Position Paper

The MMR Vaccine and the Onset of Autism The connection between the measles, mumps, and rubella vaccine administered to children in their first year of life and the onset of autism is a strongly debated topic in healthcare today. The arguments on both sides are strong, but each has its flaws. The myth that the vaccine causes the onset of autism directly has since been debunked with the removal of the preservative Therimosol. There are other explanations that have come about since the connection between the vaccine and autism onset was eliminated. Ideas such as the rise in diagnosis due to better diagnostic abilities, environmental factors such as toxins, changes in diet, and the possibility of children having a genetic predisposition to developing autism, are all being researched. I will use supportive evidence from research findings to support my claim that the connection between the onset of autism and the MMR vaccine is unclear and its validity is questioned. Autism or autistic disorder includes “an inability to relate socially or to convey meaning to others through language and an insistence on sameness in daily routines” (Primary Psychiatry). The cases of autism have increased in recent years to 1 in 160 children, with boys being four times more likely to be diagnosed with autism (Generation Rescue). Information concerning vaccines has become increasingly available despite the increased number of autism cases being documented. There are many ways to get information regarding autism. Websites like the Generation Rescue website created in large part due to Jenny McCarthy and her son’s autism battle, medical journals, and pharmaceutical company research findings are all sources for autism information. With information becoming more available parents have the ability to delay vaccines or even choose to not vaccinate their children. Even with parents becoming increasingly informed and pharmaceutical companies more wary of the vaccines they make and their safety, the number of children with autism continues to rise, showing that there are other factors in the onset of autism aside from the MMR vaccination.

While the cases of autism have been increasing daily along with the number of MMR vaccines administered to children the claim that they are directly connected is flawed. Scientists were able to pinpoint the threat in the vaccine; therimosol “which contains a form of mercury known as ethyl mercury…methyl mercury (a similar compound commonly found in some fish) can damage the brain” (Tarkan) , so scientists removed the preservative ingredient to establish a safer form of the MMR vaccine. The removal of the preservative Therimosol has resulted in the vaccines being unable to trigger the onset of autism. “There was a steady upward trend in prevalence [of autism] across time that was unrelated to thimerosal exposure” (Scahill). This trend shows that while the vaccine’s connection to autism was questioned and often supported, the statics show the connection is invalid. While parents continue to pursue the connection between autism and the MMR, scientists are moving on to other possible causes of the developmental disorder. If we had the knowledge and diagnostic capabilities 30-50 years ago, the number of autism cases would most likely be much higher and the number of mental retardation cases would most likely be much lower. The “increased prevalence [of autism] is likely due in large part to new diagnostic categories and broadening of the diagnostic criteria over the past 50 years” (Primary Psychiatry). Medical providers have the ability to more accurately diagnose autism with standardized screening procedures. “Many children who are classified as autistic today would have been diagnosed with speech disorders or mental retardation 30 years ago” (Tarkan). This shows just how many children were misdiagnosed due to lack of understanding and knowledge concerning autism in previous years, and also enables medical providers to establish proper treatment plans and/or therapy to help aid in the mental development of children affected by autism. To further support this claim “as the number of children with autism has climbed, the number diagnosed with mental retardation has dropped” (Tarkan). The increasing

knowledge medical providers are gaining through research “is critical for early identification and intervention” (Primary Psychiatry) of autism. With the development of so many cases of autism and the decrease in the number of cases of mental retardation, the statement that autism is an epidemic is questioned. Changing a child’s diet is often one of the easiest ways to start working towards an autism cure or improvement in symptoms. “Much recent research has suggested that nutritional and environmental factors also play a major role in the development of autism” (Curtis and Patel), which has sparked a new direction in development of prevention and education for parents of children with autism. A child’s diet can be instrumental in their cognitive development as nutrients are crucial to proper functioning and development of their bodies and brains. “Special diets and supplements are often called complementary and alternative medicine (CAM) therapies” (Exceptional Parent). These diets vary and the process of elimination and trial and error are commonly used to determine which diet, if any, is the most beneficial for the child. Diets that control the amount of gluten or casein that a child ingests are some suggested therapies to treat or combat autism symptoms, though their validity and effectiveness is questioned by some. Doctors encourage parents to consult a dietician when considering these diets because “the assistance of a registered dietitian who has experience with people with ASD can help ensure there are adequate nutrients for the child to grow normally, especially when a child’s variety of food intake is self-limited or when limiting groups of foods, like gluten or casein, are removed from the child’s diet” (Exceptional Parent). There are cases of improvement and elimination of the symptoms of autism through this type of therapy, but there are also cases where no improvement is observed. From speech, to the ability to regulate oneself in a socially stimulating environment, to the ability to self regulate in a quiet and stable environment are all affected with these

developmental delays. Researchers are looking into the possibility of environmental triggers for autism more and more. The introduction of toxins during pregnancy is observed as a possible trigger for mental disorders in children later in life (Taylor, Rogers). Alcohol, drugs, physical and psychological stressors during pregnancy are all known to cause a negative effect to a developing fetus. Researchers are still trying to determine if these stressors and toxins are also causes of mental developmental problems later in life, which can be associated with the onset and development of cases of autism. “The clearest effect of stress is probably in leading to premature birth, and this can have its own consequences” (Taylor and Rogers), with premature more susceptible to infections, cognitive delays, developmental delays and a wide array of other medical dangers, the effect of stress on a mother during pregnancy could easily cause a developmental shortfall that could result in autism. “Children with the stigmata of FAS [Fetal Alcohol Syndrome] are very much at risk for psychological impairment – it is one of the common causes of generalized learning disability” (Taylor and Rogers). Mothers are cautioned from drinking alcohol during their pregnancies due to the effects of fetal alcohol syndrome, but the extent of the damage from FAS is still researched with children displaying different developmental delays. The symptoms of FAS are often communication difficulties and problems functioning in different types of social situations, very similar to the symptoms of autism. “Maternal use of cocaine is well known to produce a neonatal abstinence syndrome; in addition, its use is associated with a high rate of spontaneous abortions and fetal growth retardation, suggesting that the direct effects as well as the withdrawal are damaging” (Taylor, Rogers). All of these examples are strong factors in the cognitive and developmental short falls to children born from mothers who abuse substances and expose themselves to toxins during their pregnancies. The similarities that these cognitive delays and autism share in the development of communication and social skills are many.

With childhood being such a crucial time for brain development and cognitive functions being refined the damage could be irreversible if the Lyme disease not being noticed soon enough. “Infectious diseases in early childhood can cause a wide array of neurological and neuropsychiatric dysfunctions” (Taylor and Rogers). The development of neurological problems, which can be associated with autism, can be the result of illnesses that cause damage to the brain. “The HIV pandemic has left a huge toll of neurodisability; cysticercosis is endemic in most parts of the world; Lyme disease has achieved notoriety and perhaps even over-recognition (Taylor and Rogers). The introduction of toxins to the body can affect a child’s development in many ways. Lyme disease is known for causing memory loss and cognitive delays. A child could easily be bitten by a tick which could result in Lyme disease. Damage to the protein developed by chromosome 7 could be the potential cause to the development of autism. “There is increasing evidence implicating genetic factors in the etiology of autism” (Ray-Mihm). With this evidence the assumptions concerning the causes for autism are questioned as possible triggers rather than causes. “According to the National Institutes of Health (2006), autism is one of the more heritable mental disorders” (Ray-Mihm). In families where autism is prevalent, siblings of the child with autism have a 35 percent higher chance of developing autism (Ray-Mihm). “The National Institutes of Health (2006) reported that scientists have identified a version of a gene located in the area of chromosome 7 that has been linked to autism in families with more than one autistic child” (Ray-Mihm). These findings only further display the evidence of autism being a genetically prevalent disorder. There is a protein developed by chromosome 7 that has shown to “play[s] a role in normal and abnormal development” (Ray-Mihm). Unfortunately “there is no pharmacologic cure for autism” (Ray-Mihm), but with the growing number of scientists researching autism and the information that is gained, parents and

medical providers can more accurately diagnose autism and possibly catch it early enough that developmental damage to the child can be minimal. There may still be many who argue that there is a connection between the MMR vaccine and the onset of autism in childhood, but as you can see through the many examples above that the vaccine seems to be the least of our worries. There are many of environmental, genetic, and knowledge based factors that are contributing to the growing number in autism cases. The ability to diagnose autism seems to be the front runner in the causes of autism cases becoming exponentially greater each day. Through the information that is gained through research and testing of the alternative therapies and genetic studies, we could move to developing methods to prevent, treat, and even cure autism in young children.

Works Cited "What's the Scoop on Autism Spectrum Disorders and Nutrition?." Exceptional Parent 39.2 (Feb. 2009): 28-30. CINAHL Plus with Full Text. EBSCO. University of Texas at Arlington, Arlington, TX. 5 Apr. 2009 . Curtis, LT, and K Patel. "Nutritional and Environmental Approaches to Preventing and Treating Autism and Attention Deficit Hyperactivity Disorder (ADHD): a review." Journal of Alternative & Complementary Medicine 14.1 (2008 Jan-Feb 2008): 79-85. CINAHL Plus with Full Text. EBSCO. University of Texas at Arlington, Arlington, TX. 5 Apr. 2009 .

generationrescue.org (2008) Retrieved February 1, 2009, from . "Clinical Features and Diagnosis of Autism and Other Pervasive Developmental Disorders." Primary Psychiatry 16.1 (2009): 36-44. CINAHL Plus with Full Text. EBSCO. University of Texas at Arlington, Arlington, TX. 5 Apr. 2009 . Ray-Mihm, R. "Autism: Part II. Genetics, Diagnosis, and Treatment." Journal of Continuing Education in Nursing 39.3 (Mar. 2008): 102-103. CINAHL Plus with Full Text. EBSCO. University of Texas at Arlington, Arlington, TX. 5 Apr. 2009 . Tarkan, L. "Do Vaccines Really Cause Autism?." Health 22.8 (Oct. 2008): 82. CINAHL Plus with Full Text. EBSCO. University of Texas at Arlington, Arlington, TX. 5 Apr. 2009 . Taylor, E, and JW Rogers. "Practitioner Review: Early Adversity and Developmental Disorders." Journal of Child Psychology & Psychiatry 46.5 (May 2005): 451-467. CINAHL Plus with Full Text. EBSCO. University of Texas at Arlington, Arlington, TX. 5 Apr. 2009 .