Delaware USA 19808
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Dear Abi Berger and BMJ:
Your sensationalistic review entitled "MMR: What They Didn't Tell You" (November 27) unfortunately fell short of doing its homework. For the sake of innocent children who may yet be damaged grievously by the MMR vaccine, I must hope that you and Brian Deer are not misinforming loving parents by allowing a pharmaceutical manufacturer or other entity with similarly vested interests to do your homework for you.
My 6 1/2 year old son, who is diagnosed with autism, was scoped by quite possibly the best pediatric gastroenterologist in this country. The findings evidenced that my son's gastrointestinal tract pathology is consistent with the findings of Dr. Andrew Wakefield. The work/findings of Dr. Wakefield have been replicated by various parties. Elevated titers corresponding with the antigens in the MMR vaccine may provide further substantiation of an MMR reaction, as might my son's laboratory testing showing an autoimmune reaction to brain tissue, which is consistent with the work of Dr. Singh and his correlation with vaccine strain measles virus.
Although you say that, "Large scale international epidemiological studies have repeatedly failed to find any indication for his advice to give single shots, or confirm the assertion of a causal link between the MMR vaccine and autism," you fail to mention that the most-often quoted study is the Danish MMR study, and that study has been refuted. In a press release of September 1, 2004, we read:
"Goldman and Yazbak report association between start of MMR Vaccination and Increase in Autism.
Based in part on a key Denmark study by K. Madsen in 2002, the Institute of Medicine (IOM) recently concluded that no connection existed between MMR vaccination and the increase in autism. During the period of Madsen’s study, in the US, the MMR vaccine was usually administered at the age of 12 months, often with two other vaccines (Hib and Hep B) that contained Thimerosal–a mercury derivative. By contrast, in Denmark, MMR vaccine was usually administered alone at the age of 15 months and by 1992 the thimerosal-containing pertussis vaccine had been phased out.
From 1992 to 2000, by the age of 6 months, infants in the U.S. had been exposed to 12 vaccines and up to 187.5 micrograms of thimerosal, compared to only 6 vaccines with no thimerosal in Denmark. Thus, Gary S. Goldman, Ph.D. and F. Edward Yazbak, M.D. took the opportunity to investigate the effect of the MMR vaccine on autism without the confounding (complicating) effects of thimerosal.
Goldman and Yazbak estimate that a substantial increase in autism occurred in Denmark after the introduction of the MMR vaccination in 1987. Their results therefore oppose those of Madsen who selectively restricted his review to the period between 1991 and 1998 and reported that a link did not exist.
Goldman explains some of the flaws inherent to the Madsen study, “Because autism is usually diagnosed at age 5 or older in Denmark, many children born in 1994 and thereafter would not have been diagnosed by the end of the study period.” He continues, “Since unimmunized children were clustered in the earlier years of the study, ascertainment was more complete in this cohort [group] than in those immunized a few years prior to the end of the study period, when many cases were missed owing to insufficient follow-up time to make the diagnosis.” Yazbak additionally notes, “Madsen himself concedes in a manuscript published less than a year later (Pediatrics-September 2003) that increases in autism occurred from 1991 to 2000 among children born after thimerosal had been discontinued.”
An MMR-autism link is supported by the fact that recently, measles genomic RNA has been detected in both the gut wall and the cerebrospinal fluid of some children with autism.
It has been suggested that increases in autism in Denmark were due to (1) a change that occurred in the manner in which autism was diagnosed in 1993/94 and (2) the fact that outpatients were added to the Danish registry after 1995. Goldman and Yazbak, however, avoided biases associated with these events and were the first to strictly consider data from 1980 to 1992, before the influence of these events. The results of their analysis are strengthened by the fact that in both California and North London, appreciable increases in the prevalence of autism occurred a decade apart, shortly after the introduction and large scale use of the MMR vaccine." You may read the full study in the Journal of American Physicians and Surgeons, Fall 2004, Vol. 9, No 3.
According to Dr. V. Singh, speaking at the Institutes of Medicine meeting in Washington, DC on February 9, 2004, "there was a positive correlation (90% or greater) between MMR antibody and MBP [myelin basic protein] autoantibody.... These findings led me to speculate that the measles subunit of the MMR vaccine might trigger an autoimmune reaction in a significant number of autistic children." If you would like a copy of this transcript or other writings of Dr. Singh, please let me know.
A friend of mine has a son who never had shown a sign of autism, and they have nurses in the family who might have detected such. Within 10 minutes of being injected with the MMR vaccine, he had a 104 degree fever and commenced incessantly screaming and crying; this lasted 10 hours. The next day he was "gone" -- that is, regressed into the condition called autism. They did not give her next son the MMR vaccine, and he did not become autistic. Unfortunately, her youngest son was accidentally given an MMR vaccine by a practitioner; he developed a fever and started crying 6 hours after the shot, and he regressed into autism within 10 days.
Another friend of mine has twin boys who, after receiving their MMR vaccines, also regressed into autism.
I hope that for the sake of tiny innocent children and their loving parents, the BMJ will retract their sensationalistic libel against Dr. Wakefield. You cannot attack the science, so you are attacking the man. That is most uncivilized.
Teri Small Delaware USA
Competing interests: parent of child with medically documented gastrointestinal pathology consistent with damage attributed to MMR vaccination