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Are autism and vaccinations linked, after all?

October 29, 2012

Hi Reader,

I know that you are not one of the reasonproof individuals still running around claiming that vaccines cause autism despite the pile of scientific papers demonstrating that this belief is utter nonsense. In fact, I had been under the impression that even the most stalwart anti-vaxxer had abandoned this cause. However, as  difficult as it may be to believe, recent events have proven that there are still some of them out there, standing steadfast and strong in their denial of science. If you should come across one of these people, approach with care. There is no telling what other odd and irrational beliefs they may have, and being stuck in conversation with them at a cocktail party may result in your rolled eyes “getting stuck like that”.

But anyway, I wanted to alert you to a recent publication, entitled “Immunization uptake in younger siblings of children with autism spectrum disorder” by Kuwaik et al. and published in the journal Autism on October 8, 2012. This work was conducted within a Canadian prospective study of autism, which included children diagnosed with autism, their younger siblings, and a matched control group. There are several important pieces of information provided by this study, which was designed to assess whether rates of immunization were different in siblings of children diagnosed with autism vs. controls. One of the findings of the paper is that autism is, in fact, statistically signficantly related to vaccinations after all…but probably not in the way that is expected by anti-vaxxers. In short, here are the two major results of the study.

1. In the population studied, parents of autistic children were significantly more likely to delay or decline vaccinations compared to those of non-autistic controls.

A total of 60.2% of children who had an older sib diagnosed with autism had delayed or declined MMR and/or DPTP (diphtheria, pertussis, tetanus, and polio); whereas only 9.2% of controls delayed vaccination, and all controls eventually received all vaccinations. Importantly, only 24% of the older siblings with autism had delayed or declined vaccination.

The public health significance of this finding is striking. The latter observation regarding differential vaccination rates within families is a key part of this analysis, as it strongly supports the concept that the misinformation about vaccines causing autism had a profound effect on the choice of whether to vaccinate children after an older sibling was diagnosed with autism.  It must be noted, however, that the  sample of families who had enrolled in this study may be biased, and that the rates of vaccination delay or refusal are likely to be lower among families with autistic children in the general population. We must also note that 40% of families who with an older sib diagnosed with autism fully vaccinated their younger children on time. Therefore, the paper should not be used to make generalized statements about how all families with autistic children make healthcare decisions.

Nonetheless, this finding provides strong evidence of the effect of Andrew Wakefield’s fraudulent paper and the subsequent adoption and promotion of vaccinations as a cause of autism by groups such as Generation Rescue. The findings also, finally, provide that elusive link between autism and vaccinations, in the sense that a diagnosis of autism is significantly associated with a decline in vaccination in later siblings.

2. In secondary analyses, the rate of autism was approximately double in younger sibs who had delayed (31%) or declined (33%) vaccinations as compared to those who were fully immunized  on time (15%).

First and foremost reader, we must note that these results were not statistically significantly different from one another, and were secondary analysis. Thus, we must use caution in interpreting these data, as the authors themselves state in the paper. The numbers used for these calculations were relatively small, with 6/39 fully vaccinated younger sibs having been diagnosed with autism; 15/47 of those who had delayed vaccination; and 4/12 who had refused vaccination. The relatively small sample size indicates that caution is warranted in making sweeping conclusions about the idea that vaccinations may actually reduce the risk of autism. But it would certainly be fair to say that we now have yet another paper showing that there were no significant differences in the rate of autism between unvaccinated and vaccinated children.

We can now add yet another study to the catalogue of studies showing absolutely no association between vaccination and autism rates, though it does show an association between autism and vaccination rates. I wonder how many more of these will have to be produced before we can convince those last few holdouts who cling to a belief that vaccines cause autism despite all evidence to the contrary, and who do more damage than they can possibly imagine to the families of those with autistic loved ones.

Nevertheless, in my opinion, the most important aspect of this paper is the clear and deleterious effect of pseudoscientific information on vaccination rates. And it doesn’t just strike families with autistic members; rather, perpetuation of this type of misinformation has a broad-based and negative impact on public health overall.

From → vaccines

62 Comments
  1. Thank you for sharing! I will reblog this. Autism advocates need to see this and speak out more about the damage antivaxxers do to society as a whole by peddling their false beliefs about autism and vaccines!

    Ivan

  2. Reblogged this on Athena, Ivan, and The Integral and commented:
    Autism and vaccines ARE related, but not in the way antivaxxers such as Jenny McCarthy and Andrew Wakefield would have us believe.

  3. Posted this on Twitter already, but anyway. There’s an earlier paper that suggested a lower risk of autism after vaccines containing thiomersal, though the actual conclusion was simply that there was no increased risk. http://pediatrics.aappublications.org/content/118/1/e139.abstract Strangely the antivax people rarely mention this…

  4. It has been my experience that you can try to reason with these people. You can try to show them even tangible evidence that their beliefs are misguided at best, wrong at worst. And you can bring down their demigods successfully. You will not change their minds. Some people just want to watch the world burn.

    • Or in this case, they want to douse themselves with gasoline and jump over a bonfire.

    • Chris permalink

      I often ask them questions that they have great deal of difficulty answering. Due to them just reading certain websites that they will cut and paste, they miss out on some crucial information. One of them being different MMR vaccines with varying strains of measles and mumps strains, or that an MMR vaccine was used outside the UK since the 1970s, that St. Wakefield calling for single vaccines caused parents to get their children a mumps vaccine that was illegally imported to the UK (the mumps strain that was removed in 1992), what one has to read and understand before using the VAERS database from its official portal (NVIC has a way to skip that crucial bit of info), and on and on.

      It shows the holes in their “research”, and it often trips them up. Some give up, and once in a blue moon one will go “Oh, I did not know that. Thank you.”. Then there are the trolls who will not answer even the simplest questions but just regurgitate conspiracy theories. They are ignored.

  5. Oh, you are welcome skewed. I didn’t realize it was still up though, I usually switch reblogs from posts to drafts since I can’t write out all of my thoughts in one sitting. I will switch it to a draft but once I’m done writing it will be back up again :)

    I just want to add my two cents as an advocate. Taking it down doesn’t mean I changed my mind about supporting

    Ivan

  6. oh it is a draft……never mind :p silly me.

  7. Shaliza permalink

    Thanks for another great article, Skewed. :)

    I’m surprised that rabid anti-vaxxers haven’t been all over this blog post with their plaintive cries about how vaccines DO INDEED cause Autism. Or maybe it’s the calm before the storm… sigh…

    I am often exposed to those nutjobs who walk in my office going off about the tens and thousands of vaccinated kids that they know are autistic. When I tell them about all my unvaccinated patients who ARE autistic, they are literally speechless, and then proceed to tell me that they were diagnosed wrong. LOL… they will stop at nothing to support all their incorrect, stupid ideas, and have no problem wasting my precious time in the process.

    Clearly none of them have lived in the third world where people are dying of measles, hepatitis, pertussis and the like, and the only reason autism rates are low is because they are NOT diagnosed and people are more comfortable believing that someone is possessed by evil spirits, rather than getting a behavior disorder properly diagnosed. I’ve seen it happen many times in my years of living in Sri Lanka, and my mom and I were recently discussing our own, unvaccinated relatives with such problems which we now recognize as autistic spectrum disorders. But of course, learning the truth is never easy, so anti-vaxxers would rather resort to Googling crap and come to the incorrect conclusions over and over and over again. Sheesh!

  8. Chris permalink

    You should get a kick out of the new sure-fire-this-is-definitely-the-study-that-proves-vaccines-cause-autism-because-it-is-from-MIT: Empirical Data Confirm Autism Symptoms Related to Aluminum and Acetaminophen Exposure.

    The “empirical data” is a search through the VAERS database. One would think that an electrical engineer working on speech recognition systems would have a better grasp of statistics.

    • Shaliza permalink

      LOL! Thanks for that link, Chris. :D

      I find it thoroughly amusing what you can publish and pass off as “research,” nowadays. So now Tylenol is supposed to cause autism, when given with vaccines to prevent fever? And this claim is based on “empirical data search” through the VAERS database? LOL! I would personally LOVE to see a proper research done to show that the risks of Tylenol use far outweigh the benefits, and that its use should be banned for this reason. Somehow, I feel like we’d be waiting a long time for this.

      I’m also amused thoroughly amused that they mentioned right at the end that the use of antiperspirants may account for increased aluminum exposure and thereby increase your chances of having an autistic child. Why not do a case controlled study on antiperspirants then, and on the effects they have on pregnant women using them? Vaccines have to take all the heat when it comes to autism, so how about looking in other directions like common hygiene products that also increase your absorption of aluminum through the skin, DAILY?

      Anti-vaxxers accuse us of having tunnel vision, when they themselves are more than guilty of this very vice. They are so consumed with proving that vaccines are BAD, that they continue to neglect other sources of the same so-called toxic substances, be it antiperspirants or seafood consumption.

      Give me a freakin’ break!

    • autism epi permalink

      A new well done, prospective cohort study supports the association between acetaminophen use and autism. Prolonged use during pregnancy was associated with severe neurodevelopmental outcomes (all autism phenotypes) in 3 year olds.

      http://www.ncbi.nlm.nih.gov/pubmed/24163279

  9. Population control. You people believe all these studies, go ahead. I will keep my children drug free and healthy. I don’t need to read every study. I know how studies come together. They are made for the highest bidder to read whatever will make them the most money…… Just like every other drug on the market. The FDA leaves the studies up to the drug companies to have done. And I have lived in this world long enough to know how money can make the truth whatever you want it. I will keep playing it safe and not drug my kids. At least this way if they get sick by something that could have been “prevented by vaccinations” it’s my fault and it will save me from catching a case. Because if my child was given a drug and became autistic the quack would become dead or a paraplegic. Quacks are taught by schools funded by drug companies. Wake up and start questioning what you are being taught at your overpriced school. And I don’t want to hear some over educated person telling me any different. I live in Pittsburgh, home of UPMC full of QUACKS!!!!!! Just like there is no cure for cancer…….. BS I personally know someone that made their cancer disappeared and not from something their quack prescribed. The medical field and drug companies know but their is no $profit$ from a cure but ton’s in just treating.

    • This is a hilarious use of the Pharma Shill Gambit.

      Now be original and do something different: provide real verifiable evidence. This means that you post the title, journal and dates of the PubMed indexed studies that show that the MMR is more dangerous than measles (which kills at least once out of a thousand cases), of that the DTaP is more dangerous than pertussis. Come on, you can do it, just do some thinking for yourself.

      • Once again, Chris and I will be huddled together, waiting…

      • Shaliza permalink

        Chris says:

        “This is a hilarious use of the Pharma Shill Gambit.”

        LMAO! Thanks a bunch for that link, Chris. I am still chuckling, and I guess that’s the new thing I learned for today. ;)

        Oh and Skewed, allow me to to join you and Chris as we wait for dear Curt Westley to provide *any* substantial evidence for *any* of his outrageous claims. I’m especially interested in hearing about “the person who made their cancer disappear without utilizing anything prescribed by their quack.”

        LOL!

    • “I’ve lived in this world long enough..”

      Not long enough, apparently, to be able to rationalize or critically examine evidence. But then, given his rant, I think it’s just his overall education which is lacking.

    • “Because if my child was given a drug and became autistic the quack would become dead or a paraplegic”

      Ah, yes, once again the level of violence that comes naturally to anti-vaxxers is apparent. Thanks for adding to my collection of threats by your ilk. Incidentally, UPMC is one of the premier medical institutions in the U.S., and of course, is the home of the fabulous Jonas Salk. All hail UPMC!

      • Thomas permalink

        John Best used to make threats of violence all the time too (though oddly enough only against women) – I read it as an admission that even he couldn’t imagine winning an argument via reason…

    • Thomas permalink

      ” I personally know someone that made their cancer disappeared and not from something their quack prescribed.”

      Why are you covering up this miracle cure? That’s the most evil thing I’ve ever heard of. You should be ashamed of yourself and this person you “personally know.”

  10. Five and blue permalink

    http://www.hindawi.com/journals/biomed/2012/132876/

    What do you make of this study?

      • Five and blue permalink

        The Pub Med link lists 118 studies. Is there one of those that you want me to compare to the first link? I’m not sure what the connection is that you are trying to make to the link I pasted.

        • Really? You don’t see the connection at all?

        • Chris permalink

          Hint: check the search words used, read what I called the link and then read the first link.

          Another hint: look up the difference between ethanol and methanol, there is a reason that one letter is bolded. It is something that Dr. Dorea does not seem to understand, along with dose level.

        • Chris permalink

          Here is a question for you: What vaccine in the American (not Brazilian) pediatric schedule is only available with thimerosal? Do not include influenza, since about half of the available vaccines do not have thimerosal.

        • Five and blue permalink

          Hi Chris,
          I was a little turned off by the “hints” you left for me. I was sensing a disrespectful tone and lost interest in the conversation. That said, tone can be very hard to discern in writing with people you don’t know. Let me look again at you were getting at…

        • Chris permalink

          Oh, so sorry. It seems you are new to this subject. You must not have known that thimerosal in vaccines (which were removed over a decade ago) and mercury in fish are two separate subjects.

          The Faroe Islands project was quite a while ago. It determined that mercury found in whale meat caused certain developmental delays in children when from the mercury in their mother’s bodies. It really has nothing to do with autism, since that is a developmental condition that is completely different from mercury poisoning.

          What I did was first post the FDA recommendations on fish for pregnant women. The second link that was titled “Old News” was to indicate how much research had been done.

          I have been dealing with the “thimerosal in vaccines cause autism” people for at least fifteen years. I have a son with a developmental delay which may or may not be associated with a history of seizures. His neo-natal convulsions prevented him from getting the DTP vaccine due to the scaremongering in the 1980s by certain folks (Barbara Loe Fisher), he only had the DT. But that same scaremongering reduced herd immunity, and at that time there was a pertussis epidemic in our county. Then as a toddler he had another severe seizure from a now vaccine preventable disease. He could not speak when he was three years old, and after over ten years of speech therapy he can speak, but it is hard to understand. He is twenty-four years old and we may have to get a guardian trust for him, because he may never be employed, both because of his learning disabilities and his heart condition. Fun times.

          I suggest that in order to not get bamboozled the next time you stumble into a blog post on autism and vaccines that you read the following books:

          The Panic Virus by Seth Mnookin
          Autism’s False Prophets and Deadly Choices by Paul Offit

          And you would really really enjoy The Poisoner’s Handbook, Deborah Blum is a great writer (she loves chemistry, but apparently she was too accident prone in the lab, so she became a writer):

          http://www.wired.com/wiredscience/elemental

        • Oh dear, I’m afraid I became an epidemiologist for the same reason that Blum became a writer. I am not a graceful person. I had a few lab mishaps that led to me think it would be safer for humanity if I did a more computationally-related job.

    • First, Dorea is a known anti-vax researcher.

      2nd. They attempt to use Hg in hair as proof that it’s thimerosal which is the issue, and not the amount of fish consumed during pregnancy.

      However, their test doesn’t discriminate between MeHg and EtHg. Furthermore, they have no data regarding what types of fish were consumed. As they themselves noted, eating predatory fish was associated with higher Hg levels. They also did not account for other dietary exposure sources; a test of the local water and air would have been in order – especially since there are known environmental releases to the waterways in those areas

      See: http://www.scopus.com/record/display.url?eid=2-s2.0-0032778967&origin=inward&txGid=FA7DF05F50A0499A56E24C4025FBBE1C.aXczxbyuHHiXgaIW6Ho7g%3a2

      Ethyl mercury is more water soluble than methyl. Ergo, it is excreted via the fecal route, with a much shorter half-life in our bodies. Methyl mercury tends to get caught up in enterohepatic recirculation, which is why it takes longer for us to excrete it.

      • that should read, “as they themselves previously noted” – from some of their earlier research.

        WTB preview function, sigh.

  11. Five and blue permalink

    Thank you, Darwy, for the comments on the link. I was curious about the validity of the study. You raise some interesting points.

    Chris, I’ve been working 11 hour days lately and just didn’t have the time to read through all the study titles to figure out which one you wanted me to look at. I wasn’t trying to egg you on (sorry if it seemed that way). I am not aware of any childhood vaccine in the US that is only available with thimerosal.

    I am not a fan of thimerosal, though, and am disappointed that it is used at all these days. If we have decided not to use it in our shots for children, why not take it out of the shots we give to adults? I went for a flu shot last month at work and had to make a special request for one without thimerosal. The nurses were giving everybody the shots with the thimerosal, but they had a few w/o thimerosal reserved in another room for any pregnant women seeking the shot.

    • Chris permalink

      If you read my hints you would have understood that you did not need to read through each paper.

      I went for a flu shot last month at work and had to make a special request for one without thimerosal. The nurses were giving everybody the shots with the thimerosal, but they had a few w/o thimerosal reserved in another room for any pregnant women seeking the shot.

      Excuse me, but how many full grown employed adults become autistic by being exposed to thimerosal? Give me the list of the PubMed studies, surely if it scares you there would be a PubMed indexed paper showing that this happens.

      Are you a pregnant woman? Some states have legislated that thimerosal vaccines be provided, though there is no actual scientific evidence that the tiny amount causes neurological issues. Wait, you said the thimerosal were for them, and you were denied. So you are not a pregnant woman. Because, if you look at the studies in the PubMed list, and Dr. Dorea’s paper: they are all about the children of pregnant and breastfeeding women. And the actual culprit is fish with methylmercury.

      So, if you are pregnant or lactating, you really only need to worry about fish. Otherwise, you are good to go. Unless you can show us that someone became autistic after eating a tuna steak, or a lovely chunk of whale caught near the Faroe Islands. Seriously.what evidence do you have that vaccines with thimerosal cause adults to become autistic?

      Oh, and you have not answered the question about that bolded “m”, are you going to get around to that? Do you now the difference between the two types of alcohol? (hint: read The Poisoner’s Handbook) And for all of the hand wringing you doing over that tiny bit of thimerosal (with ethylmercury), I really really hope that you do not drink any ethylmercury, and neither inhale THC nor nicotine.

      Or about the dose? How much methylmercury is in fish versus the ethylmercury in one vaccine? Why is that bolded m so important? Since this website puts my comments in moderation when I imbed a URL, I will present this list of this years influenza vaccines for you to tell us how those amounts cause an adult to become autistic:

      http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6132a3.htm#tab

      • Five and blue permalink

        So many questions to answer…
        1) Re: how many fully grown adults develop autism? I have no idea. Probably very few or none. I never indicated in my comments that I thought this was an issue.
        2) That is not a fear of mine, and I do not know of any PubMed studies on the topic.
        3) Yes, I am a woman.
        4) No, I am not pregnant.
        5) No, I am not lactating. Thank God.
        6) No, I do not have any evidence of any adults becoming autistic from eating tuna, whale, or from thimerosal in vaccines – nor did I mention or allude to any of those things in my previous comment.
        7) Yes, I know that methyl mercury and ethyl mercury have differences.
        8) No, I do not drink alcohol.
        9) No, I have not read The Poisoner’s Handbook.
        10) No, I do not smoke.
        11) I do not worry how thimerosal compares with fish. I don’t eat fish anymore because of he high levels of mercury detected by random tests at restaurants.

        Did I satisfy your need for answers from me?

        • Chris permalink

          Yes, that is satisfactory.

          If you place of employment does not provide you free thimerosal-free vaccines, then go to you local pharmacy and pay for the thimerosal free vaccine.

          ) Re: how many fully grown adults develop autism? I have no idea. Probably very few or none. I never indicated in my comments that I thought this was an issue.

          Go to the top of the page, read the title. What is the subject of the article. Now exactly why was thimerosal considered as an issue with pediatric vaccines? Think about it. Why is the main Yahoo group which was a focal point of “vaccines causing autism” in the USA called “Autism-Mercury”? This is exactly the place where Sallie Bernard asked for an old version of DTaP with thimerosal for a study over a decade ago: http://onibasu.com/archives/am/27456.html

          So call it a wild guess that your feared autism. And no, since autism is a developmental condition it is not caught by adults. You really don’t have anything to fear, and a little bit of seafood is not going to hurt you.

    • Chris permalink

      Correction: ” Wait, you said the thimerosal were for them, and you were denied.” should be

      “Wait, you said the thimerosal free were for them, and you were denied.”

    • Chris permalink

      Correction: ” Wait, you said the thimerosal were for them, and you were denied.” should be

      “Wait, you said the thimerosal free were for them, and you were denied.”

      Again, you need to provide evidence that adults are affected, since the rather weak literature is only on pregnant and lactating women. And then it would only affect the fetus or child who is being breastfed. We can assume that you a not pregnant, lactating, a fetus or getting breastfed.

    • Well, thimerosal has been removed from nearly all childhood vaccines, I believe only one individual shot has trace amounts of less than 0.3 ug (IIRC).

      There’s a few reasons why it’s difficult to get a flu shot without thimerosal at times. First – thanks to the dubious claims of thimerosal injury – they tend to save them for the pregnant women (who are more at risk from the flu, and its complications, than non-pregnant women).

      Second – if the proverbial *ahem* $hit hits the fan with an epidemic, there aren’t enough individual shots (or multidose vials) to go around for everyone. The individual shots cost more to produce, they cost more to store and to dispose of. With the multidose vials, that cost isn’t as high.

      One flu shot with thimerosal is still less ‘mercury’ than eating fish. Period. Despite the ‘ingestion/injection’ argument that many anti-vaxxers would like folks to believe, there really is NO difference between the amount of ‘mercury’ you’re exposed to via either route.

      Why?

      Methyl mercury is nearly 100% adsorbed through the GI tract. Given that the amount of methyl mercury in most fish is greater than the amount of thimerosal (and therefore ethyl mercury) in a vaccine – the dietary route is still the primary and most relevant route for ‘mercury’ exposure.

      I use the word ‘mercury’ in this manner because there ARE differences in the compounds and their toxicities, much like there are differences between them and elemental mercury. As I’ve previously mentioned, methyl mercury tends to get caught up in enterohepatic recirculation, which is why the half life for methyl mercury is nearly twice that of ethyl – but that’s also a reflection of its solubility. EtHg is more water soluble, and doesn’t undergo recirculation like MeHg does, so we see it being excreted more rapidly in the stool.

      • Chris permalink

        Dawry:

        Well, thimerosal has been removed from nearly all childhood vaccines, I believe only one individual shot has trace amounts of less than 0.3 ug (IIRC).

        Actually, they are all available without thimerosal. One out of three DTaP vaccines has a trace, and at least half of the influenza vaccines do not have thimerosal. See:

        http://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/VaccineSafety/ucm096228.htm#t1

        Which is pretty much how it has been for at least a decade, without any real drop in the percentage of children being diagnosed with autism.

        It must be some irrational fear that leads some full grown adults to think they can become autistic from a flu vaccine. Good grief, there are more dangerous substances that are constantly being consumed by adults that are sold at the corner store: liquor and tobacco… and tuna sandwiches.

  12. Mike permalink

    So this is a website dedicated to criticizing supplements, the anti-vaccine movement and alternative medicine in general?? Forgive me if I am misrepresenting the intention here but that appears to be the only goal of this entire website. Ever thought about a more productive message, writing and promoting the things you love rather than focusing your efforts on criticism for the things you dislike? Try it sometime as I think you will probably feel better about yourself and help many others much more than you are currently on this platform.

    • Chris permalink

      Read this: http://skeweddistribution.com/about/

      By the way, Mike, your comment is a perfect example of concern trolling. You are attacking the blogger, Skeweddistribution by providing what you think is constructive criticism, plus you are telling him what to write. While you may disagree with him, it would be more effective if you actually produced evidence to support an actual statement.

      And if you don’t like what he writes: then don’t read it. Then go create your own blog where you can write what makes you feel better.

      • Deeply, truly concerned permalink

        Pish tosh, mike is absolutely correct. Everyone should ignore evil whenever possible – the suffering of children in particular is something to be passive about. Learn Mike’s lesson well – the Internet should only be used to express concern, not to provide mere facts.

    • I am promoting things that I love. These include:

      1. Vaccines
      2. Science
      3. Common sense

      If you don’t like these things, mosey on over to the faeries and unicorns webpage of your choice. You know, the land where breastmilk can cure smallpox and there are rainbows in your sprinker.

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