults and 2.5% of the daily level considered tolerable by the World Health Organization [WHO].) [25] [26] The action engendered concern thiomersal could have been responsible for autism. [24]

The idea that thiomersal was a cause or trigger for autism is now considered disproven, as incidence rates for autism increased steadily even after thiomersal was removed from childhood vaccines. [8] The cause of autism and mercury poisoning being associated is improbable because the symptoms of mercury poisoning are not present and are inherently inconsistent with the behaviors or symptoms of autism. [27] There is no accepted scientific evidence that exposure to thiomersal is a factor in causing autism. [28] A study by the CDC exploring mercury poisoning in vaccines concluded no signs of poisoning were present. [27]

Under the U.S. Food and Drug Administration (FDA) Modernization Act (FDAMA) of 1997, the FDA conducted a comprehensive review of the use of thiomersal in childhood vaccines. Conducted in 1999, this review found no evidence of harm from the use of thiomersal as a vaccine preservative, other than local hypersensitivity reactions. [29] Despite this, starting in 2000, parents in the United States pursued legal compensation from a federal fund arguing that thiomersal caused autism in their children. [30] A 2004 Institute of Medicine (IOM) committee favored rejecting any causal relationship between autism and vaccines containing thiomersal [18] and rulings from the vaccine court in three test claims in 2010 established the precedent that thiomersal is not considered a cause of autism. [31] [32] [33]

Vaccine overload

Following the belief that individual vaccines caused autism was the idea of vaccine overload, which claims that too many vaccines at once may overwhelm or weaken a child's immune system and lead to adverse effects. [34] The Children's Hospital of Philadelphia Vaccine Education Center compiled a list of vaccines recommended to children throughout history. They found that from 1985-1994, the recommended number of vaccines totaled to eight. [35] The schedule for 2011 to 2020 revealed the recommended number of vaccines totaled to fourteen. [35] Vaccine overload became popular after the Vaccine Injury Compensation Program in the United States accepted the case of nine-year-old Hannah Poling. Poling had encephalopathy, putting her on the autism spectrum disorder, which was believed to have worsened after getting multiple vaccines at nineteen months old. [8] There have been multiple cases reported similar to this one, which led to the belief that vaccine overload caused autism. However, scientific studies show that vaccines do not overwhelm the immune system. [8] In fact, conservative estimates predict that the immune system can respond to thousands of viruses simultaneously. [8] It is known that vaccines constitute only a tiny fraction of the pathogens already naturally encountered by a child in a typical year. [8] Common fevers and middle ear infections pose a much greater challenge to the immune system than vaccines do. [36] Other scientific findings support the idea that vaccinations, and even multiple concurrent vaccinations, do not weaken the immune system [8] or compromise overall immunity [37] and evidence that autism has any immune-mediated pathophysiology has still not been found. [8]

Impact of vaccines on Diphtheria, Meningococcal, Polio, Haemophilus Influenzae type B, Measles, and Pertussis. The impact of vaccination on selected diseases in the UK.png
Impact of vaccines on Diphtheria, Meningococcal, Polio, Haemophilus Influenzae type B, Measles, and Pertussis.

Vaccines recommended from 1985-1994 [35]

Vaccines recommended from 2011-2020 [35]

Diphtheria, Tetanus, and Pertussis were given together as the DTap. [35] Measles, Mumps, and Rubella were given together as MMR. [35]

Aluminium adjuvants

As mercury compounds in vaccines have been definitively ruled out as a cause of autism, some anti-vaccine activists propose aluminium adjuvants as the cause of autism. [38] Aluminium adjuvants, simulates immune receptors and causes a strengthened response to the antigen in a way that is natural to the body. [39] Aluminium adjuvants can be used in the form of soluble salts, alumina, and hydroxl. [39] There is no substantial scientific evidence that aluminium adjuvants are linked to autism. When confirming that aluminium adjuvants are not dangerous in vaccines, it was concluded that there was no traces of aluminium in the children's hair or blood over the minimum level of risks according to the Agency for Toxic Substances and Disease Registry. [39] Anti-vaccination activists commonly cite a number of papers which claim that there is in fact a link. [40] These are mainly published in predatory open access journals, [41] where peer-review is virtually non-existent. Work conducted by Christopher Shaw, Christopher Exley and Lucija Tomljenovic has been funded by the anti-vaccination Dwoskin Family Foundation. [42] The work published by Shaw et al. has been discredited by the World Health Organization. [43]

Formaldehyde

Formaldehyde is another assumed link between vaccines and autism. Even though the assumption still circles around, formaldehyde has been used safely in the diphtheria vaccines to detoxify the bacteria used to make the vaccine. [44] Another way it can be used is to inactivate the disease to be used in the vaccine. [44] Formaldehyde can be found naturally in the body and environment. The human body uses formaldehyde to build amino acids and to generate the energy we need. [44] Formaldehyde is all around us in daily life activities. It can be found in preservatives, materials used to build, and many products in homes. [44] There is no safety concern for formaldehyde in vaccines. The most concerning repercussion is cancer after exposure to high levels of formaldehyde in the air. [44] The amount of formaldehyde in some vaccines is less than what the body naturally produces. [44]

Celebrity involvement and social media

Jenny McCarthy speaking against the use of vaccines. She remains convinced that they caused autism in her son. Jenny McCarthy 2012.jpg
Jenny McCarthy speaking against the use of vaccines. She remains convinced that they caused autism in her son.

Some celebrities have spoken out on their views that autism is related to vaccination, including: Jenny McCarthy, Kristin Cavallari, [45] Robert De Niro, [46] Jim Carrey, [47] Bill Maher, [48] and Pete Evans. [49]

McCarthy, one of the most outspoken celebrities on the topic, has said her son Evan's autism diagnosis was a result of the MMR vaccine. [50] She authored Louder than Words: A Mother's Journey in Healing Autism and co-authored Healing and Preventing Autism. [51] She also founded Generation Rescue, an organisation which provides resources for families affected by autism. [52]

In a September 2015 U.S. presidential debate, Republican Party candidate and future United States President Donald Trump stated he knew of a 2-year-old child who had recently received a combined vaccine, developed a fever, and subsequently autism. [53]

Robert F. Kennedy, Jr. is one of the most notable proponents of the anti-vaccine movement. Kennedy published the book Thimerosal: Let the Science Speak: The Evidence Supporting the Immediate Removal of Mercury--A Known Neurotoxin--From Vaccines. [54] He is also chairman of the board of Children's Health Defense, a group and website widely known for its anti-vaccination stance. [55]

A study conducted through Facebook explored the results of anti-vaccine ads and pro-vaccine ads. The study found that even with a similar number of anti-vaccine ads and pro-vaccine ads, the middle point in the data set of ads per buyer was higher in anti-vaccine ads. [56] Another difference the study revealed was that the anti-vaccine ads were primarily targeted toward women and young adults who possibly had children. [55] The pro-vaccination ads were presented evenly to different ages. [55]

Public opinion

In December 2020, a poll of 1,115 U.S. adults found 12% of respondents believed there is evidence vaccinations cause autism; 51% believed there is no evidence; and 37% did not know. [57]

An updated survey, conducted in March 2023, concluded that adults think the MMR health benefits are high/very high, at 72%, and the risk of side effects is low/very low, at 64%. [58] There has also been a drop from 2019 in United States adults who believe students in schools should be fully vaccinated. The 2023 survey showed that a decrease to 70% of U.S. adults agree that children should be vaccinated for school but an increase to 28% believe that it is the parent's right to choose if the child is vaccinated for school. [58]

Related Research Articles

<span class="mw-page-title-main">Vaccination</span> Administration of a vaccine to protect against disease

Vaccination is the administration of a vaccine to help the immune system develop immunity from a disease. Vaccines contain a microorganism or virus in a weakened, live or killed state, or proteins or toxins from the organism. In stimulating the body's adaptive immunity, they help prevent sickness from an infectious disease. When a sufficiently large percentage of a population has been vaccinated, herd immunity results. Herd immunity protects those who may be immunocompromised and cannot get a vaccine because even a weakened version would harm them. The effectiveness of vaccination has been widely studied and verified. Vaccination is the most effective method of preventing infectious diseases; widespread immunity due to vaccination is largely responsible for the worldwide eradication of smallpox and the elimination of diseases such as polio and tetanus from much of the world. According to the World Health Organization (WHO), vaccination prevents 3.5–5 million deaths per year. A WHO-funded study by The Lancet estimates that, during the 50-year period starting in 1974, vaccination prevented 154 million deaths, including 146 million among children under age 5. However, some diseases have seen rising cases due to relatively low vaccination rates attributable partly to vaccine hesitancy.

<span class="mw-page-title-main">Vaccine</span> Pathogen-derived preparation that provides acquired immunity to an infectious disease

A vaccine is a biological preparation that provides active acquired immunity to a particular infectious or malignant disease. The safety and effectiveness of vaccines has been widely studied and verified. A vaccine typically contains an agent that resembles a disease-causing microorganism and is often made from weakened or killed forms of the microbe, its toxins, or one of its surface proteins. The agent stimulates the body's immune system to recognize the agent as a threat, destroy it, and recognize further and destroy any of the microorganisms associated with that agent that it may encounter in the future.

<span class="mw-page-title-main">MMR vaccine</span> Combined vaccine against measles, mumps, and rubella

The MMR vaccine is a vaccine against measles, mumps, and rubella, abbreviated as MMR. The first dose is generally given to children around 9 months to 15 months of age, with a second dose at 15 months to 6 years of age, with at least four weeks between the doses. After two doses, 97% of people are protected against measles, 88% against mumps, and at least 97% against rubella. The vaccine is also recommended for those who do not have evidence of immunity, those with well-controlled HIV/AIDS, and within 72 hours of exposure to measles among those who are incompletely immunized. It is given by injection.

<span class="mw-page-title-main">Thiomersal</span> Organomercury antiseptic and antifungal agent

Thiomersal (INN), or thimerosal, also sold under the name merthiolate is an organomercury compound. It is a well-established antiseptic and antifungal agent.

<span class="mw-page-title-main">Vaccine hesitancy</span> Reluctance or refusal to be vaccinated or have ones children vaccinated

Vaccine hesitancy is a delay in acceptance, or refusal, of vaccines despite the availability of vaccine services and supporting evidence. The term covers refusals to vaccinate, delaying vaccines, accepting vaccines but remaining uncertain about their use, or using certain vaccines but not others. Although adverse effects associated with vaccines are occasionally observed, the scientific consensus that vaccines are generally safe and effective is overwhelming. Vaccine hesitancy often results in disease outbreaks and deaths from vaccine-preventable diseases. Therefore, the World Health Organization characterizes vaccine hesitancy as one of the top ten global health threats.

<span class="mw-page-title-main">Bernard Rimland</span> American psychologist (1928–2006)

Bernard Rimland was an American research psychologist, writer, lecturer, and influential person in the field of developmental disorders. Rimland's first book, Infantile Autism, sparked by the birth of a son who had autism, was instrumental in changing attitudes toward the disorder. Rimland founded and directed two advocacy groups: the Autism Society of America (ASA) and the Autism Research Institute. He promoted several since disproven theories about the causes and treatment of autism, including vaccine denial, facilitated communication, chelation therapy, and false claims of a link between secretin and autism. He also supported the ethically controversial practice of using aversives on autistic children.

Generation Rescue is a nonprofit organization that advocates the scientifically disproven view that autism and related disorders are primarily caused by environmental factors, particularly vaccines. The organization was established in 2005 by Lisa and J.B. Handley. Today, Generation Rescue is known as a platform for Jenny McCarthy's autism related anti-vaccine advocacy.

<span class="mw-page-title-main">Childhood immunizations in the United States</span>

The schedule for childhood immunizations in the United States is published by the Centers for Disease Control and Prevention (CDC). The vaccination schedule is broken down by age: birth to six years of age, seven to eighteen, and adults nineteen and older. Childhood immunizations are key in preventing diseases with epidemic potential.

Concerns about thiomersal and vaccines are commonly expressed by anti-vaccine activists. Claims relating to the safety of thiomersal, a mercury-based preservative used in vaccines, are refuted, but still subject to fearmongering, notably claims it could cause neurological disorders such as autism, leading to its removal from most vaccines in the US childhood schedule. This had no effect on the rates of diagnosis of pervasive developmental defects, including autism. Extensive scientific research shows no credible evidence linking thiomersal to such conditions.

<span class="mw-page-title-main">National Vaccine Injury Compensation Program</span> U.S. no-fault system for litigating vaccine injury claims

The Office of Special Masters of the U.S. Court of Federal Claims, popularly known as "vaccine court", administers a no-fault system for litigating vaccine injury claims. These claims against vaccine manufacturers cannot normally be filed in state or federal civil courts, but instead must be heard in the U.S. Court of Federal Claims, sitting without a jury.

Claims of a link between the MMR vaccine and autism have been extensively investigated and found to be false. The link was first suggested in the early 1990s and came to public notice largely as a result of the 1998 Lancet MMR autism fraud, characterised as "perhaps the most damaging medical hoax of the last 100 years". The fraudulent research paper, authored by Andrew Wakefield and published in The Lancet, falsely claimed the vaccine was linked to colitis and autism spectrum disorders. The paper was retracted in 2010 but is still cited by anti-vaccine activists.

<span class="mw-page-title-main">Andrew Wakefield</span> British former doctor (born 1956)

Andrew Jeremy Wakefield is a British fraudster, discredited academic, anti-vaccine activist, and former physician.

<i>Cedillo v. Secretary of Health and Human Services</i> Legal case in US Court of Federal Claims, decided in 2009

Michelle Cedillo v. Secretary of Health and Human Services, also known as Cedillo, was a court case involving the family of Michelle Cedillo, an autistic girl whose parents sued the United States government because they believed that her autism was caused by her receipt of both the measles-mumps-and-rubella vaccine and thimerosal-containing vaccines. The case was a part of the Omnibus Autism Proceeding, where petitioners were required to present three test cases for each proposed mechanism by which vaccines had, according to them, caused their children's autism; Cedillo was the first such case for the MMR-and-thimerosal hypothesis.

Frank DeStefano FACPM is a medical epidemiologist and researcher at the Centers for Disease Control and Prevention, where he is director of the Immunization Safety Office.

Kreesten Meldgaard Madsen is a Danish epidemiologist and expert on infectious diseases who, as of 2003, worked at the Danish Epidemiology Science Centre at Aarhus University. He is known for leading two studies that found no link between either the MMR vaccine and autism or thimerosal and autism. The first of these studies pertained to MMR and was published in 2002; the second pertained to thimerosal and was published in 2003. Both of these studies received considerable media attention.

<i>Vaxxed</i> 2016 anti-vaccination documentary film

Vaxxed: From Cover-Up to Catastrophe is a 2016 American pseudoscience propaganda film alleging a cover-up by the Centers for Disease Control and Prevention (CDC) of a purported link between the MMR vaccine and autism. According to Variety, the film "purports to investigate the claims of a senior scientist at the U.S. Centers for Disease Control and Prevention who revealed that the CDC had allegedly manipulated and destroyed data on an important study about autism and the MMR vaccine"; critics derided Vaxxed as an anti-vaccine propaganda film.

In early months of 2019, a measles outbreak occurred in the Portland metropolitan area, including the Clark County, Washington suburbs, in the United States. At the time, the outbreak was the largest outbreak in more than two decades; outbreaks in 2019 in areas including Brooklyn and Rockland County, New York have since seen far greater numbers of cases.

The Lancet MMR autism fraud centered on the publication in February 1998 of a fraudulent research paper titled "Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children" in the Lancet. The paper, authored by now discredited and deregistered Andrew Wakefield, and twelve coauthors, falsely claimed causative links between the measles, mumps, and rubella (MMR) vaccine and colitis and between colitis and autism. The fraud involved data selection, data manipulation, and two undisclosed conflicts of interest. It was exposed in a lengthy Sunday Times investigation by reporter Brian Deer, resulting in the paper's retraction in February 2010 and Wakefield being struck off the UK medical register three months later. Wakefield reportedly stood to earn up to US$43 million per year selling diagnostic kits for a non-existent syndrome he claimed to have discovered. He also held a patent to a rival vaccine at the time, and he had been employed by a lawyer representing parents in lawsuits against vaccine producers.

Misinformation related to immunization and the use of vaccines circulates in mass media and social media in spite of the fact that there is no serious hesitancy or debate within mainstream medical and scientific circles about the benefits of vaccination. Unsubstantiated safety concerns related to vaccines are often presented on the internet as being scientific information. A large proportion of internet sources on the topic are mostly inaccurate which can lead people searching for information to form misconceptions relating to vaccines.

JABS is a British pressure group launched in Wigan in January 1994. Beginning as a support group for the parents of children they claim became ill after the MMR vaccine, the group is currently against all forms of vaccination.

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  57. ↑ Even If It's 'Bonkers,' Poll Finds Many Believe QAnon And Other Conspiracy Theories
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