• Study linking autism, vaccines retracted by medical journal

    March 2010

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    A British study published more than 12 years ago that reported a link between a childhood vaccine and autism has been retracted by editors of the journal in which it first appeared.

    In a statement issued recently on the website of The Lancet, the editors wrote, “It has become clear that several elements of the 1998 paper by Wakefield et al. are incorrect, contrary to the findings of an earlier investigation… Therefore, we fully retract this paper from the published record.”

    Wakefield’s study was the first to be reported in a reputable journal suggesting that the MMR (measles, mumps and rubella) vaccine could cause autism. The resulting media attention has been blamed for creating unfounded concern among parents and the medical community, leading to a drop in MMR vaccination rates and an increase in measles rates in the United States and Great Britain.

    About autism

    According to the Autism Society of America, “Autism is a complex developmental disability that typically appears during the first three years of life and affects a person’s ability to communicate and interact with others.” Called a “spectrum disorder,” there is a set of behaviors that defines autism. The disorder affects each person differently and to varying degrees. No one knows what causes autism, but it is treatable with early diagnosis and intervention leading to improved outcomes.

    Signs of autism include:

    • Lack of or delay in spoken language
    • Repetitive use of language and/or motor mannerisms (e.g., hand-flapping, twirling objects)
    • Little or no eye contact
    • Lack of interest in peer relationships
    • Lack of spontaneous or make-believe play
    • Persistent fixation on parts of objects

    The Centers for Disease Control and Prevention estimates that one out of every 150 American children has autism. About 1.5 million Americans have been diagnosed with autism spectrum disorder.

    About the study

    Years ago, researchers led by Andrew Wakefield, MBBS, looked at 12 children who had developed intestinal inflammation after being given the MMR vaccine. The researchers suggested this inflammation caused proteins from the gut to circulate in the body. They believed that the proteins eventually settled in the brain, causing damage that led to the symptoms of autism. Thus, they concluded, autism might be caused by the MMR vaccine.

    Concerns about the study arose in 2004 following reports that the research was partially funded by plaintiffs’ lawyers in lawsuits filed against the vaccine makers. That funding had not been initially disclosed. Dr. Wakefield denied that the funding affected his study findings. The Royal Free and University College Medical School and the Royal Free Hampstead NHS Trust, where the study was conducted, issued a statement in 2004 noting there was no evidence of inappropriate or unethical behavior.

    Subsequent allegations in The Times of London by reporter Brian Deer were made concerning the credibility of data reported in the study. An article in MedPage Today reported that Deer’s investigation found differences between the published study and hospital records. For example, Deer alleged that while the study reported that most of the children developed symptoms after only a few days following vaccination, hospital records indicated this was true for only one child. Also, the study reported that all of the children were “developmentally normal,” but patient records note that five of the children psychosocial problems prior to vaccination. The hospital’s pathology reports did not indicate any signs of intestinal inflammation in the children in contrast to the abnormal results reported in the study, Deer found.

    On Jan. 28, 2010, Wakefield was found guilty of more than 30 charges of unethical behavior in the conducting of the study by Great Britain’s General Medical Council Fitness to Practise Panel. The council is the nation’s regulatory body that registers doctors and enforces medical practice standards. Two other study authors, John Walker-Smith, MD, and Simon Murch, PhD, were also found to have acted unethically. Ten co-authors who had previously denounced the paper’s findings were not charged.

    It was the findings of the panel that led to The Lancet’s decision to retract the 1998 paper from its published records. Dr. Wakefield, who now lives and works in Austin, Texas, has said he is innocent of any wrongdoing and will continue his research.

    Findings of other studies

    Since Wakefield’s study was released in 1998, other researchers have found no evidence of a link between autism and the MMR vaccination. In fact, a different research group from Wakefield’s institution found evidence to the contrary in The Lancet in 1999 on an analysis of 498 cases of children with autism. Researchers looked at immunization records for evidence of a trend in autism after the introduction of MMR vaccines to the UK in 1988. Brent Taylor, MD, and his team concluded, “Our analyses do not support a causal association between MMR vaccine and autism. If such an association occurs, it is so rare that it could not be identified in this large regional sample.”

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Page last updated: 8/7/2015 2:13:06 PM
  • What the news means for you

    The bottom line: Vaccines are safe and save lives

    Erich Maul, DO

    Wright, Heather, MDThe biggest news about the discrediting of Wakefield’s study is that it will help us continue to get the message out to concerned parents that vaccines are safe. Lots of data has proven over and over that vaccines are safe and save lives.

    “No one has ever been able to replicate [Wakefield’s] study. In fact, every other study has shown there is no relationship between vaccinations and autism.” 

    Wakefield’s study never came right out and said the measles, mumps and rubella (MMR) vaccine caused autism. But subsequent interviews with the researchers and the resulting news media reports that blew the study out of proportion caused a lot of parents to become afraid of having their kids vaccinated.

    Unfortunately, it’s very easy to scare people and exceedingly difficult to “unscare” them. The Wakefield study was biased and based on a small group of children. It relied on parental recollection and many of the subjects already had gastric or developmental problems that predated the vaccination. More importantly, no one has ever been able to replicate his study. In fact every other study has shown there is no relationship between vaccinations and autism.

    Suspected causes of autism

    I am the proud father of a 10-year-old with autism. Not for a second did I believe that vaccines had anything to do with my son’s condition. He was different from our other three children from the day he was born. A very complex set of situations appears to influence what causes autism. These include a genetic link that we as parents transmit, something that occurs during the development of the embryo before birth, as well as environmental factors.

    “The bottom line is that vaccines are safe.” 

    For a lot of reasons, we’ve seen a greater increase in the number of children diagnosed with this disorder. That may be because we are more aware of it, so doctors are diagnosing more cases. Also, the criteria have changed to include a greater number of children. Some children with other problems, such as Down syndrome, may also be labeled as autistic by their doctors. But immunizations have had no impact on the increase in autism diagnoses.

    The bottom line is that vaccines are safe. I don’t want my children or others dying from measles, diphtheria, Streptococcus pneumoniae, hepatitis, polio, whooping cough or any of the other vaccine preventable diseases. With the MMR vaccine, we thought we had stopped seeing cases of measles and mumps, but it’s coming back in some areas of the world.

    Concerns about measles

    Measles is highly contagious. One in 12 children with measles will get pneumonia; one out of 800 will have a complication of the central nervous system such as encephalitis that can lead to seizures, mental retardation and even death. These central nervous system side effects occur with the MMR vaccine less than once per 1 million doses of vaccine. Mumps causes swollen glands that can be painful for a child. Rubella, also known as German measles, not only causes illness in children, but it can lead to birth defects if a pregnant woman is exposed to a child with the disease.

    It’s recommended that children get two doses of the MMR vaccine: the first dose at 12-15 months of age; the second dose at 4-5 years of age. I understand that parents need to make decisions about vaccinations for their children and I respect that. But I hope that they make an educated, informed decision that’s not based on one news source or a celebrity’s views.

    Dr. Maul is a pediatric hospitalist at Kentucky Children’s Hospital. He is also associate director of the pediatric residency program and assistant professor of pediatrics at UK College of Medicine.

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