pageok
pageok
pageok
No Vaccine Autism Link:

A new study failed to find a link between vaccines and autism. This should not be a surprise. As I've noted before, there has never been meaningful evidence of such a link, despite lots of media stories and activist claims to the contrary, and the mainstream medical community firmly rejects claims to the contrary.

The Washington Post reports on the study here. Regrettably, the Post suggests that, prior to this study, there was reliable scientific evidence of a possible vaccine-autism link. In particular, the Post plays up a 1998 study of twelve children that, it says, "suggested" such a link. Given that the failure to vaccinate children has real consequences — over 90 percent of those children diagnosed with measles so far this year had not been vaccinated — it is irresponsible for journalists to suggest the evidence for a vaccine-autism link is stronger than it really is.

UPDATE: Despite fears about a vaccine-autism link, it appears childhood vaccination rates are up.

bornyesterday (mail) (www):
The fact that mercury, which people first pointed to as the cause of autism from vaccines hasn't been used in vaccines since the early or mid 90s, I've thought that anyone peddling the vaccines = autism platform is just an idiot.
9.4.2008 10:07am
Eli Rabett (www):
Orac (a surgeon/scientist) has been following the autism/vaccination issue. He has a post today on this study which is worth reading.

However, to throw red meat to the crowd, the refusal to vaccinate your child to avoid a very small risk (there are bad reactions) and reliance on the herd effect for protecting is a moral free rider problem just as much as the refusal to pay taxes to cover the costs of government.
9.4.2008 10:11am
donaldk2 (mail):
Eli Rabett: Will you please restate your second paragraph so that it is comprehensible.
9.4.2008 10:38am
wfjag:

the refusal to vaccinate your child to avoid a very small risk (there are bad reactions) and reliance on the herd effect for protecting is


-- is playing Russian Roulette with the lives and health of your children and the children of others. See, "Amanda Peet is My Hero(1)" by Dr. Mark Crislip, M.D. (Aug. 14, 2008) www.sciencebasedmedicine.org/?p=186 and "First Measles Now Mumps" by Dr. Steven Novella, M.D. (Aug. 27, 2008) www.theness.com/neurologicablog/

Is this comprehensible enough? Or, is a little more explanation needed? By relying on the herd effect, such parents are (1) assuming that their children will not be exposed to preventable diseases by someone outside "the herd" (e.g., parents, friends, relatives, or even strangers with whom the child comes into contact, who have done something like travel in a foreign country where they are exposed to the disease and then expose the unvaccinated child); and (2) assuming that enough other parents will have their children vaccinated so that the herd effect will operate. If that is no longer true, then an epidemic spreading across the unvaccinated children who are relying on the protection of the herd effect is the expected result.
9.4.2008 11:01am
MarcInBoston (mail):

The fact that mercury, which people first pointed to as the cause of autism from vaccines hasn't been used in vaccines since the early or mid 90s, I've thought that anyone peddling the vaccines = autism platform is just an idiot.



This is incorrect. It has been used and is still used. Thimerosal is one of the best preservatives there is. There is a concerted effort to replace or minimize its use, but it is still in use.
9.4.2008 11:04am
American Psikhushka (mail) (www):
Eli Rabbet-

However, to throw red meat to the crowd, the refusal to vaccinate your child to avoid a very small risk (there are bad reactions) and reliance on the herd effect for protecting is a moral free rider problem just as much as the refusal to pay taxes to cover the costs of government.

If they are correct, not at all.(And I'm not convinced they are wrong. The Amish data and the anecdotal data are very interesting.) The risk is catastrophic.

In fact, if they are correct it is the vaccinators at fault. If everyone refused the vaccines the manufacturers would be highly motivated to ensure safety.

And the tax analogy is way off. You don't risk catastrophic injury to a child when you don't pay your taxes.
9.4.2008 11:11am
Xmas (mail) (www):
I'm going to start playing up the Autism-Celiac Disease link. You know, about the time kids start showing signs of autism is around the same time you start giving them Cheerios.
9.4.2008 11:17am
matt b (mail):
measles is no worse than chicken pox. the fact that there is a large industry built on vaccinations for non-deadly diseases doesn't mean it is irresponsible to forgo vaccinations and various side effects-no matter how small or trivial
9.4.2008 11:20am
MnZ:

measles is no worse than chicken pox.


Evidence please.

I am not that old. However, my parents and grandparents had children late in life. In other words, my grandparents could relate to me stories about what life was like around 1900. If infectious diseases were not that bad, I wonder why they all viewed vaccines as wonderful inventions.
9.4.2008 11:31am
karl newman (mail):
Thimerosal is only really in inactivated influenza (shot NOT nasal) vaccine for children <6 years old. Also, the herd immunity benefit is obviously lessening since there are increasing measles outbreaks. Vaccines are an amazing benefit to public health and far safer compared to any of the actual infections. We have forgotten how terrible polio, measles, rubella really are - a testament to how great vaccines are. It is sad that we are re-entering the dark ages - evolution can't be taught, vaccines are avoided etc etc. How will we compete with scientific powers like China in the future?
9.4.2008 11:37am
O RLY?:
To matt b: Measles was, and still is, deadly.

Obviously, you are not a medical professional, so please don't try to play one on the Series of Tubes.

Compare: http://www.nlm.nih.gov/medlineplus/measles.html

And: http://www.nfid.org/pdf/factsheets/measlesadult.pdf

"Measles can cause life-threatening pneumonia and brain inflammation, middle-ear
infection, severe diarrhea and sometimes death."

With:

http://www.nlm.nih.gov/medlineplus/ency/article/001592.htm
9.4.2008 11:37am
MnZ:

This is incorrect. It has been used and is still used. Thimerosal is one of the best preservatives there is. There is a concerted effort to replace or minimize its use, but it is still in use.


True, but Thimerosal is no longer used in childhood vaccines and hasn't been for several years.
9.4.2008 11:38am
expat lumberjack:
oh god, the stupid, it burns.
9.4.2008 11:43am
karl newman (mail):
measles is no worse than chicken pox

You know that VZV (chickenpox) is a pretty bad virus too. And there is a vaccine for it. Of course, getting chickenpox as a young kid isn't too bad, but if you are older it can be very severe. In addition, reactivation of VZV (shingles) is horrible and causes get pain and economic loss in our society. Then if you are one of the 30% of us to get cancer later in life - VZV can reactivate with chemotherapy-induced immune dysfunction and lead to death that would be preventable with vaccine.

Measles is terrible too - death from encephalitis, death from pneumonia. Sure the "pox" isn't bad but you don't always just get the skin rash!
9.4.2008 11:44am
Cro (mail):
It runs in families. That should tell you something. Especially since they expanded the diagnoses, it's more and more obvious that autism is a spectrum that goes from severe disability on one end and shades into personality traits on the other. Family members often share a lot of traits even if they aren't autistic. How this would work if it has an environmental cause is hard to see.

And with better understanding, it becomes easier to cope. It's not as bad as it was before we understood what was happening.
9.4.2008 11:52am
ian (mail) (www):
Oh C'mon. You know this isn't going to stop people from believing it's all someone else's fault. If they won't accept it from the American Journal of Human Genetics, the journal Toxicological Sciences, the New England Journal of Medicine or any of a dozen others, they're not going to accept this one. The Lancet itself published a study (Taylor et al) in 1999 showing that autism prevalence rates began to rise exponentially several years before MMR, and found no difference in the onset timing compared to administration of the vaccine.

As a sidenote, the journal mentioned above (PLoS ONE) is an open-access, peer-reviewed journal published under a creative commons license. This means that you thankfully don't need a subscription to get the full text of the article. Link below for your viewing pleasure.

Link

So far I've only seen two reliable theories about GI issues and autism (mentioned in the article), and they both center around an abnormal autoimmune response; the first is documentation of the autoimmune system destroying the epithelial membrane in the GI mucosa in some autistics. The second is lymphocyte cross-reactivity to caseins and glutens. I haven't read the new study above yet, so I'm not sure what they have to say about it.
9.4.2008 11:58am
Dave N (mail):
Measles not that bad? Give me a freeking break. I realize that anecdotal evidence is just that--but within my own family, my younger brother caught the measles (before there was a good vaccine) and suffered permanent brain damage as a result. When I hear the anti-vaccine zealots, I just cringe.

So let me be very blunt: GET YOUR KIDS VACCINATED.
9.4.2008 12:02pm
ROgi (mail):
CHICAGO (Reuters) - Scientists who tried to replicate a study that once tied a measles vaccine with autism said Wednesday they could not find any link and hope their study will encourage parents to vaccinate their children to combat a rash of measles outbreaks.

Parents' refusals to have their children vaccinated against measles have contributed to the highest numbers of cases seen in in the United States and parts of Europe in many years.

Measles kills about 250,000 people a year globally, mostly children in poor nations.
9.4.2008 12:05pm
neurodoc:
The Lancet, where Wakefield published, may not be The National Enquirer, but it takes articles that would not make it into more respected, scientifically rigorous medical journals. Wakefield has been a pariah in the scientific community, deservedly so, since he published those findings, which no one else has ever confirmed, and threw his lot in with the thiomerosal->autism crowd. Not one, but two utterly bogus causation theories!

"...vaccinations for non-deadly diseases..." wrong as to measles (rubella) and chickenpox (varicella) on the "non-deadly," and wrong as to the notion that the risks of any vaccine on the market justify not vaccinating all but the few with recognized contraindications to vaccination.
9.4.2008 12:06pm
MnZ:
Prediction: There will soon be a series of long anti-vaccine posts here that look like they were cut-and-paste from something written previously. They will be emotion laden and rely on anecdotes.
9.4.2008 12:13pm
ROgi (mail):
Some people are under an impression that in medicine (and other areas) there must be a 100% safety guarantee before a medical procedure, or a drug, can be approved. This is an unrealistic expectation since almost none of our daily activities are completely risk free. In many cases we can minimize the risk and, taking into account the probability, decide if we want to engage in the risky activity. But, 100% risk free is an unrealistic goalpost, and as far as the risk of death or serious complication goes, vaccines are safer than bike riding.
9.4.2008 12:15pm
non:
My wife is a medical practitioner who treats a lot of children. She has read all the studies and says most of them are lacking in clinical rigor regardless of the journals rigorous reputation. Limited to 38 patients, or no control groups, or other factors that fails to have a significant clinical conclusion. She does believe in vaccination, but thinks the usual schedule is aggressive.

That being said, I think someone has already pointed out they could easily do an honest to goodness clinical study comparing the general population with religious groups that refuse vaccinations...an existing control group, if you will.
9.4.2008 12:17pm
ian (mail) (www):

Prediction: There will soon be a series of long anti-vaccine posts here that look like they were cut-and-paste from something written previously. They will be emotion laden and rely on anecdotes.


Bring 'em on.
9.4.2008 12:18pm
ROgi (mail):
I know a number of medical practitioners (friend's brother and sister-in-law)who say the same thing (the sister-in-law is also a fan of homeopathic remedies) non's (above post) wife allegedly claims. Both are medical practitioners in name only,k and I cannot understand how two seemingly bright people with good medical education can abandon reason and training in favor of such nonsense. They just had a child, so I think it might be a recent emotionally motivated better-safe-than sorry development that afflicts many new parents willing to listen to anti-vax rants.
9.4.2008 12:24pm
rarango (mail):
with all due respect, this debate goes more to the public's misunderstanding of biostatistics than it does to medical issues and a total misunderstanding of the fact that correlation is not causality. We are not a numerate society and the public press that reports these statistics are even less numerate.

Childhood diseases ARE potentially risky--much more so than any possible risk that might come from vaccination.
9.4.2008 12:41pm
Hoosier:
bornyesterday

How many times do people like you have to state the facts before people like my co-worker here understand? There is no mercury, there is no mercury, there is no mercury . . .
9.4.2008 1:18pm
SATA_Interface:
Its the fever from measles and related disease that really cause the permanent damage, right Dave? Vaccines are one of the pinnacles of human civilization and we want to go back to the Dark Ages again? what the hell man. Might as well discard our surgical tools and abandon gene therapy while we're at it...
9.4.2008 1:23pm
matt b (mail):
measles and chicken pox have the same side effects (brain swelling, pneumonia etc.) if left untreated, and the only reason that measles has slightly higher rate of side effects is because it is more likely to be diagnosed incorrectly. modern medicine in the west has essentially eliminated the risk measles poses...just as it has done with chicken pox. only 1 in 1000 suffer serious complications with measles, while chicken pox complications range from 1 in 100 for adults to 1 in 5 for infants under 6 months. infants over 2 months are in almost 0 percent danger with measles.

modern medicine has essentially solved whatever concerns you used to have about measles. in 20 years, we'll be hearing about how deadly chicken pox is too. that should measure on the bs-ometer
9.4.2008 1:26pm
Cro (mail):
If anyone wants to get anecdotal, here's one.

I'm autistic. I got the old vaccine. My son didn't. He's a bit autistic, too. So... where's the causation? Should I blame the vaccine, which everyone gets, or acknowledge that maybe my own genes are the cause? Especially considering that my parents were a bit odd as well?

One of the nice things about autism is that it's much easier to look at the world without your own emotions filtering out what you don't want to see. It's really not that bad. I'm not severely mentally impaired, quite the opposite, and I simply would not be the person I am if it weren't for the genes I got. There are stupid normal people, too.

The vaccine thing, it seems to me, is an attempt to blame someone, anyone, for something that is no one's fault. A lot of parents don't even want genetic responsibility for their autistic children. This doesn't help anyone.

The focus should be on finding a way to use the unique abilities of autistic people, and helping them cope with a world that doesn't understand them. I wish I'd known why I was so different when I was a child. I didn't figure it out until fairly recently. When I was growing up, "autism" meant disabling mental retardation. If you're really intelligent, you can get by with some fairly large social handicaps.

Autism is not a way to an easy life, but it's not the end of the world.
9.4.2008 1:26pm
SATA_Interface:
And I thought the American vaccines were free from the thimerosal, but the european groups were still using it?
9.4.2008 1:37pm
ian (mail) (www):
In the US: All childhood vaccines with the exception the 2yo+ activated influenza vaccines are free. Some tetanus-related vaccines still contain it, as well as some antivenoms, according to the FDA.
9.4.2008 2:01pm
Sandy G (mail):
Full autism is a terrible, lifetime affliction.

If the increase is not simply a reporting error, we must continue to look for the cause(s). A child with limited exposure to the world's hazards is one day fine and full of potential- and then poof- gone- a loss and a burden to all of us.
9.4.2008 2:06pm
Milhouse (www):
matt b, chicken pox can be deadly too. I know someone whose sister died of it, less than 10 years ago.
9.4.2008 2:08pm
neurodoc:
matt b, you are sadly misinformed about what you presume to speak of. The way to "treat" those complications (not "side effects") is to prevent them, which is to say vaccinate against the illness. When someone, usually a child, develops measles encephalitis, they face almost certain neurologic impairment, that is if they don't die, no matter what is done for them. There is even less to be done about a truly horrible complication of measles infection, that of SSPE (subacute sclerosing panencephalitis).

Has your experience diagnosing and managing these illnesses been different? Or are you just repeating some nonsense you read on an anti-vaccine website?
9.4.2008 2:10pm
neurodoc:
Its the fever from measles and related disease that really cause the permanent damage, right Dave?
Wrong!
9.4.2008 2:14pm
Sandy G (mail):
Lest anyone make too much of this study...

From the WAPO article-

"Rollens [...] praised the study for highlighting the importance of gastro-intestinal problems among autistic children, [...]


"This study has addressed one of many theories" about how vaccines might be linked to autism, Rollens said. "This study by itself does not exonerate the role of all vaccines."
9.4.2008 2:16pm
neurodoc:
I'm autistic. I got the old vaccine. My son didn't. He's a bit autistic, too...
Let's not confuse "autistic" with a small "a" and true "autism," that is "Pervasive Developmental Disorder." I very much doubt that you were given the diagnosis of PDD by a board certified neurologist or other suitably qualified medical specialist.
9.4.2008 2:19pm
neurodoc:
Since Asperger's falls under the broad label of PDD, a "spectrum" of disorders, I'll amend my statement above slightly to make clear I would allow the possibility of Asperger's, but very much doubt the "autism" part of that spectrum. And I would further hasten to add that the "autism" we are talking about here is not the "autism" Bleuler described as one of the 4 "a"s of schizophrenia (association, autism, affect, ambivalence).
9.4.2008 2:24pm
ian (mail) (www):
Sandy: as I noted above, the GI problems likely have autoimmune origins, and as there's been no convincing evidence of vaccine-induced pathology, I don't know how you can count that as a point against vaccines.

Furthermore, I'm at a loss as to where you've picked up any evidence for children being "fine one day" and then "poof-gone". Autism can be roughly split into two categories: existent (as in, autistic at birth or at least by the time it was noticeable) or regressive (fine one day, and then (usually) a regression over time into autistic behaviors). Comi et al, for example, reported 46% of families with autistic children have two or more members with other autoimmune diseases, with an even higher incidence in families with regressive autistic children.

Anecdotes get you nowhere, nor does cherry-picking an article written by a Washington Post journalist, as opposed to actually reading the medical literature itself.
9.4.2008 2:25pm
gasman (mail):
That's the problem with faith based health care decisions. When an anti-vaccinationist asked what evidences would be necessary to cause them to change their opinion, often the answer is that no degree of evidence would be persuasive.

Rephrased, imagine you are designing a research study, which if the results support the null hypothesis (no autism-vaccine link) would cause you to support the study's result. If no possible result could exist that would satify, then the beliefs are unshakable whackiness on the order of catching rides on space ships.
9.4.2008 2:35pm
wfjag:

That's the problem with faith based health care decisions.


Let's see, the top "names" associated with recent Generation Rescue and Green Our Vaccine events were Britney Spears, Hugh Hefner, Jenny McCarthy, Jim Carrey, Charlie Sheen, and Robert F. Kennedy, Jr. That sounds more like a secular-progressive, or a T &A crowd, than "faith based." Pseudo-science is its own religion.
9.4.2008 3:13pm
Dave N (mail):
SATA Interface,

I did not understand your snark. Since I am the only "Dave" who has posted here, I have to assume it was directed at me. I am in favor of vaccination. So, apparently are you, though I am not totally sure. What exactly was your point?
9.4.2008 3:13pm
David Schwartz (mail):
The problem with "better safe than sorry" is that being safe comes with its own helping of sorry.
9.4.2008 3:42pm
Cro (mail):
Neurodoc: Yes, I was. I spent a week taking neurological tests after doing some research to see what was wrong with my son. Instead, I quickly recognized my own differences.

By chance, there's a neurologist who has a practice in my town, which is out in the sticks of SW Colorado. Mostly he deals with traumatic brain trauma and autism. It cost me a lot of money, wasn't covered by insurance, but I wanted to know. I'm high functioning, so that I've learned to change my behavior to something more normal. Also, a lot seems to fade with age. I don't twitch anymore, and I stopped repeating things, and I make an effort to look people in the eye. I also ditched a bunch of compulsive behaviors I used to have. I still have to take a shower every day no matter what, and I talk to myself sometimes. It took me until my 30s to get most things right. But it's obvious to most people upon meeting me that I'm not quite normal. Writing a comment is different than delivering it in person. Trust me, you'd notice.

If you're smart enough you can get by. It's just harder. The big thing is realizing that the world isn't going to change, and no matter how much behavior fits you, no one cares if it makes you weird. Autism has an underlying logic to it. It's not just crazy.

There's lots of weird little things, like sensory mix ups. I can sometimes smell something and be unable to tell what it is. Or I smell something that isn't there.

Anyway, enough about me. I just like to comment in the autism threads because it seems to me that I'm unusually qualified to say something on a blog where I rarely have any expertise at all. It seems to me that not only is the science solidly against the vaccine explanation, unless there is some sort of genetic predisposition anyway, but autism is very misunderstood. I like to point out that it's not the worst thing ever, can be overcome, and that modern understanding is really helpful, even to someone who grew up before anyone understood what they were dealing with. The focus on who to blame isn't helpful. It should be, what can we do to understand autism and make life easier for autistics?

I think it has something to do with human intelligence and you cannot separate it from personality. It's not something you have, but something you are.

Now I'll go back to lurking.
9.4.2008 3:45pm
SATA_Interface:
Dave N, no snark intended; I was trying to understand what symptom gave your brother the brain damage, that's all. Wasn't sure if there was swelling, fever, etc involved.
9.4.2008 5:53pm
GUEST:
I think that this is a responsible take on the issue: http://www.lewrockwell.com/miller/miller15.html
9.4.2008 6:02pm
GUEST (www):
I think that this is a responsible take on the issue: http://www.lewrockwell.com/miller/miller15.html
9.4.2008 6:02pm
matt b (mail):
color me skeptical. is 10-35% of the 1 in 1000 infected and complicated a serious risk? no.
9.4.2008 6:34pm
wfjag:
GUEST, I hope that your comment was meant as sarcasm.

Note the site that carries Dr. Miller's posts:

LewRockwell.com, which under "The Principles of LRC" explains


Lew Rockwell, former congressional chief of staff to Ron Paul and founder and president of the Ludwig von Mises Institute, is an opponent of the state, its wars and its socialism.


Scientific or factual rigor are not a hallmark of postings on the site.

And, "Mercury on the Mind" by Dr. Miller, begins:


Although they afflict widely different age groups, autism and Alzheimer's disease share a common cause: mercury.

www.lewrockwell.com/miller/miller14.html

There is "zero" medical support for that assertion, no plausible scientific theory to support it, and the symptoms of mercury poisoning do not resemble either Alzheimer's or autism. Dr. Miller is part of the mercury causes autism crowd. Although there is no reason to question his credentials in cardiology, he has no demonstrated expertise or experience in any speciality relevant to autism.
9.4.2008 6:41pm
Splunge:
I'm not sure why the focus here is on the triumvirate of childhood diseases that were, historically, least fearful, and which almost all of us born before 1965 or so simply had once in childhood, namely measles, chicken pox, and rubella. As some have pointed out, even these disease can have occasional serious side effects.

But what about the rest of the vaccine group? Smallpox? Polio? Want to risk death, paralysis, living in an iron lung all your life? Meningitis? Got a 25% death rate even caught early and with the best medical treatment. Hepatitis A and B? Those can put you on the liver transplant list. Tetanus? The bacillus is found practically everywhere -- I'm sure you've all got it on your shoes right now -- and the consequences of tetanus are unbelievably hideous. The standard of treatment in the days before the vaccine was pouring hot raw alcohol down the throat in a desperate attempt to keep it open and prevent the patient from suffocating. Sound like something you'd like to risk for your child?

In short, unless you're completely stupid and fond of Russian roulette with your children's lives, you absolutely must get most of the standard list of vaccines. Why balk at adding the MMR vaccine to the already long list?

I mean, it's like saying I bet food causes cancer, so...uh, oops, looks like I can't realistically avoid eating food so...er...I know! I'll skip eating dessert, and anyone who forces me to take a bite of it is practically sentencing me to death (or autism, whatever).
9.4.2008 8:12pm
Joshua:
Sandy G: Full autism is a terrible, lifetime affliction.

But it's still neither fatal nor contagious. The same cannot be said of the diseases being vaccinated against. Which would you rather risk having: a fully autistic child, or a dead one?

Pick your poison.
9.4.2008 8:13pm
Waldensian (mail):

I like to point out that [autism is] not the worst thing ever, can be overcome, and that modern understanding is really helpful, even to someone who grew up before anyone understood what they were dealing with.

Cro: I don't want to minimize what you've faced in connection with autism spectrum disorders, as I probably can't really comprehend it, and I'm enormously gratified to see another member of the autism community standing up against the psuedoscience of vaccine conspiracy theories. We need scarce research dollars spent on real science.

So I assure you, what I say here is said with tremendous respect and admiration, and I hope politeness.

The word "autism" means different things to different people. But alas, I simply cannot sit still for the claim that "it is not the worst thing ever" and "can be overcome."

The reason is that I have 10-year-old twin boys with autism, and if it isn't the worst thing ever, it's pretty damn close. The first has been diagnosed out the yazoo by pediatric neurologists and has Autistic Disorder. He is barely verbal (able to make only very simple requests), engages in bizarre repetitive behaviors, has no real interest in socialization, is prone to wandering off at all hours, and has only the most minimal regard for his own safety. He is capable of doing basically anything humanly possible, at any time, for no known reason -- including, for example, urinating in public, leaving the house in the middle of the night, you name it. Currently there is no hope for a material improvement in his level of functioning. He will, in all likelihood, never attend college, marry, drive a car, or post on the Volokh Conspiracy. Instead he will require 24-hour care and close supervision for the rest of his life. I have no idea how that is going to be arranged or who will pay for it, particularly after I am gone.

His brother has either Autistic Disorder or a slightly less severe diagnosis, Pervasive Developmental Disorder - Not Otherwise Specified. The diagnosing physicians disagree, probably because of the subjectivity in the diagnostic criteria. He is not as impaired as his brother, but he does not have conversational speech, and likely will never have it. He engages in unusual ritual behaviors. He might remind you of the Dustin Hoffman character in Rain Man, though without any obvious savant skills (although some of his feats of memory are quite impressive). He may be able to live in some sort of structured setting some day, but I suspect he will never attend college, marry, drive a car, or live independently.

I assure you, autism in these forms is really, really, really bad. It's devastating. It's financially ruinous. It's marriage destroying. You should see the faces on the parents of young children who meet my kids for the first time. It's raw fear. If there are worse things than autism, and I suppose there must be, I wouldn't wish them on anyone, ever.

Like you, I have no patience for anyone who spouts crazed, pseudoscientific vaccine causation theories. I try to understand their need to blame, I suppose. But I also cannot let people think that autism is just a mild personality issue that can be overcome. This may be true for some forms of autism spectrum disorders, but it is not true for Autistic Disorder.

I certainly wish you the best of luck.
9.4.2008 8:24pm
Dave N (mail):
SATA Interface,

I apologize for thinking you were snarking when you were not. My brother was a toddler (I am 21 months older, so I am not in a position to remember much). His measles led to an extremely high temperature--so high, in fact, that he was hospitalized for several days.

After the fever broke, he was very different. A toddler who was meeting all developmental signs EARLY regressed into a shell of his former self--ironically best described as autistic--with most of the manifestations of autism. To use Ian's phrase from above, my brother was "poof gone."

Now Ian also suggested in his post that there is a form of autism that he defined as "regressive." Perhaps my brother always was autistic. I only know, anecdotally, what my parents and older siblings observed.

By the way, Neurodoc has always been a great poster on these autism threads and I have learned a lot from them. While we are all fairly anonymous I have absolutely no doubt that he is exactly what he portrays himself to be--a board certified neurologist.
9.4.2008 9:18pm
Richard Aubrey (mail):
I deal with some folks on the mild end of the spectrum. Although educated and employed, their employment and social progress is held up by their inability to "get it".
Kidding around with one about some clown who didn't want to use windshield wipers because they wore out the windshield--and lived in Seattle--one of these guys began explaining that glass was harder than rubber.
If you know him and have empathy, you don't yell, "We get it already, moron!" Because it would be as meaninglessly cruel as kicking a dog for no reason. He isn't always among friends.
I've known him for five years and he has yet to get it, whatever it is, although is reasonably intelligent on whatever it is once it's explained to him what the real issue is.
I also have friends who have a son with Charge Syndrome. They were inhumanly relieved to find it's a genetic--not heritable, apparently, maybe a sport--issue and not, as they had thought, a matter of the mother taking meds during pregnancy.

Yes. One would want to blame.

But keep in mind that rubella in pregnancy causes horrid birth defects. Anybody remember German Measles parties? It's not one of the safe ones.
9.4.2008 9:28pm
Dave N (mail):
Waldensian,

I certainly can empathize. My brother matches the description of your son with "Autistic Disorder or a slightly less severe diagnosis, Pervasive Developmental Disorder - Not Otherwise Specified."

And while my brother will likely never drive a car (not that I didn't try to teach him), get married, attend college, or live on his own, as adults I can also see that in his own way he lives a fullfilled life, working 40 hours a week, though also locked into his various routines and ideosyncracies.

I can only wish you the best for you and both of your sons. From your description, it sounds like they are lucky indeed to have you as their parent.
9.4.2008 9:29pm
tsotha:
Good Lord, this autism/vaccine thing has been studied to death, and there just isn't any link. I wouldn't care if it was just people damaging their own kids, but a vaccine doesn't give you 100% immunity. They're affecting other families as well.

I have nothing but contempt for parents who don't vaccinate their children.
9.4.2008 9:35pm
Fub:
Waldensian wrote at 9.4.2008 7:24pm:
Like you, I have no patience for anyone who spouts crazed, pseudoscientific vaccine causation theories. I try to understand their need to blame, I suppose. But I also cannot let people think that autism is just a mild personality issue that can be overcome. This may be true for some forms of autism spectrum disorders, but it is not true for Autistic Disorder.

I certainly wish you the best of luck.
I'll second that. My heart goes out to you both.

My experience is not as direct as yours or Cro's, but I lost an adult cousin to experimental meds for a related severe neurological condition over a decade ago.

I can understand the pain and anguish that underlie the need to find a preventable cause or culprit for the condition. I've seen it up close and personal. I can even understand without condoning the ignorance that guides the rationalization of a preposterously incorrect causation.

But I cannot begin to comprehend what motivates those who know better, or should know better, to lead such absurd crusades as this anti-vaccination crusade. The only outcome, even if it succeeds politically, is to endanger far more lives without preventing or mitigating even one case of autistic disorder.
9.4.2008 9:39pm
Martha:
We need to do away with the religious and philosophical exemptions to vaccines (and many other laws intended to protect children). Maybe not for all vaccines, and maybe allowing some flexibility in vaccine schedules, but quit making it so easy to opt out. We require car seats and allow parents to opt out of vaccines? How does that make sense?
9.4.2008 11:22pm
neurodoc:
Dave N, I vaguely recall that you and I had some "conversation" about these matters in a previous thread, and I told you that your parents were almost certainly blameless for your brother's neurologic injury, since I thought it very doubtful that anything they did or didn't do at the time contributed to that unfortunate result. High fever can cause convulsions in susceptible children and febrile convulsions can lead to a permanent seizure disorder, though most times they don't. Without all of the relevant clinical facts I can only guess, but I think it more likely that your brother's measles infection affected your brother's brain directly (encephalitis) rather than that his brain was damaged by fever, even a dramatically high one. Antipyretics would be used to reduce such a fever, but they would only be "adjunctive" therapy.

Your brother may exhibit "autistic" features, but "autism" would not be an accurate diagnostic label for several reasons, including that what he has amounts to an organic brain syndrome consequent to a viral encephalitis rather than a developmental arrest or regression. Practically speaking, this means very little for your family's purposes, but discussions about putative causes of autism have no relevance to him. Regrettably, your brother serves as rebuttal evidence to the patently absurd suggestion that measles is no big deal and the vaccine to protect against it is other than a great boon.
9.5.2008 2:20am
neurodoc:
non: My wife is a medical practitioner who...has read all the studies and says most of them are lacking in clinical rigor regardless of the journals rigorous reputation. Limited to 38 patients, or no control groups, or other factors that fails to have a significant clinical conclusion...
I think I can say without fear of contradiction that no drug, device, procedure, or other therapeutic intervention has ever been tested in clinical trials with anywhere near the numbers enrolled in vaccine trials, many of them with unvaccinated controls. Research studies looking for measles virus in tissue obtained in the course of endoscopic examinations of sedated children are a very different matter from the clinical trials done to establish the safety and efficacy of new vaccines.
non:...I think someone has already pointed out they could easily do an honest to goodness clinical study comparing the general population with religious groups that refuse vaccinations...an existing control group, if you will.
Been done many times over, always confirming the value of being vaccinated as against going unvaccinated. The Amish are one particular religious group that has served as such natural "controls," and there are other cloistered religious communities that have too, with epidemic outbreaks of measles and other infectious diseases when they are exposed. When Muslim clerics in Nigeria put a stop to a polio immunization campaign, the result was the
to-be-expected spike in poliomyelitis. What more evidence needs to be adduced, and to prove what proposition that wasn't conclusively established long ago?
9.5.2008 2:36am
TokyoTom (mail):
Jon, I think it's worth recalling that one of the factors that drives the fear of vaccines is the role of "The State" in developing and pushing them. If vaccines were purely between a parent and his family's health insurer, much of the resistance woulf melt away.
9.5.2008 4:01am
Dave N (mail):
Neurodoc,

You actually did provide comfort to my mother when we previously discussed the issue, when I relayed that I had casually spoken with a neurologist and repeated what you had said that she should not feel guilty because his brain injury was not caused by any delay in seeking medical help (I certainly did not want to get into explaining blog threads).

I understand what you say in that my brother is not autistic in the scientific sense as you describe it. However, I find it helpful to use the term "autistic" to describe him because he exhibits "Rainman" like characteristics--though he is certainly higher functioning than Dustin Hoffman's character.

And regardless of how his condition is defined medically, I heartily endorse your views on the need for vaccination and consider his experience a good example of what the measles can do.
9.5.2008 4:18am
neurodoc:
Dave N, just to be a bit clearer, it's not "scientific" versus "non-scientific" as such, but rather a matter of diagnostic precision. If a research had some hypothesis pertaining to "autism," they wouldn't include your brother in their study group because that would muddy their results. Instead, they would be after people who met the strict diagnostic criteria for "autism" or PDD (e.g., DSM-IV), not wanting to mix in those with "autistic" features attributable to a bout of encephalitis.

That's all I meant when I made the distinction, nothing more, nor less. For practical purposes, it probably matters not a wit to your lives. Where your experience is relevant to this conversation is that you can testify firsthand as to the devastating effects measles can have, and hence the value of the MMR vaccine. Almost certainly that vaccine would have prevented the tragedy that befell your brother and your family. When the conversation is one about "autism," which some claim can be caused by the MMR vaccine, your brother does not fit, because he is not truly representative of those with "autism," though his neurologic impairment may have autistic features to it. That grievous impairment of his impairment came about as the result of a bout of measles; no one's "autism" was caused by the vaccine given to protect against measles.
9.5.2008 2:53pm
wfjag:
Dave N:

As the parent of an autistic child, I do happen to object to your referring to your brother as "autistic." I don't underestimate the challenges you and your family face. Rather, mercury militia have used stories such as yours to divert limited research money away from research that may provide anwers, and possibly therapies.

A clear example of that arises from the Vaccine Court's decision in the Hannah Poling case. The mercury-causes-autism movement has been touting this as "proof" that vaccines cause autism. However, as the New England Journal of Medicine reported, "Hannah was diagnosed with encephalopathy caused by a mitochondrial enzyme deficit." "Vaccines and Autism Revisited -- The Hannah Poling Case" by Paul A. Offit, M.D., Vol. 358 NEJM 2089-2091 (May 15, 2008)http://content.nejm.org/cgi/content/full/358/20/2089

ASD is a clinical diagnosis, whereas Poling was diagnosed with a mitochondrial enzyme deficit. Accordingly, ASD is an inappropriate diagnosis under DSM-IV-RT.

That difference in no way means that your brother is entitled to any lesser services or benefits than my child. Rather, don't let your brother be cited as "proof" that vaccines cause autism. This is done all the time, and then leads to the call for "just one more study." As the comments above, and those on Orac's blog (linked by Eli Rabett above) show, there's a lot of promising areas for research.
9.5.2008 5:42pm
Dave N (mail):
wfjag,

You didn't fully read my post. My brother HAD the measles. He WAS NOT vaccinated. Because of the measles he suffered brain damage that has autism like features. He does not have his condition BECAUSE of a vaccine.

That is why I am a frevent believer in vaccination.
9.5.2008 9:13pm
Bill McGonigle (www):
Twin studies show a 90% genetic link but not 100%. It's hypothesized that there's also a trigger of currently unknown origin. The trigger has to be during gestation, not from vaccinations, to explain neurological morphology differences.

I've been meaning to look for statistics among the 90% on birth control pills and also where women met their husbands. 'At-work' seems like a good way to marry similar genotypes and it's a recent phenomena. Birth control pills have been shown to interfere with a woman's ability to smell genetically incompatible mates.
9.7.2008 10:13pm