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Study answers autism fears
By WES ALLISON © St. Petersburg Times, published March 7, 2001 She doesn't know for sure, but Michelle Guarino believes the vaccine for measles, mumps and rubella given to her daughter, Brittany, came at a terrible cost. "I gave birth to my daughter, I watched her develop normally and then she started losing speech at close to 2," said Guarino of Spring Hill in Hernando County. "Shortly after her MMR she short-circuited. Was it just coincidence?" The experts say yes, but the family decided Brittany's younger brother, Michael Conner, would not get the MMR shot, and instead would get the three vaccines separately. Many parents of autistic children have the same fear, fueled by stories on the Internet and TV and the fact that the symptoms of autism typically become evident around 18 to 19 months of age, a few months after most kids get the MMR vaccine. But a study published today in the Journal of the American Medical Association finds no correlation between autism and the measles-mumps-rubella combination, which is given to more than 80 percent of U.S. toddlers. The report, by the immunization branch of the California Department of Health Services, looked at autism and vaccination rates among thousands of children born from 1980 to 1994 in California, and it concludes what most doctors and every major public health agency, including the U.S. Centers of Disease Control and Prevention, has stated. Although diagnosed autism in the state jumped by 373 percent during that time period, the rate of MMR vaccination increased by just 10 percent. If the vaccine were to blame, the authors reasoned, then cases of autism should have shot up when MMR first became widely used, in 1980. The findings are similar to two recent studies from Great Britain. "If (the autism increase) is real, our data and the data in Great Britain ... show MMR can't be the cause," said Dr. Loring Dales, the lead author. Public health officials worry that unproven fears about the MMR vaccine will lead parents to avoid vaccinating their children, prompting a resurgence of the diseases, which can be deadly. But even Dales acknowledges the study might not assuage parents and advocates who contend the MMR connection is backed by too much anecdotal evidence, and that it needs far more research. "None of us are anti-vaccine. We all want the very best for our kids," said Rick Rollens, co-founder of Medical Investigation of Neurodevelopmental Disorders, a research center at the University of California at Davis, who blames the autism of his son, Russell, on immunizations he got as an infant. "But I think the vaccine manufacturers and the public heath community have failed in providing us with proof that these vaccines don't cause problems." Autism covers a variety of related developmental disorders that leave children unable to communicate or learn normally, and it varies in severity. Brittany Guarino, now 11, attends regular fifth-grade classes, for instance, but she doesn't talk. Others may be severely disabled, unresponsive or combative. The Autism Society of America puts the incidence at one case for every 250 to 500 people. A British scientist, Dr. Andrew Wakefield, first suggested the MMR link in a British medical journal, The Lancet, in 1998. His report, involving just 12 children, has been widely debunked by other scientists but has caught fire among parents desperate for answers. Physicians admit some vaccines have risks. The live polio virus once used in vaccines sometimes caused polio. A former version of the pertussis vaccine caused brain damage in a small number of children. But Dr. Henry L. Shapiro, medical director of developmental and behavioral pediatrics at All Children's Hospital, said evidence that MMR is to blame for autism is too weak even to withhold the vaccine from some children in order to study the autism rates among them. "How many people will get sick if you don't immunize them? I think the evidence is very strong that all the risk is in not getting immunized," said Shapiro, who treats autistic children. The CDC and National Institutes of Health have asked the Institute of Medicine to investigate the effect of vaccines on autism and other ills. Wakefield is scheduled to speak at the IOM panel's next meeting, on Thursday in Washington. The CDC does not recommend giving the measles, mumps and rubella vaccines separately because children would be susceptible to those diseases in the meantime, the agency says. The World Health Organization, which also supports the MMR vaccine, says measles kills 875,000 people worldwide every year, primarily in developing countries, while rubella infects some 100,000 and can cause deafness, blindness and mental retardation. But Shapiro does think the JAMA study's method of comparing autism rates to vaccination rates is open to critique. It doesn't leave room for the possibility that some, not all, of the autism cases were related to the vaccine. To illustrate his point, Shapiro offered this example: The number of people who smoke has dropped in recent years, yet cancer cases have remained steady. Based on the reasoning of the MMR study, one could deduce that smoking is not related to cancer, when in fact it does cause some types. "It's not a landmark study, but it contributes a little bit," Shapiro said of the JAMA piece. "It's much harder to disprove something, so these published articles never really put things to rest." Want to learn more?Institute of Medicine: www.iom.edu Autism Society of America: www.autism-society.org U.S. Centers for Disease Control: www.cdc.gov
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