Monday, 30 July 2007

What happens to autism rates if we stop MMR?

From Honda et al 2005 J Child Psychol Psychiatry 46(6):572-9 (without permission):

"The Japanese MMR vaccination program targeted one-year-olds between April 1989 and April 1993, then was discontinued. Therefore, children born during the years 1988 to 1992 received the MMR vaccine in years 1989 to 1993 at one year of age. According to Yokohama statistics, MMR vaccination rates declined from 69.8% in the 1988 birth cohort, to 42.9%, 33.6%, 24.0%, and a mere 1.8% in birth cohorts 1989 to 1992...the seven-year cumulative incidence of ASD rose progressively from 47.6 per 10,000 for children born in 1988 to 117.2 for those born in 1996, that this rise continued in cohorts of children born after MMR was withdrawn, and that no decline in ASD incidence occurred in the five-year period from 1988 to 1992 during which MMR vaccine usage fell from 69.8% to zero population coverage...Accordingly, it is possible to conclude that it is extremely unlikely that MMR has been responsible for the rise over time in the incidence of diagnosed autism. It follows that it is similarly unlikely that it causes autism frequently or at all. It cannot have caused autism in the many children with ASD in Japan who were born and grew up in the era when MMR was not available. Because this frequency is at least as high as in populations in other countries in which most children were vaccinated, it implies that MMR could not cause a substantial proportion of cases of autism."

That is, when Japan stopped MMR its rates of autism kept on rising, which is not what we would expect if the rise in autism rates (if they are real rises and not due to changing diagnostic patterns, see below) were due to MMR.

1 comment:

Anonymous said...

See the following theory:
The ‘theory of mind’ (ToM) hypothesis of autism. Tom is an hypothesis first published in 1985.
Other articles ask what caused the autism epidemic?
The CDC studies say it is not MMR or Thimerosal. Other hypotheses have included autoimmune diseases, etc.

Individuals with Disabilities Education Act (IDEA) Data website:
Pregnancy Risk Assessment Monitoring System (PRAMS) sleep position data:
Centers for Disease Control (CDC) Birth Data:
2006 Median Income Data: - U.S. Department of Housing and Urban Development
NOTICE PDR-2006-01

Autism Spectrum Disorders, Asperger's Syndrome, and Pervasive Developmental Disorders - Not Otherwise specified (PDD-NOS)
Gastrointestinal Disorders also known as GER is a common comorbidity
Autism patients tend to have minicolumn abnormalities and increased amounts of white matter
Casanova MF, van Kooten IA, Switala AE, Ven Engeland H, Heinsen H, Steinbusch HW, Hof PR, Trippe J, Stone J, Schmitz C. Minicolumnar abnormalities in autism. Acta Neuropathol. 2006 Sep; 112(3); 287-303.
Mostofsky SH, Burgess MP, Larson JCG. Increased motor cortex white matter volume predicts motor impairment in autism. Brain (2007), 130, 2117-2122

Maternal smoking decreased significantly between 1990 and 2002
Infant suffocation deaths increased 14% per year on average between 1996 and 2004
Centers for Disease Control. Smoking & Tobacco Use - Morbidity and Mortality Weekly Reports (MMWRs) – Smoking During Pregnancy – United States, 1990-2002 – October 7, 2004 / Vol. 53/ No. 39
Shapiro-Mendoza CK, Kimball M, Tomashek KM, Anderson RN, Blanding S.US Infant Mortality Trends Attributable to Accidental Suffocation and Strangulation in Bed From 1984 Through 2004: Are Rates Increasing? Pediatrics 2009;123;533-539

Here is a good article on diagnosing this:
Filipek P, Accardo P, Ashwal S, Baranek G, Cook E, Dawson G, Gordon B, Gravel J, Johnson C, Kallen R, Levy S, Minshew N, Ozonoff S, Prizant B, Rapin I, Rogers S, Stone W, Teplin S, Tuchman R, Volkmar F. Practice parameter: Screening and diagnosis of autism Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Child Neurology Society NEUROLOGY 2000;55:468–479

SIDS, Autism, Autism Spectrum Disorder, Plagiocephaly, etc. are all
conditions that the medical profession is trying to treat.
The SIDS back sleep (Supine) sleep recommendations began in 1992
The SIDS "Back to Sleep" campaign began in 1994.
In 1996 the AAP SIDS Task Force, led by Dr. John Kattwinkel recommended the supine sleep position and not the side(lateral) or front(prone).
THe Netherlands began their SIDS Back to Sleep Campaign in 1987.
Sleep is necessary for memory consolidation, declarative learning, and procedural learning.

The following are useful articles which discuss many of these issues indepth:
American Academy of Pediatrics Task Force on Infant Positioning and SIDS. Positioning and SIDS. Pediatrics. 1992;89:1120-1126
Hogberg U, Bergstrom E. Suffocated Prone: The Iatrogenic Tragedy of SIDS. American Journal of Public Health. 2000;90:527-531
National Infant Sleep Position Household Survey. Summary Data. updated: 10/16/08 Website:
Kattwinkel J, Hauck F.R., Moon R.Y., Malloy M and Willinger M Infant Death Syndrome: In Reply, Bed Sharing With Unimpaired Parents Is Not an Important Risk for Sudden. Pediatrics 2006;117;994-996
Buzs├íki, G. 1989. Two-stage model of memory trace formation: A role for “noisy” brain states. Neuroscience 31: 551–570.
Hasselmo, M.E. 1999. Neuromodulation: Acetylcholine and memory consolidation. Trends Cogn. Sci. 3: 351–359.
Wierzynski DM, Lubenov EV, Gu M, Siapas AG. State-Dependent Spike-Timing Relationships between Hippocampal and Prefrontal Circuits during Sleep. Neuron 61, 587-596, February 26, 2009
Walker MP, Stickgold R. Sleep, Memory, and Plasticity. Annu. Rev. Psychol. 2006. 57: 139-66
Gais S, Born J. Declarative memory consolidation: Mechanisms acting during human sleep. Learn Mem. 2004 Nov-Dec; 11(6): 679-685
Davis BE, Moon RY, Sachs HC, Ottolini MC. Effects of sleep position on infant motor development. Pediatrics. 1998 Nov; 102(5):1135-40.
Skadberg BT, Markestad T. Consequences of Getting the Head Covered During Sleep in Infancy. Pediatrics 1997;100;e6
AJ Williams, RD Jitendra, JB Phillips, Y Lin, T McCabe, FC Tortella. Neuroprotective Efficacy and Therapeutic Window of the High-Affinity N-Methyl-D-aspartate Antagonist Conantokin-G: In Vitro (Primary Cerebellar Neurons) and In Vivo (Rat Model of Transient Focal Brain Ischemia) Studies1
Stradling JR, Thomas G, Warley AR, Williams P, Freeland A. Effect of adenotonsillectomy on nocturnal hypoxaemia, sleep disturbance, and symptoms in snoring children. Lancet. 1990;335 :249 –253