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Autism and the MMR vaccine
Fact or Fiction?
Timeline
 October 1988
 The three in one measles, mumps, and rubella vaccine
introduced in UK after successful use in the US since
1971.
 January 1994
 Campaign group, JABS, is launched, alleges that MMR
causes brain damage and other problems in children
 March 1995
 Andrew Wakefield, a researcher at the Royal Free
medical school, files for a patent claiming that Crohn’s
disease and ulcerative colitis may be diagnosed by
detecting measles virus in bowel tissue and body fluids.
Timeline
 September 1995:
 Paediatric gastroenterologist John Walker-Smith sets up a service at
the Royal Free.
 February 1996:
 JABS solicitor, Richard Barr, retains Wakefield, at £150 an hour, plus
expenses, to support a speculative legal attack on MMR
manufacturers.
 July 1996:
 The first child is admitted to the Royal Free for research to try to show
a link with MMR. The research is commissioned by, and supported
with a £55,000 grant from, the UK Legal Aid Board.
 September 1996:
 Wakefield and co discuss market projections for a new business based
on purportedly diagnosing Crohn’s disease from the presence of
measles virus.
Timeline
 June 1997:
 Claiming that the measles virus in MMR causes problems, Wakefield files for a
patent on a “safer” single measles vaccine and for products to treat both autism
and inflammatory bowel disease.
 February 1998:
 The Lancet publishes a 12 patient case series by Wakefield and 12 others,
proposing a link between MMR and a “new syndrome” of autism and bowel
disease. At a press conference, he urges the use of single vaccines instead of
MMR.
 Wakefield and co meet Royal Free managers to discuss a joint company to
develop products based on his MMR claims, including “a replacement for
attenuated viral vaccines”
 February 1999:
 Unigenetics is incorporated. The company is awarded £800,000 by the Legal Aid
Board to perform tests on samples from children seen at Royal Free unit..
Timeline
 December 1999
 Mark Pepys, new head of medicine at the medical school,
challenges Wakefield about his business scheme and puts him
on notice that he must replicate his research.
 January 2001
 Newspapers launch campaigns backing Wakefield, working with
JABS, after he publishes a purported review of his evidence and
repeats his calls for single vaccines.
 October 2001
 Wakefield is asked to leave the Royal Free after failing to mount
a large scale controlled study to confirm or refute his claims
about MMR.
Timeline
 February 2004
 The Sunday Times reveals that the Legal Aid Board funded
the Lancet research and that many of the children were
litigants.
 March 2004
 Ten of the 1998 paper’s 13 authors, excluding Wakefield,
retract its “interpretation” section, which claimed an
association in time between MMR, enterocolitis, and
regressive developmental disorders.
 January 2003
 Vaccination among 2 year olds falls to 78.9%: below the 92%
needed to maintain herd immunity. Figures in parts of inner
London are half the national rates
Timeline
 November 2004
 Wakefield’s single vaccine patent is revealed and that, despite
claims that the culprit for the disorders is measles in MMR,
molecular tests in his laboratory found no trace of the virus.
 January 2005
 Wakefield initiates libel lawsuits, funded by the Medical
Protection Society, claiming that all allegations are false and
defamatory.
 March 2005
 Among much research rejecting any link with developmental
disorders and bowel disease, research is published showing
that, after MMR was discontinued in Japan, the incidence of
autism diagnoses continued to rise
Timeline
 April 2006
 As measles outbreaks are reported across Britain, the first
death in the UK from the disease in 14 years is reported.
 December 2006
 The Sunday Times reveals Wakefield’s personal funding from
Barr to support the lawsuit over MMR: £435,643 plus expenses,
from the legal aid fund.
 January 2007
 Medical Protection Society stops funding for Wakefield.
Timeline
 July 2007
 General Medical Council opens its case alleging serious
professional misconduct by the Lancet paper’s three senior
authors, Wakefield, Walker-Smith, and endoscopist Simon
Murch
 February 2009
 In the United States, three test case judgments for 5000 claims
based on Wakefield’s theories are handed down in federal
court, rejecting the allegation that MMR can cause autism. They
are upheld on appeal in August 2010
 February 2010
 Six years after the matters were raised with the Lancet, the
journal fully retracts the 1998 paper.
The Study
 Cases were of 12 anonymous children with apparent brain
disorders who had been admitted to a paediatric bowel
unit at the Royal Free hospital between July 1996 and
February 1997.
 Parents of two thirds of the 12 children blamed MMR for
the sudden onset of what was described as a combination
of both an inflammatory bowel disease and autism.
 He claimed that the MMR vaccine was responsible for
intestinal inflammation that led to translocation of usually
non-permeable peptides to the bloodstream and,
subsequently, to the brain, where they caused "regressive
autism", in which language and basic skills were said to
have been lost. Results have never been replicated.
The Study
 Wakefield called for a boycott of the triple MMR in favour
of breaking it up into single measles, mumps and rubella
shots, to be given at yearly intervals.
 "I can't support the continued use of these three vaccines,
given in combination until this issue has been resolved.“
 "In 1983 the shot schedule was ten. That's when autism
was one in 10,000. Now there's 36, and autism is one in
150," argued American actress Jenny McCarthy, who
blamed MMR for her own son’s autism, and gained the
highest profile in the US movement. "All arrows point to
one direction."
Research
 Whether or not thimerosal (T), a mercury-containing
preservative used in some vaccines in the past, is in any
way responsible for autism is continually being
investigated however no links have been found as of yet.
 Human autism occurs nearly four to eight times more
frequently in males. In a study, mice were given the
maximum tolerated dose of thimerosal. Seven of seven
male mice, compared with none of seven female mice,
succumbed to thimerosal, indicating a gender-selective
toxicity of thimerosal.
Media coverage of MMR
Media coverage of MMR
Measles notifications (confirmed cases)
England and Wales 1995 - 2013
0
1000
2000
3000
4000
5000
6000
7000
2013201220112010200920082007200620052004200320022001200019991998199719961995
Confirmed Patients
Tested Patients
Measles rate of infection
Conspiracy theory?
Worldwide stats on measles
New Zealand Cases
 December 2013 - November 2014 - 283 cases
 125 are in Waikato,
 113 are in Auckland,
 18 in Bay of Plenty/Lakes,
 12 in Hawke’s Bay,
 6 in Northland.
 5 in Wellington,
 2 in Tairawhiti and
 2 in Taranaki
Autism and Measles
Autism and Measles

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Autism and Measles

  • 1. Autism and the MMR vaccine Fact or Fiction?
  • 2.
  • 3.
  • 4. Timeline  October 1988  The three in one measles, mumps, and rubella vaccine introduced in UK after successful use in the US since 1971.  January 1994  Campaign group, JABS, is launched, alleges that MMR causes brain damage and other problems in children  March 1995  Andrew Wakefield, a researcher at the Royal Free medical school, files for a patent claiming that Crohn’s disease and ulcerative colitis may be diagnosed by detecting measles virus in bowel tissue and body fluids.
  • 5. Timeline  September 1995:  Paediatric gastroenterologist John Walker-Smith sets up a service at the Royal Free.  February 1996:  JABS solicitor, Richard Barr, retains Wakefield, at £150 an hour, plus expenses, to support a speculative legal attack on MMR manufacturers.  July 1996:  The first child is admitted to the Royal Free for research to try to show a link with MMR. The research is commissioned by, and supported with a £55,000 grant from, the UK Legal Aid Board.  September 1996:  Wakefield and co discuss market projections for a new business based on purportedly diagnosing Crohn’s disease from the presence of measles virus.
  • 6. Timeline  June 1997:  Claiming that the measles virus in MMR causes problems, Wakefield files for a patent on a “safer” single measles vaccine and for products to treat both autism and inflammatory bowel disease.  February 1998:  The Lancet publishes a 12 patient case series by Wakefield and 12 others, proposing a link between MMR and a “new syndrome” of autism and bowel disease. At a press conference, he urges the use of single vaccines instead of MMR.  Wakefield and co meet Royal Free managers to discuss a joint company to develop products based on his MMR claims, including “a replacement for attenuated viral vaccines”  February 1999:  Unigenetics is incorporated. The company is awarded £800,000 by the Legal Aid Board to perform tests on samples from children seen at Royal Free unit..
  • 7. Timeline  December 1999  Mark Pepys, new head of medicine at the medical school, challenges Wakefield about his business scheme and puts him on notice that he must replicate his research.  January 2001  Newspapers launch campaigns backing Wakefield, working with JABS, after he publishes a purported review of his evidence and repeats his calls for single vaccines.  October 2001  Wakefield is asked to leave the Royal Free after failing to mount a large scale controlled study to confirm or refute his claims about MMR.
  • 8. Timeline  February 2004  The Sunday Times reveals that the Legal Aid Board funded the Lancet research and that many of the children were litigants.  March 2004  Ten of the 1998 paper’s 13 authors, excluding Wakefield, retract its “interpretation” section, which claimed an association in time between MMR, enterocolitis, and regressive developmental disorders.  January 2003  Vaccination among 2 year olds falls to 78.9%: below the 92% needed to maintain herd immunity. Figures in parts of inner London are half the national rates
  • 9. Timeline  November 2004  Wakefield’s single vaccine patent is revealed and that, despite claims that the culprit for the disorders is measles in MMR, molecular tests in his laboratory found no trace of the virus.  January 2005  Wakefield initiates libel lawsuits, funded by the Medical Protection Society, claiming that all allegations are false and defamatory.  March 2005  Among much research rejecting any link with developmental disorders and bowel disease, research is published showing that, after MMR was discontinued in Japan, the incidence of autism diagnoses continued to rise
  • 10. Timeline  April 2006  As measles outbreaks are reported across Britain, the first death in the UK from the disease in 14 years is reported.  December 2006  The Sunday Times reveals Wakefield’s personal funding from Barr to support the lawsuit over MMR: £435,643 plus expenses, from the legal aid fund.  January 2007  Medical Protection Society stops funding for Wakefield.
  • 11. Timeline  July 2007  General Medical Council opens its case alleging serious professional misconduct by the Lancet paper’s three senior authors, Wakefield, Walker-Smith, and endoscopist Simon Murch  February 2009  In the United States, three test case judgments for 5000 claims based on Wakefield’s theories are handed down in federal court, rejecting the allegation that MMR can cause autism. They are upheld on appeal in August 2010  February 2010  Six years after the matters were raised with the Lancet, the journal fully retracts the 1998 paper.
  • 12. The Study  Cases were of 12 anonymous children with apparent brain disorders who had been admitted to a paediatric bowel unit at the Royal Free hospital between July 1996 and February 1997.  Parents of two thirds of the 12 children blamed MMR for the sudden onset of what was described as a combination of both an inflammatory bowel disease and autism.  He claimed that the MMR vaccine was responsible for intestinal inflammation that led to translocation of usually non-permeable peptides to the bloodstream and, subsequently, to the brain, where they caused "regressive autism", in which language and basic skills were said to have been lost. Results have never been replicated.
  • 13. The Study  Wakefield called for a boycott of the triple MMR in favour of breaking it up into single measles, mumps and rubella shots, to be given at yearly intervals.  "I can't support the continued use of these three vaccines, given in combination until this issue has been resolved.“  "In 1983 the shot schedule was ten. That's when autism was one in 10,000. Now there's 36, and autism is one in 150," argued American actress Jenny McCarthy, who blamed MMR for her own son’s autism, and gained the highest profile in the US movement. "All arrows point to one direction."
  • 14. Research  Whether or not thimerosal (T), a mercury-containing preservative used in some vaccines in the past, is in any way responsible for autism is continually being investigated however no links have been found as of yet.  Human autism occurs nearly four to eight times more frequently in males. In a study, mice were given the maximum tolerated dose of thimerosal. Seven of seven male mice, compared with none of seven female mice, succumbed to thimerosal, indicating a gender-selective toxicity of thimerosal.
  • 17. Measles notifications (confirmed cases) England and Wales 1995 - 2013 0 1000 2000 3000 4000 5000 6000 7000 2013201220112010200920082007200620052004200320022001200019991998199719961995 Confirmed Patients Tested Patients
  • 18. Measles rate of infection
  • 19.
  • 20.
  • 22.
  • 23.
  • 25. New Zealand Cases  December 2013 - November 2014 - 283 cases  125 are in Waikato,  113 are in Auckland,  18 in Bay of Plenty/Lakes,  12 in Hawke’s Bay,  6 in Northland.  5 in Wellington,  2 in Tairawhiti and  2 in Taranaki