May 18, 2006
MAYBE RITALIN CAUSES AUTISM:
Time to Vaccinate a Panic (John Luik, 18 May 2006, Tech Central Station)
A 2000 survey in Pediatrics reported that 25% of parents had serious concerns about the vaccines given to their children. And significant numbers refused to vaccinate their children, with predictably unfortunate consequences.In 2000, Ireland, reported 1,603 cases of measles -- 10 times more than the year before. Another surge to 572 cases occurred in 2003. By comparison, the US, with a population 75 times greater, had 86 measles cases in 2000 and 116 in 2003. In Colorado and Oregon where parents concerned about autism are allowed to decline immunization for their children, diseases like whooping cough are already returning. For instance, in 2004, Colorado, a state with just under a 70th of the population, had more than a 10th of the total number of cases of pertussis -- whooping cough -- 1,210 cases.
Autism is a terrible diagnosis for any parent to receive, but however much one sympathizes with parents and their children, the question still is: What is the scientific evidence that thimerosal in vaccines causes autism?
In 2004, the U.S. Institute of Medicine, which had been commissioned by the U.S. government to examine the epidemiological data, along with the idea of whether a connection between thimerosal and vaccines was biologically plausible, concluded that the majority of the evidence "favors rejection of a causal relationship between thimerosal and autism." The evidence that the Institute relied upon consisted of five major epidemiological studies from the US, the UK and Sweden, all completed since 2001, which looked at the links between various vaccines containing thimerosal and autism, and 14 other epidemiological studies that focused on the MMR vaccine and autism.
Two of these studies, both published in 2003, are particularly important since they highlight how weak the case against thimerosal is. The first (Stehr-Green et al "Autism and Thimerosal Containing Vaccines: lack of Consistent Evidence for an Association," AJPM, 2003) compared thimerosal exposure and autism rates in children in Denmark, Sweden and California.
In each jurisdiction, the study found autism rates started to increase from 1985. In Sweden and Denmark the increase continued into the 1990s even though thimerosal was eliminated from vaccines in 1992. Indeed, in Denmark the increases were substantial. Where before 1992 there were about 10 new autism cases per year, by 2000, eight years after all thimerosal had been removed from vaccines, there were 181 cases a year. Similarly, in Sweden, autism rates continued to increase even after thimerosal was removed from vaccines. Because of this lack of a consistent connection between thimerosal and autism, the researchers concluded that the hypothesis that thimerosal caused autism was inconsistent with the scientific evidence.
The second study appeared in the Journal of the American Medical Association (Hviid et al., "Association between Thimerosal-Containing Vaccine and Autism," October, 2003), and its results were even more dramatic. Led by Anders Hviid of the Danish Epidemiology Science Center, the researchers examined the medical histories of all children who were born in Denmark from 1990-1996, almost 500,000 children. Thimerosal vaccines had been eliminated in Denmark in mid-1992, so the study was able to examine two groups of children, those who received vaccines with thimerosal from 1990-1992 and those from 1993 onward who did not.
The children who had received vaccines with thimerosal had a non-statistically significant relative risk for autism of 0.85, compared with the thimerosal-free group, which meant that they were 15% less likely to get autism. There was also no dose-response link -- where risk increases with exposure level -- leading the research group to conclude that "the results do not support a causal relationship between childhood vaccination with thimerosal-containing vaccines and development of autistic-spectrum disorders."
More recent studies, including one in Pediatrics (September 2004) support these conclusions. The Pediatrics article looked at 12 different studies on thimerosal vaccines and autism published from 1966-2004 and concluded: "Studies do no demonstrate a link between thimerosal-containing vaccines and autistic spectrum disorders." Equally interesting, the authors looked at the blood mercury levels found in children after receiving vaccinations and concluded that they did not fall within the toxic range.
Moreover, autism researchers consistently caution that autism is not a single condition but a highly complex group of developmental disorders. There is no agreement on the rate of autism, though two recent reviews have placed it at one case for every 1,000 children. Indeed, it is not even clear whether autism is increasing or whether it is simply being more accurately diagnosed.
Strike the "accurately". Posted by Orrin Judd at May 18, 2006 1:56 PM
My impression is that the problem isn't even in how it is diagnosed--it is in how it is defined. We've somehow built ourselves a world in which only a few percent of people are "normal" and everyone else has some sort of pathology that requires both drugs and special treatment.
Posted by: b at May 18, 2006 2:15 PMStrike the "accurately"?
The unprecedented increase in autism in California is real and cannot be explained away by artificial factors, such as misclassification and criteria changes, according to the results of a large statewide epidemiological study.
"Speculation about the increase in autism in California has led some to (devote numerous posts on their blog to) try to explain it away as a statistical issue or with other factors that artificially inflated the numbers," said UC Davis pediatric epidemiologist Robert S. Byrd, who is the principal investigator on the study. "Instead, we found that autism is on the rise in the state and we still do not know why. The results of this study are, without a doubt, sobering."
Key findings of the study are that:
• The observed increase in autism cases cannot be explained by a loosening in the criteria used to make the diagnosis.
• Some children reported with mental retardation and not autism did meet criteria for autism, but this misclassification does not appear to have changed over time.
• Because more than 90 percent of the children in the survey are native born, major migration of children into California does not contribute to the increase.
• A diagnosis of mental retardation associated with autism had declined significantly between the two age groups.
• The percentage of parent-reported regression (loss of developmental milestones) does not differ between two age groups.
• Gastrointestinal symptoms, including constipation and vomiting, in the first 15 months are more commonly reported by parents in the younger group.
"While this study does not identify the cause of autism, it does verify that autism has not been over-reported in the California Regional Center System and that some children diagnosed with mental retardation are, in fact, autistic," Byrd said.
Vaccinations are not the sole cause, but perhaps a catalyst. Possibly linked with gastro issues?
The cause is the diagnosis, as with ADHD.
Posted by: oj at May 18, 2006 5:31 PMVaccination is not the cause or a cause. It is not a factor. Spreading the rumor that it is a factor, on the other hand, is, at best, reckless manslaughter.
Posted by: David Cohen at May 18, 2006 5:59 PMAlso dangerous is that schools no longer require proof of vaccination before students can be admitted, so the other kids may be exposed to diseases we thought were beaten. We've really done a great disservice to our kids by kowtowing to the know-nothings.
I'm beginning to think that it's as irrefutable as the laws of physics that as a malady becomes funded, instances of its diagnosis rise. Will we ever get the government's meddling interference out of our lives?
Posted by: erp at May 18, 2006 7:29 PMThe cause is the diagnosis, as with ADHD
What does that mean? If my son wasn't diagnosed, he would be able to speak? ADHD is very subjective, having your brain miswired is not.
Vaccination is not the cause or a cause
Dr. Cohen speaks! Actually, doctors don't really have an answer and that is why autism research is so important.
as a malady becomes funded, instances of its diagnosis rise
That is bass ackwards. Maybe as a malady becomes prevalent, the medical establishment decides to investigate?
The know-nothings crack is BS, many of the parents I have met know more about their children's condition than the local doctors.
I enjoy the commentary on the BJB, so I lurk here often. Unfortunately, I can always count on the autism comments to be obtuse.
" Unfortunately, I can always count on the autism comments to be obtuse."
So perhaps Jack Sheet could give us the specifics of what makes him an expert unlike the rest of us? (And please, let it be more like that he is a Ph.D and M.D who's done years of research in the subject and not one of these people who think that having a child with a disease, or a relative who dies in a publicly gruesome way, confers special knowledge exempt from criticism.) Specifically, what exactly is meant by "gastro issues"?
Jack:
Sure, there is such a thing as autism and ADHD, but prevalence hasn't increased. We just have social diagnoses because there's money that follows the kids who are so diagnosed and parents and teachers demand that a disease be identified to explain their kids difficulties. When they start calling something a spectrum disorder you know they're making it up.
Posted by: oj at May 19, 2006 7:37 AMI'm not an autism expert, but I did stay at a Holiday Inn Express last night.
My point was that the posts refer to autism as a made-up disease and efforts by parents to help discover its cause as a bunch of idiots impeding real science.
one of these people who think that having a child with a disease...confers special knowledge exempt from criticism
Me-ouch! I do not claim special victim status or an education Piled Higher and Deeper, I'm only pointing out the casual way people dismiss this stuff when there are lots of legitimate questions that need to be addressed.
Gastro issues was a catch all for several conditions that seem to have a high incidence in autistic children. Our child had reflux, others also have Krohns or Celiac. A GFCF diet made his behavior manageable so we felt there was a connection.
OJ the facts belie your assertion that prevalence hasn't increased. Every study trying to address the issue of increased prevalence looks for criteria changes that would result in more diagnoses as opposed to more actual cases.
Posted by: Jack Sheet at May 19, 2006 10:57 AMNo, autism isn't made up--the spectrum was made up so that merely awkward kids could be included.
Posted by: oj at May 19, 2006 11:06 AMMr. Sweet.
The know-things to which I am referring are people who have taken issue with the known benefits of immunization and who, with the help of the ACLU and the liberal courts, have forced the public schools to admit their un-immunized kids thereby putting everyone, including their own kids, at risk.
I'm quite sure no one, not the judges, not the ACLU, not these foolish parents and not even you, yourself, have experienced life before the polio vaccine was widely available. Every fall when we'd go back to school, there were several more kids missing, kids who either died over the summer from polio or who were so severely afflicted that they could no longer breathe or get around on their own. The benefits of the other vaccines for childhood illnesses aren't as dramatic, but they've also proved very efficacious.
I have real trouble figuring out how the left sees moral equivalency. The same people who won't have their kids vaccinated, think nothing of forcing parents to medicate allegedly hyperactive kids as well their polar opposites with the same unproved psychotropic medication in order to reach the proper zombie-like state favored by the teachers unions.
As for getting things backwards, you are quite mistaken. Here's a very good rule to live by, first, last and always, cherchez les bucks.
Jack: There is no, nada, zero evidence supporting the Themerisol/Autism hypothesis. Autism rates keep rising in countries eight years after they stopped using Themerisol. The only correlation found was a non-significant .85 correlation, meaning that children who were vaccinated with Themerisol were 15% less likely to develop Autism.
On the other hand, there is a clear connection between not getting vaccinated and the risk of developing mumps, measles, rubella, whooping cough, etc., all of which will kill.
As for Dr. Byrd's study, it was done for the California legislature to determine whether the increase in diagnosed Autism cases in California was caused by children with Autism moving into the state to receive services. He concluded that it was not. The study did not support the link between Themerisol and Autism, nor did it study whether "hyperawareness" was the cause of the increase. It is Dr. Byrd's personal opinion, not based upon the study, that doctors simply couldn't have been missing that many cases before.
Posted by: David Cohen at May 19, 2006 4:51 PM