November 6, 2002 Dear Friends and Co-workers, Although I would like to write to each of you individually, time does not permit me to do so. I wanted to let you know about an important story that is scheduled to air on tonight's NBC news and probably other national stations as well. The New England Journal of Medicine is releasing this evening a Danish study that examined the relationship between MMR vaccination and autism. It concludes that there is no relationship between MMR and autism. This is basically a good study (and I'm happy that people are taking the issue seriously and studying it), but it has a number of major problems that prevent it from drawing sound conclusions about the relationship between MMR and regressive autism which affects 10 to 20% of autistic children including my son, Sam. Children with regressive autism are those who develop normally and then experience a number of complex, debilitating, and poorly understood medical problems and eventually, develop autistic behaviors. The study concludes that it "provides strong evidence against the hypothesis that MMR vaccination causes autism." This conclusion is overdrawn and is probably inaccurate as it pertains to children with regressive autism. Perhaps the most important problem in the study is that the investigators were unable to analyze separately the children with regressive autism from all other children with autism. The investigators also made a major error in they combined some vaccinated children with unvaccinated children and then compared them to other vaccinated children. This situation prevents them from drawing valid conclusions about the relationship between MMR and autism among vaccinated and unvaccinated children. It is important to understand that there are two very different lines of research that are investigating the potential role of vaccination with the MMR and autism. One is at the epidemiological and population level and the other is at the cellular and molecular level in individual children. The investigators studying the issue at the individual level include the team headed by Dr. Andrew Wakefield as well as several other independent and well-established scientists. The latter line of research has never contended that vaccination with the MMR was a causal factor for ALL cases of autism, only those with the regressive form of the disease. This is an important distinction and for some reason, is not understood by the American media. There have been a series of population-based studies that claim to have proved that MMR is not related to autism but in the end, none have proved their point. The database developed by the Danish team, however, has the potential to be used to investigate the relationship among the relevant subgroup of children with autism who appear to be vulnerable to the effects of vaccination with the MMR. The potential for this team to better elucidate the relationship between MMR vaccination and regressive autism is heartily welcomed by me and others who are deeply invested in getting to the truth.
Until that time, the extensive work that has identified vaccine-strain measles virus in the bowel, blood and spinal fluid of children with regressive autism stands as solid peer-reviewed science that has not been disproved by the Danish study or any others. I believe and hope that at some point these two very different lines of research will converge and produce consistent results. And then, once and for all, the bitter divisiveness that plagues this issue can be put aside and we can go forth with the important work that needs to be done to prevent this illness from occurring in the future and to successfully treat those who now suffer from a serious and progressive illness that affects far too many of the world's children. I hope that you will help me to help others to understand the issue more clearly and to encourage the media to take a more critical view of the problem at hand and to advocate for the research funds that are desperately needed to solve this problem. There is much work to be done. Feel free to pass this note on to others. Most sincerely, Vicky Debold, PhD, RN Assistant Professor University of Michigan