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 the vaccine ingredients do not cause autism. [4] Vaccinologist Peter Hotez researched the growth of the false claim and concluded that its spread originated with Andrew Wakefield's fraudulent 1998 paper, with no prior paper supporting 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]

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 This paper, which was retracted in 2010 and whose publication led to Wakefield being struck off the United Kingdom medical register, has been described as "the most damaging medical hoax of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". [9]

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 ]

The Centers for Disease Control and Prevention (CDC), [10] the IOM of the United States National Academy of Sciences, [11] and the National Health Service [12] 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. [13]

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. [14] 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. [15] 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. [16]

On 12 February 2009, a special court convened in the United States to review claims under its National Vaccine Injury Compensation Program ruled parents of autistic children are not entitled to compensation in their contention that certain vaccines caused their children to develop autism. [17]

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. [18] Thiomersal contains ethylmercury, a mercury compound which is related to, but significantly less toxic than, the neurotoxic pollutant methylmercury. Despite decades of safe use, [19] 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. [20] (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].) [21] [22] The action engendered concern thiomersal could have been responsible for autism. [20]

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] There is no accepted scientific evidence that exposure to thiomersal is a factor in causing autism. [23]

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. [24] 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. [25] A 2004 Institute of Medicine (IOM) committee favored rejecting any causal relationship between autism and vaccines containing thiomersal [11] and rulings from the vaccine court in three test claims in 2010 established the precedent that thiomersal is not considered a cause of autism. [26] [27] [28]

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. [29] 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. [30] Other scientific findings support the idea that vaccinations, and even multiple concurrent vaccinations, do not weaken the immune system [8] or compromise overall immunity [31] and, furthermore, evidence that autism has any immune-mediated pathophysiology has still not been found. [8]

Aluminium

As mercury compounds in vaccines have been definitively ruled out as a cause of autism, some anti-vaccine activists propose aluminium salts as the cause of ASD. [32] This is based in part on the erroneous popular belief that aluminium causes Alzheimer disease. [33] There is no substantial scientific evidence that aluminium salts are linked to autism but anti-vaccination activists commonly cite a number of papers which claim that there is in fact a link. [34] These are mainly published in predatory open access journals, [35] 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. [36] The work published by Shaw et al. has been discredited by the World Health Organization. [37]

Celebrity involvement

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, [38] Toni Braxton, [38] Robert De Niro, [39] Jim Carrey, [40] Bill Maher, [41] and Pete Evans. [42]

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. [43] She authored Louder than Words: A Mother's Journey in Healing Autism and co-authored Healing and Preventing Autism. [44] She also founded an organisation called Generation Rescue, which provides resources for families affected by autism. [45]

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. [46]

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. [47] He is also the founder and chairman of the board of Children's Health Defense, a group and website widely known for its anti-vaccination stance. [48]

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. [49]

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. However, some diseases, such as measles outbreaks in America, have seen rising cases due to relatively low vaccination rates in the 2010s – attributed, in part, to vaccine hesitancy. According to the World Health Organization, vaccination prevents 3.5–5 million deaths per year.

<span class="mw-page-title-main">MMR vaccine</span> Any of several combined vaccines 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. 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.

David Kirby was an American journalist based in Brooklyn, New York, and was formerly a regular contributor to The New York Times since 1998. He was the author of Evidence of Harm (2005), Animal Factory (2010), Death at Sea World (2012), and When They Come for You (2019). Kirby wrote on thiomersal and vaccines and has criticized factory farms.

<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.

Thiomersal is a mercury compound which is used as a preservative in some vaccines. Anti-vaccination activists promoting the incorrect claim that vaccination causes autism have asserted that the mercury in thiomersal is the cause. There is no scientific evidence to support this claim. The idea that thiomersal in vaccines might have detrimental effects originated with anti-vaccination activists and was sustained by them and especially through the action of plaintiffs' lawyers.

A vaccine adverse event (VAE), sometimes referred to as a vaccine injury, is an adverse event believed to have been caused by vaccination. The World Health Organization (WHO) knows VAEs as Adverse Events Following Immunization (AEFI).

<span class="mw-page-title-main">Causes of autism</span> Proposed causes of autism

The causes of autism are environmental or genetic factors that predispose an individual to develop autism, also known as autism spectrum disorder (ASD). Many causes of autism have been proposed, but understanding of the theory of causation of autism is incomplete. Attempts have been made to incorporate the known genetic and environmental causes into a comprehensive causative framework. ASD is a neurodevelopmental disorder marked by impairments in communicative ability and social interaction and restricted/repetitive behaviors, interests, or activities not suitable for the individual's developmental stage. The severity of symptoms and functional impairment vary between individuals.

<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 discredited former doctor 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> Discredited British former doctor (born 1956)

Andrew Jeremy Wakefield is a British anti-vaccine activist, former physician, and discredited academic who was struck off the medical register for his involvement in The Lancet MMR autism fraud, a 1998 study that fraudulently claimed a link between the measles, mumps, and rubella (MMR) vaccine and autism. He has subsequently become known for anti-vaccination activism. Publicity around the 1998 study caused a sharp decline in vaccination uptake, leading to a number of outbreaks of measles around the world. He was a surgeon on the liver transplant programme at the Royal Free Hospital in London and became senior lecturer and honorary consultant in experimental gastroenterology at the Royal Free and University College School of Medicine. He resigned from his positions there in 2001, "by mutual agreement", then moved to the United States. In 2004, Wakefield co-founded and began working at the Thoughtful House research center in Austin, Texas, serving as executive director there until February 2010, when he resigned in the wake of findings against him by the British General Medical Council.

<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.

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.

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 MMR vaccine and colitis and between colitis and autism. The fraud 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 $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 high proportion of internet sources on the topic are "inaccurate on the whole" which can lead people searching for information to form "significant misconceptions about 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.

<span class="mw-page-title-main">Anti-vaccine activism</span>

Anti-vaccine activism, also called the "anti-vax" movement, is organized activity designed to increase vaccine hesitancy, often by disseminating misinformation or disinformation. Although myths, conspiracy theories, misinformation and disinformation spread by the anti-vaccination movement and fringe doctors increases vaccine hesitancy and public debates around the medical, ethical, and legal issues related to vaccines, there is no serious hesitancy or debate within mainstream medical and scientific circles about the benefits of vaccination.

References

  1. 1 2 3 Taylor LE, Swerdfeger AL, Eslick GD (June 2014). "Vaccines are not associated with autism: an evidence-based meta-analysis of case-control and cohort studies". Vaccine. 32 (29): 3623–9. doi:10.1016/j.vaccine.2014.04.085. PMID   24814559.
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  4. ↑ "Vaccines Do Not Cause Autism Concerns". Centers for Disease Control and Prevention . 2018-12-12. Retrieved 2019-02-07.
  5. ↑ J., Hotez, Peter (30 October 2018). "Vaccines did not cause Rachel's autism : my journey as a vaccine scientist, pediatrician, and autism dad". JHU Press. ISBN   9781421426600. OCLC   1020295646.{{cite news}}: CS1 maint: multiple names: authors list (link)
  6. ↑ Cummins, Eleanor (February 2019). "How autism myths came to fuel anti-vaccination movements A timeline leading to the 2019 measles outbreaks". Popular Science.
  7. ↑ Foster CA, Ortiz SM (February 2016). "Vaccines, Autism, and the Promotion of Irrelevant Research: A Science-Pseudoscience Analysis". Skeptical Inquirer . 41 (3): 44–48. Archived from the original on 2018-10-06. Retrieved 6 October 2018.
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  17. ↑ Vaccine court and autism:
    • "Vaccine didn't cause autism, court rules". CNN. 2009-02-12. Retrieved 2009-02-12.
    • Theresa Cedillo and Michael Cedillo, as parents and natural guardians of Michelle Cedillo vs. Secretary of Health and Human Services, 98-916V (United States Court of Federal Claims2009-02-12).
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  24. ↑ "Vaccine Safety & Availability - Thimerosal in Vaccines". www.fda.gov. Retrieved 2016-02-08.
  25. ↑ Sugarman SD (September 2007). "Cases in vaccine court--legal battles over vaccines and autism". The New England Journal of Medicine. 357 (13): 1275–7. doi: 10.1056/NEJMp078168 . PMID   17898095.
  26. ↑ "UPDATE 1-US court rules again against vaccine-autism claims". Reuters. 2010-03-12. Retrieved 2019-02-07.
  27. ↑ Salzberg, Steven. "Vaccine Court Ruling: Thimerosal Does Not Cause Autism" . Retrieved 2019-02-07.
  28. ↑ Dyer, Clare (2010-03-16). "Thiomersal does not cause autism, US court finds". BMJ. 340: c1518. doi:10.1136/bmj.c1518. PMID   20233774. S2CID   27129014 . Retrieved 2019-02-07.
  29. ↑ Hilton S, Petticrew M, Hunt K (May 2006). "'Combined vaccines are like a sudden onslaught to the body's immune system': parental concerns about vaccine 'overload' and 'immune-vulnerability'". Vaccine. 24 (20): 4321–7. doi:10.1016/j.vaccine.2006.03.003. PMID   16581162.
  30. ↑ Immune challenges:
  31. ↑ Vaccine burden:
  32. ↑ Nerd, Gid M.-K; Health (2017-12-05). "Vaccines Don't Cause Autism" . Retrieved 2019-02-07.{{cite news}}: CS1 maint: multiple names: authors list (link)
  33. ↑ Lidsky TI (May 2014). "Is the Aluminum Hypothesis dead?". Journal of Occupational and Environmental Medicine. 56 (5 Suppl): S73-9. doi:10.1097/JOM.0000000000000063. PMC   4131942 . PMID   24806729.
  34. ↑ Principi, N; Esposito, S (September 2018). "Aluminum in vaccines: Does it create a safety problem?". Vaccine. 36 (39): 5825–31. doi:10.1016/j.vaccine.2018.08.036. PMID   30139653. S2CID   52073320.
  35. ↑ "Vaccines, Autism, and Retraction". 2017-05-10. Archived from the original on 2019-10-19. Retrieved 2019-02-07.
  36. ↑ "Dwoskin Foundation – Science-Based Medicine" . Retrieved 2019-02-07.
  37. ↑ "UBC stands behind vaccine studies discredited by WHO". 2015-03-04. Retrieved 2019-02-07.
  38. 1 2 "Kristin Cavallari Defends Anti-Vaccine Stance". The Huffington Post. 19 March 2014. Retrieved 2016-02-08.
  39. ↑ "Robert De Niro defends discredited idea linking vaccines to autism". Stat . 13 April 2016. Retrieved 2016-04-13.
  40. ↑ Kluger J (2 July 2015). "Jim Carrey, Please Shut Up About Vaccines". TIME.com. Retrieved 2016-02-08.
  41. ↑ Tenbarge, Kat. "Bill Maher agreed with a controversial doctor, repeating a debunked theory that it was 'realistic' that vaccines have caused autism in children". Insider. Retrieved 2019-11-02.
  42. ↑ "Bent Spoon to celebrity chef Pete Evans – Australian Skeptics Inc". 2019-03-28. Archived from the original on 2019-03-28. Retrieved 2021-01-26.
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  45. ↑ "About Generation Rescue » Generation Rescue | Jenny McCarthy's Autism Organization". www.generationrescue.org. Retrieved 2016-02-08.
  46. ↑ "Medical experts condemn Donald Trump for debate comments suggesting vaccines can cause autism". NY Daily News. 18 September 2015. Retrieved 2016-02-08.
  47. ↑ Hyman M, Herbert MR (2014-08-04). Kennedy RF (ed.). Thimerosal: Let the Science Speak: The Evidence Supporting the Immediate Removal of Mercury--a Known Neurotoxin--from Vaccines. Skyhorse Publishing. ISBN   9781632206015.
  48. ↑ Smith, Michelle R; Reiss, Johnatan (May 13, 2021). "Inside one network cashing in on vaccine disinformation". Associated Press . AP News . Retrieved October 3, 2021.
  49. ↑ Even If It's 'Bonkers,' Poll Finds Many Believe QAnon And Other Conspiracy Theories
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