Another Study Shows No Link Between Autism and Thimerosal

No increased risk for any autism subtypes
No increased risk associated with prenatal exposure

A new study published today in the journal “Pediatrics” indicated that there was no increased risk of Autism Spectrum Disorder associated with receipt of thimerosal-containing vaccines. The study also found no increased risk for any of the subtypes of Autism Spectrum Disorder, including ASD with regression.  In addition, it found no increased risk of Autism Spectrum Disorder associated with prenatal exposure to thimerosal.

A case-control study was conducted in 3 managed care organizations of 256 children with ASD and 752 controls, matched by age and gender. Exposure to thimerosal was determined by electronic immunization registries, medical charts and parent interviews.

This study confirms previous research, which has not revealed an increased risk of autism associated with receipt of thimerosal containing vaccines. It adds to the body of knowledge by reporting that prenatal exposure to thimerosal is not associated with autism. It also looked specifically at subtypes of autism, including autism with regression, again finding no association with thimerosal exposure.

No significant differences in exposure effects were found between boys and girls for any of the ASD outcomes; there was no evidence that higher prenatal exposure exacerbated the effects of post-natal exposure; and there was no evidence that concurrent ethylmercury exposure was associated with ASD. In addition, there was no substantive difference in the association between thimerosal exposure and risk for ASD among children with an older sibling with autism and those without an older sibling with autism.

“In a way, it’d be great if thimerosal in infant vaccines was the culprit because the U.S. has already removed thimerosal from them” said Dr. Sharon Humiston, a pediatrician and FAAP, former member of the National Vaccine Advisory Committee (NVAC) and member of the Autism Science Foundation Science Advisory Board.  “Because we have not found the root causes of autism, we need to keep funding the research that will help us find them.  Because the resources to find what really does cause autism are scarce – money, scientists, and time – we urgently need to focus these resources on avenues that appear to be fruitful.  The vaccine hypothesis just has not yielded answers that help my autistic son or my typically developing daughter who may want to have children of her own one day.”

Pediatrics, September 13, 2010: Prenatal and Infant Exposure toThimerosal From Vaccines and Immunoglobulins and Risk of Autism

IMFAR Update: GFCF Diet Not Beneficial, New Biomarker, New Potential Treatment, 80% Divorce Rate Myth Debunked


ASF President Alison Singer speaking at IMFAR press conference

The International Meeting for Autism Research (IMFAR) officially gets underway tomorrow in Philadelphia, but already there is significant discussion about several studies that were presented at today’s IMFAR press conference.

Dr. Susan Hyman of the University of Rochester reported on her study that shows the gluten free casein free (gfcf) diet does not appear beneficial for children with autism.

“It would have been wonderful for children with autism and their families if we found that the gluten-free, casein-free diet could really help, but this study didn’t show significant benefits,” said Dr. Hyman

“The removal of gluten and casein from the diet of a controlled group of young children with autism did not demonstrate a change in sleep habits, bowel habits, activity or core symptoms of autism,” Hyman said.

Dr. Eric Courchesne of UCSD spoke at the press conference about his study showing a simple brain scan performed in infants and toddlers may be a biomarker for autism leading to early detection and early intervention.

The test involved using functional MRI to measure brain responses to spoken words in sleeping children.

“We discovered that autistic infants and toddlers displayed a pronounced abnormality of language activation and cortical development” said Courchesene.  “At each age studied from infancy to young childhood, most autistic subjects had greater activation on the incorrect side, namely, the right temporal cortex, compared to the left side and this incorrect activation pattern did not change or “normalize” even by 3 or 4 years of age.  The abnormal pattern was strong in a substantial percentage of autistic infants and toddlers suggesting that with further testing refinements, clinical tests revealing this abnormal activation pattern in individual cases could serve as a biomarker for risk for autism.”

Dr. Joseph Buxbaum of the Seaver Center at Mt. Sinai School of Medicine described a potential new treatment for individuals with autism who carry a Shank3 gene mutation (approximately 1% of the autistic population). “We have developed mice with a mutant Shank3 gene and observed deficits in the communication between nerve cells in the brain, which can lead to learning problems” said Buxbaum.  “Some changes we observed implicate a neurotransmitter for which several classes of drugs have been developed and we are now testing those classes of drugs in the mice. These changes, as well as other changes in the mice, indicated that the nerve cells were not maturing at the normal rate, so we gave the mice an experimental compound to help the nerve cells. This compound, which is formed as a natural derivative of insulin-like growth factor-1, is known to cross into the brain. After two weeks of injections, the communication between nerve cells was normal. Moreover, adaptation of nerve cells to stimulation, considered a key part of learning and memory, which is reduced in the mice, is restored following treatment. This indicates that similar approaches might be helpful in children with Shank3 deletions or mutations”.

Another study described today shows that divorce rates are similar for parents with and without children with autism, debunking the myth that families raising children with autism have a higher than average divorce rate.

Parents of autistic children often hear that the divorce rate in families with is 80%, but Brian Freedman of the Kennedy Krieger Institute reported that “there really weren’t any significant differences in terms of family structure when you consider children with autism and those without.”  ‘What we found is that children with autism remained with both biological or adoptive parents 64% of the time, compared with children in families without autism, who remained [with both biological or adoptive parents] 65% of the time.”

PBS Frontline’s “The Vaccine War”, Worth Watching!

We highly recommend PBS’s “The Vaccine War” which aired last night on PBS. In a rare display of tv news common sense, one side is simply declared to be wrong. The science is very clear; vaccines do not cause autism and it’s time to move on from this well debunked myth and find out what does.

The show features interviews with ASF Board Member Dr. Paul Offit, Dr. Arthur Caplan, Dr. Anthony Fauci, Dr. Cynthia Cristofani, Dr. Anders Hviid & Dr. Eric Fombonne, as well as with actress Jenny McCarthy and JB Handley of Generation Rescue. 
“Scientifically, I think the matter is settled,” says Anders Hviid, an epidemiologist at the Statens Serum Institut in Denmark. In one of the largest and most comprehensive epidemiological studies available, Hviid and colleagues analyzed data on more than a half million children and found no link between the MMR “triple shot” for measles, mumps and rubella and an increased rate of autism — a link that’s been strongly asserted for years by anti-vaccine activists. Similar epidemiological studies in Denmark also failed to reveal a link between the mercury preservative thimerosal and autism. In fact, around the world, peer-reviewed epidemiological studies have found no link between autism and either the MMR shot or thimerosal.
You can watch the full episode online or check local listings, as we’re told by PBS that the show will air multiple times this week.  

View scientific studies regarding autism and vaccines here

Vaccine Court Denies All Three “Thimerosal Causes Autism” Test Cases

By Alison Singer

This afternoon, the U.S. Court of Federal Claims (i.e. Vaccine Court) issued its decision on whether thimerosal-containing vaccines can cause autism.  The decision, handed down by three Special Masters, was a resounding “NO!”.

From King: “This case is not a close case. The overall weight of the evidence is overwhelmingly contrary to the petitioners’ causation theories…based upon all the evidence that I have reviewed, I find that it is extremely unlikely that Jordan’s autism was in any way causally connected to his thimerosal-containing vaccines. In short, this is a case in which the evidence is so one-sided that any nuances in the interpretation of the causation case law would make no difference to the outcome of the case.

From Dwyer: “In an effort to render irrelevant the numerous epidemiological studies of ASD and TCVs (thimerosal containing vaccines) that show no connection between the two, they contend that their children have a form of ASD involving regression that differs from all other forms biologically and behaviorally. World-class experts in the field testified that the distinctions they drew between forms of ASD were artificial, and that they had never heard of the “clearly regressive” form of autism about which petitioners’ epidemiologist testified. Finally, the causal mechanism petitioners proposed would produce, not ASD, but neuronal death,and eventually patient death as well. The witnesses setting forth this improbable sequence of cause and effect were outclassed in every respect by the impressive assembly of true experts in their respective fields who testified on behalf of respondent.

From Dwyer: “Petitioners propose effects from mercury in [vaccines] that do not resemble mercury’s known effects in the brain, either behaviorally or at the cellular level. To prevail, they must show that the exquisitely small amounts of mercury in [vaccines] that reach the brain can produce devastating effects that far larger amounts experienced prenatally or postnatally from other sources do not.”  

The special master also dismissed claims that some groups of children are unusually susceptible to the effects of mercury. “The only evidence that these children are unusually sensitive is the fact of their [autism] itself.”

This whole process began back in 2002 when the Special Masters from the Vaccine Court createdan omnibus proceeding for handling the claims that alleged that vaccines were associated with autism. Today’s ruling focuses on whether thimoerosal-containing vaccines can cause autism. Last August, the court ruled that thimerosal in combination with MMR vaccine could not cause autism.

There are two key points to keep in mind today. First, the special masters are not scientists and they did not answer a scientific question today. The science has been in for some time now in and it’s quite clear. Vaccines do not cause autism.  We have multiple studies ( that have been done looking at whether or not thimerosal, at the level contained in vaccines, causes autism and again, looking at hundreds of thousands of children on several different continents by several different investigators and different populations of children. Children who received thimerosal in vaccines as compared to those who received lesser quantities of thimerosal in vaccines or no thimerosal in vaccines all had the same risk of autism. And frankly, the amount of mercury one is exposed to in the environment or even breast milk as compared to what’s in vaccines would argue against vaccines being causative.

Secondly, when you look at the history of vaccine court, this court hasn’t always come down on the side of the science. The standard of evidence bar is purposely set very low in vaccine court. The court was designed to compensate victims of vaccine injury, which of course is very real. The standard of evidence is biologic plausibility, rather than scientific evidence. In other words, you don’t have to prove that thimerosal actually causes autism, only that it might. One of the goals of the legislation creating the vaccine court in 1986 was to be generous with compensation because there are people who have very real, very serious adverse reactions to vaccines and they should be compensated.  And if you look at other rulings, this court tends to err on the side of overcompensating to avoid a big spillover into civil courts. Another goal of the vaccine court is too avoid massive civil litigation that could put us back where we were in the early 1980s where companies were exiting the vaccine manufacturing business over fear of litigation.

I can understand wanting to find a reason for why your child was diagnosed with autism. As a mother, it’s hard to accept the idea that your child is going to struggle and have all these challenges.  It’s natural to want to blame someone or something. Believe me, I’ve been there. We love our children so much and we just want to do everything possible to help them. I can understand parents who are upset and angry and just want to know how this could have possibly happened, and I feel for the families who filed in vaccine court because they are clearly in a lot of pain. But they need to look at the data. You can’t be so focused on anger that you lose sight of what the science is saying because that’s not in the best interest of the kids.  At the Autism Science Foundation we always encourage parents to look at the science and make decisions based on the science.  And this is what the special masters did. They looked at the data.

And I want to stress one more point; this is really not an issue over which parents and scientists disagree. Parents have access to the studies on the internet and we know how to read. The studies are very clear. The vast majority of families have come to the same conclusions as the special masters. It’s not a scientists vs. layperson or scientist vs parents issue.  Everyone is coming to the same conclusion, except a small, vocal minority of parents who just don’t want to believe what the data clearly show.  And frankly it scares me to see children with autism being put at risk by therapies that have grown out of the incorrect vaccine hypothesis, like heavy metal chelation, that have no evidence of efficacy and can do real harm, especially when they divert time and energy away from therapies like Applied Behavior Analysis which have been proven to help our kids.

Hopefully after today’s ruling, we can put this issue behind us and move forward and direct our scarce autism research dollars to studies that will provide new information about what causes autism and how best to treat it.

Your Autism/Vaccine Questions Answered

The Vaccinate Your Baby project, sponsored by Every Child By Two, has launched a new website featuring video answers to frequently asked questions (FAQs) about vaccines and autism. Several experts in the fields of immunization and autism participated and their answers have been edited into short video clips.

Participants include:

  • Paul Offit, MD, Chief, Division of Infectious Diseases and Director, Vaccine Education Center, Children’s Hospital of Philadelphia and Board Member of the Autism Science Foundation
  • Alison Singer, Co-Founder & President, Autism Science Foundation and parent of a child with autism
  • Mark Sawyer, MD, Professor, Clinical Pediatrics and Pediatric Infectious Disease Specialist, UCSD School of Medicine & Rady Children’s Hospital San Diego
  • Mary Beth Koslap-Petraco, DNP(c), CPNP, Coordinator, Child Health Suffolk County Department of Health Services, NY 

The questions cover a wide range of topics, including Why Vaccinate?, Why Follow the Recommended Immunization Schedule?, and What does the Science Tell Us About Autism and Vaccines?

To view the video clips, visit

The Decade’s Most Overblown Fears

By Alison Singer

Newsweek  has just posted a special “end of the decade project” in which the editors attempt to recap the last ten years. They have produced twenty different top 10 lists, including one on overblown fears; threats that fortunately didn’t materialize or were later debunked. Topping this list are Y2K, and the threat of shoe bombs (and frankly nothing is more annoying than having to take off your shoes at airport security, especially in winter when the floor is cold. Number 3 on the list is “Vaccines and Autism”.

More than a dozen studies done over the past decade indicate that neither vaccines nor any specific ingredients in vaccines cause autism. While research on environmental factors is important in autism, it makes little sense to continue to pursue a specific study of vaccines, the one environmental factor that science has already ruled out.

Writing in Newsweek, Dr. Paul Offit explains the origin of the disproved notion that vaccines cause autism, and concludes with the following: “In the meantime children whose parents were frightened by MMR have died from measles and those frightened by thimerosal have died from bacterial meningitis: sacrificed at the altar of poorly conceived ideas. The tragedy is, given all we now know about the neurological basis of autism, these hypotheses had no chance of bearing fruit.”

As we approach a new decade, let’s keep focused on areas in autism research that have potential to yield new, actionable information for families. Let’s commit to asking new scientific questions in the coming decade and to putting the vaccine-autism myth squarely behind us.

H1N1 Influenza Virus, H1N1 Vaccine and Mitochondrial Disease

By Bruce Cohen, M.D.

Dr. Cohen is a staff neurologist in the Neuroscience Institute at the Cleveland Clinic Foundation. Dr. Cohen served nine years on the Board of Trustees of the UMDF from 1998-2006 and is currently Secretary of the UMDF’s Scientific and Medical Advisory Board. He has been the chairman or co-chairman of the 2000, 2005 and 2008 UMDF Annual Symposium and will be the CME Chairman for the 2009 meeting.

There have been questions regarding recommendations about people with mitochondrial disease receiving the H1N1 vaccine. The Scientific and Medical Advisory Board (SMAB) of the UMDF did discuss the issue in great detail and these comments reflect the board’s discussion. Much of the factual information has been obtained from governmental websites.

The H1N1 virus, also called “the swine flu” typically causes fever, cold symptoms (cough, sore throat, runny or stuffy nose), body aches, loss of appetite, and headache. As with any fever, chills may be present. Fatigue is part of most flu illnesses. Vomiting and diarrhea are reported in some and there are now cases where people have respiratory symptoms without a fever. These symptoms range from mild to severe. There are some people that get sick, but never are sick enough to think about seeing a doctor, whereas others with the same virus will die as a result of their infection. At this point it is not possible to know if the infection will spread to epidemic proportions, or if the virus, which now seems as “bad” as most influenza viruses but no worse, will shift to a strain that will cause more or less severe disease.

If you think anyone in the family may have the H1N1 virus, we advise that you seek out immediate medical attention. As part of general medical practice, both fever and dehydration should be treated with standard medical management. Sometimes bedrest, ibuprofen or acetaminophen and fluids are what will be recommended. Use of antiviral medication is given for more severe cases (which are believed to be safe in those with a mitochondrial disorder). For those people that have shown to be susceptible to regression after dehydration, the use of IV hydration and appropriate IV rehydration therapies is reasonable. Aspirin should be avoided.

Immunization for the H1N1 is now available. The immunization comes as a live attenuated product delivered by spraying it into the nose and as a killed form, which is delivered by injection. The nasal form (live attenuated vaccine) is not recommended for people with chronic health problems, but can be used in people 2-49 years of age that are healthy (such as healthy family members). The inactivated (dead virus) vaccine contains the preservative thimerosal, which was investigated because of the concern it was linked for causing autism. However, in 2004 the experts at the Institute of Medicine concluded there was no evidence of this and further research has indicated there is no health risk or link to autism. It is this inactivated (dead virus) vaccine that is being recommended for those with health problems, which would include mitochondrial disease.

It is important to know that it takes several weeks after the immunization is given for the body to build up immunity against the virus. The Center for Disease Control’s Advisory Committee on Immunization Practices has recommended that certain groups receive the 2009 H1N1 vaccine when it first becomes available. These target groups include pregnant women, people who live with or care for children younger than 6 months of age, healthcare personnel, persons between the ages of 6 months and 24 years old,

and people ages of 25 through 64 years of age who are at higher risk for 2009 H1N1 because of chronic health disorders or compromised immune systems. The government is not recommending the immunization for those less than six months of age. For those under 9 years of age the recommendation is two doses of the vaccine separated by four weeks. The group of healthy people between 25-64 years of age are not in the recommended category for immunization because they are less likely to have a bad outcome if they get an H1N1 influenza viral infection.

It is reasonable to believe that an H1N1 infection, or any influenza infection in a child with a mitochondrial disease will be worse than that of an otherwise healthy person. The presence of a fever, reduced food intake, risk of dehydration in addition other parts of the body’s cytokine response to the flu will result in a higher risk of injury and subsequent mitochondrial dysfunction that would likely occur in a healthy person. As with any influenza, a certain percentage of infected people will die. Historically this has been the elderly and those that are already ill. The concern among doctors who care for children and adults with mitochondrial disease is that because of the frail state, parents (or affected adults) will choose not to get immunized for fear that the vaccine will make them sick. Understanding the possible risks and the possible benefits should help alleviate this fear.

The vaccine given for the 1976 swine flu (a different strain — so if you were immunized in 1976 it does not help this year) was possibly causally linked to Guillain-Barre syndrome (GBS) in a small minority — 450 cases for the 45 million people that got the shot, or about 1 in 100,000. This is a paralyzing disorder that is now treatable (and most people that got this disorder did recover). However in 1976 there were no therapies and 30-40 of those 450 people died. It has never been proven that the vaccine caused the increase in GBS. I have spoken with senior scientists that are convinced there was a link and those that truly believe there was no link. Even after more than 30 years this has not been resolved in the scientific community. In the studies of vaccines that followed the 1976 vaccine, no clear answer has emerged and the number the government decided upon is that the risk is on the order of one in one million. Because of this situation it is recommended that people that have ever had GBS in the past do not get the vaccine. This one in one million risk (or one in 100,000 if you chose that number) needs to be considered along side of the risk of death and disability caused by the flu itself. There have been 10-11 deaths in children this week alone from the swine flu, with 86 confirmed pediatric deaths since the swine flu began being tracked in April 2009. Two-thirds of the hospitalizations in children have been in those with underlying medical problems.

This vaccine has been tested in children and adults using standard methods. There is no evidence that this vaccine will result in any more adverse reactions than other influenza vaccines. There are no special concerns about this vaccine in particular that are worrisome. Waiting to see if the H1N1 virus will cause an epidemic before making a decision about getting the vaccine (or your child) is the wrong strategy. By the time we know if this is an epidemic, given the month or so it takes to achieve immunity, it will be too late. It is easy to find information on the web that will cause you (or me) to question vaccine safety but when you read past the questions of concern, there are no clear data to support the concern.

There is no way to prevent getting the flu. Of course common sense and strict hand washing are important, but unless you live by yourself and never have contact with another person, you will be exposed to people, and the 100 people every person came into contact with that day.

It is simply not possible to make the blanket recommendation that “all children and adults with mitochondrial disease get the H1N1 immunization.” That is a decision between you and your doctor. In the last several months almost all of my patients (and their families) have asked me if I recommend the vaccine and I have said to all of them so far “I recommend the H1N1 and the regular flu vaccine in your situation.” In addition I have not told a patient they should not receive the vaccine. I am not sure what I will say with the next patient, but to date all have had my recommendation to get the vaccine.

In summary, any influenza poses more of a health risk to a person with mitochondrial disease than to an otherwise healthy person. There is no evidence that the H1N1 vaccine poses a risk of injury above and beyond other influenza vaccines (which I have been recommending to my patients for years). If there is an influenza epidemic caused by the H1N1 virus (or other virus that is covered by the regular seasonal flu vaccine) several months from now, getting the vaccine in the middle of the epidemic will likely not be very helpful. It is everyone’s hope there is no epidemic. But if there is an epidemic, those having received vaccination will have the necessary protection. There is a lot of good information in the web, which can be found by going to your search engine and typing “H1N1 Virus Vaccine”. The CDC.GOV website can give you up-to-date information about the influenza situation and immunizations.

On a personal note, the vaccine just rolled into Cleveland today. My wife just got her H1N1 vaccine when she went into work this evening, I will get mine hopefully when I return to work and we are awaiting instructions from the pediatrician so I can get all my children immunized against the swine flu ASAP (they all have gotten immunized against the seasonal flu).

Bruce H. Cohen, MD

Wired Magazine Publishes Cover Story and Series of Articles on Vaccines, Autism

Wired Magazine  (November 2009) has published a cover story and several additional sidebar stories on the anti vaccine crusade.  They all well worth reading.

Cover Story: An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All

The MisInformants: Prominent Voices in the AntiVaccine Crusade (list includes Jenny McCarthy, Jim Carrey, Joe Lieberman, Robert F Kennedy Jr, Don Imus, and MSNBC’s Joe Scarborough)

What’s the Real Story on the Vaccine Debate. Learn More (calls out disguised anti-vaccine websites, and provides links to reputable information on CDC and NIH websites)

How to Win an Argument About Vaccines (sets out myths and facts)

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