By Teresa Conrick
Duty to warn?-the ethics of disclosing
information about possible risks associated with H1N1 vaccination. Arthur L.
Caplan, PhD, Volume 33, Issue 11
Is Autism an autoimmune
disease? I think for many it evolves into a disease of the immune system
so that may swing that answer to a "yes." I know for my
daughter who has an Autism diagnosis, she has tested positive for autoimmunity
so the topic of immune functioning is important to me and also many other
parents of children with an Autism and/or PANDAS [Pediatric Autoimmune
Neuropsychiatric Disorder Associated with Streptococcus] diagnosis. Many of us
saw both our children's health and behaviors change after vaccination.
Knowing that, it is particularly interesting that in 2010, there was a growing
number of vaccine injuries that produced an autoimmune diagnosis, a frightening
one -- Narcolepsy and Cataplexy.
The vaccine implicated was the H1N1 flu shot. Here is a group of related
research and letters associated with this phenomenon that seems to be related:
Letter to the Editor—Dauvilliers et al, Post-H1N1
Narcolepsy-Cataplexy, SLEEP, Vol. 33, No. 11, 2010
"..The cause of narcolepsy is likely autoimmune based...As for most
autoimmune diseases, twin pairs are most often discordant (65% to 80%), and environmental
triggers are suspected to play a critical role.1 Most notably, two recent
reports have found an association with past streptococcus infections,7,8
leading to the speculation that upper airway infections could be involved in
many cases as a cofactor....."
"....In three major centers of reference for narcolepsy—Montpellier,
France; Montreal, Canada; and Stanford University, United States—we noticed in
the first months of 2010 an unusual increase in abrupt onset
narcolepsy-cataplexy diagnosed within a few months of H1N1 onset....Of the 31
cases, 14 post-vaccination cases were identified....The post streptococcal
marker ASO was positive in 11 cases
"...Of the 14 post-vaccination cases, 11 cases followed adjuvanated
vaccination, while 3 were vaccinated without adjuvant. Delay between
vaccination and cataplexy onset in these cases ranged from 2 days (strong local
response followed by a generalized reaction following vaccination)to 5 months,
although in 9 of the 14 post-vaccination cases the onset occurred 2-8 weeks
following vaccination. As the delay between onset and diagnosis is often
long,1,13 more cases are likely to be identified in the future."
"How could H1N1 vaccination or infection trigger narcolepsy?.....a
specific immune response to H1N1 (and possibly subsequent molecular mimicry) or
generalized stimulation of the immune system.....most cases followed
vaccination with ASO3. This vaccine has been reported
to be associated with side effects suggestive of stronger immune stimulation.14
In the United States, where vaccination did not contain the ASO3 adjuvant, only
2 post-vaccination cases were documented......Nevertheless, these correlative
findings indicate an urgent need for further examination of a possible
"The publication of the
letter from Dauvilliers et al 1 is likely to raise concerns about the safety of
H1N1 vaccines, and in some circles, the safety of vaccines in general.....It
is crucial that public policy and public health planning regarding vaccination
or any other health measures be grounded on firm evidence rather than anecdote,
suspicion, or the hypothesis of an association, as was made very clear from the
tragic consequences of allowing initial reports (subsequently unconfirmed) of risk
associations with MMR vaccine to receive premature and undeserved credibility.7,8
Scientific proof and consensus, not speculation and suspicion, are the
requisite criteria for action when lives hang in the balance.....The public
must know what risks may be associated with novel vaccines, as well as the
risks of electing not to receive vaccines, so that they can make informed
decisions about their use. Truly informed decisions must ultimately involve
more than concern over risk—they require evidence that can meet scientific
standards of proof."
Association between Narcolepsy and H1N1
Exposure, Carole L. Marcus, Sleep. 2011 June 1; 34(6): 687.
"I would caution anyone against making assumptions based on anecdotal
data, especially when the denominator is unknown. A large number of people were
immunized against H1N1 last year, and by chance some of these people
would be likely to develop narcolepsy."
Letter to the Editor—Mignot, SLEEP, Vol. 34, No. 6, 2011
"We thank Dr. Marcus for her insightful comment.1 There is no doubt that
the association reported between H1N1 and narcolepsy could still be chance,
although we find it increasingly unlikely.....Since we first reported this
observation, the association between Pandemrix and narcolepsy has become even
more likely. Of 33 million Europeans vaccinated with Pandemrix, approximately
160 have already developed narcolepsy,....As it takes years before narcolepsy
is diagnosed, many more cases are likely to be present in this sample.
Reviewing current evidence, the WHO is now suspecting a 9-fold increase in
incidence in Finish children and adolescents."
"...Surprisingly, we also found that many post-H1N1 subjects were positive
for ASO2 (as in prior samples4) suggesting a role for recent strep throat infections.4,5.....We
suggest that two factors are needed for the development of narcolepsy
: (1) a
specific immune–mimicry component,
....and (2) nonspecific factors, such
as adjuvants, flu or strep infections, streptococcus superantigens, and other
These nonspecific effects may reactivate dormant T cell cones,
increase blood brain penetration of peripheral immune responses....."
Increased Incidence and Clinical Picture of Childhood Narcolepsy following
the 2009 H1N1 Pandemic Vaccination Campaign in Finland, M Partinen et al
, 2012 , PLoS ONE,
"We observed a 17-fold increase in the annual incidence of narcolepsy in
2010 as compared to previous years in children aged under 17 years of age. A
common feature in the history of our 54 newly diagnosed childhood narcoleptic
patients was that 50 children had received an adjuvanted pandemic influenza
vaccine (Pandemrix) within 8 months before the onset of symptoms. In most
cases, the development of symptoms was fast. We consider it likely that
Pandemrix vaccination contributed to the increased incidence of narcolepsy in
Finland in 2010 in HLA DQB1*0602 positive children. Our observations warrant
further studies on the role of different environmental factors as well as
pathogenetic studies to understand how a vaccination/adjuvant and other
environmental triggers can cause narcolepsy."
Post H1N1 Vaccination narcolepsy-cataplexy with decreased CSF beta-amyloid
,Letters To The Editors - Sleep Medicine 13 (2012) 321-323 Kallweit et al
"We present the first confirmed case of NC [Narcolepsy-Cataplexy]
after vaccination in Germany.....A 17-year-old girl reported the sudden onset
of excessive daytime sleepiness and frequent cataplexies (30/day) about four
weeks after H1N1 flu vaccination on Nov 17th, 2009 with
Pandemrix....beta-amyloid in csf was152 mg/l (normal > 500
mg/l)...anti-Streptococcal antibodies (ASO) were 790 IE/ml (normal <
200 IE/ml: and anti-DNase B (ADB) antibodies were 1010 IU/ml (normal < 200
is not only of relevance in dementia processes
but is also reported to modulate the response to environmental stressors in the
brain, and is supposed to have antimicrobrial properties against different
classes of microorganism, including some strains of streptococci.
recent onset NC, elevated ASO are found....Our case is in line with previous
findings of rapid and severe development of NC symptoms after H1N1
Could Autoimmunity Be Induced by Vaccination?
"Molecular mimicry is based on the structural similarity between
micro-organisms and host antigens, such as either the epitopes recognized by
anti-group A β-haemolytic Streptococcus antibodies cross reacting with heart
tissue host antigens in rheumatic fever  or the produced monoclonal
antibodies to measles and herpes viruses cross reacting with self proteins ...."
"Bystander activation is mainly inferred from studies of experimental
animal models and it is based on the release of sequestered self
antigens from the infected host tissue, leading to activation of antigen
presenting cells, able to stimulate preprimed dormant autoreactive
T-cell clones . Alternatively, virus-specific T-cells may initiate the
process by killing the virus-infected cells aftermigrating to the affected
organ, thus releasing self antigen and contributing, with macrophages, to the
local high cytokine levels and consequent inflammation ."
"New onset of auto-antibodies not accompanied by any clinical disease
after different vaccine administration has been described. Already
at the beginning of the 1960s.....a transient rise of rheumatoid factor (RF)
after immunization of healthy people or rheumatoid arthritis
(RA) patients with a variety of vaccines, including tetanus toxoid (TT),
typhoid-paratyphoid A and B (TAB), diphtheria, polio, smallpox, and
mumps [20, 21].."
"..Recently, Toplak et al. observed an increase or appearance of auto-antibodies
in 15 and 13% of 92 apparently healthy medical workers (with a baseline high
rate of auto-antibody positivity), 1 and 6 months after flu vaccination,
respectively, suggesting de novo induction of auto-antibodies after influenza
vaccination in selected individuals...recombinant HB vaccine has been
associated with MS onset for the first time in two patients in 1991 , then
in 35 young women ....GBS has also been associated with different vaccines,
including rabies, polio (no more confirmed as responsible in later studies [38,
39]), TT, Bacillus Calmette-Gu´erin (BCG), smallpox, mumps, rubella, HB
[Hepatitis B], and diphtheria . However, its strongest association,
probably as a consequence of a molecular mimicry process, is with swine
influenza.....probably due to cross-reacting antibodies against peripheral
nerve gangliosides that may develop after vaccination with the influenza virus
of swine origin.....SLE cases have been described in a period ranging from days
to up to one
year following HB vaccination .Arthritis has also been associated with
immunizations, mainly HB vaccine [166–170]."
"Borrelia burgdorferi sensu stricto
is strictly reminiscent of that of group A β-haemolytic Streptococcus M
proteins and tropomyosin  .
OspA and M5 protein, in fact, share antigenic similarity
, such that
in the preparation of a rheumatic fever vaccine , the crucial point of
molecular mimicry should also very carefully be taken into account. More
recently, Neisseria meningitidis serogroup B has been recognized having a
capsular polysaccharide identical to the capsular polysaccharide of Escherichia
coli K1 and Pasteurella haemolytica A2  and to the surface component of
many fetal and adult mammalian tissues and of the neural cell adhesion molecule
(N-CAM) [56–58], thus creating concern that vaccine-induced specific
antibodies may be dangerous by exerting autoimmune pathology ."
"The mechanism of bystander activation should probably be invoked when the
vaccine composition contains many pro-inflammatory non
specific antigens, including the lipid A fraction of lipopolysaccharides (LPSs)
, acting as adjuvants, such as the poorly purified vaccines (whole-cell
pertussis, TAB), able to strongly stimulate innate immunity through the
Toll-like receptors (TLRs).....Bystander activation may also be invoked for the
adjuvants, which are substances able to “accelerate, prolong, or enhance antigen-specific
immune responses” .
"In conclusion, the relationship between vaccinations and autoimmune
diseases should be considered in a complex and bidirectional
way; vaccinations, in fact, prevent infections, which may in turn trigger
autoimmunity, but, on the other hand, vaccinations themselves, by a
specific mechanism of molecular mimicry, or a non specific mechanism of
bystander activation or finally by yet unknown mechanisms, may
trigger autoimmunity ."
What we see here is research showing strong connections of vaccine injury
leading to an autoimmune disease. We can even see biological mechanisms and a
pattern among victims. Another pattern is the one we see of denial, of
attempts to minimize these catastrophic injuries. It is when there is that
strong connection of evidence
that we then see the attacks on not only the
research but the researchers. MMR vaccine and the research done by Dr.
Andrew Wakefield and other researchers
is a pertinent example.
Teresa Conrick is Contributing Editor to Age of Autism.