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
HREF="http://www.time.com/time/magazine/article/0,9171,1101021118-388948,00.html\
">
http://www.time.com/time/magazine/article/0,9171,1101021118-388948,00.html</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
development.
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
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