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« Why is the Media Ignoring the Bailey Banks Autism Vaccine Decision? | Main | Play The Age of Autism Irony Game! »

Best of A of A: Autism Explosion Followed Big Change in MMR Shot

Columbia explosion Managing Editor's note: This piece ran in January. It seemed appropriate to re-post it following the Banks v. HHS decision.  Merck no longer makes the single MMR components.

By Dan Olmsted

In 1990, Merck & Co., manufacturer of the mumps-measles-rubella vaccine known as the MMR, made a significant but little-noticed change: It quadrupled the amount of mumps virus in the combination shot, from 5,000 to 20,000 units. Then in 2007 it reversed course, reducing the amount to 12,500 units. Neither the measles nor the rubella (German measles) component of the MMR was changed at all -- each remained at 1,000 units throughout.
 
Merck also makes the single-component mumps shot, and in 1990 it also increased the potency of that shot by the same amount, from 5,000 to 20,000 units. But unlike the MMR shot, the standalone mumps shot’s potency was not scaled back in 2007. It remains at 20,000 units.
 
These changes were mentioned in passing recently during an informal conversation with a Merck scientist. I started looking for an explanation for the sequence of events, but Merck did not respond to a detailed written request for comment.
 
Absent such an explanation, simple logic dictates the reduction had something to do with the MMR in particular rather than the mumps vaccine in isolation. But what? And what about the timing -- the increase in 1990 and the decrease in 2007?


 
The huge rise in autism cases began about the time the mumps component in the MMR was raised in 1990. One theory, dismissed by Merck and federal public health officials, is that viral interference between the components in the MMR could create a persistent sub-clinical measles infection in a subset of vulnerable children; and because the measles virus can cause brain damage, that could lead to autism.
 
A study released last week by the M.I.N.D. Institute at UC Davis reported that most of the fivefold increase in full-syndrome autism -- from 9 in 10,000 children in 1990 to 44 in 10,000 children in 2000-- is real and cannot be accounted for by broader categories or diagnostic substitution. And from 1990 to 2007, the mumps portion of the MMR was higher by roughly the same amount -- quadruple.
 
Merck’s decision to cut back on the increase in the mumps vaccine also is surrounded by interesting timing.  The cutback, in 2007, came at the same time Merck announced it was suspending its recently introduced, much-hyped four-in-one shot, ProQuad -- the MMR with the chickenpox vaccine added to it. In suspending ProQuad, Merck cited a shortage of chickenpox vaccine; subsequently, a study showed ProQuad caused twice as many fever-induced seizures as separate MMR and chickenpox shots given at the same time, and a CDC advisory committee withdrew its preferential recommendation of the vaccine. Merck won't say when ProQuad will return to the market.
 
An investigation I conducted while at UPI in 2006 found two cases of regressive autism in one small city -- Olympia, Wash. -- in clinical trials leading up to approval of the vaccine. Merck said the parents originally failed to report those cases to it (though the pediatricians paid to conduct the studies for Merck certainly knew about them and would have been expected to report them); the company alerted the FDA only after my inquiry.

The Merck scientist I spoke with recently also acknowledged that viral interference can affect the potency of individual MMR ingredients; that explains why the company added a whopping dose of chickenpox vaccine to the ProQuad shot, several times more than the standalone chickenpox vaccine contains. Using the same amount of chickenpox vaccine in the MMR shot as the standalone vaccine simply wouldn’t have protected children against the disease, because more virus was needed to offset the interference from the other components.
 
A significant number of parents of children with regressive autism cite the MMR as the proximate cause -- they say their child was developing normally until the shot, then in many cases had a serious physical reaction within a short period of time and began losing developmental milestone and showing typical signs of the disorder. Some also developed severe gastrointestinal problems, an ailment first described in cases of regressive autism following the MMR shot by Dr. Andrew Wakefield in Britain in 1998; he named it autistic enterocolitis and found measles RNA in the children's GI tract, suggesting persistent infection.
 
In looking at whether the increase in mumps potency in 1990 could buttress this theory of the autism epidemic, two questions arise: Is there evidence that increasing the mumps portion of the MMR could have any impact on measles infectivity or create symptoms consistent with those described by Wakefield and parents? And, could ProQuad's higher rate of measles rash and fever-induced seizures be a warning sign that something is amiss with the MMR itself, especially beginning in 1990 when Merck tinkered with the proportions of the components?
 
The answers seem to be, yes and yes.
 
In the real world, children rarely get two viral illnesses at once -- for instance, chickenpox and rubella. But when they do, viruses tend to interact -- or interfere -- with each other in unpredictable and synergistic ways. One example: Studies in the UK and Iceland showed that when mumps AND measles epidemics hit these populations in the same year, the risk of inflammatory bowel disease spiked. That's an epidemiological argument for immune interference, and a striking fit with the observations by Wakefield, and thousand of parents, that a similar condition occurs in many children with regressive autism after they get the measles-mumps-rubella shot.
 
A related finding comes from a study funded by Merck.  In 2005, the study reported that the four-in-one ProQuad shot -- the MMR and chickenpox -- was "generally well tolerated" and had a safety profile similar to the MMR and the chickenpox shot (also made by Merck and called Varivax) when given separately.
 
But there were a couple of interesting differences. First, "Measles-like rash and fever during days 5-12 were more common after the first dose of MMRV [ProQuad]" than after the MMR and Varivax given separately. The difference was substantial -- 5.9 percent who got the MMRV had the rash and 27.7 percent had fever, compared to 1.9 percent with rash and 18.7 fever after getting separate shots. While that did not alarm the researchers, it could be a foreshadowing of the doubled rate of fever-induced seizures that was spotted after ProQuad was approved.
 
Second, even though the new element in ProQuad was the chickenpox portion, something new and unexpected was also going on with the mumps and measles components. "Geometric mean titers to measles and mumps were significantly higher after 1 dose of MMRV than after administration" of MMR and Varivax separately, according to the study's summary. Later, the authors state: "This suggests that the measles and mumps virus replication is greater after MMRV than it is" after the MMR and Varivax given separately.
 
In non-scientific language, it looks like the addition of another live virus -- chickenpox -- potentiated the measles and mumps components: It kicked both viruses into higher gear and they replicated at rates higher than in the MMR. At the same time, the researchers observed a greater incidence of measles-like rash, and fever, in those who got ProQuad. Were the increased measles and mumps viruses interacting in some unexpected and potentially dangerous way?
 
Then, for whatever reason, sometime between February and December of last year Merck reduced the mumps component of the MMR from 20,000 units to 12,500 while leaving the standalone mumps shot as it was. During that same period, it decided to suspend production of ProQuad. In April 2007, it announced the suspension, and said no more would be available after July. Then in early 2008, Merck’s study showing the doubled risk of seizures in ProQuad was unveiled and the CDC withdrew its recommendation.
 
And just last month, Merck said it would stop making the individual MMR component shots including, of course, the mumps shot. That leaves the MMR as the only vaccine in town, and it means there will no longer be a mumps vaccine formulation on the market with the dose the MMR contained from 1990 to 2007.
 
None of this might matter if not for the fact that measles is capable of causing cause catastrophic brain damage and death; that's an argument for the measles vaccine. In medical parlance, it’s a neurotoxic virus.
 
"The invasion of the CNS [central nervous system] by MV [measles virus] is apparently not an uncommon event, as reflected by the finding of genomic sequences in normal autopsy cases and the widespread distribution of MV in in neurons, glial cells and vascular endothelial cells of the diseased brain," according to "Measles Virus Infections of the Central Nervous System" by Uwe G. Liebert of the University of Leipzeig, Germany, published in Intervirology in 1997. "The susceptibility of the host as well as his age and immune status at the time of infection constitutes significant factors for disease progression."
 
Merck acknowledges the three viruses can indeed interact to affect a child’s immune system, although in ways it says are not harmful.
 
A Merck scientist publicly discussed the interference issue at a CDC meeting in 2004, the year before ProQuad was approved, according to agency minutes. Dr. Florian Schodel "confirmed the possibility that the chickenpox virus component of ProQuad was causing a local immune suppression and an increase in measles virus replication. ... The current hypothesis is that the varicella and measles virus are co-infecting the same or proximate areas of the body and engaging in a specific interaction, but how that works is as yet unknown.
 
"He said the interference appeared to involve only the chickenpox and measles viruses – 'there is no such effect for the mumps or rubella vaccines administered locally at the same time.'"
 
Yet based on Merck's own 2005 study cited above, ProQuad triggers an increase in mumps virus replication, too. Live viruses in ProQuad seem to be behaving in ways "as yet unknown" that cause immune suppression, co-infection, interaction and increased replication. Even without ProQuad on the market, interaction between the MMR components and the chickenpox virus remains a possibility. The CDC started recommending the chickenpox shot in the mid-1990s at the same 12-month well-baby visit as the MMR. 
 
That suggests the pattern highlighted by ProQuad could be at work through the increased mumps component of the MMR and the addition of chickenpox to the childhood immunization schedule in the mid-1990s. The lesson could be that combining live viruses, and then increasing them or adding new ones, is inherently dangerous, especially when invasion of the brain by one of them “is not an uncommon event.”
 
As Andy Wakefield told me when I was working on the series in Olympia describing the children in the ProQuad clinical trials who became ill after the vaccination and subsequently regressed into autism: "It's actually heartbreaking, listening to these parents, for more than just the immediate reasons their child has met this fate. It's that you're staring into an abyss," Wakefield said. "You're listening to stories which reflect the fundamental misconception of vaccine manufacturers of what viruses are and what they do."
 
Two additional points worth noting: After the increase in 1990 and decrease in 2007, there is still more than twice as much mumps virus in the MMR as there was in 1990.
 
The changes in the mumps virus component of the MMR serves as a potent reminder of something else: MMR is not one thing but three different exposures. And over the period 1980-2009 the MMR has changed significantly at least twice, making epidemiological studies even more difficult to interpret.
--
Dan Olmsted is Editor of Age of Autism.

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Okay, so I'm sitting here at my desk with a 1991 Pluserix vaccine insert. That says 20,000 TCID (small 50 after the D) Mumps virus.

Next in my file is the MMR II insert which was the vaccine which replaced Pluserix in September 1991, when it was withdrawn. That says 20,000 TCID small 50 mumps virus.

Now, I pull out of the folder, a 1994 Merck Sharpe and Dohme, USA Phsician's circular IPC-MMR-1-0191a which says 5,000 CID small 50 mumps virus.

So what is the difference between TCID and CCID? I'm not sure...

1997 USA MSD IPC also lists the same. 5,000 CCID small 50.

the one we use now is here http://www.medsafe.govt.nz/Profs/Datasheet/m/MMRIIinj.htm and says, "12,500 CCID 50 of mumps virus;"

Might I suggest that someone gets hold of the actual data sheets and checks this?

I would find it extraordinary that an American manufacturer would make an MMR for New Zealand between the years 1991 - 2004 with only 5,000 CCID in it, yet keep 20,000 in the USA one.

There is no need to ask them for the data sheets. Go to a medical library and take out one issue of JAMA for each year, and track the MMR advertisements through, and that will give you the mumps component for each year. Should take you about 15 minutes once you get to a medical library to check that.

Monica, my answer to you, is not very well, responding to vaccines with T Cell abnormalities. Chicken egg question is...is that because of vaccines, or genetic? For instance, my kids were in a study at Utah State, that suggests, that complement problems are the factor here. Complemnet C4B to be exact. My husband and I have an allele, which came together in both of our autistic children, and two others they are carriers. So, those kids with ZERO complement, cannot bind measles viruses. So the answer of the day is, where is the friggen biomedical markers, especially dealing with immune abnormalities, starting at testing moms and dads during pregnancy? For instance, when I worked on a cord blood study, we found that HYPER IGE on cord blood indicated an immature immune response, prone to anaphylaxis. This simple test would cost thirty dollars. That would save millions for our governmnent, and would give mom a PASS on vaccines. I just feel the technology is ALREADY THERE..why in the heck are we not implimenting them? Most kids also have NKT cell problems which makes infections EASY hey days in the body. Low NK cell function means, your in trouble dude..and what causes that? Oxidative stress, low glutathione, LOW SELENIUM as HANS has suggested, and so on. It is obvious we are punching out all the gentics we can that are easily broken and fragile by our foods, air, water, vaccines, etc...it's mankinds disease...

How is changing the components of a vaccine and giving it to the public without informed consent or any clinical trials done before hand, legal???

I'd like the cdc or Merck or the FDA to answer that!

Funny how Dr. Keys dropped in for just long enough to tell us about a baby who died of Hib, and hasn't been heard from since. Guess he's not interested in a dialogue after all.

The question here is the interaction between various viral components of a vaccine.

Dr. Ethan Will Taylor has done a lot of work on viral replication and has found that selenium is a kind of sleeping pill or birth control pill for viruses: If they have enough selenium, they keep quiet. As Se decreases, they start replicating and mutating.

If you infect with two types of viruses, you double the need for Se, and as the Se goes down, the viruses increase and become more aggressive due to mutation. And the course of this is entirely unpredictable.

Dr. Foster from CA has drawn the practical conclusions from this and feeds AIDS patients with selenium and the amino acid components of glutathione peroxidase, with good results.

He also points out that Finland, basically very low in selenium, has laws now prescribing the addition of Se to fertilizer, and this has reduced the rate of HIV infections by two thirds. Whereas formerly, Finland was on an equal footing with Norway, it has fallen back now considerably in the rate of HIV infection compared to Norway.

It is a somewhat expensive way to combat HIV infection, but even if it does not help all the young people concerned, it will at least not do them any harm and make them more resistant to all types of viral infections.

Hans Raible

Dr. Keys,

To be clear, the Hib vaccine itself is not implicated in my comments as a cause of autism.

I mentioned the study I found as a curiosity as mitochondrial issues may be more common than originally thought in kids with autism, or conditions related to autism, and the mechanism for those problems are not well explained, nor are the conditions under which they can be exacerbated, nor is the disorder itself easily identified, at least from what I've read. I don't know enough to make much out of it, but I thought it was interesting that a contamination issue could have unexpected relevance.

Here is another study quote “The symptoms provoked by the toxin in spermatozoa indicated that B. cereus emetic toxin was acting as a membrane channel-forming ionophore, damaging mitochondria and blocking the oxidative phosphorylation required for the motility of boar spermatozoa. “

http://cat.inist.fr/?aModele=afficheN&cpsidt=2258978

In addition to the actual contamination, the related manufacturing issues at Merck are troubling to me.

For one it raises awareness of how undersized, fragile and inflexible our vaccine supply chain is. To me, that is a big problem and should be addressed from a big picture standpoint so that shortages like this do not occur again and so that we have the ability to respond to future threats quickly.

Second, this was a huge failure. Over one million doses from 12 batches (plus 1 batch to China ) were produced and distributed beginning in April 2007, and the discovery that the quality of this material could not be assured was not disclosed until December 2007.

Third - some of the suspect doses were administered before being recalled.

Forth – assurances that the “Sterility tests of the vaccine lots themselves prior to their release have not found any contamination” needs to be clarified to indicate if this was the release prior to the packaging operation, or sampling of packaged product off of the line. In any case, the more important statement is that ”The company cannot assure sterility for these specific vaccine lots. “

Fifth – The 8+ month timeline of production, distribution, and subsequent recall deserves closer scrutiny as it relates to “In routine testing of the vaccine manufacturing equipment used to produce PedvaxHIB® and COMVAX®, Merck identified the presence of a bacteria called Bacillus cereus.” What is the frequency of “routine” testing, what type of equipment was involved, and when did the test occur? Was sterilization equipment faulty, processing/packaging equipment contaminated, or was faulty testing equipment and/or procedures involved (or all of the above)?

Sixth – While this one particular bacteria was identified, the larger issue is that “Merck identified an issue that creates the potential for microorganisms to survive the sterilization process.” ie, there may be other contaminants.

Seventh - The severity is only underscored by statements that distribution may not resume until mid 2009. While this may all be an admirable abundance of caution, as an industrial engineer, a year a half of production down time strikes me as a pretty big deal and suggests a very serious process control issue existed.

Dr Keys, if you have a chance, possibly you could answer a question for me. How would an individual with a genetic T Cell deficiency respond to live viruses?

Would their immune system respond appropriately?

Jay-

Just so you know, everyone here is very familiar with what an abstract is. I thought maybe I'd give you the benefit of the doubt on being overly polite/policy-driven vs condescending and agenda-driven. I'm still not sure but it could be the latter. Since you mentioned only these items on the study I posted,

"when inherent bias, a tainted sample population, or statistically insignificant results are uncovered.",,,

I sense a foreshadowing of dismissal based on your own possible bias. If there is an issue on using acetaminophen even if it is based on parental reports via a study, why isn't the AAP concerned? Your info on ibuprofen use in infants less than 6 months does not relate to this as MMR is given way past 6 months so I'm not quite sure why you brought that up.

From Jay Keys

"Apropos to our discussion of the current news, NOT giving the HiB vaccine can give you one thing-- it can give you a dead 7 month old."

Hello there Dr. Keys. So now, can you back up that comment you made above with scientific proof? Seems to me like civilization must have somehow circumvented that particular observation, since there wasn't a HiB vaccine until very recently. Wonder how all those kids made it past the 7 month mark!

As an aside, we met with a young medical student who was interning at our DAN's clinic the other day. She very candidly stated that she was going into "Integrative Pediatrics." Seems that that is the new specialty that young curious doctors are into these days. She said they studied biochemistry in their first year, and not at all after that, and she could not fathom why. It seems to me like you guys ought to spend more time studying immunology and virology in addition to biochemistry, because it would seem that you are clearly out of your depth in understanding exactly what is going on in autism.

We might not know which vaccine causes autism exactly, or what vaccines in combination cause autism, but we do know that you people have NOT done your homework. And the rest of the world out there is slowly becoming aware of it.

Dr. Keys -
You put this very well: "There have been some great papers out there that claim great things... only to then be leveled to the ground after gone over with a fine-toothed comb, when inherent bias, a tainted sample population, or statistically insignificant results are uncovered."

That is exactly what many in our community have been saying about the studies which supposedly prove no link between vaccines and autism.

BTW, it was Mark Twain who first said, "There are lies, damn lies, and statistics."

It's very frustrating that all the information we provide about vaccine safety concerns is greeted with statements such as, "But what about polio?" or "An infant died of HIB" or "People can get encephalitis from measles".

The fact is, vaccines have both risks and benefits. Yes, diseases are dangerous. We understand that. But for most of us the issue is not whether to do away with the vaccine program altogether, but how to better evaluate risk factors in order to better prevent and treat adverse reactions.

If I had a baby now I would probably vaccinate against polio and HiB. But Hepatitis B for all babies on the day of birth? That's insane. Maybe I would vaccinate against measles, but MMR + varicella + flu shot on the same day? Or MMR + DPT on the same day? That's insane. Flu shots still containing mercury, when individual shots without mercury are only slightly more expensive? That's insane, and the need for/effectiveness of flu shots is debatable.

It's very frustrating to raise safety issues and describe adverse events over and over, only to be told, "diseases are dangerous". We know that.

If there were only 1 in 100,000 infants suffering adverse events, maybe you could argue that the current schedule has more benefit than risk. But with 1 in 150 (or maybe it's 1 in 100 now) kids with autism, and increases in diabetes, asthma, severe allergies, ADHD, and even lupus and multiple sclerosis, there are serious problems here which need to be addressed instead of being swept under the rug.

Again, see http://www.washingtonpost.com/wp-dyn/content/article/2008/03/03/AR2008030303200_pf.html We are giving an unprecedented number of vaccines. What is the effect on our children's immune systems?

Please read Mark Blaxill's series of articles on "The Atlanta Manifesto" starting on Nov. 7, 2007 “Congratulations! You’ve Been Named to a Blue Ribbon Panel.”

Thank you for continuing this dialogue.

Jay, I'm glad you came back to comment.

I agree with Mark and have made the same observation. Dr. Offit also shows ZERO empathy or concern for the people with autism. It's utterly missing in all of the blogs that condemn us. Not ever a cursory, "I know autism is difficult, but...." It's always an attack on our children, and on us as parents. Curious. It's like there's a playbook. Or something. Maybe another letter from the AAP telling you how to handle us? We love seeing those.

Jay,
In your desire to lecture our readers on the importance of vaccination, you seem to summon all of your concern for the tragic but rare deaths of children due to infectious disease. You neglected to mention that two of these Hib cases were in vaccinated children. You also overlooked the fact that the fatal case appears to be another rare instance in which the family chose to refuse medical treatment subsequent to the Hib infection. All of these circumstances make this incident a lesson of nothing at all and certainly don't lend any support at all to the intolerant, compliance driven, "safety last" orientation that has been adopted by the leadership of the pediatric profession.

Autism can bring with it fatal risks (like seizures and drowning), so can other conditions, like asthma in which risk clearly rises with vaccination intensity. (see http://www.ageofautism.com/2008/07/earlier-vaccina.html ). And that doesn't even include the numerous (and certainly incomplete) vaccination deaths that one can discover on VAERS. But none of the deaths that come with these conditions are greeted with the gnashing of the teeth and the compliance propaganda that accompanies a single death from an infectious condition like Hib.

I suggest you step down from your compliance soapbox and recover your sense of proportionality. We don't have a meningitis epidemic in this country, we have an autism crisis. The sooner well-meaning but confused people like you catch up to that, the sooner we can begin to make progress on the real problems that face us. But as long as you are exercising your spare cycles defending legacy policies like the existing ACIP schedule (and the extraordinary pharmaceutical profits that have grown alongside the schedule), we will remain incapable of discussing the tough issues involved in stopping the autism epidemic.

Dr. Keys,

Just one question. Dr. Paul Offitt (who I know has many titles, but I'll just call him "the vaccine talking head") has said in regards to vaccines causing autism, "The question has been asked and answered, vaccines do not cause autism." Do you agree with this statement? Do you feel the question has been "asked and answered"?

Jay,

You wrote previously:
"To everyone else-- There is some skewed writing out there on the Internet" and yet you are referencing Wikipedia as a source?

Out of curiosity, have you ever reported a vaccine reaction on behalf of one of your patients?

I just re-read "Ben's dad"s most recent entry, and I feel I have to write an addendum.

Bacillus cereus (B. cereus) is a facultative anaerobic bacteria that predominantly lives in soil, but does occasionally contaminate food and is a minor contributor to food poisoning (2-5%) <-- this is all from Wikipedia.

The link you provided was a case report of two people who ingested contaminated food with B. cereus and developed a severe case of gastroenteritis and liver failure, leading to the death of the younger victim. The article you reference states at the bottom that the endotoxin that B. cereus produces is a mitochondrial TOXIN (not deadly poison) which interferes with mitochondrial fatty acid metabolism in the LIVER and is linked to the the liver failure that killed the patient. Nowhere does your link state that this emetic ('emetic' which means vomit-inducing) toxin has ever been linked to permanent mitochondrial injury, especially in the central nervous system.

Consumption of a large dose of contaminated food with B. cereus is what gives you this illness, and it gives you food poisoning, nothing else.

So I'm just curious about the basis of your supposition that exposure to these Merck HiB vaccines, or to B. cereus in general, would have led to "autism like symptoms"? Is it now all vaccines that you implicate in triggering autism? Does B. cereus now cause autism, as well?

Apropos to our discussion of the current news, NOT giving the HiB vaccine can give you one thing-- it can give you a dead 7 month old.

Jay

Hi Teresa,

You're correct, I don't need a medical librarian to be able to comment on the article... but what I do need is the complete article, not just the abstract-- something I'll be able to access from work the next time I'm at the hospital. The abstract is where the authors grab your attention to try to draw you in to then read the guts of the article, the statistics applied, and the specifics about the test subjects.

They say there are liars, bad lairs, and then there are statisticians. Haha. There have been some great papers out there that claim great things (phenobarbital use to help prevent intraventricular hemorrhage in extreme preemies, for example), only to then be leveled to the ground after gone over with a fine-toothed comb, when inherent bias, a tainted sample population, or statistically insignificant results are uncovered.

I'll get back to you for sure.

I can tell you that the party line in Pediatrics is to preferentially use acetaminophen over ibuprofen in infants less than 6 months out of concerns for kidney problems and GI bleeding caused by the later. This has not been widely studied, and the only recent literature on the subject didn't show a worrisome correlation, however the paper is admittedly limited per the paper's authors.

Lesko SM, Mitchell AA. The safety of acetaminophen and ibuprofen among children younger than two years old. Pediatrics. 1999;104:e39.

To "Ben's dad"... You're correct, the reason for the HiB recall was that B. cereus was detected on the EQUIPMENT used to make the vaccines, but that sterility tests of the actual batches of the vaccine did not show any contamination.

We're hoping to see the HiB vaccine back in regular production and supply in the next quarter. We offer the monovalent HiB in the clinic and hospital.

Talk soon,
Jay

Jay-

Can you also comment on this? I don't think you will need your medical librarian.

http://www.ncbi.nlm.nih.gov/pubmed/18445737
Acetaminophen (paracetamol) use, measles-mumps-rubella vaccination, and autistic disorder: the results of a parent survey.Schultz ST, Klonoff-Cohen HS, Wingard DL, Akshoomoff NA, Macera CA, Ji M.
University of California San Diego, USA. Stephen.schultz@med.navy.mil

The present study was performed to determine whether acetaminophen (paracetamol) use after the measles-mumps-rubella vaccination could be associated with autistic disorder. This case-control study used the results of an online parental survey conducted from 16 July 2005 to 30 January 2006, consisting of 83 children with autistic disorder and 80 control children. Acetaminophen use after measles-mumps-rubella vaccination was significantly associated with autistic disorder when considering children 5 years of age or less (OR 6.11, 95% CI 1.42-26.3), after limiting cases to children with regression in development (OR 3.97, 95% CI 1.11-14.3), and when considering only children who had post-vaccination sequelae (OR 8.23, 95% CI 1.56-43.3), adjusting for age, gender, mother's ethnicity, and the presence of illness concurrent with measles-mumps-rubella vaccination. Ibuprofen use after measles-mumps-rubella vaccination was not associated with autistic disorder. This preliminary study found that acetaminophen use after measles-mumps-rubella vaccination was associated with autistic disorder.

PMID: 18445737 [PubMed - indexed for MEDLINE]

oops - that top line belong to another post, but I guess it fits here somehow. There are issues that still need to be studied.

I am sure there are many issues on which I agree with Ms Singer and mr , but

Dr. Keys - this is certainly tragic. I understand that the Hib shortage was not the issue in these cases, but it is unfortunate that Merck had to recall its Hib vaccinates due to contamination of bacillus cereus during the manufacturing process.

http://www.cdc.gov/vaccines/recs/recalls/hib-recall-faqs-12-12-07.htm

I found an interesting study from the New England Journal of Medicine mentioning “The emetic toxin isolated from the B. cereus cultures was found to be a mitochondrial toxin. “

http://cat.inist.fr/?aModele=afficheN&cpsidt=2636221

At least we can be thankful that the Merck vaccine never made it out there to cause mitochondrial injuries, which may have led to autism like symptoms as a result of multiple vaccinations similar to what Hannah Poling experienced.

I thought this article was very interesting Dan. Thanks. The issue of interactions affecting the efficacy of vaccines and the severity of reactions is fascinating. The recipe changes can only be described as trial and error as others have mentioned, and says a lot about the state of knowledge and the quality of the science involved in vaccine delivery.

I hope everyone will be hopeful to hear that the newly appointed director of the CDC, Dr. William Besser, is a practicing Pediatrician.

I'm still researching the questions posed to me regarding viral titers and associations with autism. My medical librarian who is excellent at helping with literature searches has been on vacation this past week. I'll get back to those who asked, as promised.

Jay

P.S. there's a sad situation in Minnesota with 5 cases of Hib infections, and one infant died. You can read about it here:

http://www.cnn.com/2009/HEALTH/01/23/hib.vaccine.cdc/index.html

Not only did our ped not do bloodwork before any vaccinations, he found it "unnecessary" to do any after the autism diagnosis as well. He was "confident" that our son was perfectly healthy, even with the nightly vomiting. As far as he is concerned, autism is a psych diagnosis. As for all the other things we found after our DAN! bloodwork? Comorbid - my favorite new word! I had to look it up of course, and found out that it means that even though all these medical conditions exist at once in our son, they have nothing to do with each other, nor did one cause the other. I guess that's the pediatrician's safety net - sure your child is actually sick, but it's just bad luck, it has nothing to do with the autism. And doctors wonder why we look elsewhere for answers

Not once did our pediatrician do bloodwork on our kids prior to vax. Did yours do that routinely?? Does everyone's? Sheesh.

Jill my son had the high fever prior to the ProQuad vaccine. Looking back at his lab work of blood taken the day he received his vaccine, his immune system was compromised by the earlier high fever (Roseola). Apparently no one bothered to check his white blood cell count and administered the vaccines anyway, seven in total. He lost everything he had accomplished in his first 12 months, was diagnosed at 18 months as being in the spectrum and exhibits most, if not all, the classical traits of a 3 year old with autism.

Check your child's medical records and see what his white blood cell count was the day he got his shots.

Vaccines are causing the injury, but those administering the vaccines in doctor's offices are not doing their duty to verify the wellness of the child PRIOR to administering the vaccines.

And who is it that determined that a 12 month old can handle this sort of deadly viral invasion in the first place? Seriously, I want his/her name.

i have been looking at this very same thing. after my son recieved the MMR and chickenpox vaccine, he got a really high fever. i mean really high. like 106. i brought him to my old pedi, she said it was a normal reaction to the shots he got a week earlier. normal?? is the autism he regressed into after that normal?thankfully the biomedical treatments we are doing are working. but i think about those vaccines all the time! i also think about how he kept getting a little worse after each subsequent vaccine. it's like after the MMR and chicken pox vaccine(i'm not sure if he got the proquad but i think he did) we opened a whole can of worms. his immune system couldn't take it anymore. he just got worse. now i am just thankful, and keep trying to get him better!

Garbo -
I'm right with you. By the way, my son's titers 4 years after receiving his second MMR at 5yrs old were very similar to yours..2x the expected level for mumps, 3x for measles and over 5x for rubella. (BTW - my son's autism hit AFTER his second MMR at 5). Its amazing doctors can see our similar labs specifically indicating a bad take to the MMR and still be as defensive as DR.JK. Denial, denial, denial.

Garbo, you don't have to apologize for a thing. You have every right to be pissed off about what's happened to you child.
Quadrupling of mumps component... this certainly is interesting and maybe it's part of the answer as to why the MMR is mentioned so often by parents whose child regresses into autism shortly after. Apparently (well according to the Alberta health minister, our dpt's never had thimerosal-I guess because they were not mult-dose vials?) and I understand MMR just does not contain thim. (don't know about aluminum). It will be hard (but not impossible) to know what the diff was now that they've pulled back the level again.

To all:
My apologies if my snark scared off an inquisitive pediatrician. It wasn't my intention.

4 years after a single MMR at 12 months, my son's IgG titers were 2x reference range for measles and mumps, and more than 6x reference range for rubella. Two years after that, we still have gut issues. I can only imagine what might have happened if I'd let them do the second shot.

It's insane to continue injecting all babies and children with more doses of something that might have worked the first time around, simply on the premise that there may be some who don't respond to fewer doses. The only thing more insane is the crazy notion that quadrupling the amount of virus in a shot will make it more effective rather than more dangerous. No, I take it back, the only thing more insane is that most pediatricians haven't even got a clue about individualized medicine and testing titers, and the AAP's instructions to peds whose patients question vaccines is to toss them out of their practices. One look here will explain why:
http://www.aap.org/donate/fcfhonorroll.htm

Dr. Keys
I'm glad you're looking into all of this because, as an educational assistant, who has been to many, many different schools within the public system (in Canada, albeit), there really is something troubling going on. I have to tell you that the sheer number of kids that I see with ADHD, seizures, autism, aspergers and "learning disabilities" is crazy. What is causing it? It can't all be a "genetic epidemic." I was an adult during, and am aware that, in the 80's there was a "de-institutionalization" movement but I still don't see that as accounting for the higher number of neuro -problems (i.e. we're better at recognizing them now). Now, we're seeing a lot of immigrant chlldren with this same (even heightened) pattern of problems. And believe me, it's really frustrating to get at the root of what is an ESL issue and what is a learning disability issue. Now, more and more, it seems to be a mix of the two. I have even heard that in the U.S. now that Gardasil is mandatory for female immigrants. Nice. You could look into the Somaili immigrants in Minneapolis.. Montreal, Canada is also discussing this.
Recently, I wrote a letter to the editor re. the Gardasil vaccine (and I would NEVER give this to my 15 year old daughter even though I had severe-pre-cancerous displasia), and when I researched the vaccine trials I came across the fact that they were allowed to give "controls" aluminum-containing placebos instead of saline-containing placebos. That just seems pretty wrong. And definately could hide many of the side effects (especially since aluminum is a neuro-toxin and the3re is no minimal safety study for amount done for it).
I have two kids (one girl, 15 and a boy, 11) I did most of the recommended shots for the first-born girl (I skipped the 18 month dpt because I just felt it was over-kill).I think she actually had whooping cough anyways before the 18 month sh0ot-I don't think the efficacy of that shot is too high. By my second child (the boy) they had introduced the chicken pox vaccine and that definitely made me skeptical of the whole shebang.They both had chicken pox, swam in toxic lakes and were just fine. I knew that boys were, for some reason, more at risk and I only gave him one dpt at 3 months, one at 12 months an MMR at 2 years then no more dpt 'till one at 8 years. Oh yeah, I got scared into a meningitis shot for them both when she was 8 and he was 4. No hep b for my kids. It is not a casual contact disease. My boy does seem allergy prone, more so than his sister (he doesn't tolerate milk very well) and he even used to hand flap a little when he was younger. I am SO SO glad, even more in retrospect, that I was cautious about vaccinating him. In Canada vaccines are not mandatory like they are in the U.S. If I were a parent there I would be FURIOUS at this forced poisoning of our children. Honestly, when you are a woman, and you nurture and are responsible for bringing as healthy a baby into this world as possible, it is bizarre to hold up this pure, precious bundle to be shot up with stuff that hasn't been studied with any true scientific integrity. Hep b at birth? Over-kill, and un-necessary in my opinion.
I honestly think that if we went back to allowing some childhood diseases it would be a better trade-off. I hate to be too Darwinian but we are in the territory of frankenscience now.
It must be really frustrating for doctors to have this all be questioned by patients but "do no harm" is really a fundamental tenet in medicine. Doctors' feeling of betrayal in sheer acceptance of this immunization agenda instead of critically thinking about it must be very hard to accept.

Dr. Keys,
I've got a question for you. What would you do if I brought in my sick 15 month old and told you that I had given him Tylenol, Motrin, PediaCare, Benadryl and some prescription cough medicine all at one sitting. Would you call Family Services on me? But you would give that same child 5 vaccines in one day. How does that make sense?
Thanks for your honest reply.
Kim

Dr Keys

I was pleased to see that you are interested in the facts. Here are just a few:

Not one of those 14 studies touted by the CDC and Big Pharma to "prove" that vaccines don't cause autism ever looked at an unvaccinated child. They compare vaccinated childred to more vaccinated children and then tell you they found no causal relationship between vaccines and autism. How can they possibly know that if we do not know the autism rate in unvaccinated children?

15 years ago, my first son was born at 26 weeks gestational age. He weighed 2 lbs and was in a NICU for 11 weeks. They did not vaccinate him at 1 week old, or at 4 week or at 6 weeks. They waited until the day before discharge to start vaccinating. The reason behind this? Preemies have a poorly functioning immune systems, and we were told it would be wise to spread out his shots. Oh, and also, we were told by his neonatologist to make sure the DTP shot was separated out, and to never give him the pertussis portion of the vaccine - again because his immune system couldn't "handle it". So to recap, 15 years ago a neonatologist told me that vaccines and poorly functioning immune systems don't mix.

Our son made a great comeback and grew into a happy, healthy typical child. When he was 8, he developed a stutter. I spent a fortune on speech therapy, specialists, etc, but all I ended up with was that no one had any idea how it happened. I was told again and again how unusual it is to develop a stutter past the age of 3 or 4, and that is was surely neurological in origin. Flash forward 5 years to the diagnosis of my younger son. I started researching the vaccine connection, and something clicked in my mind. I checked our eldest's vaccine record, and sure enough, the stutter began right after a round of vaccines (including his first flu shot). I had just finished reading David Kirby's "Evidence of Harm", and was horrified to find that the Verstraeten Study (which the CDC uses to prove vaccines are safe) did show that there IS a causal relationship between thimerisol-containing vaccines and stutters. The CDC admits this! They also found in that same study a causal relationship between vaccines and ADD/ADHD. But vaccines have nothing to do with autism. Right.

In the 11 years between the birth of my 2 children, 12 new vaccines were added to the early childhood schedule. But I was told that now I didn't have to worry. Thimerisol was gone (which it's not, but maybe I'll leave that to Twyla to explain), our youngest was a healthy, full-term 9-pounder, and his immune system could handle anything. It seemed to be so, until the MMR visit.

In the comprehensive testing ordered by our DAN! doctor we have discovered that our son has measles titers 4X higher than needed, rubella 3x higher, and no mumps immunity at all. He had very elevated titers to HHV-6, low insulin levels, a malfunctioning methylation pathway, and a Th1 dominant autoimmune reaction (he is able to produce antibodies, but no natural killer cells). Surprise, surprise -autism is an IMMUNE disorder, and yet it is diagnosed only by the presence of a minimum # of symptoms. I'll repeat that - it is diagnosed only when the patient displays a certain # of symptoms! Until my DAN! doc, no one had bothered to tell me the reasons behind the symptoms. Now I get it.

On to metals - our son showed very little to no toxic metals in his bloodwork. His BLL was 1.3, very low. Our doc told us how and why bloodwork is not reliable in the kind of metal poisoning our kids suffer. Bloodwork is useful if the child is spike-dosed with heavy metals (chewing on lead-painted toys, etc), but the metals only remain in your bloodstream for 30 days. After that - it's settled in your tissues, and mainstream medicine has no way of calculating body burden. Of course, this is assuming that your methylation pathway is functioning properly and your body is producing enough glutathione to be able to detox. Not so much in our kids. They accumulate all the toxins they are exposed to (not only from vaccines, but from their living environment and food), and when their bodies reach the "toxic tipping point" - Hello, autism!

We are now in round 9 of chelation. With the results of a urinary porphyrin test (which our regular pediatrician had never even heard of), we discovered that our son had a very high body burden of lead and aluminum, with a fairly serious burden of mercury. So far, Jack excretes about 25 mcg of lead per round of chelation, about 125 mcg of aluminum, and about 8 mcg of mercury. I'm not even going to get into the arsenic and uranium, because it's still tough to wrap my head around. In total he has excreted about 220 mcg of lead, 1,000 mcg of aluminum and about 60 mcg of mercury. I have excreted $5,000. What my money got me? A child who knows when I am gone and who says "I missed you" when I get home. They should make that a MasterCard commercial.

When my husband and I were going to the DAN! doc to get the results of our son's initial testing, we were shaking like we had the DT's. Our worst fear? That his testing would show that his body is functioning perfectly, and that there would be no treatment for his condition. When we told this to our doc, he laughed. He told us not to worry, because every autistic child he works with has real medical problems. Can you imagine what it must feel like to actually pray that your child is sick? But for parents in our boat, it is preferable to the alternative. I don't ever want to hear "There is nothing we can do" again.

There are several suggestions I have for research into this topic. As Twyla said, "Evidence of Harm" is a must. Please, please read it right away. You would be doing a tremendous service to your patients by hearing the "other side of the story". Equally important is Dan Olmstead's series on the Amish, and his series on the first patients diagnosed with autism in this country. I believe you can find them on this site under archives, Dan Olmstead original UPI Age of Autism series (Kim, please correct me if I am wrong). Thanks for listening (again).

Dr. Keys -
You asked about the studies that supposedly prove vaccines don't cause autism. I will jot down a few resources:

- David Kirby's book "Evidence of Harm" - definitely read this book.

- For a history of some of the studies go to http://www.putchildrenfirst.org/index2.html

- See JB Handley's article here: http://www.ageofautism.com/2009/01/cdc-aap-paul-offit-feeding-a-hungry-lie.html

Here are some quotes from page 3 of Dr. Bryan Jepson's book "Changing the Course of Autism..." After their son was diagnosed with autism, Dr. Jepson's wife "immersed herself in the Internet, searching for anything related to autism" -- including GFCF diet, vitamins, DMG, antifungals, probiotics... Dr. Jepson thought this seemed like a waste of money, but a small price to pay for his wife's need to do something.

"But when she told me about the possible link to vaccines, I could no longer be impartial. After all, this was striking at one of the few areas of preventive medicine that physicians are passionate about. Vaccines are good! They eliminate life-threatening disease! I have seen first-hand how vaccines have successfully turned fairly common serious illnesses into rare interesting cases. Wasn't autism just one more of those coincidental childhood illnesses that the crazy anti-government people were opportunistically using as an excuse to push their agenda?

"I looked at the research, largely to prove to my wife that the theory was unfounded. The further I looked, the more interested I became. And before long, I realized that this theory of a vaccine-autism link wasn't driven by the whims of angry activists or the wallets of vitamin manufacturers. Rather, it was based on real science with a strong foundation of biological plausibility, led by knowledgeable and motivated physicians, research scientists, and parents of autistic children, all of whom weren't afraid to question dogma."

That's all for now -- time to sleep...

"Dr. Jay"
You certainly did not "leave your credibility at the door" by being a physician, literally every one of these "more polarized members" consults with a physician. The just have to work a little hard to find one that is "receptive" and "open minded"

You did lose your credibility when you came in here "guns a blazing" dsiplayed a agressive and condescending tone even though it was painfully obvious that you are a complete newbie on this topic. You say "it's sad" we have gotten off topic, to me it's sad that you have been a pediatrician for 10 years and you are just now investigating the topic of vaccine safety, and you approach it with a chip on your shoulder. Those "reportedly well-designed" studies you "haven't reviewed" have been waiting for you the whole time.

Your credibility also took a hit when you say you "see an occasional case of measles". There have been about 800 cases of measles in the US over the last ten years. As of 2006, there were 82,264 pediatricians in the US. That's less than one case of measles each year for every 1000 pediatricians in the US. How many cases have you seen in your office?

http://www.cdc.gov/mmwr/preview/mmwrhtml/figures/m733a1f1.gif

http://www.aap.org/workforce/

Cut the "woe is me" drama. This is not about you this is about our kids.

Dr. Keys, "welcome to the kitchen." Yes, we're heated. I was more than happy to run your comment, despite your pugillistic entry. But we do welcome your comments - and we will try to confirm if you are a pediatrician or a lurker. That happens all the time. Just like that petite blonde on the dating site is actually, well, something else. That's just the nature of the blogging beast.

My last ped still sends me a Christmas card and we have wonderful exchanges of opinion.

Keep reading A of A, we hope to have more from Dr. Bob Sears - and then you and he can chat too.

Have a good weekend.

Kim

When I posted my first comment a few days ago, I was admittedly surprised to see it published. My suspicions about filtering dissenting opinions were incorrect... not that my opinions are dissenting, mind you, I was simply asking for more information regarding the claims made in this particular article. In fact, I've still not even shared with you the specifics of my opinions and philosophies regarding vaccinations and their suspected side effects. I've spent most of my time swatting away the hornets.

As you know, I reviewed this article for a friend of mine who had worries about vaccine-related injuries. However, I have quickly realized that this website is much more than just a sounding board about immunizations... it's a meeting place for people who have a common connection --- the struggle in how to approach the entire spectrum of care of children with autism, not just vaccine-related concerns.

It's been difficult to consider how to craft this response without flaming back at some of the retorts that have been directed at me. To my respondents who have offered some constructive insight into so many aspects of autism, I am so thankful. (thank you "chrissie", "twyla" for sharing your struggles and perspective... that's very helpful for me to hear. "Angela Warner", I assure you, I AM listening). "Teresa Conrick", I will definitely learn more about viral titers and how they can be interpreted in all kids, with or without autism... I'll let you know what I learn.

I don't continue to respond on this forum as the voice of the AAP, or the CDC, or of academic researchers, and I am hardly an authority figure on autism. (I must point out, however, at the risk of being burned a little more at the stake, that no one here on this website, is, by definition, an expert on the topic ... I'm feeling the flames get hotter). I'm a specialist in pediatrics, which is a tremendously broad field, and I rely on sub-specialists when I need specific evaluation for a patient who needs additional resources. I hope the questions were rhetorical that asked, 'why did my children get pertussis when they were vaccinated?' or 'why did my child start to regress around the time he/she got the MMR vaccine?'. Why do some kids develop schizophrenia without a family history? Why are some kids persistently anemic despite a full work up with negative test results and excellent iron intake? Why do some kids do better than others after similar insults following traumatic brain injury? I don't know... I really wish I did. But I'm allowed to say "I don't know", hopefully without losing all credibility in this forum. Not that I really had any from the onset-- given the degree of negative physician interactions amongst this readership, my credibilty was left at the door as soon as I identified myself as a physician, regardless of what I had to say on the topic.

I don't know how to communicate with this readership. One of your more open-minded readers astutely pointed out that the gold standard for evidence-based medicine (EBM) is the randomized control trial (thanks "jen"), and the interpretation of such is the basis of my training. However, I see the readership (specifically "Garbo") has summarily dismissed a handful of reportedly well designed and widely accepted studies before I even had a chance to review them, with the warning that "I'd be set straight" if I dared reference them. Why have these articles been discredited by you? Okay, so you won't accept anything I say from an EBM stance. I guess there is anecdotal evidence (or personal experiences), or the notorious "n=1" study, which, while fraught with bias, can certainly have some place in medical decision-making when better designed studies have not yet been performed or are not feasible (example, there's very little data regarding most medications and their safety during pregnancy or breast-feeding). The problem exists when people embrace anecdotal experiences despite exhaustive, well designed studies that support a contrary opinion (I'm speaking hypothetically, not pointing to anyone in this readership). But if we're talking about anecdotal experience, I can say that my clinic sees a few hundred kids each week, and I can assure you, I see many more cases of pertussis, chicken pox, and the occasional case of measles (mostly but not certainly not exclusively in my under-immunized patient population) than I do cases of suspected or confirmed autism... and my clinic administers hundreds of doses of immunizations a week.

I'm trained to interact with parents and their kids, offering recommendations based on EBM, consensus statements, and admittedly a fair bit of anecdotal experience that I gather along the way. I'm ALWAYS interested in having my views challenged by parents, and in challenging parents to consider new perspectives and ideas. But the common thread between me and them is being RECEPTIVE. I appreciate the reception from a few of my respondents... thank you. But for the more polarized members of this blog spot? You and I would NEVER interact in real life... the most extreme of you don't even see a pediatrician. So it's artificial to think that most of us could have a gay old time here on the forum in a neutral face-to-face exchange about vaccines.

Does anyone else find it ironic that, hours of typing and pages of emails later, we've not actually discussed the central topic of vaccinations? That's sad. Garbo said it when he noticed that we had gotten off topic. But don't point that finger at me, because I WANT to talk and learn more about vaccines.

I really am interested in learning more through posts from people like chrissie, twyla, and Teresa Conrick, and perhaps a few others. I will definitely find out what I can and give a medical perspective about the things you have asked. But I'll pass on further responses to off-topic flamers so as to avoid further reinforcing untrue stereotypes we ALL have of each other. Sound fair?

For the kids,
Jay

p.s. Can anyone fault me in wanting to retain some anonymity after Garbo has tried to track me down via a Google search after only two posts?

p.p.s. To "sorsha"... Regarding heart murmurs... During residency, I was involved separately in the care of a 5wk old and 3 year old, both of whom had murmurs, both of whom had scant pediatrics visits (the ER visit was the 5wk old's first doctor visit), both of whom were diagnosed with a critical coarctation of the aorta requiring surgery. The 3yo, given the delayed diagnosis, had developed left and right ventricular hypertrophy and a congestive heart condition called Eisenmenger's syndrome and had post-op complications. While most murmurs in children ARE benign (Still's murmur, venous hum, peripheral pulmonic stenosis), I think I'm qualified to say kids need routine health maintenance visits to avoid things going "vitally wrong".

p.p.p.s. For the record, I'm no fan of the New York Times. Despite the risk of my humor being misinterpreted, the NYT is far too grown up for this Pediatrician.

Jay-

I posted earlier regarding my 15 year old daughter's mumps titers. I would like to hear your opinion on why you think so many kids with an autism diagnosis have bacterial, viral, and heavy metal issues? Do you see any kids in your practice and do you test for these things? So you don't have to search for my prior post, here is the information:

Megan's mumps titer at age 12 (done in 2005) was 3.42 where 1.09 shows immunity. Therefore, 11 years after her vaccination with MMR, she had 3x the amount of mumps antigen.

Funny, in looking for pediatricians around the US, I find a Theresa Keys in San Francisco and a Steven Keys in Kentucky. I find Jay's Lock and Key in Newport Beach. But I don't see Dr. Jay Keys anywhere...maybe he's real low profile...

Seem to have gotten off topic with the old doc here. Wonder if that was the point? How about that this article is awesome and damning. Has it been sent to Carolyn Maloney or anyone else on the appropriate committees?

Dr "Jay Keys", or whatever your real name is

Before you accuse Kim of an "adversarial response" go back and read the pompous tone of your orginal post.

I just want to say I wish that you had as much concern for children who have had there lives destroyed iatrogenically as you do for physicians who are "demonized" by some words that are uncomfortable for you to hear.

Dr. JK,
It's always heartening when a pediatrician wants to discuss this issue rationally, and I'm sure we all look forward to the many large studies that you plan to cite exonerating vaccines. But if you were planning to bring up the CDC's Verstraeten study, Ip et al, the Danish study, or that debunked California study, you will be roundly mocked and then set straight, possibly in ALL CAPS. It's like Kevin Costner said to Tim Robbins in "Bull Durham". "Don't try to throw that cheese by me, meat." Just a word to the wise, no disrespect.

"what if he has a HEART MURMUR?" Is that a joke? DR JK - your panic that an 18-month old child who has never seen a pediatrician could possibly be alive and well is evident based on that old 60s fear of the dreaded, but nearly always benign childhood condition known as a HEART MURMUR. You speak as if a parent would have no idea if their own child were developing normally, growing normally...you think you need an MD to recognize these things? Most of us here bring our children to MDs after something has gone vitally wrong, only to be told its all in our heads. To be told that the elevated measles, mumps and rubella titers in our child's body has nothing to do with the vaccine they received 5 years ago right before autism developed, and other mind blowingly ignorant statements full of denial.....what if the kid has a heart murmur? I've heard it all now.

Wow, maybe Chrissie's post ought to be run as a standalone piece. And then handed out to every pediatrician.

And maybe we could print Twyla's post on the back of it because it was pretty good too.

I think those two summed it up pretty well for our docs.

Dr Keys,
Reading your comments regarding the level of hostility directed at pediatricians by the parents commenting on this site set me to thinking. I too feel this hostility. I would like to explain why.
Say you have a baby and he is perfect. He is healthy and happy and eats well and sleeps through the night. He hits all his milestones early or on time. You take him on vacation when he is 8 months old and in no time everyone in the hotel knows him because he is so friendly. They all comment on his beautiful eyes and his amazing smile. You couldn't be any happier.
At age 16 months, your baby is given 5 live virus vaccines in one day. Now he stops eating everything he ate before that day. Soon you notice that he hasn't said a new word in a month. The next month you notice he hasn't said any of his old words for a while. He gets mysterious fevers and vomits in his bed almost every night. He hasn't had a solid bowel movement in months. Your pediatrician tells you that he's fine, this is just a string of intestinal viruses that are going around. He's a boy, they develop later, he'll start talking eventually. More months go by and now your beautiful baby is 2 years old. He can't sleep more that 3 hours in a row, he can't understand a word you are saying and when you tell him he can't do or have something he turns into a wild animal. You (and the rest of your family) are covered in bite marks and bruises. There are special ed teachers and speech therapists coming to your house every day now to try and teach your son things he should already know how to do. He can't learn at all.
You take him to an esteemed pediatric neurologist who takes all of 15 minutes to evaluate your son and diagnose him with autism. In addition to pulling the rug out from under you, he tells you to "face the facts". Your son will never get better. He will probably get much worse. You are told to take him to a local autism treatment center and he prepares you for the eventuality of medicating your child into robotic compliance.
You ask if there is need for further testing. MRI? Bloodwork? Other diagnoses that need to be ruled out? All these questions are answered with a no. At this point you begin to feel hostile. That's it? What about when he was perfect? Sometimes your baby just goes away and that's all there is to it? I'm supposed to just take your word for it? Do these rules apply to his baby as well? Hostility now growing exponentially.
You bring your son back to your pediatrician, who you have trusted since the birth of your first child 13 years ago. He has absolutely nothing to offer. He advises you to love your son for who he is. Apparently you don't already do that. You tell him that you do love your son for who he is, but you also love him for who he was before he got sick. You cannot forget that child, even though he is farther gone every day. He tells you that there was no change. There must be signs we all missed. Your son was never healthy and typical, because he has autism. You were just unable to recognize it right away. It's all autism's fault. It is an insidious disorder that lulls parents into a false sense of comfort before tearing their world apart. He is very sorry for you, but that is all he has. You are shocked at the level of anger you feel.
Then Jenny McCarthy goes on Oprah Winfrey and talks about vaccines and alternative treatments. You read her book and see yourself in it. You put your child on the GF/CF diet out of sheer desperation and against your pediatricians advice, because simply nothing else is working. Within 48 hours, your child is sleeping through the night. Within a month he can say simple sentences. It is miraculous! With every step on the DAN! protocol your son makes gains. His evaluations show 18 months worth of cognitive growth in the first 5 months of treatment. You are a believer because you have lived through his regression and his recovery. But very few other people believe you. You get eye rolls, ridiculous statements about better diagnosis methods, and study after study quoted to you showing you there is no link between autism and vaccines. Because you are so angry, you read everything you can get your hands on and you realize that the link has not been disproved. It has simply not been done, but your pediatrician clings to his AAP promises like it is a lifeline. He treats you like a pariah, he may try to boot you from his practice, and you feel like he will vaccinate your child against your wishes if you turn your back for a moment. The trust is gone. You will forever hold him responsible for your child's condition, even though you cannot hold him responsible legally.
Your hostility reaches epic proportions as you slowly spend every cent you have in the course of treatment. Your health insurer will not cover chelation because your child has a blood lead level of only 1.3, but when you do it anyway, he excretes 200 mcg of lead in the first 3 months. At that point he starts dumping higher levels than ever and you realize that the people who injured your child are getting away scot-free, while you (and your fellow taxpayers) are paying for treatment and education.
Dr. Keys, I hope you can see where I'm going with this. Yes we are hostile to the mainstream medical community. You would be too if you has these experiences. Keep your New York Times and Journal of Pediatrics. They have nothing to say that I can trust, they have nothing to offer for my son's future. I'll stick with my DAN! doctor and my fellow warrior parents. We can all be angry together, but we'll still be recovering our kids.

Dr. JK -
One of the labels that we often receive is "anti-vacccine" -- for example in the recent NYT article. Our concerns are dismissed because the issue is twisted into the question of whether we should do away with all vaccines and go back in time to a period when diseases such as small pox and polio were common.

I understand and believe in the value of vaccines. I do not recommend doing away with all vaccines. But we have seen many problems with the current weighing of risks and benefits, safety monitoring, study of adverse events, and study of longterm effects of the current schedule.

Vaccines are developed by the same pharma companies who have recently had many problems such as, for example, recall of a drug after it was found that the company had suppressed studies showing serious side effects.

Pharma companies have a lot of financial influence on government agencies, the media, and groups such as the AAP.

There is an inherent conflict of interest in the CDC monitoring vaccine safety but also being responsible for promoting vaccines -- hence very reluctant to admit to any mistakes.

Some examples of vaccine concerns:

- giving the Hepatitis B vaccine to all newborns on first day of life, when most are not even at risk for this disease, and the baby's kidney and liver are not even fully functioning yet. Where is the risk/benefit analysis here?

- rotavirus vaccine -- in the U.S. problems with rotavirus are very rare. Reported side effects of the vaccine include intussusception -- very serious.

- thimerosal -- never tested for safety. Mercury is one of the most toxic substances on earth. Was initially even included in Hep B vaccine at birth!

- multiple viruses -- we do not understand the interation of multiple viruses injected at once.

- aluminum -- safe levels not established. See Dr. Rober Sears' article www.mothering.com/articles/growing_child/vaccines/aluminum-new-thimerosal.html

- longterm effects of vaccine schedule. Children these days have increased rates of many immune-system related disorders. See www.washingtonpost.com/wp-dyn/content/article/2008/03/03/AR2008030303200_pf.html Uh -- big mystery -- what could be impacting our kids' immune systems? How about giving two dozen vaccines by the age of 2, which is unprecedented in human history? Do we really know the impact of this? Usually drugs continue to be studied for long-term effects after release. But our government refuses to do a comparison of health issues in vaccinated vs. unvaccinated kids.

- Better understanding of who is at risk for vaccine reactions. Adverse reactions should be studied. And, some of the serious reactions suffered by toddlers come after prior less serious (but escalating) reactions were ignored.

Most of us truly are not anti-vaccine. But we have serious, valid, sensible concerns about the current program. Good things can have unintended consequences.

And as with drugs, there is a risk of overdose.

Dr. Jay,

First I will say that a little bit of paranoia and distrust is healthy. Disagree??? Think of yourself in the wilderness fighting for your life... that is what we have been doing for years for the health and recovery of our children.

You make reference to the diseases that are still around. Yes, doc, they are. At 14 I had the measles. I was vaccinated. My vaccine record is the picture for a posting on AoA that ran several months ago. I had a pretty bad case too, but I am still here. Hmmm... and three of my four children (my youngest wasn't even conceived) had whooping cough in early 2005. Confirmed by the county. Guess what - they all had been vaccinated. Can you please explain to me why my younger son who was vaccinated and actually had whooping cough shows no immunity to whooping cough???

The medical negligence thrust upon my children far beyond the scope of vaccines has led to the firing of many a peditrician over the years. So don't try to tell me that we all have the same goal of the health and well being of our kids. Truly the only ones who have had the health and well being at the front and center have been my husband - their father - and myself.

And last I'll leave you with this little goodie... My youngest, who is now 2 1/2 has had one well baby visit. That visit was with my midwife when she was six weeks old. She has had no vaccines, and ironically, she is the healthiest of all my kids. No chronic ear infections. No chronic diarrhea. No yeast issues. Nothing. Although I'm sure you'll have some "medical" something to explain her health away...

Parents are the ones who have the health of their children at heart. Doctors should be listening. I know you think you may know something, but until you've lived autism day in day out, you don't know a thing. You should be listening to us!

Angela Warner
Mom to four children - two with vaccine induced autism

Dr. JK -
You say, "The friend for whom I was reviewing this article is absolutely mortified to take her child to see her pediatrician because of the way some of these websites are written. In 18 months, he has seen his Pediatrician ONCE. What if he had a heart murmur?"

I can't understand why anything written on this web site would cause a parent to not want to see her pediatrician, unless she fears a conflict over which vaccines she wishes her baby/child to receive. I have not heard anyone advising against seeing a pediatrician. If the mom has vaccine concerns, the pediatrician should be open to discussing them. If the pediatrician chastises the mother for those concerns and insists on a certain vaccine schedule thus alienating the mother, that is not the fault of this or any web site.

It's amazing that in this democracy we live in where so many issues are openly discussed, there has been so much censorship of vaccine safety concerns, as if those concerns should not even see the light of day because then fewer people will vaccinate and infectious diseases will return.

As Dr. Bernadine Healy said in an interview on CBS News:

Healy goes on to say public health officials have intentionally avoided researching whether subsets of children are “susceptible” to vaccine side effects - afraid the answer will scare the public.

"You're saying that public health officials have turned their back on a viable area of research largely because they're afraid of what might be found?" Attkisson asked.

Healy said: "There is a completely expressed concern that they don't want to pursue a hypothesis because that hypothesis could be damaging to the public health community at large by scaring people. "First of all," Healy said, "I think the public’s smarter than that. The public values vaccines. But more importantly, I don’t think you should ever turn your back on any scientific hypothesis because you’re afraid of what it might show."
www.cbsnews.com/stories/2008/05/12/cbsnews_investigates/main4086809.shtml

The cat is out of the bag. These problems need to be discussed, and better yet researched and addressed.

See this interesting article:
http://cjrarchives.org/issues/2005/6/schulman.asp

Jay,
Factual accuracy and objectivity at The New York Times? Judith Miller and Iraq? McNeil and Harris on autism? The sleazy allegations of an affair between John McCain and a lobbyist? I am a longtime and loyal NYT reader but I must say that the direction the paper has taken in recent years disturbs me.

As for Dan, you are clearly an autism newbie if you haven't heard of Dan Olmsted. He has covered autism issues for several years, starting at UPI and then continuing the work here. Dan has a long and distinguished journalism career and was part of the team that launched USA Today.

And I can personally guarantee that all of the facts in the MMR article were checked rigorously.

Sometimes, in the new world of commercial journalism, it takes a blog like ours to cover the real story.

From Dr. Jay K -

"To everyone else-- There is some skewed writing out there on the Internet, some even here on this website, which ultimately serves to demonize physicians and the public health community at large, and instill paranoia and distrust."

Dr. the paranoia and distrust comes from the fact that:

1. there have been no studies to date that look to the safety of a humongous bloated vaccine schedule on infants - vaccinating for infectious diseases whilst losing out to chronic disease does not make for a healthier nation of kids.

2. the CDC has not researched the families of kids on the autism spectrum to find out exactly what in their medical histories is triggering the epidemic. The CDC told Sharyl Atkisson of CBS news "we don't do that." WTF do you do then? Take a look at this article AoA ran recently that details the disorders running in ASD families.

http://www.ageofautism.com/2008/12/new-clues-to-who-is-susceptible-to-autism-via-vaccine-injury.html

Is it not the duty of the CDC and the AAP to identify the susceptible so that we can prevent more ASD cases?

3. nobody so far has deigned to run a vaccinated vs unvaccinated kids study. Generation Rescue did an informal poll nobody has followed up on.

Do you now understand why parents of injured kids don't trust the public health system? Because, simply speaking, it is inept. And its dangerous to your health. You have a better chance of staying healthy by keeping away from your pediatrician. Sad but true.

Dr. JK -
You express an interest in talking about the facts, and that is wonderful. There tends to be a lot of emotion and even vitriole that spills over in blog discussions, which is unfortunate. I hope that if you encounter vitriole you can continue the dialogue. There will surely be some posters who will debate science and convey personal experiences without name-calling.

To give you some perspective, many parents have experienced variations on this story:

- Beautiful healthy baby is developing normally, playing, socializing, talking, expressing affection, learning, meeting milestones on time.

- Toddler goes to 12-month or 15-month "well baby" visit and receives several vaccines, such as MMR plus Varicela plus flu shot and maybe even DPT. The CDC's schedule recommends giving multiple vaccines at the same time, and Dr. Paul Offit says that theoretically 10,000 vaccines are o.k. for a baby. http://pediatrics.aappublications.org/cgi/content/full/109/1/124

- Soon thereafter, toddler has vaccine reaction including high fever, inconsolable crying, arching back, eczema, rash, febrile seizure, inflammation at the injection site.

- Vaccine reaction is followed by loss of language and eye contact, development of repetitive behaviors and obsessions, and often health conditions such as IBD.

- Parent goes to doctors for help and is told that autism is genetic.

- For example, I know parents who have gone to gastroenterologists only to be told that the GI issues are psychological, related to the autism which is genetic, and no treatment is offered. There are a handful of gastroenterologists who treat the GI problems of children with autism -- one of whom is Andrew Wakefield, who is being unjustly prosecuted.

Read Katie Wright's introduction to Dr. Bryan Jepson's book "Changing the Course of Autism..." (Then read the rest of the book.)

The above is roughly Hannah Poling's story, which was conceded by the government but the "spin" is that her story is unique. It is not.

Sometimes vaccine injury is not so obvious, but sometimes it is. Yet government agencies and medical organizations continue to insist that all of these thousands of stories are simply coincidental and to be ignores as anecdotal. As Dr. Bernardine Healy said, these injured children should be studied.

Hence, the anger. Yet there are still many people engaging in constructive dialogue.

For the pediatricians:
http://insidevaccines.com/wordpress has a whole slew of articles, all carefully referenced, analyzing problems with the vaccine program. Our series on serotype replacement and the link between Prevnar and staph has been widely read and praised. So, if any of you are really interested in understanding why there are plenty of parents with questions about the safety of vaccines, this site is a good place to begin. Oh, there is a good article on chickenpox and shingles, and a series on the before and after vaccines disease statistics and how they are fudged.

To the moderators, sorry to be boosting our own stuff, but it is really just what the doctor ordered, so I couldn't resist temptation!

Going to a mainstream American pediatrician with a child with autism is like asking your favorite Orthodox Rabbi to prepare your Easter Ham dinner.... You may quote me.

I asked one of the peds in our large practice if she'd write up forms for basic labs for metabolic testing. Quest and SKL can do these tests under insurance, so why not get coverage, right? Deer in headlights. "We have a developmental ped on staff who handles the kids with autism." I was asking for basic labs, not heavy metals testing or something that might have upset her.

To her credit, when I later asked for comprehensive stool analysis the word "worms" must have clicked with her and she gave me several test kits.

Kim,
My sentiments exactly. I just switched pediatricians - again. My oldest is recovering (a victim of ProQuad at 12 months and then two doses of Fluzone complete with thimerosal). My 15 month old is already showing indicators of inflammatory bowel disease (but developmentally intact at this point) and after begging and arguing with our doctor for a referral to a Pediatric Gastroenterologist, I just made the decision to "find another doctor." He, of course, isn't alarmed that my baby has dysbiotic bacteria and chronic overgrowth of yeast in his bowels. Coincidentally, however, we were advised not to vaccinate further. No surprise there. So anyway, during my first appointment with a new doctor, I was, of course, asked why my baby is "not up to date" on his vaccinations. After sharing with her that TWO PEDIATRICIANS ADVISED AGAINST VACCINATING FURTHER DUE TO THE INFLAMMATORY BOWELS AND HIS BROTHER'S AUTISM RECOVERY, she looked at me blankly and said "did you say recovery?"
My problem is that I don't understand how those who are supposed to be at the forefront of our children's medical care are so in the dark. Seriously - I have two very ill children. Even I catch the news from time to time. And the truth - THE TRUTH - is that NONE of us started out having Aurora Greenway episodes. I find myself crazy only now, after being honest, professional, charming, helpful, pleading, and begging haven't produced any results. So do I have a proverbial chip on my shoulder? You bet I do. As respects the epidemic that is mowing our children down in droves, the parents on this site and other reputable sites can, will, and DO go head to head as respects getting our children treated and healed - not because we want to, but because we have no choice but to do so. And THAT'S the truth.

Jay K

Someone simply is not listening. According to normal medical practice and ethics if a patient or their adult representative tells you something has happened, you wouldn't turn on them and demand that they prove it. But this is precisely what you are doing. Until you realise this you will be professionally dysfunctional.

Dr. K - My writing style does have a snap to it, I realize. I've always had excellent doctor parent relationships with my pediatricians , including the one in my own family (not so much with the neurologists.) As individuals, they are caring dedicated doctors. They are still unable to coordinate adequate care for my children. They refer out, they rely on the schools, because they/you/AAP still accepts the psych diagnosis for autism. It's a behavioral diagnosis, therefore, not under the medical umbrella. That paradigm has changed. Forget vaccines for a moment. My girls have real medical conditions, including the "rare" mitochondrial dysfunction as proven by tens of thousands of dollars of tests at The Cleveland Clinic by a top doctor named Marvin Natowicz, whom I happen to adore. After years of seizures, decline, regression, lack of progress in three children, it was MARVIN who showed true scientific curiousity about my family. My middle child needed an EEG here in CT. It was ordered from her ped office. We had the EEG. NO ONE gave me the results. Ever. I had to call and call and ask. I finally saw the head of the practice when I thought my youngest had a concussion - I told him I was wondering about our EEG results. His answers? "You didn't get an EEG through my office! I'm a peditrician, I've never ordered an EEG in my life!" (His colleague had.)

If my car mechanic sent me home with a car that didn't work every time I went to him I'd be upset. Why should I not be upset that the doctors we must see for school forms and everything else, know precious little about an epidemic that so grossly affects our/my children?

It's like politics. Everyone "hates" Washington, but individual politicians keep getting re-elected. My disdain is for the AAP - and for docs who seem unwilling or uninterested in truly helping our kids.

Thanks, Dr.

KIM

I will first respond individually to each of those who responded to my earlier post.

To Josh Day: I posted my concern about moderated comments because I did peruse a handful of the articles on this website and felt like I was seeing only one side of the spectrum. I obviously do care.. that IS why I went into Pediatrics in the first place! I'm glad that open discussion on the topic CAN be had. There shouldn't be a divide-- there shouldn't be "this side" and "that side". It shouldn't be "me" vs. "you". Don't we all have the same common goal of the health and well being of our kids? Thank you for the welcome to this forum.

To Kim Stagliano: It is your adversarial response that puts Pediatricians like me instantly in the defensive stance, so I ask, Why are you and I automatically enemies? Your disdain of the medical community can be seen from outer space. I truly am sorry to hear about your daughters' diagnoses of autism. I also share in your frustration and difficulty acquiring insurance coverage. But I'm not the insurance company. Trust me, if there's anything we can come together on, it's the inadequacies of our insurance coverage system!!
I am a licensed physician with nearly 10 years of post-graduate medical training, so I have to take offense that you suggest that I'm nothing but a brainwashed tool of the vaccine industry without higher brain function and the ability to form my own opinions on the topic of vaccines. Pediatrics is a field in which the average practitioner takes a hefty pay cut to pursue their passion of tending to the medical needs of children, so your sarcastic undertones in referring to me as a "healer" are myopic, and distract from the true goal here.

To Mark Blaxill and Jen: Thanks for the clarification. Knowing someones credentials helps lend credence to their particular viewpoint, and I am still interested in knowing about this author's background in the subject matter. No, the New York Times doesn't list item-by-item citations, but it is accepted that its stories are vetted for factual accuracy (there have been a few high-profile vetting mistakes the NYT have made in the past years). Simply speaking, the Age of Autism website is not the New York Times (or Pediatrics journal, NEJM, Journal of Infectious Diseases, etc. for that matter), so I have to still poke around and question when there isn't much verifiable data provided within a very strongly worded position statement on such a hot button topic. Who independently checks the factuality and basis of articles on blogs like this? I mean, EVERYONE should question every single thing they read because there is bias in EVERYTHING! (even in my writing here) Jen, you're right that double-blinded, randomized control trials are the gold standard for evidence-based medicine. With that said, they are notoriously difficult to organize while trying to filter any sources of bias out of the data. I will need to read this article out of Manitoba, thank you for the reference. I will also brush up on a few of the larger studies that have searched for any potential link between MMR/thimerosal and autism and share if anyone is interested ... there are some LARGE well designed studies on the topic.

To everyone else-- There is some skewed writing out there on the Internet, some even here on this website, which ultimately serves to demonize physicians and the public health community at large, and instill paranoia and distrust. The friend for whom I was reviewing this article is absolutely mortified to take her child to see her pediatrician because of the way some of these websites are written. In 18 months, he has seen his Pediatrician ONCE. What if he had a heart murmur? Wasn't growing correctly? What if he wasn't reaching developmental milestones? Can anyone reading this honestly say that's okay?
I'm certainly not a vaccine expert, I'm just a pediatrician here to learn more about vaccine concerns and hopefully, if there is a receptive environment, to share with you some of the things I know and understand about immunizations. In this whole argument though, while we talk about cover-ups, and brainwashing, and understudied vaccine ingredients, we completely lose sight of the fact that the diseases vaccines have been used to prevent for >70 years STILL exist. We forget about Strep pneumo and H. influenzae type B-- bacteria that cause deadly forms of meningitis in infants. What about polio, or measles, or whooping cough? All debilitating and deadly ailments that still exist in the world and oh yes, here in the United States.

Let's talk about the facts we know and get past the distrust. Maybe next time, I can actually write something about vaccines.
For the kids,
Jay

Dr. Keys,

My grandson received the Proquad. Two days after being injected with this vaccine, he was spinning in circles with one arm and hand extended outward like a compass hand.

We have this change documented. He was caught on video two days after this vaccine was given. His mother was in the background, questioning him about his strange new dance. Dancing normal before proquad, life forever changed after.

Your immediate arrogance in addressing Mr. Olmsted's article is typical of many in your profession. You briefly address an issue you know little about and then you threaten the authors' writing from your towers of authority.

Dr. Keys, children are suffering and your profession is at the forefront for this crisis. Your sworn oath to protect the health of this country is in serious jeopardy.

You might want to read the body of Mr. Olmsteds' work before you venture back. And oh, you might have to dust off some old medical school books so you can keep up.

Dr. Keys -
There is contact info (see "Contact Us" near bottom of lower left corner). There are often dissenting opinions among the comments. There are a variety of articles, often with many sources cited.

Why not focus more on reading and learning instead of on our "motivations and agenda" which are no big mystery. Our motivation is to help our children, and our agenda is to make our country's vaccine program safer and to learn more about causes of and treatments for autism.

People who have concerns about vaccine problems are often accused of having an anti-vaccine agenda. What ulterior motive could we have? What benefit is there to us when we point out, for example, that studies have found inflammation in the autopsied brains of people with autism, and that there is a long history of vaccines causing encephalitis?

Read Dr. Bernardine Healy's articles, and Dr. Bryan Jepson's book "Changing the Course of Autism". Our vaccine program is seriously out of control. Too much too soon, with unintended consequences.

I've been stewing on this all day, wondering if, as it appears, these changes mean that someone at FDA or CDC was complicit in getting Merck to boost the levels in the first place, and then realized the problems it caused and ordered the levels lowered again, without ever notifying the public. If so, there must be some sort of study data, somewhere, that back the reasons for the boost, and the reasons for returning to a level (12,500) that seems at first glance to be random. I am praying that you get the documents on this, that they are not in a pile of shreds under Julie Gerberding's desk.

You know, some days I wonder if we are like dogs with a bone, with the MMR issue... but articles like this reaffirm that WE are not the ones in denial when it comes to vaccines and autism. Thank you for all of your tireless work!

Dr. Keys, like Josh said, there are articles on this site where I see comments from others, like you, who think vaccines are all perfecty safe.
Alot of the people that come to this site are smart people-some are doctors, some are lawyers, some are business people, some are nurses, some are smart parents. They are not afraid to debate the issue using science. In fact, recently, a doctor (who feels his child is vaccine-damaged)mentioned that there is not one randomized double blind study comparing vaccinated VS un-vaccinated children for neurological problems. And this is supposedly the gold standard for evidence-based medicine.
Have you heard about the study out of Manitoba (U. of Manitoba, Dr. Allan Becker) It showed a much less incidence of development of asthma (half) if the dpt shot was delayed for even one month. We just think there are a lot of unanswered questions....

Dear Jay,
I know Dan Olmsted is away today, but I think I can respond to some of your comments, having some knowledge of Dan's investigations.
1. This is a blog and Dan is a journalist. This report is not a scientific paper. Do you see citations in The New York Times? No, but even though you may occasionally see them here (I use citations frequently in my own essays), news articles do not typically have a references section and I don't see why you would expect them here.
2. The individual sources that Dan cites are identified,in keeping with common journalistic practice, only to the degree that they were comfortable being identified and they are all accurate.
3. The documentary information on the mumps dosing is available in the MMR pacakge inserts. You can consult past copies of these documents if you feel a need to verify the numbers yourself, but this is the result of a fair amount of investigation. You can, however, find the FDA approval notice of the 2007 dosage change online here at:
http://www.fda.gov/cber/appr2007/2007lsup.htm
4. As for your comment on dissenting views, this is a moderated blog, so we do exercise our discretion on comment approval. Practically speaking, we exclude rude dissenters and/or those with dissenting views that have clear financial conflicts (i.e. they work for a vaccine manufacturer) and insist on posting anonymously. That has the effect, an intended one, of deterring disruptive commenters and attracting a loyal readership. That said, civil commentary from people who aren't afraid to say who they are is welcome.

I hope that's helpful.

I got no message of care from pediatrician Keys. He used the same approach the ND's use, "I dare you to publish my comment!" with a judgement following.

Dr. Keys, my girls are sick. Your colleagues can not even perform a hearing or vision check on them. The best they do is write a referral to "someone else."

My family does not qualify for insurance (my husband is out of work and we have been turned down by 6 insurers because of the autism diagnosis.)

Your colleagues have patted me on the head, cluck clucked at our misfortune, marveled at my fortitude and the mere fact that I haven't run onto the highway naked and screaming and praying for a quick hit by a Hummer after managing three autistic children for so many years.

You come to us with nothing, Dr. Nothing but the information you are fed by your organization. My friend's daughter is in medical school. Her training on vaccination began and ended with how to insert the needle and push the plunger. However, having a little brother with autism has opened her eyes.

You're welcome to comment here anytime. It's always good to know what our "healers" think.

Kim Stagliano
I run this joint....

Pediatrician Keys,

Comments such are yours are frequently posted. Examine some of the other articles.

Always nice to hear from another pediatrician who really cares and who isn't even slightly condescending. It's almost refreshing.

I am a Pediatrician who was asked to review this article for a friend who has vaccine concerns. You list no references in your article here, however frequently reference "a Merck scientist" or "a study at a top University" or "a group of parents you talked to". You state much of your 'findings' as fact, but offer no basis for those facts, and no opportunity for a third party to verify them.

I find it curious that the authors and editors on this website offer no direct contact information, nor are there listed credentials that support the unwritten claim of their authority on the subject of autism.

I also find it curious that there are no dissenting opinions in your "comments" section, which speaks to my suspicions that you do more than just moderate comments left here.

I challenge you to leave this comment in place. If not, then it speaks volumes to this website's motivations and agenda on the topic.

Jay

The more I learn about viruses, vaccines, and the immune system, the angrier I get.

So much really remains a mystery, and I wish a doctor could tell me precisely what happened to my little girl.

I wish someone could explain why my daughter's active varicella levels have quadrupled in a 2 yr period. I wish someone could explain why she gets lesions, that look like varicella, and coincide with regression.

I really want to storm the dept of health and human services, spell it out for them, and get it over with.

Thanks for the article Dan, no matter how much it makes my blood boil, I am so thankful you are reporting the truth.

Wow John, those MMR files were interesting reading. Thanks. I keep hoping that the media will really and truly pick up on the harm that is being done but all I feel we can do now is hope. A change in U.S. gov't, Gerberding leaving the CDC, news of mumps component quadrupling in 1990 and now this report out of UK detailing particular MMR concerns. SURELY the planets are lining up for some truth?
My hat is off to all you people who work so tirelessly to expose the truth.

Re: Julie's response

"The good old days" when clinicians could dismiss any talk of an environmentally induced cause of ASD are over."

Not over yet. Take a look at this comment from the January 2009 Pediatric Annals journal. In fact almost the whole issue is devoted to Autism.

http://www.pediatricannalsonline.com

http://www.pediatricannalsonline.com/showPdf.asp?rID=35971

January 2009 - Autism Aspects (pdf) - journal article (Pediatric Annals) - "What is clear is that this has nothing at all to do with our highly successful immunization programs, which have saved innumerable lives and countless episodes of morbidity."

Then at the other end of the "spectrum" we "almost" have a sort of confession.

I searched the full text of the article only to find two vaccine related references at the end, so it is still very shameful to implicate the greatest medical find in all of humanity.

Information from yesterday's vaccinationnews.com

http://www.newswise.com/articles/view/548056/
January 13, 2009 - Early Immune System Exposures Linked to Chronic Disease - Scientists and regulators have a golden opportunity to reduce the health toll from a range of diseases by focusing more attention on identification of environmental factors that can damage the prenatal immune system as well as that of infants and children, according to an article scheduled for the January 19 issue of ACS' Chemical Research in Toxicology, a monthly journal. - American Chemical Society (ACS) via Newswise - "In the study, Rodney R. Dietert points out that a scientific field known as developmental immunotoxicology (DIT) focuses on the effects of exposure to biological materials, drugs, medical devices, chemicals, and other environmental factors on the developing immune system in fetuses, infants and children. Research so far suggests links between those factors and an increased risk of asthma, autism, diabetes, leukemia, and other important diseases."

http://pubs.acs.org/stoken/presspac/presspac/full/10.1021/tx800198m?
December 15, 2008 - Developmental Immunotoxicology: Focus on Health Risks (full text) - journal article (Chemical Research in Toxicology) - "Additionally, initial tissue damage may result in autoantibody production and further insult to the organ or physiological system. Several disorders or neurocognitive deficits connected to the brain fall within this category. For example, autism and autism spectrum disorders are candidates for DIT influence because they feature both early life environmental risk factors and associated immune dysfunction."..."28. MacArthur, A. M., McBride, M. L., Spinelli, J. L., Tamaro, S., Gallagher, R., and Theriault, G. P. 2008 Risk of childhood leukemia associated with vaccination, infection and medication use in childhood Am. J. Epidemiol. 167 598 606 [CrossRef], [PubMed]"

I feel physically ill after reading these comments. What is going on??? Sorry, government agencies and pharma companies - you can't deny this. It's happening. Informed (thanks AOA!), educated, angry parents are going to hold you responsible for your actions. "The good old days" when clinicians could dismiss any talk of an environmentally induced cause of ASD are over. Responsible service providers are going to need to come up to speed on current findings and think twice (or three or four times) before we think about saying that there is no connection between autism and vaccines. As if we weren't all stressed enough. Now we have to take a crash course in bio-chemistry. But for us the stakes have nothing to do with GPA and everything to do with our children's lives.

Dear Dan,

Thank you for your excellent article. How can vaccine manufacturers be allowed to randomly change the potency in a vaccine without a clinical trail. Madness and insanity that damaged our children.

My son received the MMR, had "real chickenpox" and then another MMR right after. I asked the nurse about vaccinating so soon after the chickenpox. Meanwhile the sun was streaming in the window and hitting the vials of vaccine sitting on the countertop, no refridgeration. The rest is history of hand flapping, no eye contact, "swollen lymphoid aggregates" diagnoses from Dr. Buie at Mass General Hospital.

Oh, by the way he has Down syndrome. Down syndrome is a population group that is documented to have low immune system functioning and functional nutriutent deficiencies of zinc, selenium, A, E and others and disruption of the SAMe cycle. The diagnosis of autism in Down syndrome is 1 out of 10.

Once again the DS organizations and medical and scientific advisors are asleep at the wheel.

Essential reading

In 5 weeks time the British Government will be forced to open its secret files concerning the introduction of MMR in 1988

http://childhealthsafety.wordpress.com/2009/01/13/secret-british-mmr-vaccine-files-forced-open-by-legal-action/

Thank you Mr. Olmsted for going on with this investigation.

It's too bad they made this change about the same time they recommended infants receive Hep B and HIB. Unraveling where all this neurological and immune damage is coming from might not take so much "trial and error," but now apparently Merck thinks it has measles, mumps, and rubella prevention maximized for the good of all.

Didn't the AAP or CDC or whoever follows up on these things once tell pediatricians to stop giving the MMR in combination with Varicella because it was causing neurologic damage? Did they later decide it was damage set up by earlier thimerosal exposure instead, or did they just say "oh well" when Proquad was licensed?

I'm not an expert on the history of vaccination, but it doesn't seem like any combination vaccine has had a good safety record, and it seems like the younger the exposure the more problems, and yet that's where they adamantly (tell us to) go.

Often, what it says on the bottle isn't worth the print on the label.

Years ago, there was a reactive batch of DPT vaccine in New Zealand, which was sent to Australia for testing.

They tested a whole lot of vials from the same batch, and found a 20-fold deviation from the label, from low to very high amounts.

So tell me, how does MSD even guarantee that there are exactly "that" amount in any one bottle. Do they have an automatic virus counter, which ensures that the virus comes out nice and evenly, from that big vat?

My child was typical, got the MMR, and crashed. Within three weeks my child would not let me hold him and was running around in circles.

And no one cares.

As much as I appreciate this information Dan, I wish I knew it would change anything.

And I thought my frustration level could not get any higher.

Thank you Dan for this excellent article. My son is now 12-1/2 years old and received his MMR shot at the age of 15 months old. Over the past 8 years, we have run titers testing on 6 different occasions for our son, and he has always had very elevated titers for measles, mumps and rubella.

We are currently treating his "autism" via sequential homeopathy. This past August, we were clearing, among other things, his MMR vaccine at the CM potency. My son broke out in a full body presentation of the measles rash, covering him from head to toe, along with other typical symptoms of the measles virus (red, watery eyes, fever, lethargy, light sensitivity, cough, runny nose). And, not only measles, but at the same time, he also broke out in mumps on the right side.

No one will ever tell me that these vaccine viruses that were injected into my son all of those years ago haven't been persisting and wreaking havoc ever since.

Hi Dan,

I read this earlier and have been reading everyone comments -- how criminal is Merck and how more criminal and crazy were these agencies (FDA/CDC/AAP) that allowed this to happen?

I waited to comment as I wanted to get my daughter's titers as I knew that the mumps stood out as being "irregular" along with some others.

Megan was born in 1993. At that time ironically, Megan's dad invested her christening and birthday gift money in -- I can hardly think about it...but Merck stock. That means not only did she receive this quadrupled mumps antigen but we were stockholders at the same time! I don't recall ever getting any information about a "change in their MMR product". I am truly sickened thinking about this.

Megan's mumps titer at age 12 (done in 2005) was 3.42 where 1.09 shows immunity. Therefore, 11 years after her vaccination with MMR, she had 3x the amount of mumps antigen. She did not have the 2nd dose of MMR as I began to suspect something was wrong medically with her, though none of her doctors could (would?) figure it out. This may be a part of why her Absolute CD8+ cells are 1036 when the reference range is 240-890? Her immune system is forever mounting an attack. This on top of dozens of other "irregular" findings on labs -- How can we help these kids? How can autism be included in DSM-V when there are such significant biological markers haunting our children? Thank you for exposing this hurtful truth and may Merck be held responsible so this madness will be stopped

Very disturbing, very important article. Thank you so much for your dedication to the truth and to our children. You are saving lives.

Dan, do you happen to know when in 1990 the mumps component of the MMR was raised? This would be helpful information to those of us whose children received MMRs that year. (Would it be traceable by the lot number?)

Excellent post & info, Dan. The subject of interaction between multi components, and when such vaccines are given with other shots, is one that has been horribly overlooked, in the 'professional' assumption about vaccines that 'their benefits far outweigh their risks', without a legitimate, in-depth scrutiny OF those risks. Interactions potentizing the ingredients as a possible cause of inflammatory bowel disease/disorder should have been a no-brainer to investigate. What a sad chapter in the history of medicine this hubristic & mercenary stonewalling is playing out to be. (And perhaps worse in motivating factors, to take Kathy's point.)

And incidentally, speaking of bowel disorders, & for future reference: it's GI tract, not track.

Keep up the important work, Dan. Piece by piece.....

Dan,

What fantastic reporting. Thank you.

I haven't been here much lately, but I believe your efforts are worth more than you'll ever know.

You aren't just preaching to the choir--there are new members in this "congregation" every day.

Thank you so much.

Mindblowing. All very interesting. Especially as I think of the news last week that Merck was shutting down its PA plant for "upgrades" that will result in an interruption in their HepB supply, and that they also sold off their vaccine testing facility to another firm. Despite the spokesperson denials, it's all pretty fishy coming on the heels of the FDA's warning last April on the same facility, which cited contamination of childhood vaccines as one of the issues. And just as a new administration is about to come in and get a look at all those records....

Seems as though, they think that "improvements" in the amount of viral particles in a vaccine makes them better or more effective. This only confirms that they are experimenting on our children for over decades, and the confirmation of their experiment, is the rise in autism and other autoimmune disorders. So, now we can't truly say "it was the thimersol", but that the very viruses in those vaccine have the ability to mimick our own brain tissue, or sit in our children's gut linings forever. Why all the ear infections in the first year of life? Not only has the mercury downed the immune system response, but the VIRUSES in those vaccines, particularly measles, can cause otis media. I was reading the other day, that MUMPS can cause lifetime thyroiditis, which many of our kids have. This markedly says to me, there is no such thing as greening a vaccine...because if the toxins our out, the viruses are in there to do just as much damage, if not more to our babies. We should have said this in the green vaccine rally, but when I voiced that, it was downplayed. Until we parents get really scientific about how these medical devices are made, and how often they are contaminated/botched up with mycoplasma, "pathogenic bacteria" (mind institute), then, we need to understand that vaccines in any form, in our children particularly, is a no go. I don't believe you can slow the schedule down and have success either...because a predisposed child, is a predisposed child...and that is not even being measured or defined...thereby, it is a russian roullette game. Particularly because pediatiricians are not taking into account a at least 20 point by point contraindication not previously thought of before. I vote, vaccines are a way to control the population by inducing illnesses in the population, IQ loss, and if you think of it, population control, by virtue of generations of children who are not able to take care of themselves or procreate. See the writing on the wall, every autism organization that espouses they are not anti vaccine, is my public enemy number one. The inner vessel must be cleansed.

Thank you Dan for your continued efforts with regards to vaccine safety. I am continually appalled at the lack of attention being given to the autism community as the numbers continue to rise. Please know that you and everyone else in the autism community who has spoken out has helped me make better decisions for my now 18 month old daughter. Your research is helping people like me and hopefully it will help people with children who are already affected. Thank you.

Dan,
This is an amazing piece and such a great example of the lack of transparency in the vaccine industry. If we had known all of this when it was happening... I can't even imagine. We, as "the public", may not be able to calculate how many units of an antigen it takes to jump start our immunity, but we all pretty much mastered the concepts of More and Less quite a while ago. This information could have been life changing.

Interesting timing Dan.

As you know Mercola articles (love 'em or hate 'em) often talk about vaccine safety issues. This week they distributed this piece (related to the RSV vaccine): http://articles.mercola.com/sites/articles/archive/2009/01/06/decades-old-vaccine-mystery-solved-why-did-rsv-vaccine-make-kids-sick.aspx

"The problem, they report this month in the journal Nature Medicine, was that the children's antibodies were not binding strongly enough to the inactivated virus to produce a protective immune response. Instead, the antibodies were dragging the dead virus with them, triggering a massive attack by other arms of the immune system."

To me, the big red flag is not the specifics of the problem with this particular vaccine design, it's the bigger picture - as Jack pointed out - we really just don't know what the hell we're doing. We expect a preventative intervention, instead we get a "massive attack", and it takes 8 years to figure out why. Meanwhile more shots, more combo's, more arrogance.

In the end, the "fix", as suggested by the researchers, would be to move to an attenuated form of the virus, which, as AA pointed out, might just result in a smoldering fire. The massive attack gets stealthy.

Dr Diane Harper referred to mandating the Gardasil vaccine for younger (school age) girls as a "great big public health experiment". But she really summarized the entire program for us, especially when she said that "nobody will listen".


Very interesting, important information.

Someone commenting on another AoA article said that his statistics professor had said that you can use statistics to prove anything -- either side of an arguement -- depending on the statistical methods used. Yet statistical studies are constantly being held up as "proof" that the MMR does not cause autism. And we constantly hear that Dr. Wakefield's work has been discredited. Case histories of real children say otherwise.

Very interesting that "Studies in the UK and Iceland showed that when mumps AND measles epidemics hit these populations in the same year, the risk of inflammatory bowel disease spiked."

Apparently many of the autism/vaccine-link-deniers know full well that vaccines can and do cause autism.

Responsible intelligent journalists, where are you? Pay attention and write about this! Obama administration, are you listening? Our vaccine program needs serious overhaul!!

I just e-mailed CNN and encouraged them to run Dan's story. Maybe some encouragement from us will get it done one one of the big media outlets. They love a whistle blower story...
_________________________________________
I just read an amazing story that deserves national attention on CNN and I think CNN, as a reputable source for news without bias, should run it today:

http://www.ageofautism.com/2009/01/olmsted-on-autism-autism-explosion-followed-big-change-in-mmr-shot.html

I'm with others on this one.....the MMR and the then BRAND NEW chicken pox vacciantion....made my son instantly ill into regressive autism. When I was on The Doctors...the AAP rep made a point of saying vaxwes are "getting safer and safer all the time.." whiich to me is an admittance they aren't always safe when given!

Thank you Dan. This was very informative info.

sincerely,
Julia berle

Great post. I believe there to be a fundamental misunderstanding of attenuated viruses. The notion that it is weakened enough to only produce an immune response, then subsequent memory (antibody) is so utterly foolish and rather arrogant.

Survival of the fittest... the virus simply bounces about the host, and depending on the host never really gets eliminated because the exposure was artificial. The biochemical cascade of events dictated by natural exposure is required for full recovery and elimination of the threat. This trickery is simply allowing the virus an ample body in which to live and thrive and it evolves in its new environment (a delightful ecosystem by the way). Poking its head during times of stress, usually in different clothes. All in the name of herd health management for diseases afflicting entirely different (and more socially and environmentally susceptible) generations of people.

Not to mention, if you look at the policies outlined by the FDA for record retention - it would be rather impossible to prove any certain vaccine caused "damage" if you cannot track down the original vaccine that was administered. Proving causation as it relates to vaccine court is a trojan horse, and they know it.

AA

Nice work Dan! I hope that you are really onto something so that we can get through the age of autism forever.
The secrecy around the formulations and the reasons for the changes is very troubling for me. Vaccines are basically mandated in our society. Public officials say we must get them and tout their benefits, schools and daycares require them...you are frowned upon if you dont get them. Since vaccines are basically mandated in our society, the studies, the reasoning for changes, the formulations and all the documentation around vaccines should be public information. Hiding behind the private corporation veil is wrong when we are basically forcing our society to comply. Add to the fact that vaccine makers are also indemnified by congress so why wouldnt we force openness on this issue?

Let's not forget that children are not only getting the MMR on their 12-18 month visit. My daughter recieved the MMR,IPV,and DTP WHILE on her 5th round of antibiotics and was given tylenol afterwards. Talk about interference...sometimes I'm amazed she's alive.


Our son, Eric was given the MMR vaccine before this change in the MMR vaccine in April 1986. Eric tested positive for myelin basic protein antibodies, elevated measles antibody titers (10 times higher than normal) and gastrointestinal problems. Eric was born normal but after receiving the MMR vaccine he regressed into autism.

Dr. Yazbak did a study on Moms and kids that was never duplicated, unfortunately. The CDC, NIH or Autism Speaks will NEVER do an extensive study on this so more kids will join the ranks of the autism epidemic.

A shame.....but nobody cares except the families affected.

See..........

Autism : Is there a vaccine connection?
Part I-III

http://www.whale.to/vaccine/yazbak.html

http://www.whale.to/vaccine/yazbak2.html\

http://www.whale.to/vaccine/yazbak3.html

Ray Gallup

Just below this essential article under the category 'Information All Parents Should Know', I would place the following -
http://fanaticcook.blogspot.com/

Which post? Like here, take your pick.

Wow Dan, really excellent important piece!

Anyone else find it interesting that sometime last year is when Paul Offit started using the statements "we're using less antigens than we used to"? So the vaccines are safer, he says. I realized that most of the non live virus vaccines started at some point to use more food antigens rather than more of the disease, possibly contributing to the increase in food allergies. But maybe he knew something we didn't about this mumps change as well. It still does not mean that they even know how this new vaccine effects the immune system. Just because they changed them doesn't mean it's safer, it just begs the question "why?" In reality we are all just a bunch of guinea pigs.

LIARS,LIARS pants on fire!! A "shortage of chicken pox vaccine" when really the number of seizures doubled! Merck is full of crap and the more that people hear this information, the more duped they will know they have been. It's sad. You're right, their little "changes" to the schedule does make it more difficult to interpret the epidemiological data but thank God we have people like you to point out these facts and do a little figuring for ourselves!

Maybe other parents have found this when their child was tested...my son, when his titers were checked, showed he had no protection to the mumps after his inital shots. He had enough titers to measles though...he never had another shot after 2 years old for obivious reasons...but I find it curious from this story how they added more of the mumps factor. maybe they found kids weren't protected as much as they thought and added more mumps but then maybe their testing showed it wasn't as simple as adding more and it caused unintented consequences so they lowered the amount...

Dan, thank you for continuing your efforts. I am sickened by the lack of information without your efforts. How would parents ever know these details? How can these changes be justified? Who is the oversight for these individuals making these decisions that affect millions of children? What about the children where the vaccine change is "not well tolerated?"

Those are just the questions I have today. I am sure I will think of more later.

How do these decision makers sleep at night? (I told you there would be more. Came faster than I expected...) I would like the answers.

This is a REALLY interesting piece and I think very important.

And, it also highlights that basically it is as simple as this: We don't know what the hell we're doing. We are nowhere close to understanding the complexities of the human body and immune response. We thought we knew it all, just like all people in all times have. We know very little. Unfortunately, we know enough to now do mass harm in a multitude of unknown way and on a large scale.

Dan, this is an incredible piece. I don't know whether to shout with excitement that you've exposed this information; punch a hole in the wall from the anger bubbling in me right now; or sit in a corner and cry... again. I think I'll do all three (well, maybe I'll punch a pillow instead).

Just goes to show how much information is hidden from parents. So much for informed consent, eh?

Dan, this is a remarkable article. I hope somebody shows it to the people in Great Britain who are deciding Andy Wakefields fate.

Calling it a fundamental misconception is damning to the manufacturers. It contradicts all we've been told about vaccine safety. It should also put the manufacturers on notice. They massively screwed up, and caused an iatrogenic disater.

Please submit this work as an entry -

http://www.pulitzer.org/node/7887
"February 1, 2009 is the deadline for entries in the 2009 Journalism competition. Since the deadline falls on a Sunday this year, entries postmarked up to and including February 2, 2009 will be accepted

Prizes broadened to include online-only publications primarily devoted to original news reporting.

The Pulitzer Prizes in journalism have been expanded to include many text-based newspapers and news organizations that publish only on the Internet.

The Pulitzer Board also has decided to allow entries made up entirely of online content to be submitted in all 14 Pulitzer journalism categories."

I'm sorry, I just have to post again. This makes me so angry that I need to go hit a punching bag!!!

The sons of pitches know it!!! They know that their vaccine cause it and they're do nothing about it because it is guarenteed income!

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