HLTH101: Information and Evidence in Health and Social Care

Subject Code : hlth101
University : University of New England Gradesaviours is not sponsored or endorsed by this college or university.
Subject Name : Medical Sciences

Introduction

Autism is a developmental disorder that influences the functioning of the brain. It is a neurodevelopmental disorder and many genetic and non-genetic factors contribute to its development. The symptoms associated with autism can be impairment in speech and the prevalence of restricted behavior. Mostly the signs of autism are visualized early in childhood (Sauer et al., 2021). It impacts nervous, cognitive, and emotional well-being. Autism often can be visualized as difficulty in interaction and having effective communication with people, social isolation, repetitive and restricted behavior, and speech impairments. No accurate diagnostic tools are available to test for the presence of autism. Visualization is one of the key ways of analyzing children with autism (National Institute of Mental Health, 2023). No vaccine is formulated to provide relief from autism. Whereas MMR (measles, mumps, and rubella) vaccine is a vaccine that is developed to provide immunity against viral diseases such as measles, mumps, and rubella. This vaccine is administered usually between 12 to 18 months of age. Though there has been an increasing conception that the MMR vaccine causes autism. In order to assess the claim she consulted a health care professional to gather evidence-based information in support of the imperativeness of getting vaccinated with MMR doses, she consulted a health professional assisting her to confirm whether the MMR vaccine administration is associated with incidences of autism. In order to answer her question, I would provide her with research-based knowledge supporting literature to provide enough evidence to support the claim. I would provide her with the studies based on different settings and reviews that have assessed similar claims and will try to make her understand that there exists no causal link between the two.

The Original Research

The most significant vaccine controversy of all time is the claim that MMR vaccination increases the prevalence of autism. This notion was raised due to a study, original research that came in the year 1998 that shocked the belief regarding the employment of the MMR vaccine. However, there has been a significant amount of scientific evidence that the employment of the MMR vaccine is not correlated with the occurrence of the neurological developmental disorder. The research conducted by Wakefield et al., (1998) was the first study that probably exploited the relation between the MMR dose and the development of autistic behavior in children. The research has now been retracted from The Lancet journal due to ethical violations, which almost caused thousands of parents around the world to believe that the MMR vaccine causes autism in children (Khan et al., 2021). In his study, Wakefield and co-authors analyzed the link between the measles vaccine and inflammatory bowel disease (IBD). They performed the procedure on the frozen section of the ileum, colon, and rectum of 12 children who had a history of developmental disorders and problems associated with the intestine. While studying the correlation connecting the MMR vaccine and IBD proposed a hypothesis that generated the progression of degenerative disorder in children due to the MMR vaccine. He came up with this hypothesis after a parent reported behavioral abnormalities in eight of the children after getting a dose of the MMR vaccine. He further suggested that out of 12, 5 children had adverse reactions like fever and rash after immunization. He further claimed that viral encephalitis may be related with the progression of autism. He did not conclude definite links rather he proposed a hypothesis stating the possibility.

The Rebuttal Research

Hviid et al.,(2019) conducted a nationwide cohort study to comprehend the relation connecting the MMR vaccine and autism in the Danish population. He took 657461 Danish children and analyzed them based on survival analysis. Analysis of the survival time was done via Cox regression. They divided children into various subgroups. After the analysis, it was visualized that after the comparison of MMR vaccinated with MMR unvaccinated children, autism adjusts the ratio of 0.93 was obtained. No link between the enhanced risk of autism with the employment of the MMR vaccine was observed. The study further elaborated that vaccination does not causes the symptoms of autism and is not correlated with the accumulation of autistic incidences post-vaccination.

The study presented by Honda et al., (2005) analyzed the consequences of removal of the MMR vaccine on the occurrence of autism in children. To analyze this the researchers analyzed the incident rate of autism in children up to the age of 7 in the Kohoku ward born between the years 1988 to 1996. The rise in autism from 47.6 per 10,000 children born in 1988 to 117.2 born in 1996. This rise was visualized after the withdrawal of the MMR vaccine for five years i.e. 1988 to 1992. This study summarized that The MMR vaccination is not associated with and the withdrawal of the MMR vaccination does not cause a reduction in the cases of autism. The rise in autism cases despite the removal of the MMR vaccine was incompatible with the hypothesis proposed by Wakefield.

The review formulated by DeStefano & Shimabukuro, (2019) highlighted analyzing various epidemiological studies that there exists no link between MMR vaccination and autism. The review also highlighted that despite the wide spread evidence that there exists no association between the MMR vaccine and incidences of autism, parents are hesitant due to the widespread importance that the study published by Wakefield in the year 1998 received. The review article highlighted ecological and epidemiological studies employing case-control and cohort study designs from the UK, Japan, and the United States. And all the studies concluded one similar thing there exists no correlation between autism and the MMR vaccine. The paper highlights the role of healthcare professionals to educate and maintaining the confidence of parents in getting their children vaccinated with the MMR vaccine as this vaccine causes prevention with serious complications associated with measles, rubella, and mumps virus.

The review conducted by Davidson, (2019) explores the myths that exist concerning the association relating the MMR vaccine and autistic behavior in children. The author points out that because autism behavior becomes prevalent at one year of age and the vaccine is also administered between 12 to 18 old children, the belief of the possible link is raised. The theory of Wakefield was retracted by Lancet due to many issues highlighted that the hypothesis was baseless and lacked scientific backup. Further, it was also pointed out in the review that a decline in exposure to MMR doses was not directly related to the decline in autism cases. The withdrawal of MMR elaborated the existence of autism further. Though efforts need to be done to change the communities' perception regarding the similar issue.

Conclusions

MMR vaccine is extreme is an extremely crucial dose that provides immunity against viral infections such as measles, mumps, and rubella. This vaccination is administered to children of the age between 12 to 18 months old. Though there has been an increased perception amongst the community that the administration of doses of this vaccine is associated with increased incidences of this vaccine. This notion became popular due to Wakefield’s study stating the possible association which was published in the year 1998. However, following this claim there have been numerous investigations and studies that deny it and further added that withdrawal of the MMR vaccine further causes the occurrence of varied infections.

Questions and Answers

Is the MMR vaccine suitable for children with compromised immune systems? Is this vaccine safe for children’s immune systems?

Why does there still exist disbelief among parents and communities in getting their children vaccinated with the MMR vaccine?

References

Davidson, M. (2022). Vaccination as a cause of autism—myths and controversies. Dialogues in Clinical Neuroscience, 19(4), 403-407. 10.31887/DCNS.2017.19.4/mdavidson

DeStefano, F., & Shimabukuro, T. T. (2019). The MMR vaccine and autism. Annual Review Of Virology, 6, 585-600. https://doi.org/10.1146/annurev-virology-092818-

Honda, H., Shimizu, Y., & Rutter, M. (2005). No effect of MMR withdrawal on the incidence of autism: a total population study. Journal of Child Psychology and Psychiatry, 46(6), 572-579. https://doi.org/10.1111/j.1469-7610.2005.01425.x

Hviid, A., Hansen, J. V., Frisch, M., & Melbye, M. (2019). Measles, mumps, rubella vaccination and autism: a nationwide cohort study. Annals of Internal Medicine, 170(8), 513-520.https://doi.org/10.7326/M18-2101

Khan, H., Gasparyan, A. Y., & Gupta, L. (2021). Lessons learned from publicizing and retracting an erroneous hypothesis on the mumps, measles, rubella (MMR) vaccination with unethical implications. Journal of Korean Medical Science, 36(19).10.3346/jkms.2021.36.e126

NIMH. (2023). Autism spectrum disorder. https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd

Sauer AK, Stanton JE, Hans S, et al. Autism Spectrum Disorders: Etiology and Pathology. Brisbane (AU): Exon Publications; 2021 Aug 20. Chapter1. https://www.ncbi.nlm.nih.gov/books/NBK573613/

Wakefield, A. J., Murch, S. H., Anthony, A., Linnell, J., Casson, D. M., Malik, M., ... & Walker-Smith, J. A. (1998). RETRACTED: Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. https://doi.org/10.1016/S0140-6736(97)11096-0