Vaccine autism proven

Autism, Vaccination and Immigrants - Yet Another Clear Correlation

by F. Edward Yazbak MD

Autism and Autistic Spectrum Disorders (ASD) seem more common among young Somalis in Minnesota and among immigrant communities in several western countries. At least as late as 2003, Ethiopian-born immigrants to Israel had no recorded cases of autism. [That is correct: Not a single one!]

The medical literature contains several reports of a higher prevalence of autism among immigrant communities worldwide.

The earliest report I could find was published on March 6, 1976 in the Australian Medical Journal. According to Haper and Williams, relatively more New South Wales children who had at least one foreign-born parent whose native language was not English, carried a diagnosis of infantile autism. The authors attributed the behavioral changes to environmental stresses, adjustment difficulties and a confusing language environment leading to de-compensation of an already vulnerable child. [i]

Autism was a purely psychiatric disorder at the time. Just nine years earlier, Bruno Bettleheim had published his widely read The Empty Fortress: Infantile Autism and the Birth of the Self, where he promoted his sad and offensive "refrigerator mother" theory of autism.

Gillberg and Gillberg reported in 1996 that of 55 thirteen-year-old children with autism they investigated, 15 (27%) were born to parents, “at least one of whom had migrated to Sweden”. In several cases, the affected child was the first born in Sweden after the mother’s arrival to the country.[ii]

In 2006, Maimburg and Vaeth [iii] reported results of a “population-based, matched case-control study of infantile autism” in Denmark and stated that the risk of infantile autism was increased with foreign citizenship.

Across the Atlantic in 2007, Canadian physicians were reporting similar findings from Montreal to Vancouver and some complained that there was “little research to understand why.”[iv]

At the time, I talked to a few informed parents in Montreal and reviewed with them the local situation.

I was told that for years, the “mother tongue” of students in Montreal schools was French 42%, Non-English 36% and English 22% and that most if not all non-English-speaking immigrant children attended “French” schools.

The parents also claimed that the city’s French schools enrolled a significant number of children with Pervasive Developments Disorders and provided me with school year 2001-2002 data from a “Special Needs School” in a Montreal French School Board. Of the 185 students aged 4 to 13 in that French school, 56 (30.3%) carried a diagnosis of Pervasive Developmental Disorder (PDD).

The demographic data are illustrated in the following table.

Students in a “Special Needs School” in Montreal – 2001-2002


Mother-language French

Mother-language Creole (Haitian)





No. of Students





Students with PDD





% with PDD in Group





Table I
The above data very strongly suggest that in Montreal French schools, children of immigrants had a relatively higher prevalence of PDD than French-Canadian-born children.

To please the genetic crowd, I will concede that Haitian, Arab and Asian children are genetically different from French children. But it is also a fact that they have different vaccination patterns.

As an example, the Regional Program of Vaccination for the Province of Quebec [v] states that Hepatitis B vaccination is recommended and available free of charge to children whose families (or at least one parent) immigrated from regions where hepatitis B is highly endemic. The lists of hepatitis B-highly endemic countries that followed the above recommendation included 47 countries from the Sub-Sahara, 18 from Asia, 4 from the Middle-East, 24 from the Pacific Islands, 5 from the region of the Amazon in addition to Haiti and the Dominican Republic.

According to the Canada Communicable Disease Report of May 1, 2002, "the only thimerosal-containing vaccine in routine use in the infant immunization schedules of some Canadian jurisdictions is hepatitis B vaccine."

More recently, the Public Health Agency of Canada reported that “The influenza vaccine and most hepatitis B vaccines are multi-dose vaccines, which contain thimerosal as a preservative. For immunization of infants against hepatitis B, parents or guardians in some provinces and territories have the choice of a thimerosal-free vaccine.” [Updated 12/2/2010] [vii]

The Federal Canadian Immunization rules [viii] are in effect in all Canadian Provinces including the Province of Quebec. Part 3 of the Canadian Immunization Guide exclusively deals with “Immunization of Persons New to Canada”.

It includes the following statements:
  • New immigrants, refugees and internationally adopted children may be lacking immunizations and/or immunization records because of their living conditions before arriving in Canada or because the vaccines are not available in their country of origin.

  • Only written documentation of vaccination given at ages and intervals comparable with the Canadian schedule should be considered valid.

  • Therefore health care providers in Canada who see persons newly arrived in the country should make the assessment and updating of immunizations a priority.

Section 341 of the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 imposed certain vaccination requirements on all persons seeking green cards in the United States. These requirements apply to persons seeking to adjust their status to permanent residence in the U.S. as well as to those who apply for immigrant visas to enter the U.S.

Under “New Vaccination Criteria for U.S. Immigration” the CDC [ix] presently lists vaccines for the following diseases as currently required: Mumps, Measles, Rubella, Polio, Tetanus and diphtheria, Pertussis, Haemophilus influenzae type B (Hib), Hepatitis A, Hepatitis B, Rotavirus, Meningococcal disease, Varicella’ Pneumococcal disease and Seasonal influenza.

The human papillomavirus (HPV) and zoster (Shingles) vaccines were
removed from the list of required vaccines for immigrant applicants in December 2009.

After carefully reviewing the Canadian and United States vaccination practices related to immigrants, the following is very evident:
  1. Both countries take vaccination of immigrants very seriously

  2. Immigrants and refugees will likely have a 100% compliance with US vaccine requirements and Canadian “recommendations”

  3. Improperly administered or poorly documented vaccinations WILL be repeated as needed

The following is quite evident in most Western and developed countries:
  • The present generation of children is the most vaccinated ever
  • The present generation of young parents is also the most vaccinated ever.
This is particularly relevant to this discussion where both immigrant children and children born to immigrant parents in Canada, Israel and the United States are discussed.


In 2008, Somali parents in Minnesota were alarmed and devastated when they started noticing disproportionally high rates of Autism Spectrum Disorders (ASD) among their children when compared to their schoolmates in preschool programs.

As expected, those parents asked a simple question: “Why was this happening?

They also hoped to get an answer.

The situation attracted a lot of attention [x] nationwide. Any mention of some relationship to vaccination among immigrants was promptly squashed with the argument that many Somali children born in Minnesota also had a high prevalence of autistic disorders.

As of July 24, 2008 the Somali tragedy in Minnesota was still a mystery [xi] and the Minnesota Department of Health was still “scrambling to put together a "pre-pilot program" to assess autism in the general population.” The DOH claimed that its failure to assess the situation and come up with accurate statistics about autism among immigrant children with autism was “in part because of laws restricting access to school data.”

The Minnesota Department of Education on the other hand had no difficulty stating that “in the Minneapolis' early childhood and kindergarten programs, more than 12 percent of the students with autism reported speaking Somali at home. According to Minneapolis school officials, more than 17 percent of the children in the district's early childhood special education autism program are Somali speaking.”

At the time, Somali-speaking students constituted almost 6 percent of the district's total enrollment in early childhood/kindergarten special education programs.

A special education official in the Minneapolis school district was quoted as saying “I've been working to get somebody to look at this and pay attention because it feels like this is too specific [to Somalis]. It's got to be preventable.” The same official also reported that she knew of an apartment building in the city were almost every Somali family has “at least one autistic child” and added “They're given more [vaccines] then we get, and sometimes they're doubled up. Then their children are given immunizations. In Somalia, their generations have not received these immunizations, and then suddenly they're getting just a wallop of them in the moms and then in the babies. That's certainly a concern that's been expressed to me by the Somali population.”

On March 31, 2009, the MN Department of Health published “Minnesota and the Somali Community - Report of Study.” [xii] Only one statement was highlighted in “Bold” character: “This study did not attempt to identify possible causes or risk factors for ASD.”

The following paragraph was the only mention of the Somali issue in the 2-page report:
"Administrative prevalence of Somali children, ages 3 and 4, who participated in the MPS ECSE ASD programs was significantly higher than for children of other races or ethnic backgrounds. This is consistent with what families and others observed. Because of the study’s limitations, it is not proof that more Somali children have autism than other children; however, it does raise an important question of why Somali children are participating in this program more than other children.”

On January 15, 2011, the Minnesota Autism Spectrum Disorder Task Force that included two state senators and two state representatives in addition to delegates from several agencies and professional organizations issued an “Interim Report" [xiii] in which the Somali tragedy was discussed in the following sentence: “However, a Minnesota Department of Health and CDC report showed that Somali American children enrolled in Minneapolis Public Schools had an administrative prevalence of up to seven times higher.”


The Israeli Paradox

For those who do not know the terribly sad story of the Jews in Ethiopia, I would like to suggest “History of Ethiopian Jews”, a remarkable review. [xiv]

Page 2 of the review is particularly relevant to the present discussion.

It is unlikely that vaccines or medications ever reached the poor Ethiopian Jews who had been isolated for years under atrocious conditions and were waiting to be secretly evacuated to Israel, in the dark of the night. Certainly their concerned saviors could not care less whether they were vaccinated and had completed, signed and stamped “Yellow cards”.

For their part, the government and social organizations looking after the refugees during their first months in Israel had plenty to do treating their diseases, improving their health and nutrition, providing them with much needed psychological support and “relocating ” them in general. Whether or not the refugees were “up to date” vaccination-wise was certainly NOT a priority: These new citizens had in all likelihood survived all the infectious diseases that Israel had vaccines for.


I recently discovered a remarkable Israeli “File Review Study” by Kamer, Zohar et al [xv] that was published in 2003 and that I somehow had missed all these years.

For accurate reporting, the authors reviewed a national Israeli registry of 1,004 Jewish children who were diagnosed with PDD. (Arab children were not included)

They also examined relevant data available from the Israeli National Bureau of Statistics and found that those
Jewish children born in the years 1983–1997 and living in Israel at the time belonged to four distinct groups:
Group 1: Native Israelis of non-Ethiopian extraction: 1,198,300
Group 2: Native Israelis of Ethiopian extraction: 15,600
Group 3: Immigrants of non-Ethiopian extraction: 110,300
Group 4: Children born in Ethiopia: 11,800

Data related to the prevalence of Pervasive Developmental Disorders among those groups are summarized in Table II.


PDD Prevalence among Jewish children in Israel 1983-1997


Born Abroad






























Table II

There were significant differences in PDD prevalence between Israeli-born children and immigrant children. But unlike the situation in Canada and the United States, the estimated prevalence of PDD among first-generation Ethiopian children in Israel at the time was 0 (Zero) per 10,000 while among Israeli-born children who were not of Ethiopian origin, the estimated prevalence was 9 per 10,000.

Not to belabor the point, not a single immigrant child of the 11,800 born in Ethiopia and living at the time in Israel carried a diagnosis of PDD.

Native Israeli children had a higher prevalence of PDD than foreign born children. Among the children who were born in Israel, those born to non-Ethiopian parents had a higher prevalence of PDD when compared to those children who were born to Ethiopian parents.

A genetic immunity to autism among the Ethiopians is unlikely because:
1. Autism does occur in Ethiopia
2. Children of Ethiopian extraction born in Israel do develop autism

Trying to explain every aspect of the paradox is not easy.

I do propose that Jewish Ethiopian immigrants to Israel, both infants and adults, probably received no vaccinations in Ethiopia in the rural distant areas where they lived. Their immigration journey was hasty, at night and cloaked with secrecy unlike Somali refugees who stayed in pre-immigration camps for relatively long periods of time waiting to come to the United States and certainly available for “catch-up measures.”

The Ethiopian infants may also have been older when they started their pediatric vaccinations in Israel.
Group 3 included children of non-Ethiopian origin who came to Israel in the 1990s. These children had more PDD than Ethiopians but less that “Native Israelis”. A plausible explanation could be that many if not most children from that group came from post-USSR countries, where vaccination programs were limited when compared to those of Israel.

There has been a continuing barrage of attacks on Dr. Andrew Wakefield and on anyone who dares to say that a vaccine–autism connection has not as yet been properly ruled out.

It is evident that the CDC and its supporters have not done, and will never propose to do, a vaccinated v unvaccinated study, the only way to rule out such a connection.

A thorough discussion of the subject requires attention to the child’s and his or her mother’s vaccination profiles.

In this review, I have shown that Autism and Autism Spectrum Disorders seem to be more prevalent among children of immigrants in some western countries.

The fact that such disorders have not been reported among Israeli children born in Ethiopia, and in all likelihood differently vaccinated, speaks for itself.

Similarly, the fact that children born in Israel to women of Ethiopian origin (who may have had different vaccination profiles) are relatively less likely to carry a diagnosis of PDD than children born to non-Ethiopian and Israeli mothers is also worth noting.

This review is as close as anyone can get to an unvaccinated v vaccinated study without undertaking such a study and a Zero PDD count among Ethiopian-born children in Israel should be convincing enough that the issue is by no means settled, as some would like us to believe.



i   Haper J, Williams S. Infantile autism: the incidence of national groups in a New South Wales survey. Med J Aust. 1976 Mar 6;1(10):299-301.
ii   Gillberg IC, Gillberg C. Autism in immigrants: a population-based study from Swedish rural and urban areas. J Intellect Disabil Res. 1996 Feb;40 ( Pt 1):24-31.
iii   Maimburg RD, Vaeth M. Perinatal risk factors and infantile autism. Acta Psychiatr Scand. 2006 Oct;114(4):257-64.
xv  Kamer A, Zohar AH, Youngmann R, Diamond GW, Inbar D, Senecky Y. A prevalence estimate of pervasive developmental disorder among Immigrants to Israel and Israeli natives. Soc Psychiatry Psychiatr Epidemiol. 2004 Feb;39(2):141-5.

F. Edward Yazbak MD, FAAP
Falmouth, Massachusetts

January 21, 2011