Saturday, March 29, 2014

The proof is in the putting (not the pudding.)

During the past week, I have been working steadily on an article expressly focused on the anti-vaxxer argument. I will admit here a predetermined bias, coming from a family deeply enmeshed in the medical field. However, benefiting from the self same type of study that promoted and disseminated the anti-vaxxer argument at the outset, utilizing highly focused search methodology and accessing social media realms where the scientific community directly discusses these topics, the collection which follows of peer reviewed research articles resulted. As they are generated by experts in the field with a pointed presentation of statistical information, it may be important to consult with professionals capable of translating some of the contained language into layman's terms if you should need it. Not everyone is a trained physician, or statistician, or trained researcher, and that, specifically, is the problem with this entire intellectual melee: untrained minds selecting blind belief over bona fide biology is indeed a choice. But not one we can afford to make. This, then, is returning science to its rightful place in the public administration structure, opting for the design of intelligence rather than intelligent design. Opinions are my own, research is from elsewhere.


Age at First Measles-Mumps-Rubella Vaccination in Children With Autism and School-Matched Control Subjects: A Population-Based Study in Metropolitan Atlanta: Frank DeStefano, Tanya Karapurkar Bhasin, William W. Thompson, Marshalyn Atlanta Yeargin-Allsopp and Coleen Boyle, Pediatrics 2004;113;259-266 DOI: 10.1542/peds.113.2.259

ABSTRACT: Objective. To compare ages at first measles-mumps-rubella (MMR) vaccination between children with autism and children who did not have autism in the total population and in selected subgroups, including children with regression in development. Methods. A case-control study was conducted in metropolitan Atlanta. Case children (N   624) were identified from multiple sources and matched to control children (N   1824) on age, gender, and school. Vaccination data were abstracted from immunization forms required for school entry. Records of children who were born in Georgia were linked to Georgia birth certificates for information on maternal and birth factors. Conditional logistic regression was used to estimate odds ratios (ORs). Results. The overall distribution of ages at MMR vaccination among children with autism was similar to that of matched control children; most case (70.5%) and control children (67.5%) were vaccinated between 12 and 17 months of age. Similar proportions of case and control children had been vaccinated before 18 or before 24 months. No significant associations for either of these age cutoffs were found for specific case subgroups, including those with evidence of developmental regression. More case (93.4%) than control children (90.6%) were vaccinated before 36 months (OR: 1.49; 95% confidence interval: 1.04–2.14 in the total sample; OR: 1.23; 95% confidence interval: 0.64–2.36 in the birth certificate sample). This association was strongest in the 3- to 5-year age group. Conclusions. Similar proportions of case and control children were vaccinated by the recommended age or shortly after (ie, before 18 months) and before the age by which atypical development is usually recognized in children with autism (ie, 24 months). Vaccination before 36 months was more common among case children than control children, especially among children 3 to 5 years of age, likely reflecting immunization requirements for enrollment in early intervention programs. Pediatrics 2004; 113:259–266; autism, autism spectrum disorders, MMR vaccine, immunizations, epidemiology.

Lack of Association between Measles Virus Vaccine and Autism with Enteropathy: A Case-Control Study
Mady Hornig, Kimberly Hummel Pickering, W. Ian Lipkin, Thomas Briese, Paul A. Rota, Timothy Buie, William J. Bellini, Margaret L. Bauman, John J. O’Leary, Gregory Lauwers, Orla Sheils, Ulrike Siemetzki, Errol Alden, Larry

Abstract
Background: The presence of measles virus (MV) RNA in bowel tissue from children with autism spectrum disorders (ASD) and gastrointestinal (GI) disturbances was reported in 1998. Subsequent investigations found no associations between MV exposure and ASD but did not test for the presence of MV RNA in bowel or focus on children with ASD and GI disturbances. Failure to replicate the original study design may contribute to continued public concern with respect to the safety of the measles, mumps, and rubella (MMR) vaccine.

Centers for Disease Control and Prevention. Update: vaccine side effects, adverse reactions, contraindications, and precautions—recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1996;45(No. RR-12):[inclusive page numbers]. [(Please keep in mind this article is from 1996, but its significance is prominent because of the historical basis of rejection of a premise relating to vaccines causing autism)]

This report provides updated information concerning the potential adverse events associated with vaccination for hepatitis B, poliomyelitis, measles, mumps, diphtheria, tetanus, and pertussis. This information incorporates findings from a series of recent literature reviews, conducted by an expert committee at the Institute of Medicine (IOM), of all evidence regarding the possible adverse consequences of vaccines administered to children. This report contains modifications to the previously published recommendations of the Advisory Committee on Immunization Practices (ACIP) and is based on an ACIP review of the IOM findings and new research on vaccine safety. In addition, this report incorporates information contained in the “Recommendations of the Advisory Committee on Immunization Practices: Use of Vaccines and Immune Globulins in Persons with Altered Immunocompetence” (MMWR 1993;42[No. RR-4]) and the “General Recommendations on Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP)” (MMWR 1994;43[No. RR-1]). Major changes to the previous recommendations are highlighted within the text, and specific information concerning the following vaccines and the possible adverse events associated with their administration are included: hepatitis B vaccine and anaphylaxis; measles vaccine and a) thrombocytopenia and b) possible risk for death resulting from anaphylaxis or disseminated disease in immuno-compromised persons; diphtheria and tetanus toxoids and pertussis vaccine (DTP) and chronic encephalopathy; and tetanus-toxoid–containing vaccines and a) Guillain-Barré syndrome, b) brachial neuritis, and c) possible risk for death resulting from anaphylaxis. These modifications will be incorporated into more comprehensive ACIP recommendations for each vaccine when such statements are revised. Also included in this report are interim recommendations concerning the use of measles and mumps vaccines in a) persons who are infected with human immunodeficiency virus and b) persons who are allergic to eggs; ACIP is still evaluating these recommendations.

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Additionally, there is an entire page from the CDC's website dedicated to vaccine safety and a potential causal relationship between vaccines and autism. It should be read carefully, and realized that not only does the CDC support the results of the research, the research itself is mostly done by agencies and entities outside of the CDC. 

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