Autism, vaccines and the need to keep our kids safe

shutterstock_161622521An excellent study was published on Tuesday in the Journal of the American Medical Association that should permanently lay to rest the oft-repeated claims of links between autism and the MMR vaccine given to children to protect against measles, mumps and rubella. I’ll share the abstract here…

Importance Despite research showing no link between the measles-mumps-rubella (MMR) vaccine and autism spectrum disorders (ASD), beliefs that the vaccine causes autism persist, leading to lower vaccination levels. Parents who already have a child with ASD may be especially wary of vaccinations.

Objective To report ASD occurrence by MMR vaccine status in a large sample of US children who have older siblings with and without ASD.

Design, Setting, and Participants A retrospective cohort study using an administrative claims database associated with a large commercial health plan. Participants included children continuously enrolled in the health plan from birth to at least 5 years of age during 2001-2012 who also had an older sibling continuously enrolled for at least 6 months between 1997 and 2012.

Exposures MMR vaccine receipt (0, 1, 2 doses) between birth and 5 years of age.

Main Outcomes and Measures ASD status defined as 2 claims with a diagnosis code in any position for autistic disorder or other specified pervasive developmental disorder (PDD) including Asperger syndrome, or unspecified PDD (International Classification of Diseases, Ninth Revision, Clinical Modification 299.0x, 299.8x, 299.9x).

Results Of 95 727 children with older siblings, 994 (1.04%) were diagnosed with ASD and 1929 (2.01%) had an older sibling with ASD. Of those with older siblings with ASD, 134 (6.9%) had ASD, vs 860 (0.9%) children with unaffected siblings (P < .001). MMR vaccination rates (≥1 dose) were 84% (n = 78 564) at age 2 years and 92% (n = 86 063) at age 5 years for children with unaffected older siblings, vs 73% (n = 1409) at age 2 years and 86% (n = 1660) at age 5 years for children with affected siblings. MMR vaccine receipt was not associated with an increased risk of ASD at any age. For children with older siblings with ASD, at age 2, the adjusted relative risk (RR) of ASD for 1 dose of MMR vaccine vs no vaccine was 0.76 (95% CI, 0.49-1.18; P = .22), and at age 5, the RR of ASD for 2 doses compared with no vaccine was 0.56 (95% CI, 0.31-1.01; P = .052). For children whose older siblings did not have ASD, at age 2, the adjusted RR of ASD for 1 dose was 0.91 (95% CI, 0.67-1.20; P = .50) and at age 5, the RR of ASD for 2 doses was 1.12 (95% CI, 0.78-1.59; P = .55).

Conclusions and Relevance In this large sample of privately insured children with older siblings, receipt of the MMR vaccine was not associated with increased risk of ASD, regardless of whether older siblings had ASD. These findings indicate no harmful association between MMR vaccine receipt and ASD even among children already at higher risk for ASD.

A brief explanation of the data…a relative risk ratio less than 1.00 suggests that the risk of autism is lower than what would be expected by random chance, while relative risk >1.00 suggests a greater than expected risk. In this study, the statistics suggest that in kids with older siblings with autism who received both recommended doses of the MMR vaccine, rates of autism approached the statistical threshold of being significantly lower than the rate in siblings who were unvaccinated. The authors had some interesting observations about this finding that were discussed at some length in the paper.

So…why bring this up here? Because what church leaders communicate to their congregations really matters, and the medical consequences of measles are potentially very serious for the young children we minister to.

ManWearingTinFoilHatWe just finished a blog series about attitudes regarding mental illness and the church and it’s pretty obvious that skepticism in large pockets of the church about recommendations from the medical community run pretty deep…and from where I sit, some of that skepticism…especially when people in the medical and scientific community operate from a very different worldview…is well-deserved. But there’s a point at which blind rejection of good science jeopardizes our ability to credibly communicate our witness to the world outside our Christian cocoon. We become as easy to dismiss as people who wear tinfoil hats and reinforce the perception among outsiders that one needs to check their brain at the door in order to come to church.

There’s a real possibility that you have kids in your church with a chronic medical condition that precludes them from getting the MMR vaccine. Kids who are being treated for cancer, kids who are HIV-positive (3.2 million children worldwide, according to the Kaiser Family Foundation) and kids receiving high doses of oral steroids are unable to take the vaccine. They depend upon “herd” immunity from infections that are potentially fatal for those with compromised immune systems. When large numbers of families forego immunization, vulnerability to outbreaks increases.

One such outbreak occurred at Eagle Mountain International Church in Texas in 2013. In that church, 21 people contracted measles, 16 of whom had never been vaccinated, including all of the children who developed measles. The story received national scrutiny from major media, including Fox News, NPR, USA Today, the Washington Post and ABC News. From the Fox News story

Although church officials were quick to act after the outbreak — including hosting clinics in August where 220 people received immunization shots — and have denied they are against medical care or vaccinations, people familiar with the ministry say there is a pervasive culture that believers should rely on God, not modern medicine, to keep them well.

“To get a vaccine would have been viewed by me and my friends and my peers as an act of fear — that you doubted God would keep you safe, you doubted God would keep you healthy. We simply didn’t do it,” former church member Amy Arden told The Associated Press.

What are our “take home” points…

  • The finding that the MMR vaccine doesn’t cause autism is as close to “settled science” as we can get in modern medicine. Additional money spent researching this topic would  represent extraordinarily poor public policy and stewardship of research money better spent determining the causes of autism and studying interventions to limit the functional impact of the condition.
  • If I were a parent of a child with a vulnerable immune system, I’d be very concerned about bringing my child to church if I had concerns that many of the kids present in the children’s ministry were unvaccinated.
  • If I were a pastor or an elder at a church in an area shown to have low immunization rates or families involved with adopting orphans from Sub-Saharan Africa (where HIV-positive status is endemic), I’d have to consider a policy of asking (if not requiring) families who are regular attenders to provide vaccination information as part of the children’s/youth ministry registration process. Obviously, we don’t want to create unnecessary barriers to families attending church, but we also need to maintain safe ministry environments for the kids we serve. One alternative might be to offer kids with immune system vulnerabilities classes/activities with kids who have been vaccinated. Note: On a statewide basis, Ohio, West Virginia and Colorado currently have the lowest MMR immunization rates according to the CDC, while some neighborhoods and private schools in affluent areas of Los Angeles have immunization rates comparable to those found in South Sudan!

While it’s critical to not allow controversies to divide us (and to continue to welcome families opposed to vaccines at church) we need to maintain ministry environments that are safe for all kids. Where significant numbers of kids go unvaccinated, other kids with medical conditions that preclude vaccination are exposed to risk.

COMMENTS ARE NOW CLOSED ON THIS POST.

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Square Peg Round HoleKey Ministry has assembled a helpful resource on the topic of Asperger’s Disorder and Spiritual Development. This page includes the blog series Dr. Grcevich and Mike Woods developed for Key Ministry, links to lots of helpful resources from other like-minded organizations, and Dr. Grcevich’s presentation on the topic from the 2012 Children’s Ministry Web Summit. Click here to access the page!

About Dr. G

Dr. Stephen Grcevich serves as President and Founder of Key Ministry, a non-profit organization providing free training, consultation, resources and support to help churches serve families of children with disabilities. Dr. Grcevich is a graduate of Northeastern Ohio Medical University (NEOMED), trained in General Psychiatry at the Cleveland Clinic Foundation and in Child and Adolescent Psychiatry at University Hospitals of Cleveland/Case Western Reserve University. He is a faculty member in Child and Adolescent Psychiatry at two medical schools, leads a group practice in suburban Cleveland (Family Center by the Falls), and continues to be involved in research evaluating the safety and effectiveness of medications prescribed to children for ADHD, anxiety and depression. He is a past recipient of the Exemplary Psychiatrist Award from the National Alliance on Mental Illness (NAMI). Dr. Grcevich was recently recognized by Sharecare as one of the top ten online influencers in children’s mental health. His blog for Key Ministry, www.church4everychild.org was ranked fourth among the top 100 children's ministry blogs in 2015 by Ministry to Children.
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25 Responses to Autism, vaccines and the need to keep our kids safe

  1. Andrea says:

    Reblogged this on WILMECNEWS.

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  2. Anne says:

    As a adoptive parent (one child has autism) I come at this issue a bit different. I do not blame myself for anything that I may have done. I did not pass on genetics. My son was vaccinated TWICE for everything because he came from a foreign country. The pediatrician was unsure if the vaccines my son received were okay. I have read LOTS of books on autism. That being said, I do think parents still feel vaccines are the source of the increase for autism.

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    • drgrcevich says:

      Hi Anne,

      Thanks for commenting.

      “That being said, I do think parents still feel vaccines are the source of the increase for autism.”

      That’s part of why I wrote this post. Because many parents “feel” vaccines are the source of the increase in autism, that doesn’t make it true. I realize this one is tough. There’s something to be said about a mother’s intuition. What makes this different is that there are potentially serious consequences for kids when parents are wrong about vaccines…the children of the parents who believe the risks of vaccines have been seriously understated AND the kids with medical conditions that preclude them from being immunized against the diseases the vaccines are intended to prevent.

      Like

  3. My daughter is immune efficient but I think churches asking for vaccine records is stepping over their bounds. Enforce hand washing and your sick child policy. It will do much more than knowing if someone’s child has been vaccinated. Then let ALL parents know if you find an illness has been brought into the church, close the rooms and disinfect.

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    • Did you mean “immune deficient,” rollercoastermama? Mine is too, as am I. That said, I agree with you about not having this as part of church policy, and I’m writing a post from a different perspective that will also be shared here.

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    • drgrcevich says:

      Thanks for your comments.

      I realized when I saw Shannon’s comment that something I said was misconstrued. If folks read this post and took away from it the impression that I think churches in general should be asking families for vaccination information before letting kids come to Sunday School, that’s most definitely NOT the idea I’m trying to convey. I’d only consider asking about this if I knew (or had strong reason to suspect) my church was serving kids with medical conditions that put them at enhanced risk of serious complications from conditions like measles AND I had reason to believe that “herd immunity” didn’t exist in the environments where groups of kids congregate.

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  4. Katie says:

    This is deeply disappointing and shows a profound ignorance or lack of caring about the thousands of parents who’ve watched their children regress into autism immediately following shots. Have you ever actually read Wakefield’s study? Have you read the history of autism, tracing it back to the 1940s (and the introduction of the DPT) shot? Have you watched or listened to, personally, parents who do believe vaccines were the cause? Have you ever considered the risk of measles–in a FIRST world country–compared to permanent and severe brain damage?

    You might also do some reading on vaccines and aborted fetal tissue, a point which should give many Christians pause.

    Either way, it is outrageous to discuss adopting from Africa, where there is no way to know that the person’s community was vaccinated, and then discuss a “policy” on required medicine for God’s people to fellowship together in the next breath.

    I don’t know the heart, but this post certainly sounds like someone’s been bought. There’s a mountain of evidence you are either ignoring or dismissing. (This is before we even get to many, many other issues linked to vaccines such as SIDS, autoimmune issues, paralysis, etc.)

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    • drgrcevich says:

      Hi Katie,

      I guess it was my “profound ignorance” that got me appointed to three terms on the Program Committee and New Research Subcommittee of the American Academy of Child and Adolescent Psychiatry. I’d also wonder why hundreds of parents have brought their kids with autism to our practice for the last 25 years in view of my lack of caring. Dr. Kanner’s original papers from the early 1940s about “infantile psychosis” were part of the required reading in my child psychiatry fellowship.

      I did read Dr. Wakefield’s paper. There were major problems with the methods he used in recruiting patients to participate in the study. He was less than transparent about the source of funding for the study (trial lawyers) or the potential for financial gain for himself and his co-authors by providing services to lawyers based upon the results of the study.

      Here’s what the editor of the British Medical Journal had to say about Dr. Wakefield’s study…

      “The Office of Research Integrity in the United States defines fraud as fabrication, falsification, or plagiarism. Deer unearthed clear evidence of falsification. He found that not one of the 12 cases reported in the 1998 Lancet paper was free of misrepresentation or undisclosed alteration, and that in no single case could the medical records be fully reconciled with the descriptions, diagnoses, or histories published in the journal.

      Who perpetrated this fraud? There is no doubt that it was Wakefield. Is it possible that he was wrong, but not dishonest: that he was so incompetent that he was unable to fairly describe the project, or to report even one of the 12 children’s cases accurately? No. A great deal of thought and effort must have gone into drafting the paper to achieve the results he wanted: the discrepancies all led in one direction; misreporting was gross. Moreover, although the scale of the GMC’s 217 day hearing precluded additional charges focused directly on the fraud, the panel found him guilty of dishonesty concerning the study’s admissions criteria, its funding by the Legal Aid Board, and his statements about it afterwards.

      The first line of the editorial sums up the paper…

      “Clear evidence of falsification of data should now close the door on this damaging vaccine scare.”

      Here’s a link to the entire editorial…

      http://www.bmj.com/content/342/bmj.c7452

      I’m not the one who was (and may still be) making money off this study.

      Like

  5. NickyB. says:

    I am on the fence with this one…in regards to the vaccines…It was right after that I saw a change in my son. I later had a daughter and I vaccinated her as well but I waited until she was a few months older to give her the MMR vaccine. My doctor understood my hesitation and was totally fine putting it off for a while. I am not against vaccination but I think something should be changed in terms of the amount and frequency with which we give them.

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  6. Rachel says:

    As the mother of a child who has a medically documented vaccine injury (Post Vaccination Encephalopathy-brain damage) this is incredibly insulting. I could not get past the photo with the tin foil hat before disgust took over and I had to exit out. Our son’s special needs are a DIRECT result of vaccines. I am shocked and disappointed that you would post something like this. Vaccine injuries are REAL, are SERIOUS, and life alter in ways you can simply not imagine. If our son had an injury caused by any other means, people would rally around us, support us, be compassionate. Because this is what injured him, it has been and isolating and very lonely path. Articles like this…. photos like that…. my son’s suffering does not deserve to be ridiculed and down played. We did not ask for this, but we ask for people, especially in the special needs community, to be compassionate.

    Like

    • drgrcevich says:

      Hi Rachel,

      I’m sorry that your child developed encephalopathy after being vaccinated. Unfortunately, such reactions, while very rare, are real. In no way did we mean to ridicule you or your son’s suffering, and we work very hard to help churches include families like yours.

      One of the challenges we face in medicine is that there are risks of treating and risks of not treating when we’re caring for kids. 160,000 kids worldwide die each year as a result of measles. Up until the early 1960s, nearly all kids contracted measles and roughly one in 500 would die. Too many kids with measles develop encephalopathies like that your son experiences. According to the US Centers for Disease Control, encephalopathy is far more likely as a complication of measles (by a factor of hundreds) than as a adverse effect of the vaccine. http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/meas.pdf

      Every experience like your son’s is a tragedy. My intent in sharing this post is not to cause pain, but to prevent other families from experiencing similar tragedies.

      Like

  7. Laura Hoch says:

    Yes, to changing the vaccine schedule. First, why in the world would anyone give a Hep. B vaccine to a two day old baby, like my son was given (and later developed autism), especially when there are no known risk factors in the family for Hep. B.? Next, never give more than one vaccine at a time and never when the child is already sick and fighting off some kind of illness. Finally, why not wait until the child is older, perhaps start vaccines a few months before kindergarten and give only one at a time with enough time between to monitor the child’s immune response. Some children are just unable to detox as well as others and their little bodies can’t handle the dramatic assault all at once that all these vaccines pose.

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    • drgrcevich says:

      Hi Laura,

      Here’s what the American Academy of Pediatrics says is the explanation for the current recommended vaccine schedules, which are reviewed on an annual basis…

      https://www.aap.org/en-us/advocacy-and-policy/Documents/Vaccineschedule.pdf

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    • amy says:

      Our OBGYN has a child with autism. He told me specifically to not to get the hep B and to consciously consider all vaccines. He didn’t want to get too much into it with me but since i asked him.. he told me. As has our own doctor- to be cautious and not do too many. Our doc follows a delayed schedule for her own children. Smart to be smart.

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  8. Laura Hoch says:

    Also, these studies “proving” that the MMR is safe don’t take into account all the other environmental assaults our kids are exposed to. There is a compounding effect that takes place sometimes and no study is able to effectively recreate this.

    Liked by 1 person

  9. Nell says:

    The disciples turned away those disease-ridden, non-immunized children too, when they wanted to see Jesus.
    I hope you enjoy the cheap click-bait views you get from this none-of-the-church’s-business topic. I’m taking my tin-foil hat, my vaccine-injured child, and finding another place to play.

    Like

    • drgrcevich says:

      Hi Nell,

      “While it’s critical to not allow controversies to divide us (and to continue to welcome families opposed to vaccines at church) we need to maintain ministry environments that are safe for all kids. Where significant numbers of kids go unvaccinated, other kids with medical conditions that preclude vaccination are exposed to risk.”

      Not sure how you’d come to the conclusion that we seek to turn away “disease-ridden, non-immunized children” wanting to see Jesus, especially in light of the other 851 posts we’ve shared over the last five years that are all about including kids at church.

      Sorry you feel led to find “another place to play.”

      Like

    • Laura Hoch says:

      Amen Nell!

      Like

  10. Robin Eliason says:

    You are presenting the standard line on vaccines. I would guess that before you wrote that article you did not read the two PDF’s below, for which I will paste links. Also, I am thinking that you did not watch the movies, “Trace Amounts” or “Bought.” I could bring many more important articles or information to your attention, but I will simplify and just say that the CDC is full of fraud and it’s research is untrustworthy. Anyone basing their opinion on what the CDC says and decides is appropriate with regard to vaccines hasn’t done their due diligence and doesn’t understand one simple fact: the regulation agencies (CDC, etc.), our politicians, the courts, and the media have ALL been bought by the pharmaceutical industry. The only thing left standing between corporate power and little children are the parents. It would have been much better for Merck, etc. if they had never started a war against the parents of California because all the corruption is coming out into the light of day.
    It is so sad that you have sided with the billionaires rather than the parents of vaccine injured children. We all want to be “safe” from infectious diseases, but not at the expense of our kids’ neuro-developmental and gut health. Why doesn’t it seem that the vaccine injured child’s life matter to you? Why doesn’t the isolation and difficulty of their parent’s lives deserve just as much of your understanding as say, the parent of a Down’s Syndrome child? Shaming parents who don’t follow the exact CDC schedule for medical, religious and/or personal reasons is unconscionable. It is unbecoming of a Christian ministry. Forced vaccination OR no public or private school education is on the horizon (see CA fight over SB277), and is NOT the answer. Please reconsider your stance on this issue. Don’t just dismiss those parents who saw their kids deteriorate after a vaccine as collateral damage to achieve a “infectious disease free” society. There never has been nor will there ever be such a thing. My child is not ATLAS.
    Here are the links I referred to above. I truly hope they will help someone.
    http://www.thinktwice.com/simpwood.pdf (non-public meeting held by 51 individuals on the Vaccine Safety Datalink)
    http://medicalveritas.com/manBlaylock.pdf (notes on the above PDF)
    http://traceamounts.com (link to Trace Amounts the movie)
    http://www.boughtmovie.com (link to Bought)

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  11. Pingback: Five reasons churches shouldn’t have vaccine policies | Church4EveryChild

  12. Laura Hoch says:

    Then for about 4 to 6 weeks after children are given a live virus vaccine, we need to exclude them from all church activities because they will be shedding those viruses in their environment.

    Liked by 1 person

  13. Val says:

    Have you done the research yourself into this? How many of big Pharma are in key position at. CDC, FDA, etc.? Interesting to me is the number of vaccinated that are not protected! Also, something important that I found in my research is the effectiveness of large doses of vitamin A in protecting health in a measles outbreak. This is something that has been known since early 1900s. In fact WHO & UNICEF include this now WITH measles vaccine especially in third world countries where malnutrition is a concern. The effectiveness rate for healthy outcomes after a measles outbreak in these third world countries owe much to vitamin A & not necessarily the measles vaccine!! (just do a Google search with terms vitamin A & measles, see what comes up under WHO & UNICEF)

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    • Val says:

      It is also important to note that big pharma doesn’t have patents on vitamins and can’t make $$ on their use…..but, if they can mandate the use of their products via state or federal law, they ensure the use of their product = $$$ in their pockets. we’re talking multi-billions!!! In Japan, about 25 to 30 years ago, they implemented use of a vaccine. One child died. They pulled the vaccine, studied it, And improved it for administering to their people. In that country, one death was unacceptable. In our country how many deaths are acceptable? And in comparison, how many deaths actually occur from the disease itself? Why is it acceptable to have deaths from the medical treatment? Not to mention what are the long term affects to our immune systems? Are auto-immune diseases one of the outcomes of vaccinations? If so, is that a price we want to pay? Or will we even have the choice, if vaccines are mandated by law?

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      • Val says:

        AND, many people do not know that pharmaceutical companies have legal immunity to medical liability caused by immunizations. If they have no repercussions from faulty vaccines, what’s their incentive to take more time and/or money to prove them safe for public use?

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  14. drgrcevich says:

    Hi Val,

    Since I was part of the group for my specialty that wrote the guidelines for ethical interactions between physicians and drug companies, I’m pretty familiar with how drug companies behave. Drug companies have PARTIAL immunity from lawsuits…cases are heard and settlements issued by a vaccine court in Washington DC, and plaintiffs are able to access local courts under some circumstances, although there are limits on awards. Prior to the law, a number of companies that made vaccines went out of business because of the liability risks, although some are profiting pretty well, including the makers of Gardasil. Here’s a summary article… http://www.wsj.com/articles/SB123535050056344903

    In one of the posts above, I included a link from American Academy of Pediatrics about the review process for vaccination schedules. The risk/benefit ratios from vaccines are reviewed as well. Every serious adverse event is a tragedy, but in the case of MMR, the risk of encephalitis appears to be at least 100X greater for kids for kids of parents who forego immunization.

    BTW…I don’t get any money from drug companies. The research our practice has been involved with since 2006 was funded through a National Institute of Mental Health grant to a research network established through Duke University. I love my two kids very much and want all kids to be healthy. I don’t have a horse in this race…I call ’em as I see ’em. And yes, both of my daughters (one studying to be a research physician) were fully immunized.

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