[back] Danish study

Autism Expert: Time Quote "MMR Doesn't Cause Autism" Misrepresents Him,  Issues (Jeff Bradstreet)

In the current edition of Time, in an article  "Do Vaccines Cause  Autism? by Christine Gorman <A
                the magazine quotes Dr. Jeff Bradstreet, a leading Florida clinician
                treating children with autism as denying a MMR vaccine and autism link. The
                magazine covers the controversial 'Danish Study' in the New England Journal
                of Medicine, November 7, 2002 publication regarding MMR and Autism that
                claims there is no connection. Here is the passage with the quote: . .
                . The accumulated evidence is strong enough to convince
                even onetime proponents of the MMR-autism link, like
                Dr. Jeff Bradstreet, director of the International Child
                Development Resource Center in Palm Bay, Fla. "MMR does not
                appear to cause autism," Bradstreet concedes. "If it did,
                it would be a godsend because we could change the vaccine
                and that would be it." Still, he suspects that the MMR
                vaccine might worsen a preexisting autistic condition. Bradstreet
                says the national magazine has misrepresented both his
                words and the surrounding issues. Here is his response and commentary on
                the Danish Study, vaccines and autism.
                Jeff Bradstreet, MD I spent about 30 minutes talking to
                Christine Gorman from TIME
                magazine about this difficult subject. Obviously, what was printed
                represents a very small piece of that interview, and is highly edited by
                TIME to reinforce their perspective. Everyone who knows me, also knows the
                very public life led by my son Matthew. His laboratory findings are part of
                the Congressional Records of the Reform Committee Hearings from both 2001 and
                2002. No one has more reason for concern about the MMR than I do, having
                found vaccine strain MV in my son's bowel, blood and spinal fluid.

                Simultaneously, I know he developed seizures shortly after his second MMR
                vaccine, and that he lost precious developmental ground after each vaccine
                containing MMR. But MMR was never given to Matthew in isolation. He always
                had other vaccines - mercury containing vaccines given at the same or nearly
                the same time. How is it then that I am quoted as stating the MMR vaccine
                does not cause autism?

                Before getting into details about my position regarding the NEJM
                "Danish MMR" study, I would first like to discuss the misrepresentations
                inherent in the TIME piece.

                The caption and title imply all vaccines were study and that all
                vaccines have always been safe as in their caption, "Childhood shots get a
                clean bill of health." This is decidedly not my position. I told the
                reporter it is clear that MMR is not the main cause of autism in Denmark.
                The in Denmark portion didn't find its way into the article. But I am not
                that uncomfortable saying MMR cannot be supported as a major cause of autism
                with the epidemiological data available to us today. Simultaneously, as I
                will discuss, MMR is unquestionably associated with autism. The difference
                occurs in the meaning of first causes (primary causality) and co-occurrence,
                which by definition would represent an association.

                Here's an analogy. If I let the air out my tire it goes flat - in
                this example letting the air out is casual to the flat tire - and everybody
                accepts it as truth. But in another example, if I go the beach I always get
                sand in my shoes, and if I go without sunscreen I get sunburned if it is a
                sunny day. Sand in my shoes does not cause sunburn and not using sunscreen
                doesn't cause sunburn - exposure to the sun causes sunburn. Sand in my shoes
                is associated with my sunburn, but not causally. Not using sunscreen seems
                logically associated with my sunburn, but if I was well tanned, or the day
                was cloudy, or I was of African decent, I wouldn't need sunscreen, and
                likely still wouldn't get burned, but I would still have sand in my shoes.

                This second example became a little more complicated and parts of it
                were less obvious. Some of you would be arguing that lack of sunscreen,
                caused, my sunburn. Scientifically, you would be wrong, even though there is
                a clear association. And lack of sunscreen is not always associated with
                sunburn or with sand in my shoes. These are what we call conditional
                variables. Amount of shade, time of year, weather and lots of other things
                are also variables in my sunburning or not. But ultimately, we cannot get
                away form the simple first cause which is exposure to sun in a vulnerable
                person (pale-skinned). Those of you who are thinking I need to get out
                more - are right, and I will take my sunscreen if it is a sunny day.
                So, logic and science tell us that when we find vaccine strain measles
                virus years after exposure almost exclusively in children with autism, that
                there is an association. There must be an association, but it need not be
                causal to autism and it may not be causal to bowel or brain symptoms,
                although it likely plays an important role in symptoms. So, if the
                epidemiologists tell us MMR is not the cause of autism (and remember we are
                not talking about autistic entercolitis), we can accept that until new,
                better or different data refute these observations. But equally it is a
                tremendous injustice to the children suffering with persistent measles virus
                and autism to claim there is no association. How is this true? The best way
                to understand this is through the hypothesis that an underlying immune
                disorder which would permit MV to persist if exposed through the injected
                pathway, also directly or through other pathogens allows the development of
                autism. And this immune disorder likely has many manifestations.
                Remember for a moment that a wide array of pathogens have been
                proposed, published and associated with autism. These include yeast,
                anerobic bacteria, borna viruses, influenza in pregnancy, as well as other
                viruses and toxins, including mercury. How do we explain all of these and MV
                at the same time? Given the large body of immunological and immunogenetic
                literature in autism, it is appealing to assume a foundational immune
                disorder is the actual first cause, or that toxins like mercury are directly
                involved. But even in the case of mercury we still have to account for
                gender differences and variable expression of toxic effects despite equal
                exposures. All of these exposures could start at any point in the child's

                Unlike the comments in the TIME article and many others like it,
                primary genetic disorders are not the cause of autism. This fact was driven
                home by the recent MIND Institute California study which clearly and rightly
                concluded environmental factors had to account for the rapid rise in autism
                rates in that state.

                Mercury, aluminum and the inherent immune skewing of vaccines are
                still under intense scrutiny and research. All of these directly influence
                the immune system as does the MMR vaccine itself. So MMR in its current form
                is certainly not my choice way to protect children from these diseases.

                Neal Halsey MD from Johns Hopkins, who is decidedly in favor of the
                MMR vaccine and believes it has no association with autism whatsoever,
                admitted before the Institute of Medicine in July of 2001 and in a New York
                Times story, Sunday November 10th, 2002, he had never calculated the dose of
                thimerosal (mercury) in micrograms and that the dose in the vaccines greatly
                exceeded all Federal guidelines. He has repeatedly apologized publicly for
                this obvious toxicological error.

                In 1991, the NIH (Vaccine 1991 Oct;9(10):699-702) reported that the
                aluminum in vaccines was of toxic concern and could be replaced with safer
                adjuvants (things that make the vaccine more potent). They also recommended
                the removal of aluminum from vaccines. To date no action by the FDA or CDC
                has been taken to heed the NIH recommendations.

                Recently, Imani and Kehoe (Infection of Human B Lymphocytes with MMR
                Vaccine Induces IgE Class Switching. Clinical Immunology, Vol. 100, No. 3,
                September, pp. 355-361, 2001) also from Johns Hopkins, reported that MMR
                vaccine induced a change in human immune cells consistent with the induction
                of allergy and asthma.

                They stated this: "Vaccination provides great protection against the
                mortality and morbidity associated with many childhood diseases and should
                not be discouraged, but it is possible that a side effect of viral
                vaccination constitutes an increase in the incidence of IgE-mediated
                disorders. A better understanding of the mechanism underlying this event may
                yield improved vaccines in the future."

                And the Danish study in question in no way investigated the occurrence
                of bowel disease in children with autism (vaccinated or otherwise).

                Recently, Professor O'Leary and his team of molecular pathologists did in
                fact identify vaccine strain measles virus in the gut of children with
                developmental disorders, but not in healthy controls (V Uhlmann, C M Martin,
                I Silva, A Killalea, O Sheils, S B Murch, A J Wakefield, J J O'Leary.
                Potential viral pathogenic mechanism for new variant inflammatory bowel
                disease. J Clin Pathol: Mol Pathol 2002;55:0-6).

                In the well reviewed article they state this: "Conclusions: The data
                confirm an association between the presence of measles virus and gut
                pathology in children with developmental disorder."

                In July of 2002 they presented their additional data which clearly
                identifies vaccine specificity for the type of measles virus, and so they
                have continued to enhance our understanding of MMR in this disorder.

                Let me be very clear, I in no way believe a live attenuated MMR
                vaccine is safe for a subset of children. How large that subset is remains a
                mystery to me at this time. But equally, these concerns are different from
                placing a causal relationship for autism at the vaccine's doorstep. I know I
                can find persistent measles in the blood, bowel, cerebral spinal fluid and
                brain (through recent biopsy findings), and that gives me no reassurances of
                safety. My belief is hinted at in the TIME article when they share my
                comment about worsening pre-existing conditions (I never limited my concerns
                to autistic conditions as inflammatory bowel disease is not an autistic
                condition) and I assume this is a simple misunderstanding by the reporter.
                So, with regard to the TIME article I find it cleverly deceptive and
                far from conveying a balanced view of the debate. My view of the Danish
                study is much the same.

                I believe the authors greatly overstep the bounds of their data and
                make general comments about MMR vaccine safety while sweeping the molecular
                biology aside with barely a thought. As an example, the authors sometimes
                claim a lack of association of MMR with autism, when in fact they mean to
                state a lack causality of MMR for autism. While they usually do limit their
                discussion to causality this slip is no subtle difference. It is by no means
                trivial to the science at hand or to the children afflicted. Here is an
                example of how the line gets blured: "Studies designed to evaluate the
                suggested link between MMR vaccination and autism do not support an
                association, but the evidence is weak and based on case-series,
                cross-sectional, and ecologic studies." For the reasons already stated, I do
                not believe this is a true reflection of the state of the science. "Studies"
                in this sentence actually should say "epidemiological studies" and
                "association" should say "casual association".

                Why am I being so particular in this situation? We are not dealing
                with something as simple as the letting air out of tire example. And it is
                far more complex than the sunburn example too. Ignoring the immunological
                weakness or peculiarity of the children who cannot rid themselves of the
                measles virus is a huge error in scientific reasoning. There is an
                un-refuted association of MV with autism, because children with autism are
                much more likely than controls to still possess the virus for years after
                exposure. The epidemiology may be giving us accurate data about causation at
                the same time. In the early 1990s the Institute of Medicine rightly
                concluded vaccines could do three things: 1) nothing harmful, 2) exacerbate
                (worsen) an existing condition, or 3) cause a disease de novo. The Danish
                study provides an additional piece of evidence that MMR does not participate
                in number three - ONLY for autism, not for all the other issues (like bowel
                disease or allergies) which we have discussed regarding the vaccine. Why?
                Because they didn't have those data, nor did they seek to find the data for
                a cohort of children with autism.

                The reality is that we are still a long way from the truth despite the
                joyful proclamations of the public heath officials and the epidemiologists.
                The Danish study is still important in several ways. The number of children
                on a percent basis is much less than the US and England. What is protecting
                them from our rates of autism? We do not know why, but it would be a great
                place to start looking. Further, it is a small country with unique genetics
                which may preclude easy comparison to other populations, a point which is
                lacking from the article as the authors attempt to use their findings to
                generalize to all autism in the entire World. Finally the authors admit
                measles virus causes an autoimmune reaction to myelin proteins, and yet they
                neglect the large body of research by Warren and Singh on this subject with
                regards to autism.

                >From the study:
                "However, wild-type measles can infect the central
                nervous system and even cause postinfectious
                encephalomyclitis, probably as a result of an
                immune-mediated response to myclin proteins. <A