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          "Healing Autism: No Finer a Cause on the Planet"
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March 7, 2001                      Search   www.feat.org/search/news.asp


Time Trends in Autism and in MMR Immunization Coverage in California
Loring Dales, MD; Sandra Jo Hammer, RN, PHN; Natalie J. Smith, MD, MPH

      [The following is the abstract to the above paper being widely
reported today in the media.  Included are excerpts of quotes made in
response as reported in various newspapers.]

      Context
      Considerable concern has been generated in the lay and medical
communities by a theory that increased measles-mumps-rubella (MMR)
immunization among young children may be the cause of an apparent marked
increase in autism occurrence.
      Objective
      To determine if a correlation exists in secular trends of MMR
immunization coverage among young children and autism occurrence.
      Design, Setting, and Participants
      Retrospective analyses of MMR immunization coverage rates among
children born in 1980-1994 who were enrolled in California kindergartens
(survey samples of 600-1900 children each year) and whose school
immunization records were reviewed to retrospectively determine the age at
which they first received MMR immunization; and of autism caseloads among
children born in these years who were diagnosed with autism and were
enrolled in the California Department of Developmental Services regional
service center system.
      Main Outcome Measures
      Measles-mumps-rubella immunization coverage rates as of ages 17 months
and 24 months and numbers of Department of Developmental Services system
enrollees diagnosed with autism, grouped by year of birth.
      Results
      Essentially no correlation was observed between the secular trend of
early childhood MMR immunization rates in California and the secular trend
in numbers of children with autism enrolled in California's regional service
center system. For the 1980-1994 birth cohorts, a marked, sustained increase
in autism case numbers was noted, from 44 cases per 100 000 live births in
the 1980 cohort to 208 cases per 100 000 live births in the 1994 cohort (a
373% relative increase), but changes in early childhood MMR immunization
coverage over the same time period were much smaller and of shorter
duration. Immunization coverage by the age of 24 months increased from 72%
to 82%, a relative increase of only 14%, over the same time period.
      Conclusions
      These data do not suggest an association between MMR immunization
among young children and an increase in autism occurrence.
      JAMA. 2001;285:1183-1185

In Their Own Words: A Bad Conclusion

http://jama.ama-assn.org/issues/current/rpdf/jbr00284.pdf

      From excerpts of the research paper itself, the authors acknowledge
the insufficient quality of the data for purposes of drawing conclusions
based on the reported rates of autism.  They give six different reasons for
this.
      Then, contradicting themselves, they go ahead and draw a conclusion
anyway (see below).

      "Difficulties in interpreting the increasing numbers of autism cases
are highlighted in the California Department of Developmental Services 1999
report, which repeatedly stressed that its data cannot be interpreted as
measuring trends in the actual incidence of autism. It is unknown how many
children with autism have not enrolled in the system and as the system
expanded and matured over time, the proportions of children enrolling in the
system who were born outside of California may have changed over time.
      "Recommendations have been made for a detailed investigation into the
apparent increases in autism cases, carefully evaluating the extent to which
apparent increases in autism are real as opposed to artifact, as well as
evaluating factors that may have contributed to any true increases including
immunizations. Such investigations are in progress (Robert Byrd, MD,
University of California Davis Medical Center, Department of Pediatrics,
written communication, November 1, 2000).
      "The data presented herein have some limitations. It would have been
useful to examine individual immunization and autism records on the same
children, however, these could not be linked. Further, the childhood
immunization coverage data used in the study do not provide precise
quantification of the percentages of children who received the combined MMR
vaccine product vs separate injections of the measles, mumps, and/or rubella
components."

But an improperly drawn conclusion is made anyway:

      "However, the issue here is, assuming that the secular trend noted in
the report represents a true increase in autistic disorder incidence, what
is the evidence that MMR immunization may be associated with this trend?. .
."

      How can they assume the report represents a true count when they just
gave six reasons above, why it cannot?  Then based on this false assumption,
they draw this conclusion:

      "The lack of correspondence between the trends in MMR coverage and
numbers of autistic disorder cases does not support the hypothesis that
increasingly widespread MMR immunization of young children is associated
with the marked secular trend of increasing numbers of autism cases enrolled
in the California Department of Developmental Services regional service
center system."

      What could be the real purpose for this misleading exercise, if not as
for propaganda?   -LS

* * *

Media Quotations in Response

In the LA Times:

      . . .Dr. Bernard Rimland of the Autism Research Institute in San Diego
argues that it is not the vaccine--known as MMR--alone that triggers autism,
but the entire burden placed on the immune system by the 22 separate
vaccines that are now given to children between birth and age 2.
      "By focusing on MMR, these guys are missing the boat," he said. "It's
much too early to dismiss the [vaccine] hypothesis."
http://www.latimes.com/news/state/20010307/t000020117.html

In the St. Petersburg Times:

      "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."
http://www.sptimes.com/News/030701/TampaBay/Study_answers_autism_.shtml

In the San Francisco Chronicle:

      "Quite frankly, something that appears in a journal that is controlled
by the American Medical Association, which is one of the world's No. 1
promoters of vaccine policy, needs to be taken with a grain of salt," said
Rick Rollens of Sacramento. He is the father of a 10-year-old autistic son
and has been vocal in asking for research into the possible link between
vaccines and autism.
http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2001/03/07
/MN152164.DTL

In the San Jose Mercury News:

      Some parents of autistic children, however, remain convinced that the
vaccine may have caused the disease, in part because the vaccine typically
is first given at 12 to 15 months, slightly before parents usually first
detect the problems that characterize autism. A second dose is recommended
at 4 to 6 years.
      Lenny Schafer, whose 12-year-old son is autistic, still believes the
MMR vaccine could have played a role.
      "Parents are just desperate for hard science on this," said Schafer,
who is based in Sacramento and helps run a financial-support organization
for parents of autistic children. "This study is not going to convince the
average parent one way or another. It's just going to make things really
confusing. Parents are real gun-shy on vaccines and they're getting more
 so." http://cgi.mercurycenter.com/premium/local/docs/vaccine.htm

In the Sacramento Bee:

      In Sacramento, the MIND Institute, part of the UC Davis Medical
Center, was established in 1999 to try to solve the mystery. Two parents who
helped found the institute said Tuesday that they want to see more studies
before they'll believe MMR isn't a culprit.
      Rick Rollens feels strongly that vaccines (although not MMR) had a
hand in the development of autism in his son Russell at 7 months of age.
Russell is 10 now.
      "Until we get good independent science research into this question,
the spin control that the public health community continues to put out on
this issue just doesn't pass the smell test," Rollens said.
 Another Sacramento father of an autistic son, Chuck Gardner, was likewise
suspicious of the state Department of Health Services as a source of
unbiased research.
      "Three words," he said: "Conflict of interest."
      Dr. Robert Byrd, a pediatrician at the MIND Institute who was not
involved with the state autism study, said he did not see any flaws in the
study's methodology.
      "Irrespective of who's doing the study, if MMR were to be the prime
reason, we'd see a different curve (in the data)," said Byrd, who is doing
his own epidemiological study of autism in California, trying to figure out
the factors behind the rise.
http://www.sacbee.com/news/news/local03_20010307.html


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