February 28, 2009

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.
http://www.ageofautism.com/2009/02/olmsted-on-autism-autism-explosion-followed-big-change-in-mmr-shot.html
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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Comments

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