The MMR Vaccine and Autism Conspiracy. Enough Already!

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Abstract:

Just when you thought it was safe to go back in the water, the anti-vaccination “conspiracy” movement continues to attempt to raise its ugly head. It’s time to finally set the record straight and establish public health policy around the world based on real documented medical evidence. The widespread urban myth, that the MMR vaccine (Measles, Mumps and Rubella) was linked to an increased risk of autism, has been called by an international health researcher as, “the most damaging medical hoax in the past 100 years”.1

Main Article:

Scientific Studies Have Refuted the Link

The real scientific evidence from multiple sources has found no link whatsoever between the MMR vaccine and autism. For example, The Journal of the American Medical Association (JAMA) released a comprehensive study in April 2015 utilizing 95,000 children in a health insurance data base. The JAMA researchers stated, “Consistent with studies in other populations, we observed no association between MMR vaccine and increased ASD (autism spectrum disorder) among privately insured children.”2 The University of Sydney released a study in 2014 examining 7 sets of data involving 1.25 million children from around the world and also found no link between MMR Vaccinations and autism. 1,3

The overwhelming medical evidence finding no link whatsoever is also supported by the Centers for Disease Control and Prevention (CDC)4, the U.K. National Health Sciences5, The Institute of Medicine at the U.S. National Academy of Sciences6, and the Mayo Clinic,7 to name just a few. Despite the overwhelming medical evidence contrary to their claims, the anti-vaccination movement continues to promote a “controversy” and/or a “conspiracy” largely based on one reported study in 1998.

Where the Urban Myth Began

The original belief was based on the 1998 “study” by Dr. Andrew Wakefield in the U.K. which has since been 100% discredited. (This is the same Andrew Wakefield who recently had his film on the link between MMR vaccine and autism pulled by Robert Di Niro at the Tribeca Film Festival.)  His reported study launched the anti-vaccination movement and unnecessarily panicked parents around the world which caused a sharp decline in the number of children getting the MMR vaccine.8,12

The real problem was that this “research” was published by the world famous British Medical Journal, The Lancet. The Lancet subsequently partially retracted the article, but not until 2004 and then fully retracted the article in 2010.9,10 It was determined that Dr. Wakefield had multiple conflicts of interest, had manipulated evidence and broken several ethical codes of medical research, including accepting funding by attorneys involved in lawsuits against MMR vaccine manufacturers.11 The editor-in-chief- stated in the retraction that the research was “utterly false” and that they were “deceived.” 10 The BMJ (British Medical Journal) editor-in-chief-labeled Wakefield’s research as “fraudulent” and stated, “It’s one thing to have a bad study, a study full of error, and for the authors then to admit that they made an error. But in this case, we have a very different picture of what seems to be a deliberate attempt to create an impression that there was a link by falsifying the data.”12

The Canadian Medical Journal in 2010 went on to say that the original research was a “callous” disregard for the “carefully selected” study of only 12 children. 10 The Lancet retraction published on February 2, 2010 stated, “It is now clear that several elements of this research were incorrect and contrary to findings of an earlier investigation.” 10 Dr. Wakefield subsequently lost his license to practice medicine in 2010 as a result of what was determined by the General Medical Council in the U.K. to be severe ethical breaches and fraudulent research. This original false research has done significant harm to the field of public health and has resulted in serious harm to children of parents misled by this report which resulted in unnecessary deaths, severe impairment and permanent injury to unvaccinated children exposed to disease around the world. Because of the wide dissemination of this discredited link, it grew into an urban legend, and as a result, there were many lawsuits by parents of children with autism against MMR vaccine manufacturers. In 2009, a special court convened by the National Vaccination Injury Compensation Program denied all claims in U.S. federal court against vaccine manufacturers. 15, 16

History and Recent Outbreak

Most people born before 1957 had the measles. The disease was once so prevalent that in New York City, in the first 10 weeks of 1933 alone, there were 10,000 cases and 434 deaths.12 One of the greatest public health success stories in history had been the eradication of the measles in the U.S. due to the introduction of childhood immunizations first developed in the late 1950’s and early 1960’s. In fact, The Centers for Disease Control and Prevention (CDC) officially declared that measles was eliminated in the U.S. in 2000.12

Fast forward to January 2015 when the CDC reported more confirmed cases in the U.S. than are typically diagnosed in a full year.8 The 2015 surge of reported cases, most notably in California, has been scientifically linked by researchers from MIT and Boston Children’s Hospital to the outbreak that began in Disneyland in December 2014.14

These and other medical researchers firmly believe the outbreak of measles was solely due to the low vaccination rates in certain communities as a result of misinformed parents’ fears based on the false link to autism. The MIT and Boston Children’s Hospital researchers determined that the exposed California population rate in certain communities (non-vaccinated population including adults and children) may have been as low as 50% and likely no higher than 86%.14 These vaccination rates are well below the 96%-99% level required to prevent future outbreaks known in epidemiology as “herd Immunity”.

Dr. James Cherry, a pediatric infectious disease outbreak expert at UCLA, stated he believes the recent outbreak in California was, “100% connected to the anti-immunization campaign”.  He went on to say, “there are some really dumb people out there”.17

Facts about the Measles

An unvaccinated person has a 90% chance of infection if exposed to the virus

Symptoms of the measles typically begin with a high fever, runny nose, sore throat, and cough, which can easily be misdiagnosed as a simple cold or flu. The incubation period is between 7 and 18 days of exposure to the virus. It is very dangerous because people are contagious up to 4 days before the signature red rash appears and unlikely to know they are infected. A single infected person can spread the disease to between 11 and 18 people. In addition, an infected person can contaminate a room for up to two hours after they leave. An unvaccinated person has a 90% chance of infection if exposed to the virus. The risk of serious complications and death is actually greater for adults and infants than for school age children and teenagers. 18

Rubella, known as the German measles, is also caused by the virus and is usually a mild form of the disease but is a very serious infection that causes still births or birth defects in children when pregnant women are infected.18

Measles is still a widespread disease throughout the world. Travelers from overseas continue to bring the disease into the U.S. on a daily basis. Now public health officials fear the potential for a public health crisis for this disease that was once officially declared eliminated, based on blatantly false research and unfounded fears perpetuated by people who continue to dispute the facts and who have no background in the field of public health.

Do the Math

Although many parents in the anti-vaccination movement believe the measles is not dangerous and the MMR vaccine is, the medical facts state otherwise. The CDC reported from 2001 to 2013 (remember, the measles was officially eliminated by the CDC in 2000) that 28% of children in the U.S. with the measles had to be hospitalized. 19 Parents need to do the math. According to the CDC19:

99 in 100: the effectiveness of the MMR vaccine in preventing Measles, Mumps and Rubella (and it provides immunity for a lifetime). It works by helping the body produce antibodies against the virus.

1 in 3,000: the chance of a mild allergic reaction to the MMR vaccine

9 in 10: the chance of infection if an unvaccinated child is exposed to the measles virus

1 in 10: the number of children with measles that will develop an ear infection (which can lead to permanent hearing loss)

1 in 20: the number of children with measles that will develop pneumonia (the most common cause of death from measles in young children)

1 in 1,000: the number of children with measles that will develop encephalitis (swelling of the brain that can leave the child deaf or with intellectual disability)

1-2 in 1,000: the number of children with measles that will die

The numbers show that the risk to a child’s health is much higher for the unvaccinated than for the vaccinated. In order to alleviate any fears of a mild allergic reaction, parents should confirm with their family physician and/or pediatrician that their child is not allergic to other medications. In addition, parents should verify that their child does not have an immune deficiency condition, which may cause side effects and decrease the vaccine’s usefulness. For people with a potential allergic reaction to the MMR vaccine or unable to use it for any reason, an immune globulin, a blood product containing antibodies is also available.19

The MMR vaccine is the best way to prevent this disease both for the individual and the general population. The small percentage of people who cannot be vaccinated due to age or medical conditions will benefit from the herd immunity that results from the rest of the population receiving their vaccinations.

Public Health Policy and Dispelling the Myths

Public health experts fear that this 100% preventable disease will make a comeback unless aggressive public health education and public policy is enacted.  What is required is an extensive education campaign, including widespread vaccination of unvaccinated people, starting with infants at 12 months and a booster shot at age 4 to 6 prior to entering pre-school or kindergarten. Unvaccinated adults also need to be vaccinated.

The anti-vaccination movement includes parents who believe the following myths:

  • MYTH: there is no medical risk for not vaccinating their child (FALSE)
  • MYTH: measles is extinct (FALSE). The disease still kills more than 100,000 people per year around the world, mostly under the age of 5 and that
  • MYTH: you can catch the measles from the vaccination shot (FALSE). 19

Others now claim there is a “conspiracy” by health insurers to increase profits by promoting vaccinations. Not only is this false, it is absurd.  Under the Affordable Care Act (Obamacare) in the United States, preventative vaccinations are provided free of charge with no out of pocket costs. How do you get rich providing something for free that costs you money?

State legislatures must strengthen immunization laws requiring all school age children to be vaccinated, except those with a medical exception such as childhood leukemia or other immune deficiency conditions certified by a licensed physician. No “personal” or “religious” beliefs should be allowed.

Public health official should also track and verify both local and statewide immunization rates and mandate that all schools maintain an up-to-date list of pupils with certified exceptions so they can be removed quickly if an outbreak occurs. The list will also help to temporarily exclude unvaccinated students, teachers and other school staff from attending school, while offering free of charge measles vaccinations for unvaccinated students, staff and teachers.

The State of California enacted such legislation in June 2015 after the measles outbreak that began in Disneyland in late 2014 appeared to be spreading in California and other surrounding states. The anti-vaccination movement sponsored a petition campaign to recall this legislation and received over 230,000 signatures.  Luckily, it was not enough to get the recall petition on the ballot. However, the anti-vaccination movement vowed to continue the fight for “parents’ rights”.  What right do parents have to risk the health of not only their own children but dramatically increase the risk to other children, the general population, people with weak immune systems or cancers, and infants under 12 months of age based on an urban myth or personal beliefs that are completely unfounded?

There is also a myth that unvaccinated populations are in poor or rural neighborhoods. The true fact is that the measles outbreak in California was concentrated in wealthy neighborhoods. Guess which state has the highest vaccination rate (99%) for school age children? Mississippi. Another myth down the drain. 20

The anti-vaccination movement is both troubling and dangerous. The fact that it was perpetuated on poor science, deception and fear-mongering makes you wonder how the movement persists today, even when those in the movement are presented with real science that both refutes the original conclusions by Andrew Wakefield and goes even further to rule out any connection between vaccines and autism.

References:

  1. No Links Found between Autism and Vaccinations- Study (2014, May 19). New York Post. Accessed via: http://nypost.com/2014/05/19/no-links-between-autism-and-vaccinations-study/
  2. Jain, A., Marshall, J., Buikema, A. et al. (2016, January). Autism Occurrence by MMR Vaccine Status among US Children with Older Siblings with and without Autism. Journal of the American Medical Association Volume 315, Issue 2, Page 204.
  3. Vaccines not linked with autism, study finds (2014, May 20). NHS Choices. Accessed via: http://www.nhs.uk/news/2014/05May/Pages/Vaccines-not-linked-with-autism-study-finds.aspx
  4. Measles. Mumps, and Rubella (MMR) Vaccine (2008, August 22). Centers for Disease Control and Prevention. Accessed via: www.cdc.gov
  5. MMR the Facts (2004). NHS Choices. Accessed via: http://www.nhs.uk/
  6. Immunization Safety Review: Vaccines and Autism (2004, May 14). Institute of Medicine of The National Academy of Sciences. Accessed via: http://www.nationalacademies.org/
  7. Autism Spectrum Disorder (2014, June 3). Mayo Clinic-6/3/2014
  8. Haberman, Clyde (2015, February 1). A Discredited Vaccine Study’s Continuing Impact on Public Health. New York Times. Accessed via: http://www.nytimes.com/2015/02/02/us/a-discredited-vaccine-studys-continuing-impact-on-public-health.html
  9. Retraction – Ileal-lymphoid-nodular hyoerplasia, non-specific colitis, and pervasive developmental disorder in children (2010, February 6). The Lancet. Accessed via: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60175-4/abstract
  10. Eggertson, Laura (2010, February 8). Lancet Retracts 12-year old article linking autism to MMR vaccine. Canadian Medical Association Journal Vol. 182 no.4. Accessed via: http://www.cmaj.ca/content/182/4/E199.short .
  11. Deer, Brian (2009, February 8). Wakefield’s Article linking MMR Vaccine and Autism was Fraudulent The Sunday Times.
  12. Retracted Autism Study an ‘elaborate’ fraud, British Medical Journal Finds (2011, January 5). CNN Wire Services . Accessed via: http://www.cnn.com/2011/HEALTH/01/05/autism.vaccines/
  13. Deer, Brian (2004, February 22). Revealed: MMR Research Scandal. The Sunday Times. Accessed via: http://briandeer.com/mmr/lancet-deer-1.htm
  14. Majumder, Maimuna S., Cohn, Emily L. et al. (2015, May). Substandard Vaccination Compliance and the 2015 Measles Outbreak. Journal of the American Medical Association Pediatrics, vol. 169, no.5.
  15. Autism Decision (2009, February 12). U.S. Court of Federal Claims.
  16. Vaccines Didn’t Cause Autism, Court Rules (2009, February 12). CNN. Accessed via: http://www.cnn.com/2009/HEALTH/02/12/autism.vaccines/index.html?eref=rss
  17. Nagourney, Adam and Goodnough, Abby (2015, January 21). Measles Cases Linked to Disneyland Rise, and Debate Over Vaccinations Intensifies. New York Times. Accessed via: http://www.nytimes.com/2015/01/22/us/measles-cases-linked-to-disneyland-rise-and-debate-over-vaccinations-intensifies.html
  18. Rubella and the Vaccine (Shot) to Prevent It. CDC. Accessed via: http://www.cdc.gov/vaccines/vpd-vac/rubella/fs-parents.html
  19. Diseases and Conditions-The Measles (2014, May 24). The Mayo Clinic. Accessed via: http://www.mayoclinic.org/diseases-conditions/measles/basics/definition/con-20019675
  20. Frankel, Todd C. (2015, January 30). Mississippi – yes, Mississippi – has the nation’s best child vaccination rate. Here’s why. The Washington Post. Accessed via: https://www.washingtonpost.com/news/storyline/wp/2015/01/30/mississippi-yes-mississippi-has-the-nations-best-child-vaccination-rate-heres-why/
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Daniel Miller, M.P.H.
Mr. Miller is President of Daniel R. Miller, MPH Consulting based in Morris Plains, NJ with 35 years’ experience in healthcare, workers’ compensation and disability consulting. Mr. Miller’s clients have included Fortune 500 corporations such as; AT&T, Black & Decker, American Express, Kmart, Nabisco, McDonnell Douglas, Times Mirror, Domino’s Pizza and Molson. Other clients have included The State of Ohio Bureau of Workers Compensation (BWC), The State of Rhode Island and Nationwide and The Travelers Insurance Companies. Mr. Miller is a graduate of Northeastern University in Boston, Mass and received his Master’s degree in Public Health (MPH) from Columbia University School of Public Health and Cornell Medical College in New York, NY. Mr. Miller is a published author on a wide variety of healthcare issues such as emerging healthcare technologies, childhood immunizations, the stigma of mental health treatment, unnecessary surgery, carpal tunnel syndrome and back injuries. In addition, he has many workers’ compensation related published articles on such topics as Independent Medical Exams (IMEs), provider networks and return–to-work. He is an expert on both state and U.S. Federal laws dealing with healthcare, workers’ compensation and disability related issues such as; The American’s with Disability Act (ADA), Family Medical Leave (FMLA), The Patient Protection and Affordable Care Act (Obamacare) and state specific workers compensation laws and systems. Mr. Miller has a lifelong keen interest in the field of global public health, evidence-based medicine and medical research.

4 COMMENTS

  1. News Update 9/13/16
    The American Academy of Pediatrics issued a dramatic statement earlier this month to its members that it is OK to stop seeing families who refuse to take their shots. The Academy also urged states to repeal state laws that allow parents to use religion for the grounds that they don’t vaccinate their children.

    The anti-vaccination crowd here in NJ stated ” Immunizations interfers with free exercise of a pupil’s religious rights.” The number of unvaccinated children in NJ has grown by 600% in the past 10 years.

    The Journal Of Pediatrics in September published; ” Countering Vaccine Hesitation ” and reported that 87% of their MD members reported resistance to childhood vaccinations.

    Anyone with ideas on how best to distribute my article to MDs , Government, Department of Health etc, please let me know,

  2. The World Health Organization (WHO) announced an aggressive polio vaccination campaign underway in Northern Africa for children under age 5 after two children in Nigeria became paralyzed with wild polio.

    Polio paralyzes between 1 in 200 and 1 in 1,000 children who are infected leading WHO to believe polio is widely circulating in these countries and just may be the ” tip of the iceberg”

    It is heart breaking to hear when this scourge was thought to be eradicated, not so much.

  3. Anti-Vaccination leaders held a “Revolution for Truth” Rally in Washington DC on March 31 outside the White House to protest the Government and Rx Industry “conspiracy” to cover up the link between childhood vaccination to autism. RFK Jr was the featured speaker and leading organizer for this event. RFK Jr is said to become the leader of a Commission on Vaccine Safety endorsed by President Trump

    In the meantime over 350 organizations, lead by The American Academy of Pediatrics, sent a letter to President Trump fully endorsing the safety of childhood vaccines stating that; “Vaccines protect the health of children and adults and saves lives…and are one of the most significant medical innovations of out time.”

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