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News › How two issues became confused by study of child bowel condition
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Health: How two issues became confused by study of child bowel condition
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Posted by Sylvia on Tuesday, November 04, 2003 (13:57:54)
The Times online
UK 01/11/2003
By Nigel Hawkes
Where does the science of MMR and autism stand? So many claims have been made that it is hard to sort what is evidence and what conjecture.
There are two issues, which have become conflated. The first is whether children with autism suffer from a higher rate of a form of inflammatory bowel disease. The second is whether measles, or measles vaccine, is linked to this bowel disease. The 1998 paper in The Lancet that started the controversy mentioned MMR only in passing. One of the authors, John Walker-Smith, has since said that he wanted to avoid all mention of MMR. “I just wanted to describe the bowel changes we had found in children with autism,†he wrote in his autobiography, published this year. “All we had was anecdote about MMR.â€
But a mention of MMR was included, and a press conference was held by Dr Andrew Wakefield to publicise it. Since then the controversy has raged, even though the original paper supported MMR vaccination.
This is why Dr Simon Murch denies that he has changed his mind. The original paper backed MMR without reservation, he says, and evidence that has emerged since has corroborated its safety, so now he recommends it even more strongly. He still thinks that there may be a relationship between autism and bowel disorder. The problem is, as he says, that any evidence for this hypothesis is taken by parts of the media as evidence of a link between MMR and autism, which it is not.
“This is deeply frustrating, as it is simply not so,†he said. Similar bowel changes have been seen in children who have not suffered the regression that characterises autism, in children who have not been vaccinated and in children whose first autistic symptoms appeared before vaccination.
Full Article
At the press conference in February 1998, Dr Wakefield made his first call for MMR to be given as three separate vaccines — an issue unmentioned in the paper and unsupported by his co-authors. The bandwagon started rolling.
Since then he has done relatively little research to back his thesis. Many other people have done research that supports the safety of MMR.
The evidence is largely epidemiological. Autism has risen sharply as a diagnosis, but its rise has not paralleled that of the introduction of MMR.
Autism is no commoner among children vaccinated with MMR than those who are not vaccinated. More than 500 million doses have been given, in more than 90 countries, with no evidence of a link.
An analysis in Clinical Evidence looked at all published studies. It found four studies that had failed to find any link between the MMR vaccine and autism, two studies that showed no link between the MMR and bowel disease, and three studies showing no link between the single measles vaccine and bowel disease.
A study by US doctors, using British data, identified 96 children with autism diagnosed between 1988 and 1999. Each case was matched with five children without autism. When the two groups were compared, they found no evidence of an increased level of gut disorders in the children with autism compared with the others. Nor did the onset of gut disorders in children with autism coincide with the MMR vaccination.
A study followed autism in Gothenburg. While the study was going on, a two-dose MMR vaccination programme was introduced. The incidence of autism did not change.
These studies and others have convinced virtually every expert that MMR is safe. None claims that it cannot, in some children, provoke a short-term reaction. But none, save Dr Wakefield and a few followers, believes that it causes autism.
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Posted by Sylvia on Tuesday, November 04, 2003 (13:57:54) (1373 reads)
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