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In Perspective: Autism 2015 - Still a Mystery

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F. Edward Yazbak MD, FAAP


Autism has increased at a much faster rate than all other disabilities served under IDEA, the Individuals with Disabilities Education Act. 

At the CDC, all matters related to autism (Autism/ASD) research are the responsibility of the National Center on Birth Defects and Developmental Disabilities (NCBDDD). 

For the longest time, the Center Director, a Biostatistician and Epidemiologist did not believe that the increase in autism prevalence was a true increase. She appears to have recently changed her mind.

The Director does not yet know what causes autism but like others at CDC, she seems convinced that it is not, in any way, a vaccine-related cause or causes.

Congressional Committee Hearings on autism-related issues should be held regularly.

The few research reports on autism and vaccines that the CDC has acknowledged supporting were clearly designed and intended to rule out any vaccine-autism connection.

It may be time to ask parents of children with autism what kind of research is needed based on their observations and on the historical fact that autism suddenly appeared in the 1940’s and has substantially increased, in spurts, since then.

Outsourcing research may seem useful but trusting a fox to guard your hens is never a good idea. 

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The Committee on Government Reform, House of Representatives, 106th Congress held a meeting titled “AUTISM: PRESENT CHALLENGES, FUTURE NEEDS--WHY THE INCREASED RATES?” on April 6, 2000. http://www.gpo.gov/fdsys/pkg/CHRG-106hhrg69622/html/CHRG-106hhrg69622.htm

Committee Chairman Dan Burton of Indiana opened the meeting mentioning among other things that all articles, exhibits, and extraneous or tabular material referred to in the presentations had to be submitted in order to be included in the record. The Congressman then mentioned the previous meeting, explained that some parents will be testifying first and then went on to his opening statement describing what had happened to his grandson Christian.

I urge every parent and grandparent reading this to stop and go to the link above to read Congressman Burton’s emotional account of what happened to Christian following his MMR and other vaccinations.

Well-prepared and intelligent parents testified first describing in detail what happened to their children and families. They were followed by a long list of experts, both for and against an autism-vaccine connection. 

I arrived to the meeting early and sat in the center of the first audience row just behind the magnificent wood railing that separated the public from the speakers. After years watching scientists testifying, I had become somewhat of an expert at promptly recognizing whether the presenter really believed what he or she was saying under oath.

This is how Dr. Andrew Wakefield started his testimony: “Yes, thank you, Mr. Chairman, members of the committee. It is a great privilege to be here. The purpose of my testimony is to report the results of the clinical and scientific investigation of a series of children with autism. Nothing in this testimony should be construed as anti-vaccine; rather, I advocate the safest vaccination strategies for the protection of children and the control of communicable disease. I am also here on my behalf representing the children who have come to me for investigation. I would like you to look at the screen if you would, please, and I will take you through the presentation.

Next slide, please. Just as a little bit of background, this represents 12 years of intensive clinical and scientific research, collaborative research, into the causes and mechanisms of bowel Inflammation; I am a gastroenterologist. The principal authors of this work have contributed to over 1,500 peer-reviewed and published scientific papers and abstracts. Again, these represent my views.

Next slide, please. I want to report the results today from the first 60 children that we have investigated. We have now investigated over 150 children, and the results that I am going to describe are pertinent to all those children bar about four. As far as the range of psychiatric assessments, the great majority had autism, but there was a spectrum of neuropsychiatric problems including Asperger's Syndrome and Attention Deficit Disorder. By far and away the most important investigation has been direct visualization of the bowel and taking biopsies by the procedure of ileocolonoscopy… “

Dr. Wakefield went on very calmly presenting slide after slide. He ended by saying: “So finally, in summary, we have an environmental insult in perhaps a genetically susceptible child. The problem is that if you go to Sweden now, autism affects over 1.2 percent of the pediatric population. So if there is a genetic background, it is clearly widely distributed within the population. We believe that in many children, clearly, the subset of autistics, it leads to gut infection and damage; that leads to an ingress, an impaired metabolism, degradation of these chemicals from the gut which then get through and impact upon the brain. And the disregulated immune system which measles classically can produce also encourages immune diseases, atopic diseases, and immuno disregulation.”

Dr. Wakefield was calm during his presentation. He did not move his microphone up and down and sideways several times, his voice did not dip or quiver, he did not stutter, he did not raise a sweat, and his color never changed. He knew what he was talking about and …he knew it was all true.

Now this is how Dr. Brent Taylor, Wakefield’s main British opponent at the time, started his sworn testimony at that hearing: “Hello. I am Brent Taylor. I am the professor of community and child health at the Royal Free and University College School of Medicine and the head of the Department of Pediatrics and Child Health on the Royal Free campus of University College London. I am honored to have the opportunity to testify today. I am here as a clinical scientist, but I am also a practicing pediatrician. My clinical work involves children with disabilities including autism.

I know how desperate families can be to understand the cause of their child's often devastating condition. I also know that if we are to avoid families being led astray by false hopes, advances in understanding and treatment must be based on high-quality and rigorous science. Mr. Wakefield and Professor O'Leary's testimony not withstanding, the belief that MMR is the cause of autism is a false hope.

I have four main points. We do not fully understand the reasons why autism has recently increased. We do know that there is no evidence that immunizations are involved.

Second, there is no evidence that MMR vaccine causes autism.

Third, there is no conspiracy to suppress information about the side effects of vaccines--completely the reverse.

Fourth, because of poor science, uptake of MMR vaccine has fallen to dangerously low levels in the United Kingdom, putting children's lives at risk from a resurgence of the damaging and occasionally killing of preventable diseases, measles, mumps, and rubella. The same thing could happen in the United States of America.”

By now, Taylor was visibly agitated, restless and squirming and the back of his neck was purple. His hoarse voice was harsh, angry and cracking as he went on: “If I could have the first overhead, please. Here are some figures from the United Kingdom. You can see at the top, in the black closed circles, MMR uptake, which has fallen from about 90 percent in 1995 to 75 percent in April 1999. There is almost an exact parallel fall--shown in the open circles--in mothers' confidence in the safety of MMR vaccine.

Taylor went on: Could we have the next overhead on top of this one, please? The reason for this loss of confidence relates mainly to two papers produced by Mr. Wakefield and colleagues. The first, which incorrectly related measles vaccine to Crohn's disease, one form of inflammatory bowel disease, has subsequently been completely undermined. There is no evidence that measles or measles vaccine play any part in inflammatory bowel disease.The second arrow shows the timing of a paper produced by Mr. Wakefield and colleagues describing a small group of inadequately described children with a range of autism-related disorders. Following each of these papers, there was a major effect on mothers' confidence and a resultant further decline in MMR uptake. I will now discuss the results of an epidemiological study…”

So, Wakefield was “just a Gastroenterologist” and Taylor was a “Professor of Pediatrics and Child Health” who had the obligation to condemn Wakefield and O’Leary's findings before even starting to present his own statistics that he judged more reliable than evident pathological findings on a slide. Within minutes, it had become very apparent that Taylor hated Andy Wakefield much more than he disagreed with his research actually demonstrating gut findings in children who had visibly and suddenly regressed following vaccination.

The first of the stale four reasons Taylor enumerated to the committee was the well-known credo of our own US vaccine-autism “experts”: “No one knows why autism has increased but we are sure the increase is not due to vaccines.”

The second reason was similarly familiar: “There is no evidence that MMR vaccine causes autism.” Obviously no one had ever officially investigated such possibility pre-2000 and if the health authorities in the UK and IOM Committees had their way, no one will … ever. For a few seconds, Taylor actually sounded relieved that he was able to get that statement over with.

The third reason Taylor mentioned, under oath, was that there was no conspiracy to suppress information about vaccine adverse events; “completely the reverse”he said. .

Of course, I thought … and it never rains in London either!

The fourth and last reason was the threat of the disaster that was doomed to happen, a clear threat we had already heard for a while - on both sides of the Atlantic:“You keep these silly meetings up and measles cases will increase here and kids will die, just like in England.”

Taylor’s “four reasons” were followed by two slides that had nothing whatsoever to do with his own work or research in London clinics. They were simply scary slides about measles and how easily it spread and they were solely intended to show how much damage Andrew Wakefield had already done because he listened to parents who reported that their children had regressed and had developed peculiar intestinal symptoms shortly after vaccination.

It is only by the third slide that Taylor started discussing his “epidemiological” statistics and figures…that he hoped were going to “prove a negative” and convince the Committee that Wakefield and his pathological slides were wrong.

Years later, when I was able to obtain the official measles incidence reports of the UK Health Protection Agency, I realized that Taylor's measles statistics presented under oath at the Hearing were incorrect.

As I documented in “Measles in The United Kingdom: The Wakefield Factor”: 

The number of reported measles cases kept dropping after1998 and only exceeded the 1998 figures ten years later, when there were measles outbreaks worldwide.

There were strikingly far fewer reported measles cases in the UK in the 10 years that followed Wakefield’s paper than in the 10 years that preceded its publication

The reporting of measles cases in the United Kingdom was not affected by Dr. Andrew Wakefield’s research.

/measles-united-kingdom-wakefield-factor

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The CDC’s Dr. Coleen Boyle also testified at the April 6, 2000 hearing.

“Good afternoon, Mr. Chairman and Members of the Committee” she started. “I am Dr. Coleen Boyle, Chief of the Developmental Disabilities Branch at the Centers for Disease Control and Prevention. I am presenting the agency's testimony, and I am accompanied by Dr. Ben Schwartz, who is the Acting Director of the Epidemiology and Surveillance Division at the National Immunization Program at CDC. I am pleased to discuss our work at CDC to prevent developmental disabilities including autism. I want to begin by assuring the parents that we have heard from today that CDC is concerned about autism, and that we are working hard to find the causes of autism and other developmental disabilities so that all children will have the opportunity to have a healthy and productive future. “

Dr. Boyle who is usually accompanied by an MD often seems uncomfortable when testifying at Congressional Hearings.

Anyway! In April 2000, the scientist in charge of CDC Research and ... the rest of the CDC, were still “working hard to find the causes of autism.”

Dr. Boyle went on to tell the Committee that autism rates “appeared” to be higher than previously thought in studies from other countries, that NO prevalence studies had been conducted in the United States but … that a CDC monitoring program was “being developed” in the Atlanta area. She then discussed how the diagnosis of autism had changed considerably, how the first studies were based on fairly narrow criteria and that more recently, broader criteria had been introduced. Dr. Boyle then mentioned the then popular issues of “Increased Recognition” and "Better Awareness" as if pediatricians and parents had recently become smarter and more able to recognize the children's regressions. 

Dr. Boyle added: “The one study that has addressed this is the study by Gilberg which I mentioned earlier, which looked at trends over time. If you look at the range of functioning of those children over time, it appeared that the increase was in children who were higher-functioning as well as children who were lower-functioning. So the classic group seemed to remain constant. Now, why that is happening, we do not know. That is what we hope to do the research to understand.”

I am not sure that I understand what Dr. Boyle meant to say. What is clear is that in 2000, she thought that the Gilberg study was indeed the one to follow-up.

Swedish psychiatrist Christofer Gillberg built his international reputation largely on research involving genetic aspects of autism. At the time, he was the one to follow if one wanted to keep believing that autism was all genetic and that mercury in pediatric vaccines was safe even if it had been banned in Sweden in 1991.

A couple of years after the Washington DC hearing, Gillberg refused to grant his University’s Science Review Committee access to some of his research raw data. He was dragged to Court and fined the then equivalent of $4,800 plus substantial legal fees. The court ruled that Gillberg had acted “willfully” when he refused to follow his employer’s directives to make his research data available for review. http://tinyurl.com/npxnua7

Interestingly, when asked by Chairman Burton at the 2000 Congressional Hearing to provide his research raw data like everyone else who had testified, Dr. Brent Taylor stated: “In principle, I have no problem, but I would need to discuss that with my employing authority, University College London, and with the Department of Health, who funded this study.”

Taylor never provided his raw data even though he was present and heard Chairman Burton say that “all articles, exhibits, and extraneous or tabular material referred to” were to be provided and included in the record.

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Dr. Boyle testified again before the House Committee on Government Reform and Chairman Burton on April 18, 2002. She was now the Associate Director for Science and Public Health, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention.

Dr. Boyle who was to discuss the "CDC Activities Related to Autism" was accompanied by Melinda Wharton MD of the National Immunization Program.

Dr. Boyle’s testimony can be found at http://www.hhs.gov/asl/testify/t020418.html

Dr. Boyle said: “CDC continues to take a proactive role in addressing vaccine safety concerns. In 2000, CDC and NIH contracted with the Institute of Medicine (IOM) to establish an independent expert committee to review hypotheses about existing and emerging immunization safety concerns. Some researchers have suggested that the receipt of either the MMR vaccine or thimerosal-containing vaccines has been associated with various neurodevelopmental disabilities including autism, attention deficit disorder, language delay, or speech delay. The IOM was asked to review the vailable scientific information on these issues. CDC has initiated a broad range of studies to better assess these findings as well as to address recommendations made by the Institute of Medicine (IOM) Immunization Safety Review Committee.”

The magic sentence is of course the clever opening sentence “CDC continues to take a proactive role in addressing vaccine safety concerns.”

The conclusion was similarly very elaborately worded: “CDC remains committed to collecting accurate data on prevalence of autism and conducting studies to find causes of autism. Research is already underway, and more is planned, to look at the relationship between the MMR vaccine and autism. We want each child to be born healthy and to grow and develop normally, so that they are able to lead productive lives. We are dedicated to finding the answer to what causes autism and how it can be prevented. We will continue our work until the answer is known.”

Apparently, Dr. Boyle simply wanted to say: “We still don’t know what causes autism in 2002 but at least we are trying.”

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The CDC’s National Center on Birth Defects and Developmental Disabilities decided to drop any Swedish-style research and start a Danish Liaison to provide the IOM Immunization Safety Review Committee the needed epidemiological ammunition to end once and for all, any future research interest in MMR vaccine or Thimerosal contributing to autistic regression.

In the 1990s, Danish Psychiatrist Poul Thorsen worked as a visiting scientist at the CDC researching infant disabilities. When the “need was created”, Thorsen successfully promoted the idea of awarding grants to Denmark. (In 1990, the population of Denmark was 5,141,000; The population of the state of Missouri was 5,129,000)

Between 2000 and 2009, the CDC in its largesse, awarded over $11 million to two governmental agencies in Denmark to study a) the relationship between autism and exposure to vaccines b) the relationship between cerebral palsy and infection during pregnancy and c) the relationship between fetal alcohol exposure and childhood development.

In 2002, Dr Thorsen moved back to Denmark to become the principal investigator for the grant, responsible for administering the research money awarded by the CDC.

On April 13, 2011, US Attorney Sally Quillian Yates of the Northern District of Georgia indicted Thorson and released the following information:

“…Once in Denmark, THORSEN allegedly began stealing the grant money by submitting fraudulent documents to have expenses supposedly related to the Danish studies be paid with the grant money. He provided the documents to the Danish government, and to Aarhus University and Odense University Hospital, where scientists performed research under the grant. From February 2004 through June 2008, THORSEN allegedly submitted over a dozen fraudulent invoices, purportedly signed by a laboratory section chief at the CDC, for reimbursement of expenses that THORSEN claimed were incurred in connection with the CDC grant. The invoices falsely claimed that a CDC laboratory had performed work and was owed grant money. Based on these invoices, Aarhus University, where THORSEN also held a faculty position, transferred hundreds of thousands of dollars to bank accounts held at the CDC Federal Credit Union in Atlanta, accounts which Aarhus University believed belonged to the CDC. In truth, the CDC Federal Credit Union accounts were personal accounts held by THORSEN. After the money was transferred, THORSEN allegedly withdrew it for his own personal use…. THORSEN allegedly absconded with over $1 million from the scheme.” http://www.justice.gov/usao/gan/press/2011/04-13-11.html

The Office of the Inspector General, HHS, updates its Fugitives Profiles Lists regularly. OIG Fugitive Poul Thorsen’s photograph and details have been featured on the list for quite a while together with the statement that “Thorsen is currently in Denmark and is awaiting extradition to the United States.”
https://oig.hhs.gov/fraud/fugitives/profiles.asp

While many may think that individuals awaiting extradition are incarcerated until they are promptly picked up and returned to the jurisdiction where they were indicted, this is not always the case. International Extraditions are particularly complex with multiple issues to be resolved. Thorsen can certainly afford the best Danish lawyers money can buy, if he prefers, under the circumstances, to stay in Denmark instead of coming back to Georgia. It is likely that many in Georgia would love to see him do just that and live happy ever after at home."
http://www.justice.gov/usao/eousa/foia_reading_room/usam/title9/15mcrm.htm

It seems that while “awaiting extradition”, Dr. Thorsen remains as busy as ever “researching” and “being an investigator.”

A PubMed search reveals that Dr. Thorsen published 128 peer-reviewed articles in all including several in 2012 and eight in 2013-2014, after he was indicted in Atlanta and “while awaiting extradition.” These are: PMID 24732104 (July 2014), 24376591 & 23404041 (December 2013), 22175527 (September 2013), 23340191, 23221172, 22837141 & 22684193 (January 2013).

The last listed publication (PMID 22684193) was authored by US researchers affiliated with prestigious US Universities and a CDC epidemiologist. Dr. Thorsen, who was listed last, declared affiliations with the Lillibaelt Hospital, OB/GYN Department, Kolding, Denmark and the Rollins Schoolof Public Health, Emory University, Atlanta GA.
http://www.ncbi.nlm.nih.gov/pubmed/?term=Thorsen+P

Dr. Thorsen, a psychiatrist, researched a multitude of pediatric issues for the NCBDD. The CDC had evidently truly discovered its “Man for All Seasons”.

Even the American Psychiatric Association (APA) could not find a better-qualified US Psychiatrist to work on its upcoming DSM-V, the latest “Diagnostic and Statistical Manual of Mental Disorders” that we all must live with for at least ten years. In his Disclosure Report to the APA, Thorsen listed that he was since January 2010 an Adjunct Associate Professor at a distinguished Pennsylvania University.
http://www.rescuepost.com/files/thorsen---disclosure---1-22-10.pdf

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Autism in the United States

(2000-2010)

The Individuals with Disabilities Education Act (IDEA), enacted in 1975, mandates that “children and youth ages 3–21 with disabilities be provided a free and appropriate public school education.”

The Fast Facts Table of The National Center for Education Statistics of the Institute of Education Sciences lists accurate statistics on such disabilities for the ten years that followed Dr. Boyle’s testimony at the April 2000 Meeting of the Committee on Government Reform of the House of Representatives discussed earlier.

In School Year (SY) 2000-2001, there were 6,296,000 individuals with disabilities who were 3 to 21 years old and were served by IDEA. Of these, 94,000 had a diagnosis of “Autism” (Autism/ASD).

In SY 2010-2011, ten years later, the total number of individuals with disabilities in the same age group had reached 6,419,000, an increase of 1.9% and the number of individuals with autism was 417,000, an increase of 344%.

Again: All Disabilities ▲ 1.9% and Autism/ASD ▲ 344% in 10 years http://nces.ed.gov/fastfacts/display.asp?id=64

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Dr. Boyle joined the CDC in 1984 to work on the "Agent Orange Studies". In 1988, she joined the Division of Birth Defects and Developmental Disabilities first as Section Chief and later as Branch Chief and Division Director. In 2001, Dr. Boyle was named Associate Director for Science and Public Health for CDC’s newly created National Center on Birth Defects and Developmental Disabilities (NCBDDD). She is presently the Director of the Center. 

Another Hearing before the Committee of Oversight and Government Reform of the House of Representatives, “1 in 88 Children: A Look at the Federal Response To Rising Rates of Autism” was held on November 29, 2012.

http://www.gpo.gov/fdsys/pkg/CHRG-112hhrg80405/pdf/CHRG-112hhrg80405.pdf

California Congressman Darrell E Issa chaired the meeting. At that hearing, Dr. Coleen Boyle announced to the Committee that on March 2012, the CDC released updated estimates of ASD prevalence indicating that 1 in 88 children had been identified with ASD compared to 1 in 110 in 2009 and 1 in 150 based on 2002 data. She then stated: … “We will continue to document the burden of ASD … and maintain our important epidemiological focus …to better understand why some children are more likely to develop autism than other children.”. For the parents in the audience and those later watching on C-SPAN, Dr. Boyle’s statement simply meant that the Director and the scientists of the CDC Division of Birth Defects and Developmental Disabilities still did not really know what caused autism and why more children were affected every year.”

There is little doubt that some of those parents must have thought: “I wish they would ask me.”

[In 2015, the NCBDDD Director and the CDC are still “working hard to find the causes of autism.”]

Dr. Boyle’s full 2012 report that she attached to her statement can be found at: http://oversight.house.gov/wp-content/uploads/2012/11/Boyle-Bio-and-Testimony.pdf

At the Congressional Hearing, Florida Congressman Posey asked Dr. Boyle several questions related to autism research and vaccinations. That video exchange can be seen at: https://www.youtube.com/watch?v=uNWTOmEi_6A

When pressed during that interesting exchange, Dr. Boyle conceded that the CDC had not conducted a vaccinated v un-vaccinated study.

When asked by Congressman Posey whether the CDC had reviewed any of the research carried out by Dr. Thorsen, Dr. Boyle answered that Dr. Thorsen was just a “co-investigator on a couple of studies that came out on autism”.

During most of the exchange, Dr. Boyle was “adjusting” her microphone in an attempt to make her slowly fading voice a bit more audible. There were several times when the Director could not answer Congressman Posey’s questions and promised to get him answers later. That seemed to amuse two ladies sitting behind her in the audience. The Director did agree with Congressman Posey that Thimerosal was still being used in vaccine vials.

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In an official CDC document titled: “Vaccines and Autism: A Summary of CDC Conducted or Sponsored Studies”, the CDC lists one study on antibodies, five (5) on Thimerosal in vaccines and four (4) on MMR vaccine and autism.

 http://www.cdc.gov/vaccinesafety/00_pdf/CDCStudiesonVaccinesandAutism.pdf


The only “Danish” study the CDC officially admits “Conducting or Sponsoring” is the MMR vaccine - Autism Study by Madsen et al published in the November 2002 issue of the New England Journal of Medicine.

A population-based study of measles, mumps, and rubella vaccination and autism
Madsen KM, Hviid A, Vestergaard M, Schendel D, Wohlfahrt J, Thorsen P, Olsen J, Melbye M.N Engl J Med. 2002 Nov 7;347(19):1477-82. [PMID: 12421889]

Quite interestingly, on that official publication, the CDC only mentions the first five listed authors by name and then replaces Thorsen and the last two co-authors by “et al”. Usually of course, "et al" is added following the lead author’s name, not the names of five out of eight authors.

Our convincing response to the claims of that particular Danish study can be found at:   

http://www.jpands.org/vol9no3/goldman.pdf

To get accurate data for our response, I requested the help of a wonderful Danish Mom who had a son on the Spectrum. During one of our phone calls, I asked that kind lady what she thought of the Danish scientists who were cranking up studies for the CDC. Her answer in her wonderful accent was immediate: “Having them do that research is like having a fox watch a chicken coop”.

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Regarding Dr. Boyle’s comment to Congressman Posey that Dr Thorsen was “just a co-investigator on a couple of studies on autism”: PubMed lists nine otherautism-related studies by Thorsen and epidemiologist Diana Schendel Ph.D. when she was with the CDC:

PMID 12523209 (2002)     PMID 15265850 (2004)     PMID 15870155 (2005)

PMID 17202868 (2007)     PMID 19000294 (2008)     PMID 19047542 (2008)

PMID 20414802 (2010)     PMID 20439799 (2010)     PMID 20584728 (2011)

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Less than a year after the above-mentioned Congressional Hearing and that memorable Posey-Boyle exchange about Thimerosal in vaccine vials, I received a letter from Dr. Boyle dated September 13, 2013, reminding me (and all US pediatricians) about the importance of influenza vaccination in pediatric patients with neurologic disorders and developmental disabilities.

The letter never mentioned that preservative-free single doses of  seasonal influenza vaccine were available.

http://www.cdc.gov/flu/pdf/professionals/pediatric-letter-providers-2013.pdf

After my many years in Pediatrics, I was certainly somewhat surprised to receive that “reminder.”

In her letter, Dr. Boyle referred to a recent MMWR that was also dated September 13, 2013 and was titled: “Influenza Vaccination Practices of Physicians and Caregivers of Children with Neurologic and Neurodevelopmental Conditions — United States, 2011–12 Influenza Season.”

Although the first paragraph (and the title) mentioned “neurodevelopmental conditions”, the actual quoted statistics were only related to neurologic conditions, and specifically intellectual disabilities and epilepsy.

Also noteworthy was the Editorial Note stating: “The results of this survey are consistent with 2011–12 national seasonal influenza vaccination coverage estimates of 52% among children aged 6 months–17 years in the general population.”  Also mentioned were several selection biases.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6236a3.htm

To further investigate the accuracy of the allegation that children with autism were found to be more susceptible to influenza complications during the 2011-2012 flu season, I went back and researched all earlier related information. I found an official CDC Press Release dated August 29, 2012 titled “Children with neurologic disorders at high risk of death from flu. Health care and advocacy groups join to protect children most vulnerable to influenza”. Just like the title, the main statement of the Press Release did not mention autism or neuro-developmental disorders: “Of the 336 children (defined as people younger than 18 years) with information available on underlying medical conditions who were reported to have died from 2009 H1N1 flu-associated causes, 227 had one or more underlying health conditions. One hundred forty-six children (64 percent) had a neurologic disorder such as cerebral palsy, intellectual disability, or epilepsy. Of the children with neurologic disorders for whom information on vaccination status was available, only 21 (23 percent) had received the seasonal influenza vaccine and 2 (3 percent) were fully vaccinated for 2009 H1N1.” http://www.cdc.gov/media/releases/2012/p0829_neurologic_flu.html

It is still not clear when “someone” decided to suggest that “children with neuro-developmental disorders including Autism/ASD” were at high risk of influenza complications and to recommend giving those children a yearly dose of a vaccine containing Thimerosal without even bothering to mention that a “preservative-free” product was available. What is clear is that pediatricians would have had a hard time trying to convince parents who have children on the spectrum that they really need a yearly injection of the ONLY vaccine on the market still containing mercury and recommended for children.

Never to be outdone, AUTISM SPEAKS joined the choir on Friday the 13th of September 2013. The title was certainly just as catchy as Influenza itself: “Half of Kids with Neurodevelopmental Disability Lack Flu Protection.” http://tinyurl.com/ljnlmtf

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Conclusions

Autism is the worst pediatric epidemic our Nation has faced. 

After 50 years, NO ONE at the CDC or elsewhere knows "Why some children are more likely to develop autism than others" 

What everyone knows or should know is that Genetic Disorders do not cause epidemics.

Unless something is done promptly, autism will affect 1 in 25 children pretty soon.

A pediatric calamity can only become a much more serious adult disaster.

The best available, most experienced and most qualified Pediatric specialist should be hired to lead the research at the National Center for Birth Defects and Developmental Disabilities and he or she should be offered all the needed and required funding and support.

Serious attention should be paid to parents’ accounts and ALL autism-related long-suspected issues – without exception- should be investigated.

Lastly, by all means, let us make sure to keep foxes away.


F. Edward Yazbak MD, FAAP, Falmouth, Massachusetts