Controversy with vaccines, adverse reactions of the MMR vaccine and the negative publicity surrounding it SHAPE

Measles, Mumps and Rubella Vaccine:

Absence of Evidence for Link

to Autistic-Spectrum Disorders

Henry K. Nguyen, MD Candidate

Increased incidence of measles, mumps, and rubella is directly due to controversies regarding the measles, mumps, and rubella vaccine despite the absence of data supporting a correlation between this combined vaccine and development of autism.

Correspondence to:

Mentor:

Dr. Anshu Kacker

5650 including Abstracts

Increased incidence of measles, mumps, and rubella is directly due to controversies regarding the measles, mumps, and rubella vaccine despite the absence of data supporting a correlation between this combined vaccine and development of autism.

Methods and materials: A literature search was performed using key phrases, including the search-requisite abbreviation 'MMR' (measles, mumps, rubella), such as: 'autism mmr vaccine', 'colitis mmr vaccine', 'controversy mmr', 'mmr adverse results', 'vaccines autism-spectrum disorders', 'vaccine effects mmr', 'vaccine measles', and 'vaccine rubella'. The results were compiled, following which appropriate publications were chosen for review and critical analysis.

Results: Detailed analysis of publications found in the literature search reveal negative health effects arising from administration of the measles, mumps, and rubella vaccine. These effects include: arthritis, aseptic meningitis, fever, lowered platelet count, rash, seizures, and swelling of glands. However, none of the reported 'side-effects' include autism and/or autism-spectrum disorders.

Conclusions: Following highly publicized reports by Wakefield and colleagues in the United Kingdom and by Geier and Geier in the United States that directly implicated the measles, mumps and rubella vaccine to childhood autism, 'colitis', and neurological disorders, many parents refused vaccine compliance for their children. Although the reports were later retracted, proven fraudulent, and the physicians/scientists discredited along with their work, the observed incidence of these once nearly eradicated diseases rose, particularly measles and mumps. No causal connection of significance between the vaccine for measles, mumps, and rubella and childhood autism, autism-spectrum disorders, or pervasive developmental disorders was found.

ULTRAMINI ABSTRACT: The now-retracted 1998 publication by Wakefield and colleagues suggested a correlation between childhood autism and the measles, mumps, and rubella vaccine. This false report generated controversy as well as directly decreasing vaccine compliance, raising incidence of these diseases. This study evaluates evidence for any potential vaccine -- autism correlation.

Table of Contents

Abstract & #8230;. 2

Introduction 4

Materials and methods & #8230;

Results 10

Discussion & #8230; 17

Conclusion 21

References 22

Appendix 24

Introduction

Historical Overview and Background

The general public today considers measles, mumps, and rubella to be relatively benign childhood diseases that are almost completely eradicated. This obliteration of historical diseases (vide infra) came about through an effectively combined measles, mumps, and rubella (MMR) vaccine that is routinely required in the United States for children prior to entering public school kindergarten, in all but the State of Iowa (CDC, 2008; 2014).That is, these diseases were considered to be 'nearly eradicated' until fairly recently, when a controversial set of publications by Wakefield and colleagues (1998) in the United Kingdom, and by Geier and Geier (2004) in the United States, raised a fairly high public furor with concomitant media attention, leading many parents to fear that MMR vaccine utilization could result in autism and/or autism-spectrum disorders in their children.

Historically, measles were reported in approximately 900 CE by Rhazes, a Persian physician, who noted that smallpox and measles were distinct diseases (The College of Physicians of Philadelphia, 2015a, 2015b). As early as 1657, measles were reported in Boston, but not studied in detail until approximately the mid-1700's, when Francis Home first explored the infectivity of this disease in Scotland. His procedure was to expose healthy patients to the blood of infected patients, and this did result in measles transference (The College of Physicians of Philadelphia, 2015a, 2015b).

Measles is a generally short-term disease that often affects children. It results in 'spots' and/or rashes on the patients skin (hence potentially confused with smallpox), oral lesions, and potential complications in adulthood such as myocarditis, pneumonia, and even a severe 'sclerosing panencephalitis' of the sub-acute form, that can result in motor and mental deterioration that may worsen (Gladwin et al., 2014).

In the case of mumps, skin rashes are also observed for child patients, however other significant symptoms can occur, including orchitis (inflammation of the testes), possibly resulting in sterility...

In 1934, Goodpasture and Johnson demonstrated that mumps were infective via transmission of saliva from patients having mumps to Rhesus monkeys (The College of Physicians of Philadelphia, 2014). By 1948, the first vaccine was made from isolated and inactivated mumps virus; this vaccine was, however not long-lasting in the immunity it produced, and by 1970 it had been discontinued. In 1967, the Jeryl Lynn strain of mumps was prepared via tissue culture as an attenuated live version; this licensed version is still in use, and decreases the incidence of mumps by up to 95% (World Health Organization, 2007).
A third mild but common childhood disease, the "German Measles," was initially described in 1740 by Friedrich Hoffman (The College of Physicians of Philadelphia, 2015a, 2015b). In the mid-1800's, the German measles was re-named 'rubella' (little red) following a large outbreak in India. Infectivity was demonstrated by disease transfer from infected to healthy children in 1939 in Japan. The utter seriousness of rubella was unfortunately demonstrated some thirty years later when a rubella outbreak in the United States resulted in thousands of miscarriages, as well as over 3500 children being born both deaf and blind, and another 8000 children being born deaf. The total, nearly 20,000 infants born with 'congenital rubella syndrome', brought home the highly serious potential consequences for pregnant women exposed to rubella. These arise because the rubella virus can cross the placenta and significantly perturb fetal development. Unfortunately, these highly deleterious consequences might have been at least partially ameliorated had the warnings of public health officials been heeded (The College of Physicians of Philadelphia, 2015a, 2015b) This disaster resulted in stronger efforts towards vaccine development and led to the work by the American physician Stanley A. Plotkin, who developed a rubella vaccine. According to Greaves and colleagues (1983), the rubella vaccine has an efficacy of up to 90%.

While measles and mumps are related as part of the non-segmented, negative RNA-stranded viral family paramyxoviridae (Gladwin et al., 2014), rubella is from the togavirus family of viruses (World Health Organization, n.d.). The paramyxoviruses can induce host cells to fuse and form giant multinucleated cells, as is the case for retroviruses and the herpes virus, due to their fusion protein (Gladwin et al., 2014). In children, both measles and mumps are far more severe than rubella, which is generally mild, with only a maculopapular rash (World Health Organization, n.d.) that disappears after as short a time as three days. However, the consequences of rubella for an exposed pregnant woman make this disease of significance because it causes very serious congenital effects. Indeed, in terms of potential complications, rubella is by far the most serious of the measles, mumps, and rubella group. Embryonic cells are targeted during the period of differentiation and there can be effects in the infant such as pulmonary stenosis, septal defects, patent ductus, blindness, cataract formation, deafness and effects upon the central nervous system including retardation (Gladwin et al., 2014).

Thus, it can be seen that measles, mumps, and rubella are generally relatively mild childhood diseases, which can have potentially serious long-term detrimental effects upon newborns, adults, and children. Because these diseases have an extremely high rate of contagion, the scientific community invested considerable effort into development of successful vaccines. By 1963, the first vaccine for measles reached the public, after considerable testing in rhesus monkeys, efficacy research, and safety trials. The initial measles vaccine, by John Enders and colleagues, was used for nearly 12 years, and during that time, nearly 20 million individuals were vaccinated. Subsequently, in 1969, Merck improved the measles vaccine with a more highly attenuated version that is part of the combined measles, mumps, and rubella (MMR) vaccine in present use (The College of Physicians of Philadelphia, 2015a, 2015b). It was the combination of the separate vaccines into a single, highly effective MMR vaccine that led to the nearly 99% halting of measles in the United States. Thus, it is now possible to prevent the occurrence of the measles, mumps, and rubella diseases at a level that is well over 90% and may approach nearly 100%.

Autism and The Wakefield Controversy

In 1998, Wakefield and colleagues published a manuscript in The Lancet, a leading global medical journal. In this report, the group reported that use of the MMR vaccine could be correlated with colitis and autism in children, based on a report of twelve children having autistic-spectrum disorders; eight of these were said to have onset following their MMR vaccination. This paper further described a series of additional symptoms that were typical for the children, and were defined by Wakefield et al. (1998) as 'autistic enterocolitis'; they further suggested a potential link between the MMR vaccine and the colitis.

What perhaps caused the most damage, however, was a press conference in which Wakefield directly implicated the MMR vaccine as being responsible for the autistic enterocolitis.…