MMR and autism: studies

[bumpy_j]

Can't a severe illness such as measles trigger autistic behaviour that's already dormant though? My belief is that if there ever was a solidly proven link (which hasn't really manifested itself yet - not to many peoples standards), it wouldn't be the cause, simply because there isn't a true 'cause' of Autism. Maybe it could possibly be one day proven as a trigger, but surely dormant autism will nearly always eventually surface? I mean, perhaps I'm wrong but is there anything out there that has been finitely proven to cause Autism aside from hereditary factors?

Well, its a broad question. Did you know there are FIVE types of autism, and another that technically isnt autism, but causes autism? Retts, Disintigrative, PDD-Nos, Autistic Disorder, and Aspergers....and then there is Fragile X. These are vastly different diseases and some require lifelong care, and some are functioning, and some are both. I think first, narrowing down the TYPE of autism would help. I help by lending my child, or sometimes children (as sometimes they want children with and children without autism) for studies. My older two just did a study last month. I think it is more complicated than just a syringe with stuff in it. Personally, for e type of autism my daughter has (PDD-NOS), I think it was from a combo of things. Extreme stress during pregnancy, lack of oxygen at birth, mixed with either an illness she had at 6 days old, or an illness I had during pregnancy. I personally dont think it will be the same for everyone. And some autisms have different causes.

Wow, very interesting, thank you! Re-reading what I previously wrote, it possibly sounds like I believe that there isn't a cause of Autism aside from a genetic lottery; I more mean that there aren't any concrete and preventable 'action directly causing Autism - regardless of possible dormant autism' examples that I know of, that has been proven to correlate with a sizeable demographic. My knowledge admittedly isn't broad though...

Is there much evidence in the sense of easily preventable actions with a direct correlation a parent can withhold from (such as vaccines)? As it certainly sounds like what your daughter experienced was totally out of your hands.

If there was a pattern with MMR and autism that we could hypothetically draw up, as the concentration that the toddler experiences will be consistent with others, could we not assume that there not be vastly more cases of one type more than others? As I've heard claims of 'changing' after exposure from high-function/Aspergers to the more severe end of the spectrum.

 

[bumpy_j]

Please correct me if I'm wrong but I do think they've shown a pretty conclusive increase in autism with conditions that cause decreased blood flow/flow of nutrients/oxygen during gestation and birth? I think there can be a genetic predisposition to it that, in the absence of environmental triggers, never gets expressed. In other cases, the environmental triggers (fever during first tri, oxygen deprivation during birth, pollution exposure during pregnancy) seem to activate the genes.

I know two kiddos on the spectrum and in both cases, there was oxygen deprivation during birth. Their siblings do not show signs of a spectrum disorder, but one of the parents exhibits spectrum-like behavior in each case that was passed with severity to the children with birth trauma but not to the children without. I think it's interesting. In one case, the child was entangled and had to be delivered via EMCS after minutes of intermittent heart decels. In the other case, the back of the baby's head was up against the cervix (rather than the crown of the head) and the baby wasn't moving and had decels too, had to be delivered via EMCS.

Interesting, I have to admit that I didn't know much about oxygen starvation having so much of a solid link to Autism - my experiences have been namely with high functioning children, and I have had little interaction with other types of it. The proof of oxygen starvation causing disorders is clearly there though, so I would certainly regard this as a natural conclusion to make.

However as we've seen many times before, the MMR is being cited as causing Autism by many - rather than a trigger. Yet the evidence remains to seem more anecdotal than statistical, and we have the barrier of whether any evidence can actually be solidly regarded considering that signs of Autism appear to crop up around the same time the MMR is generally given.

I delayed Joels MMR until he was 2, as I was concerned about the hereditary factor that's within my family (both my dad and brother are on the spectrum) and wanted to be aware of any initial signs first and foremost - I know now that if I had done the MMR at 13 months, I would have possibly started blaming his ongoing speech delay and his sudden aggressive behaviour on the vaccine. Needless to say, there was absolutely zero behaviour change when he eventually had his vaccine.

 

[WantsALittle1]

I have heard the MMR can do some pretty nasty things as far as the GI tract goes but with the folks I know, they too agreed that there was no personality change and that questionable behaviors were present before the shot. We are planning to delay too (only 18 months in our case), although there is a measles epidemic in our state right now (all in the news) so I'm a bit nervous about that.

 

[Foogirl]

For anybody who still believes there may be a link, I implore you to read Ben Goldacre's "Bad science" book's section on the subject. He unravels the myth from the fiction. One (or two or three) small studies, poorly conducted with a small sample, do not fall into the category of studies showing a link. These are no better than the anecdotal stories told on several websites. When the AAP say they are no studies, they are talking about recognised, peer reviewed and scientifically legitimate studies, not some bloke in his garage, poking needles into a self selected group of individuals.

 

[WantsALittle1]

The Singh studies are peer-reviewed...

 

[bumpy_j]

ooo I actually have that book on my Kindle -mentally bookmarks-

 

[Foogirl]

The Singh studies are peer-reviewed...

yes they were, and the result of the peers reviewing the Singh study was that they rejected the claims saying there was a tremendous logical gap in the research.

https://news.bbc.co.uk/1/hi/health/2182690.stm

 

[Foogirl]

ooo I actually have that book on my Kindle -mentally bookmarks-

It's a great read and deals with everything for Homeopathy to vaccines to MMR.

 

[WantsALittle1]

The Singh studies are peer-reviewed...

yes they were, and the result of the peers reviewing the Singh study was that they rejected the claims saying there was a tremendous logical gap in the research.

https://news.bbc.co.uk/1/hi/health/2182690.stm

Thank you, I had never seen that link! However, nobody explains anything in it, still. They dismiss the study, say it has logical fallacies, or that it shows no link, but they don't explain why they are making those claims. Just stating that is not enough for me. I'm a scientist, I need those statements to be backed up with meaningful explanations. I'm still looking for those explanations. What are examples of the logical fallacies? What are examples of 'no link'? What would be needed in order to adequately establish causality? Details, please, doctors! We can handle it!

I was hoping to find something that spent a good amount of explanation and time on each of the paper's claims, explaining why the claims were spurious. Do you know of anything like that?

 

[Foogirl]

If you are a scientist then you should know how peer review works. It's not just one person saying something, it is a whole bunch of people reviewing it and coming to a conclusion and they will have written papers about it. "They" don't say anything in that link about it because it wasn't "they" who wrote it, it was a journalist, who has no idea about how to report on science and frankly, that's how we got into this who,e sorry mess with the MMR=Autism thing inn the first place. If you are a scientist then some very basic rules of science should jump out at you with the initial study and the fact there are a couple of tiny studies saying yes followed up by some massive studies saying no, should indicate to you what the real answer is.

 

[WantsALittle1]

I am an earth scientist. And I do know how peer review works. I don't work with human subjects, so I'm not used to reading studies that involve medical work and I know nothing about the appropriate sample sizes. No need to be snarky in your reply. People come here to educate themselves, learn, and communicate with other moms, not to be made to feel stupid.

The reason I made this post is because I was hoping people who do know *medical science* could answer some questions about the Singh studies, and provide specific detailed explanations of why these studies are not being considered credible. I am aware of the large-scale studies on the MMR and autism, and as I've stated, our daughter is getting the shot. I didn't ask about those studies, and I didn't ask where people stand on the MMR-autism controversy. I asked for anyone to shed some light on the small studies because it seemed weird to me that large governing organizations in the US don't mention these studies. Ever. Not even to explain why they are not considered credible.

 

[Foogirl]

I am an earth scientist. And I do know how peer review works. I don't work with human subjects, so I'm not used to reading studies that involve medical work and I know nothing about the appropriate sample sizes. No need to be snarky in your reply. People come here to educate themselves, learn, and communicate with other moms, not to be made to feel stupid.

The reason I made this post is because I was hoping people who do know *medical science* could answer some questions about the Singh studies, and provide specific detailed explanations of why these studies are not being considered credible. I am aware of the large-scale studies on the MMR and autism, and as I've stated, our daughter is getting the shot. I didn't ask about those studies, and I didn't ask where people stand on the MMR-autism controversy. I asked for anyone to shed some light on the small studies because it seemed weird to me that large governing organizations in the US don't mention these studies. Ever. Not even to explain why they are not considered credible.

And now it has been explained. The studies perhaps aren't mentioned because they aren't actually credible studies. But I disagree that nobody talks about them. Our own NHS website talks about them and how they have been discredited. https://www.nhs.uk/Conditions/vaccinations/Pages/mmr-vaccine.aspx

Having a look on Google, there do appear to be a number of articles on the AAP website where they talk about the discredited studies, but for some reason I can't access that website at all at the moment.

 

[WantsALittle1]

From what I can tell, the NHS link doesn't talk about the Singh studies at all, except via indirect reference to studies that looked at measles antibodies in the guts of ASD children. It never mentions the word Singh, or describes why the Singh studies specifically are inadequate.

It then cites a study with smaller sample size (90 exp, 90 control) than the Singh study (125 exp, <80 control?). So if sample size is an issue in the Singh study, it's one in the other study too. So so far, two studies looking for the same thing: one study finds the measles antibodies and gut inflammation, one study doesn't. The Baird study seems no better set up than the Singh study according to this news summary.

I, too, found that AAP links (and National Geographic) referencing Singh specifically were broken and inaccessible. It was that way weeks ago when I checked. It's frustrating!

 

[WantsALittle1]

Note:

This document of conference proceedings (https://pediatrics.aappublications.org/content/107/5/e84.full.pdf) acknowledges the measles-antibody-gut-studies, not discrediting them but saying that the methods in the various studies were non-uniform and that further research and replication needs to be done before a causal relationship could be established. It doesn't sound like they are discrediting the studies at all. It seems that they are simply saying that these results alone don't provide enough reason to alter vaccination protocol yet. More evidence is needed.

The document also says that children with autism have been shown to display increased antibody response (8). Measles vaccination is also associated with acute gastrointestinal symptoms (12). These two statements, taken independently, parallel conclusions of the Singh study. The extra claims of the Singh study are that the gastrointestinal response leads to a systemic antibody response that is correlated with the presence of ASD symptoms.

Still, multiple replications of this study would be needed in order to confirm the findings. A better-designed study would be needed to find the direction of causality. But I really don't see this AAP document as dismissing the Singh study and that is interesting.

There is a whole fascinating section on causality. Just getting to that now!

 

[suzib76]

I am shocked everytime I come across anyone who still sees this as a possibility

It must be 14 or 15 years since Andrew Wakefield had his flawed, and since discredited 'study' published.

In all those years extensive studies have never come close to replicating a link between the 2

 

[WantsALittle1]

This thread is not about the discredited Wakefield study.

It is about the Singh studies, and a discussion of specifically why they are not considered credible by governing bodies. I know that the small Singh studies have been dismissed, that is why I made this post in the first place, because I want to know the details of why the studies have been considered flawed.

I would really appreciate if folks would take the time to read the entire thread before responding to what they think the thread is about.

 

[suzib76]

This thread is not about the discredited Wakefield study.

It is about the Singh studies, and a discussion of specifically why they are not considered credible by governing bodies. I know that the small Singh studies have been dismissed, that is why I made this post in the first place, because I want to know the details of why the studies have been considered flawed.

I would really appreciate if folks would take the time to read the entire thread before responding to what they think the thread is about.

the title of your thread is MMR and autism: studies

i would really appreciate if folks would allow people to respond without being told they are doing it wrong.

 

[WantsALittle1]

Yes, that's the title. I'm not going to type the entire thread content into the title. I'm going to attempt to summarize it as best I can with a few words and then explain my question below. I assume that people will actually read my question, and not just the thread title. I think that is a reasonable assumption.

I do not want to debate. This thread was moved to the debate section and I never wanted it there. I just wanted someone to answer the question that I asked--why the two Singh studies are considered flawed.

I have requested that this thread be closed because it's turned into a debate over whether or not we should vaccinate, and frankly I don't care to know anyone's opinions on that topic. I just wanted to talk about two specific studies, hence the title. MMR and autism: studies

 

[MommyJogger]

I think it's foolish to throw out every point of view that says vaccines can cause autism. Based on the research I've combed through, I think it's highly possible that there is a subset of the population who are predisposed to autism for whom vaccines can trigger a degeneration into the disorder. That's why the large population-based studies used to make public health recommendations may not find any link (when there are multiple triggers and the vaccine was the trigger for only a small portion of population on the spectrum, it's not going to show up as significant in that kind of analysis) but the small, poor sample size studies looking specifically at subjects for who the disease presented on a time consistent with a vaccine trigger may find a link, if not being large scale enough to show causation. My main criticism of the singh studies (and it's a whopper of an unfair critique when I know how many ethics panels you have to wade through just to get a project started) is that if you're going to do a small scale study like this (twice!!!!!), you have to be careful enough with the design that the first one has to have a chance to indicate mechanism for cause and the second one has to be clever enough to test that mechanism. If after the first one he had taken a sample of younger siblings of kids with autism and w/o autism, looked at brain MBP autoantibodies at 10 mo, time of vaccine, and 6 mo later, then looked at those results in relation to whether those siblings displayed autistic tendencies at 2-3y, I think he really would have had something interesting to publish that moved the science forward, even if the results were completely inconclusive.
This is the most specific critique I've found:

A new US study proposing a link between the measles, mumps, and rubella (MMR) vaccine and autism in children could further inflame the controversy surrounding MMR vaccination in Britain. The research, led by Vijendra Singh, professor of immunology research at Utah State University, was prominently covered in the Daily Mail and other British media on 9 August but received a frosty response from most British experts.
The researchers examined blood samples from 125 autistic children and 92 controls. They found an unusual MMR antibody in serum samples from 75 autistic children but not in the control samples The authors suggested that “an inappropriate antibody response to MMR, specifically the measles component thereof, might be related to pathogen- esis of autism.” Dr Mary Ramsay, epidemiol- ogist at the Public Health Labor- atory Service in London, said: “We have problems with the methodology of the study. I find it a strange technique to use the vaccine as a combined antigen. The internationally validated technique is to look at these antibodies individually.” Dr Singh’s article explains his reasoning in choosing this method: “Antibodies to MMR will be a true measure of sero- conversion for this triple or polyvalent vaccine, instead of antibodies to measles, mumps or rubella viral proteins that are individually used for measuring virus serology in routine practice.” Dr Ramsay added: “The authors report that the sera from autistic children react with one particular component of the vaccine. The evidence that this component is one particular antigen of the measles virus is not credible. Firstly, there is insufficient virus protein in the vaccine to come up positive in the type of test used by the authors.
Secondly, they were unable to detect the main anti- gen of the measles virus (NP) while apparently detecting another antigen (HA). This doesn’t hold together. If there is sufficient measles virus in the vaccine to be detected then both the NP and the HA antigens should be present.” Dr David Elliman, consultant in community child health at St George’s Hospital, London, said: “What worries me is the underly- ing assumptions about causality. I don’t think this research moves the debate forward.” England and Wales reported 126 measles cases this spring, compared with 32 in the last quarter of 2001. Dr Singh was not available for comment.

I think the bit about the combined antigen unfair, as his way is still scientifically valid if not standard (because the standard way is used to look at effectiveness against actual strains and not to study the variety of antibodies humans make in response to the vaccine-- his way is much more valid for the purposes of his experiment and doesn't intrinsically bias his results). But the point about finding one antigen and not the other is valid. Peer reviewers should have demanded at least a supplementary figure showing that his detection of both were not atypical in his control sample.

 

[WantsALittle1]

Mommyjogger: thank you so much! That is really helpful.