A highly respected and well-published scientist at the Utah State University, Vijendra K. Singh has further linked autism to the MMR vaccine. His study published in New Foundation of Biology, Elsevier Science BV 2001: 447-58 titled Neuro-immunopathogenesis in Autism provides brain autoantibody and virus serology evidence that links autism to MMR and postulates autism as a neuroautoimmune response that occurs at the neuroimmune biological interface.

Singh found that autoantibodies to myelin basic proteins were present in 80% of autistic children but that none were found in the normal children control group and only rarely in all other controls. These autoantibodies attack the basic proteins that constitute myelin, which surrounds the sheaths of nerve fibers. Regarding the virus serology, autistic children had a significantly higher level of measles virus antibodies as compared to controls, which suggests a temporal link of measles virus with autoimmunity in autism.

Furthermore, Singh found a very important serological association between measles antibody level and antiMBP, which showed that the higher the measles antibody titer the greater the chance of autoantibodies to myelin basic protein. The shocking fact is that none of the children had a wild-type measles infection, but they all had the measles mumps rubella (MMR) vaccine.

Singh also offers hope. He notes an open label trial of oral Sphingolin (myelin containing autoantigen) is being assessed. Preliminary results show significant improvement in autistic people, which further support the neuroimmune pathogenesis in autism. -transcribed by Susan E. Kreider

Vijendra K. Singh, Department of Biology and Biotechnology Center, Utah State University, Logan, Utah, USA 84322-5305

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Introduction:

In 1986 the U.S. Congress passed the National Childhood Vaccine Injury Act, which set up a system whereby the families of vaccine-injured children could be compensated for such injuries. Based on personal experience and observation, there has been much criticism of this system and question whether not it is serving its intended purpose. (1) One of the major areas of controversy surrounding the act involves its limitations in the latent periods, whereby certain defined reactions following vaccines must be identified within a certain time period to qualify for compensation by the childhood vaccine injury act. For the complication of encephalitis, the time limitation for the DTP or DTaP vaccine is 3 days; for the measles-mumps-rubella (MMR) vaccine it is 5 to 15 days.

The limitations in latent periods following vaccines have been generally accepted by our medical-legal system as guidelines in other areas as well. Prominent among these is the "shaken baby syndrome" (SBS) in which a parent or caretaker is accused of injuring or murdering an infant by violent shaking and causing a triad of findings now commonly accepted as diagnostic of SBS: retinal hemorrhages, subdural hematomas, and diffuse axonal injury. (2-5)

However, it has been observed that many cases attributed to the SBS have occurred in a time-related fashion following routine childhood vaccines, especially in compromised children that had been born from medically complicated pregnancies. (6) Consequently there are valid reasons for questioning whether or not some or many cases that have been accused of SBS were not the result of mistaken diagnoses, the true causes of death or injury of the child having been vaccines.

Since questions surrounding the latent period play a prominent role in many of these cases, it is timely and appropriate to review the background of this issue.

Are Current Guidelines in the Latent Period Artifactual?

(A) The DTP (diphtheria-tetanus-pertussis) Vaccine:

If we think in terms of a vaccine-induced encephalitis, most of the earlier literature deals with the pertussis vaccine. Flexner (1930) noted a strong tendency for the nervous system manifestations to declare themselves between the 10th and 13th days. (7) In a review of 108 cases recorded before 1929 by Gorter (1933) , the onset of encephalitis was "strikingly constant," usually observed between the 10th and 12th days following vaccination, commonly with a febrile period on the 7th and 8th days, followed by recovery until onset of the encephalitis. (8) In 1929 an editorial in the Journal of the American Medical Association reported on an increase in severe neurological complications following infections and inoculations occurring on about the 11th day after vaccines. (9) Over 50 years later Munoz, (1984) in a mice study of experimental encephalomyelitis elicited by injection of pertussigen, found the same latent period of 11 to 13 days. (10)

In contrast, some of the literature since the 1970s has reported an entirely different pattern, with the onset of encephalopathy largely falling within a 3-day period following vaccines. (11-13) We can only speculate as to the reasons for this changing pattern. Perhaps it can be attributed to the fact that, in those early years, children were given very limited numbers of vaccines in comparison with more recent years during which they have routinely received the hepatitis B, H influenza, and polio vaccines in addition to the DTP, all given at the same time. The hepatitis B vaccine has been implicated in neurological disorders, autoimmune disorders, various forms of vasculitis and cutaneous reactions, as well as hemorrhagic complications. (See below, page 6) Both the pertussis and H influenza vaccines have been shown to have unusually high hyper-sensitizing properties. (14) In many vaccines thimerosal, which contains ethyl mercury, has been added as a preservative. (In some vaccines its use dates back to the 1930s.) Thimerosal has also been found to have sensitizing properties. (15) Consequently there are valid reasons for believing that the pertussis and H influenza vaccines, some of which contain mercury, may be acting in a three-way synergy in causing hypersensitivity reactions.

In the text, Vaccinations and Behavioral Disorders, by Greg Wilson, the author made the following comment in regards to the latent period:

"Today the latent period is rarely mentioned in connection with neurological complications of immunization…Contemporary studies on the pertussis vaccine select an arbitrary time limit in which reactions have to occur to be considered as vaccine related. This time limit is usually 3 to 7 days.

"Perhaps the only study which explores the dynamics of post DPT reactions is an independent Australian study by Karlsson and Scheibner which, with a monitor which followed breathing volumes, found particular times of stress-induced breathing following DPT injections." (16) "Of special importance (for stress) are days 2,5,6, and 8,11,13-16 and 18-21. (17)

By way of explanation, the above study involved the use of a Cotwatch breathing monitor controlled by a micro-processor and designed to provoke alarms with breathing delays (apnea of hypopnea with 5% or less of normal breathing patterns) following DTP immunizations. It was found in the study that these periods of stressed breathing occurred in clusters of 15 minutes at a time on the post-vaccine days listed above, varying greatly from child to child. From our point of view, the important feature of the study is not so much the specific post-vaccine days on which the stressed breathing occurred but the fact that the clusters continued for 21 days following the vaccines, (18) which would tend to discredit the current medical-legal limitation for DPT reactions to 3 days.

Dr. Scheibner's findings do have some support in a study which showed a fairly high incidence of cardio-respiratory complications in premature infants following vaccinations. (19) Unfortunately, this study was of limited duration. Another study throwing light on the latent period is one coming from Japan, from which it was found that increased histamine sensitivity in mice, brought about by the pertussis vaccine, showed two peaks, one on the 4th day following vaccination, and a second on the 12th day. (20) In the same vein, in a letter to the British Medical Journal, Rosemary Fox, secretary of Parents of Vaccine Damaged Children, made the following comments:

"Two years ago we started to collect details from parents of serious reactions suffered by their children to immunizations of all kinds. In 65% of the cases referred to us, reactions followed the triple vaccine (diphtheria-pertussis-tetanus). The children in this group total 182 to date; all are severely brain damaged, some are also paralyzed, and 5 have died. Approximately 60% of reactions…occurred within 24 hours of vaccination, 80% within 3 days, and all within 12 days." (21)

It is important to point out in the above-survey that 20% of reactions occurred beyond the current 3 day medical-legal limitation for the DPT vaccine.

Another important study throwing light on the latent period involves an unpublished series of 25 cases with accusations or convictions of parents or caretakers for the shaken baby syndrome, a series collected by attorney Toni Blake of San Diego, California (personal communication, 2000) which have the following features: 1) All occurred in fragile infants born from complicated pregnancies. Problems included prematurity, low birth weights, drug/alcohol problems, diabetic mothers, or other maternal complications. 2) All infants were 6 months age or less. 3) Onset of signs and symptoms occurred at about 2,4, or 6 months of age,WITHIN 12 DAYS OF VACCINES, 4) All infants had subdural hematomas. 5) Some had multiple fractures.

In addition to the work of Dr Viera Scheibner and attorney Toni Blake, another enlightening area of study for the latent period is the federal Vaccine Adverse Events Reporting System (VAERS). In her book, What Your Doctor May Not Tell You About Children's Vaccinations, (22) Dr. Stephanie Cave makes the following observations about VAERS: "It is common knowledge that less than 10% of all adverse events following vaccinations are reported to VAERS, which means that instead of the 12,000 to 14,000 reports of hospitalizations, injuries, and deaths made every year, there may be as many as 120,000 to 140,000."

Even a cursory examination of the VAERS database for DTP/DTaP vaccines will reveal that the latent periods for many vaccine reactions extend into the 7 to 13 day periods, some extending beyond 14 days. (23)

No review of the latent period would be complete without pointing out an almost insuperable difficulty in getting dependable data on these reactions due to the extreme reluctance of doctors to report on vaccine reactions, a pattern which has existed since the earliest days of childhood vaccines. There are a number of reasons for this. From their earliest years of training, medical doctors have been taught to look upon vaccines as one of the greatest achievements in medical science, and any question about the vaccines is often looked upon as disloyalty to the profession. In addressing this issue in the classic text, Shot in the Dark, by Coulter and Fisher, the authors quoted an attorney specializing in vaccine-damaged children. In commenting on the deficiency in doctors' reporting of vaccine reactions, the attorney commented, "As is the case with many pertussis-vaccine-injured children, none of the treating physicians would commit themselves to a final etiological diagnosis. It is strange that parents of pertussis-vaccine-damaged children often can only get an etiological diagnosis by hiring an attorney and seeing one of the few recognized experts in the U.S. on post-pertussis vaccine encephalopathy." (25)

As a result of this physician-reluctance to report vaccine reactions, large numbers of reactions may be taking place beyond the currently established time limits of the latent period, unrecognized as to their true nature.

(B) The Hemophilus influenza (HiB) vaccine:

In one of the largest, if not the largest randomized epidemiological trial ever conducted, the effect of the Hemophilus vaccine on the development of insulin dependent diabetes mellitus (IDDM) was studied in Finland. (26) All children born in Finland between October 1st, 1985 and August 31st, 1987, approximately 116,000, were randomized to receive 4 doses of the HiB vaccine (PPR-D, Connaught) starting at 3 months of life or one dose starting at 24 months of life. An intent to treat method was used to calculate the incidence of IDDM in both treatment groups until age 10. The incidence of IDDM was also calculated in a control group of 128,500 children which did not receive the HiB vaccine. (27) The results demonstrated a rise in IDDM which was specific for the vaccinated cohort. (28) However, the important point for our purposes was that there was a consistent delay of 3.5 years between vaccination and onset of IDDM. (It should be pointed out that IDDM is considered an autoimmune disease.)

At a presentation this past spring in Nashville, Tennessee sponsored by the American College for the Advancement of Medicine, (29) Dr. John Classen reviewed 32 publications in the medical literature showing a similar increases in diabetes mellitus in a number of countries with the MMR and hepatitis B as well as the HiB vaccine, again with latent periods up to three years or more, according to graphs that were provided. (Copies of references will be provided on request). Rather than being specific to any one vaccine, Dr. Classen offered his opinion that the general immune stimulation from the vaccines was the cause of a rise in autoimmunity. As an interesting sidelight, Dr. Classen mentioned that personnel in the U.S. navy are more heavily immunized than their European counterparts, and that the U.S. navy personnel have five times more diabetes than their European counterparts.

(C) The MMR (measles-mumps-rubella) vaccine:

Whereas DTP and Hib vaccine-related encephalopathy may be the result of interactions between endotoxin and mercury, (the latter in the form of the additive, thimerosal), the primary mechanism of viral vaccines in causing encephalopathy may be related to the propensity of viruses (and viral vaccines) in bringing about autoimmune reactions. (30)

In order to provide an overview of the latent period, there are two basic classes of immune systems, the humoral or antibody producing system, which tends to produce immediate-type reactions, and cellular immunity, in which reactions are delayed. Either class is capable of producing autoimmunity. (31) Obviously, the usual 15 day limitation for the MMR vaccine excludes a recognition of the delayed-type autoimmune reactions and, by inference, even denies their existence. In an article by Cohen and Shoenfeld dealing with questions of vaccine-induced autoimmunity, the authors pointed out that it is a subject about which relatively little is known, due to the paucity of clinical and laboratory studies. (32) In point of fact a more recent review on this subject cites a temporal relationship of 2 to 3 months between vaccines and autoimmune reactions. (33)

Recently the subject of the latent periods for the MMR vaccine came sharply into focus in an article published in Adverse Drug Reaction & Toxicology Review, (34) in which researchers Andrew Wakefield and Scott Montgomery, who have been investigating a possible causal relationship between the MMR vaccine and the autism-enterocolitis syndrome, carefully reviewed deficiencies in the early pre-licensing trials of the MMR vaccine. In the article they pointed out that follow up periods following the vaccine were a maximum of 28 days and in some studies even shorter periods. They stressed that such short periods of observations following the vaccine were totally inadequate to detect delayed reactions, including pervasive developmental delay (autism), immune deficiencies, and inflammatory bowel disease, which are known from earlier published reports to occur following both the natural measles infection and the measles vaccine.

The most interesting feature of the Wakefield/Montgomery article was that it was reviewed by four leading British authorities, all of whom had previously held positions in the regulation and licensing of medicines in the United Kingdom. (35) Taken as a whole, the reviewers were supportive of the article, three highly so. Peter Fletcher, formerly a senior professional medical officer for the Department of Health wrote, "being extremely generous, evidence of safety (of the MMR vaccine) was very thin." Noting that single vaccines for measles, mumps, and rubella already existed, he argued, "caution should have ruled the day…granting of a product license was definitely premature." Professor Duncan Vere, former member of the Committee on the Safety of Medicines, agreed that the periods for tests were too short. "In almost every case," he wrote, "observation periods were too short to include the onset of delayed neurological or other adverse events."

(D) The Hepatitis B vaccine:

Other than the references provided by John Classen, M.D. on the findings of increased diabetes from the hepatitis B vaccine with a latent period of 3 years, I am not aware of additional information bearing on the latent periods between hepatitis B vaccine and other forms of reactions, which reflects the sheer lack of data on the subject.

However, many reactions to hepatitis B vaccine may be taking place unrecognized, for two reasons: Reason one, I have in my possession a list of 109 references of published articles reporting on complications from the hepatitis B vaccine including autoimmune disorders, neurological disorders, vasculitis and cutaneous reactions. This list will be provided on request.

For reason two, in 1994 a special committee of the national Academy of Sciences (Institute of Medicine) published a comprehensive review of the safety of the hepatitis B vaccine. When the committee, which carries the responsibility for determining the safety of vaccines by Congressional mandate, investigated five possible and plausible adverse effects, they were unable to come to conclusion for four of them because they found that relevant safety research had not been done. Furthermore, they found that serious "gaps and limitations" exist in both the knowledge and infrastructure needed to study vaccine adverse events. Among the 76 types of vaccine adverse events reviewed by the IOM, the basic scientific evidence was inadequate to assess definitive vaccine causality for 50 (66%). The IOM also noted that "if research…(is) not improved, future reviews of vaccine safety will be similarly handicapped. (36) For this reason, the published reports of hepatitis B vaccine reactions may only be a small portion of those actually taking place, with large numbers of delayed reactions taking place unrecognized.

Conclusion:

Based on published evidence that many vaccine reactions take place beyond current medical-legal time limits that have been established for vaccines, and on overwhelming evidence that large numbers of delayed vaccine reactions may be taking place unrecognized, there are grounds for believing that these time limitations may be unrealistic and artifactual.

References:

(1) Buttram HE, The National Vaccine Childhood Injury Act - a Critique, Townsend Letter for Doctors & Patients, October, 1998:66-68.
(2) David TJ, Shaken baby (shaken impact) syndrome; non-accidental head injury in infancy, Royal Soc Med, Nov., 1999; 99:556-561.
(3) Weston IT, The pathology of child abuse, in:Heifer RE, Kempe CH, editors, The Battered Child, University of Chicago Press, 1968:77-100.
(4) Caffey J, On the theory and practice of shaking infants; its potential residual effects of permanent brain damage and mental retardation, Am J Dis Child, 1972; 124:161-169.
(5) Guthkelch AN, Infantile subdural hematoma and its relationship to whiplash injury, Brit Med J, 1971; 11:430-431.
(6) Buttram HE, Shaken baby syndrome or vaccine-induced encephalitis?, Medical Sentinel, Fall, 2001; 6(3):83-89.
(7) Flexner S, Postvaccinal encephalitis and allied conditions, JAMA, 1930; 94(5):305-311.
(8) Gorter E, Postvaccinal encephalitis, JAMA, 1933; 101(24):1871-1874.
(9) JAMA (editorial), Postinfectious encephalitis, a problem of increasing importance, May, 1929; 92(18):1523-1524.
(10) Munoz JJ et al, Elicitation of experimental encephalomyelitis in mice with the aid of pertussigen, Cellular Immunology, 1984; 83(1):92-100.
(11) Menkes JH & Kinsbourne M, Workshop on neurologic complications of pertussis and pertussis vaccination, Neuropediatrics, 1990; 21:171-176.
(12) Menkes JH, Neurologic complications of pertussis vaccination, Ann Neurology, 1990; 28:428.
(13) Cody CL et al, Nature and rates of adverse reactions associated with DTP and DT immunization in infants and children, Pediatrics, Nov., 1981; 68(5):650-660.
(14) Terpstra OK et al, Comparison of vaccination of mice and rats with Hemophilus influenza and Bordetella pertussis as models, Clin Exp Pharmacol Physiol, March-April, 1979; 6(2):139-149.
(15) Patrizi A et al, Sensitization to thimerosal in atopic children, Contact Dermatitis, Feb., 1999; 40(2):94-97.
(16) Vaccination and Behavioral Disorders, a Review of the Controversy, Greg Wilson, Tuntable Creek Publishing, PO Box 1448, Lismore NSW 2480, Australia, 2000, pages 48-49.
(17) Karlsson L & Scheibner V, Association between non-specific stress syndrome, DPT injections and cot death, paper presented to the 2nd immunization conference, Canberra, May 27-29, 1991.
(18) Vaccination: 100 Years of Orthodox Research Shows that Vaccines Represent a Medical Assault on the Immune System, Viera Scheibner, Ph.D., Australian Print Group, Maryborough, Victoria, Australia, 1993, pages 230-235.
(19) Pourcyrous M et al, Interleukin-6, C-reactive protein, and abnormal cardiorespiratory responses to immunization in premature infants, Pediatrics, March, 1998; 101(3):461.
(20) Horiuchi S et al, Two different histamine-sensitizing activities of pertussis vaccine observed in mice on the 4th and 12th days of sensitization, Japan J Med Sci Biol, 1993; 46:17-27.
(21) Fox R, letter, British Med J, Feb. 21, 1976.
(22) What Your Doctor May Not Tell You About Children's Vaccinations, Stephanie Cave, M.D., F.A.A.F.P., Warner Books, An AOL Time Warner Company, 2001, page xvi.
(23) VAERS Databases: www.vaers.org, www.fda.gov/cber, or www.fedbuzz.com/vaccine/vacmain.htm
(24) Reisinger RC, A final mechanism of cardiac and respiratory failure, SIDS, 1974, Proc of Camps Intern Symp on SID in Infancy; also Congressional Record S. 1745, September 20, 1973. (25) A Shot in the Dark, Harris L Coulter & Barbara Loe Fisher, Avery Publishing Group, Inc., Garden City Park, New York, 1991, Page 47.
(26) Classen JB, Classen DC, Association between type I diabetes and Hib vaccine, causal relation likely, British Med J, 1999; 319:1133.
(27) Tuomilehto J, Virtala E, Karvonen M et al, Increase in incidence of insulin-dependent diabetes mellitus among children in Finland, Intern J Epidemiology, 1995; 24:984-992.
(28) Tuomilehto J, Karonen M, Pitkaniemi J et al, Record high incidence of type 1 (insulin dependent) diabetes mellitus in Finnish children, Diabetologia, 1999; 42:655-660.
(29) American College for the Advancement of Medicine, 23121 Verdugo Dr., Ste. 204, Laguna Hills, CA 92653, phone 949-583-7666, fax 949-455-0679.
(30) Singh V & V Yang, Serological association of measles virus and human herpes virus-6 with brain autoantibodies in autism, Clin Immunol and Immunopath, 1998; 88(1):105-108.
(31) Immunobiology, Charles A Janeway et al, fourth Edition, Current Biology Publications, New York, 1999, page 495.
(32) Cohen DC & Shoenfeld Y, Vaccine-induced autoimmunity, J Autoimmunity, 1996; 9:699-703.
(33) Shoenfeld Y & A Aron-Maor, Vaccination and autoimmunity-'vaccinosis:' a dangerous laison?, J Autoimmunity, Feb., 2000; 14(1):1-10.
(34) Wakefield AJ & S Montgomery, Measles, mumps, rubella vaccine: through a glass darkly, Adv Drug React Toxicol Rev, Jan., 2001; 19(3):1-19.
(35) Hurley DR, DW Vere, AP Fletcher, Referee 1, 2, 3, & 4, Adverse Drug React Toxicol Rev, 2001; 19(4): 1-2.
(36) Stratton KR, CJ Howe and RB Johnston, Jr., Editors, Adverse Events Associated with Childhood Vaccines; Evidence Bearing on Causality, Institute of Medicine, National Academy Press, Washington D.C., 1994, pp 211-236.

Francine Yurko (NMW)
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Introduction:

As a matter of personal opinion and observation, there is at present a dichotomy of almost schizophrenic proportions between ongoing American scientific research in the medical field, most of which takes place in academic institutions and medical centers, and the genuine needs of the American public.

The scope and direction of this research, most of which is funded by the National Institute of Health (NIH), is of tremendous importance in that it forms a source of guidelines and a scientific foundation for the clinical practice of medicine. In other words, the clinical practice of medicine as it exists today has been largely shaped by decisions made in the NIH and other government health agencies in the granting of research money. This is a system which has existed since the 1930s, but there may be serious misdirections which are proving to be very costly in terms of the health and welfare of the American public, especially as applies to its children.

There are two medical conditions from which it is predictable that American society and economy will be strained to the breaking points in coming years by overwhelming numbers of medical indigents unless these conditions are addressed effectively and decisively in the very near future. The two conditions to which I refer are childhood autism and environmental illness with chemical sensitivity, neither of which are being recognized for their true nature by mainstream medicine because of a misdirection of research funding in certain key areas, as will be reviewed in the following:

Childhood Autism, Predominantly an Environmental Illness

In regards to childhood autism, a condition characterized by severe mental regression, fifty or so years ago autism was so rare that many pediatricians had never heard about it. At least this was the experience of Dr. Bernard Rimland, founding director of Autism Research Institute. In 1956 Dr. Rimland, whose Ph.D. is in research psychology, had a son who was later found to be autistic. In his annual DAN (Defeat Autism Now) conferences Dr. Rimland is fond of telling the story about the early days with his son during which he had great difficulty in finding a pediatrician who knew anything about or who had ever seen a case of autism. How different it is now. Childhood autism has become so prevalent that there are very few who do not know of a family with an autistic child. Families with two autistic children are not uncommon, and I personally have seen a family in which all three of the family's children were autistic. Latest statistics estimate that over one half million American children are autistic, (1) and with numbers steadily growing, there is no end in sight. It can be expected that treatments will improve the outlook of these children, but as far as is known at present, many or most of these will require custodial care for life, at an average cost to society as much as three million dollars per child. (2)

In the opinion of this observer, the misdiagnoses in childhood autism come not in the diagnosis of the condition itself, something that is unmistakable once one has seen a few children with the condition, but from a failure to recognize autism as predominantly an environmental illness. (In this instance the term, "environmental illness," is used to include illnesses brought about by exposures to commercial chemicals and medical interventions as well infectious microorganisms and other exposures from the natural environment). This statement is based on a recent seminar on childhood autism held in the Washington D.C. area as sponsored by the National Institute of Health and other health agencies September 6th and 7th, 2001, at which the largest portion of the meeting was devoted to areas of genetics and neuropathology of autism. (3)

As related to childhood autism, it should be stressed that the field of genetics involves a susceptibility to autism but, except in rare instances, has nothing to do with its causes. The same could be said about virtually all epidemic-type diseases, in which there will be variability in genetic susceptibility. By their very nature, epidemics always arise from environmental sources of one type or another and not from genetic causes. Genetic changes take place very slowly in an evolutionary scale over a period of millennia and never with the rapid increases as seen today with autism.

Major areas now under suspicion as being causally related to childhood autism include childhood immunizations, (4) toxic environmental chemicals, (5) commercial food processing, (6) and the overuse of antibiotics. (7) The only possible way of salvaging the situation is to find and modify the causes while at the same time doing the very best we can to develop effective treatments for those already afflicted with this condition.

Childhood Immunizations – Deficiencies in Basic Science and Safety Guidelines

As reflected in a series of U.S. Congressional Hearings concerning issues of vaccine safety which have taken place annually since 1999, (4) there is now growing awareness of major deficiencies in safety testing for current childhood immunizations. A few examples will be given here:

(a) Safety studies on vaccinations are limited to short time periods only: several days to several weeks. There are no (none) long-term (months or years) safety studies on any vaccination or immunization.
(b) In 1994 a special committee of the National Academy of Sciences (Institute of Medicine) published a comprehensive review of the safety of the hepatitis B vaccine. When the committee, which carries the responsibility for determining the safety of vaccines by Congressional mandate, investigated five possible and plausible adverse effects, they were unable to come to conclusion for four of them because they found that relevant safety research had not been done. Furthermore, they found that serious "gaps and limitations" exist in both the knowledge and infrastructure needed to study vaccine adverse events. Among the 76 types of vaccine adverse events reviewed by the IOM, the basic scientific evidence was inadequate to assess definitive vaccine causality for 50 (66%). The IOM also noted that "if research…(is) not improved, future reviews of vaccine safety will be similarly handicapped. (8)
(c) In an article published in Adverse Drug Reaction & Toxicology Review, (9) researchers Andrew Wakefield and Scott Montgomery, who have been investigating a possible causal relationship between the MMR vaccine (measles-mumps-rubella) and the autism enterocolitis syndrome, carefully reviewed inadequacies of the early pre-licensing trials of the MMR vaccine with a maximum follow up of 28 days and even shorter periods in some of the studies. They stressed that such short periods of observation following the vaccine were totally inadequate to detect delayed reactions, including pervasive developmental delay (autism), immune deficiencies, and inflammatory bowel disease, which are known from earlier published reports to occur following both the natural measles infection and the measles vaccine.

The most interesting feature of the Wakefield/Montgomery article was that it was reviewed by four leading British authorities, all of whom had previously held positions in the regulation and licensing of medicines in the United Kingdom. (10) Taken as a whole, the reviewers were supportive of the article, three highly so. Peter Fletcher, formerly a senior professional medical officer for the Department of Health wrote, "being extremely generous, evidence on safety (of the MMR vaccine) was very thin." Noting that single vaccines for measles, mumps, and rubella already existed, he argued, "caution should have ruled the day…the granting of a product license was definitely premature." Professor Duncan Vere, former member of the Committee on the Safety of Medicines, agreed that the periods for tests were too short. "In almost every case," he wrote, "observation periods were too short to include the onset of delayed neurological or other adverse events."

(d) In 1984 an intriguing study was reported in a little noted letter-to-the-editor in the New England Journal of Medicine in which a significant though temporary drop in T-helper lymphocytes was found in 11 healthy adults following routine tetanus booster immunizations. (11) Special concern rests in the fact that, in 4 of the subjects, the T-helper lymphocytes fell to levels seen in active AIDS patients. If this was the result of a single vaccine in healthy adults, it is sobering to think of the possible consequences of multiple vaccines (19 within the first 6 or so months of life at latest count) given to infants with their immature and vulnerable immune systems. Unfortunately, other than clinical observation, we can only speculate at these consequences, as the test has never been repeated.

Environmental Illness – Deficiencies in Basic Science and Safety Measures

In my opinion, the second area of misdiagnosis is the common approach of mainstream medicine in dealing with environmental illness and its related condition of multiple chemical sensitivity (MCS). In contrast to the American Medical Association, which denies the existence of MCS as a valid diagnosis, there is a group of physicians in the field of environmental medicine who believe that millions of Americans are being made ill and sensitized in various degrees to toxic airborne chemicals from a class of chemicals known as volatile organic compounds (VOCs). (12) Illnesses brought about by breathing these chemicals inside buildings are referred to as "The Sick Building Syndrome." A number of official government and health agency publications have been issued on this subject. (13-18) However, the major thrust of most of these publications is to stress how little we actually know about the effects of these chemicals and emphasize the over-riding need for further safety research in this area. As pointed out in the text, Multiple Chemical Sensitivity, (National Research Counsel, 1989), "about 70,000 chemicals are used in commerce, of which several hundred are known to be neurotoxic. However, except for pharmaceuticals, only 10% have had any testing at all for neurotoxicity, and only a handful of these have been evaluated thoroughly." (19)

Since the publication of Multiple Chemical Sensitivity, the situation has changed in one respect: There is now a substantial body of literature dealing with occupational exposures to solvent-type chemicals or VOCs, prominent among which are publications by Lisa Morrow and coworkers at the University of Pittsburgh, several of which are sited here. (20-23)

For the issue of multiple chemical sensitivity, on the other hand, it is far different. Once again we are faced with major deficiencies in safety-oriented studies on the effects of potentially toxic environmental chemicals on the human system and of safety measures that would have followed, had these studies been done. Basic science in this area, at very best, has been fragmentary. For this reason and this reason alone, evidence for support of the diagnosis of MCS has not yet reached standards of scientific proof. However, the fact that adequate research has not yet been done to prove its existence, it does not follow that MCS has been disproved or that it does not exist. Yet, this is the practical conclusion one generally finds in mainstream medicine.

Based on my own experiences in many workman's compensation cases involving airborne chemical exposures, the near universal response of mainstream medicine has been to deny its existence.

As a result, many patients with more advanced forms of chemical sensitivity are becoming like the lepers of ancient times, disabled outcasts of society, and their numbers are growing larger by the day. (24)

However, we are not entirely barren in this area. Though small in number and preliminary in nature, there are a number of publications tending to confirm a widespread presence of MCS in our population, publications which can form a nucleus for further study. A few of these are enumerated below:

(a) Two publications involving studies with SPECT brain scans have shown impairments in brain functions resulting from chemical exposures. (20,25)

(b) In a recent study of a group of veterans with the Persian Gulf War Illness, an activated coagulation system was found with platelet activation and fibrin deposits on the endothelial surfaces of blood vessels, which resulted in a constriction of blood flow. The authors concluded that heavy exposures to toxic chemicals during the Gulf War in all probability were the underlying cause of the pro-coagulant state, although other possible causes were also mentioned in the article. (26)

(c) Studies of patients with chronic fatigue and fibromyalgia at the Electron Microscopy Unit at the Adelaide Institute of Medical and Veterinary Science, Australia demonstrated deformities in the red blood cells (RBCs) of these patients described as dimpled spherocytes (rather than the normal oval shapes of RBCs) along with increased rigidity of the RBC membranes, these changes resulting in reduced flow of the RBCs as a result of their deformities. The article went on to point out that a great majority of these patients had been exposed to environmental chemicals, some working in chemical factories, others in wheat fields or orchards subject to periodic pesticide/herbicide sprayings, many patients noting deterioration following these exposures. (27)

(d) In an article by P Beaune and coworkers, the term "suicide inactivation" was used to describe the mechanism whereby foreign toxic chemicals may damage and cripple the enzyme systems necessary for detoxification and elimination of toxic chemicals. (28) This now thought or suspected of being a major factor in the pathogenesis of MCS.

(e) Among those working in the field of environmental medicine, (12) The Environmental Health Center in Dallas, Texas has always been considered a major center of research in this field. Authored by William J. Rea, M.D., much of the work of this center has been recorded in a four-volume set of books with the simple title, Chemical Sensitivity. (29) Many of those familiar with this center believe it will in time be accredited with being one of the earliest centers to fully recognize the increasing impact of foreign chemicals on human health and to do meaningful, systematic study in this area.

With reports such as these now in the scientific literature, further documentation and confirmation of environmental illness and MCS as valid diagnoses cannot be long in following, along with a more realistic appraisal of their prevalence.

Finally, no treatment of environmental illness would be complete without mention of possible ongoing damage being done to the reproductive systems of both men and women when exposed to toxic airborne chemicals during their reproductive years, (30) or of fetal damage when women work in such conditions during their pregnancies. (5) Although as yet largely theoretical, sooner or later these are issues which must be addressed.

Conclusions:

In the late 1800s and early 1900s there was a time now referred to as the golden age of medical diagnosis. Those were the times of Sir William Osler of Johns Hopkins University, remembered as the father of internal medicine, and of other stellar names of the times. In those days doctors took time to listen to their patients, and equally important, took very seriously the information given by the patient. It was a time of clinical observation, when doctors believed what their eyes told them and deduced diagnoses based on these observations. It is no small coincidence that the mythical master of observation and deduction, Sherlock Holmes, the creation of Sir A Conan Doyle, was based on a physician that Doyle had known in his student days.

How does this compare with today? Based on personal experience, very few doctors listen to parents of autistic children, or if they listen to them, very few believe what they are told by the parents. (31) This is even truer for patients with environmental illness who, in a majority of cases in my experience, are commonly referred to psychiatrists or psychologists by their physicians, their physicians telling them that their symptoms are psychosomatic or imagined.

However, in defense of doctors directly involved in care of the public, it is doubtful that there has ever been a time with greater demands on their time combined with greater economic/political pressures intervening in the care of their patients than at present. Most of them are doing the best they can under the circumstances.

I take great pride in being a medical doctor. I would not change places with anyone in the world. But I also fear for the future of my profession. Whether in the realm of nature or human affairs, all things must remain relevant to survive. In the natural world all life forms must adjust to their environment or perish. In the healing professions, these professions must both recognize and address the genuine needs of the public or stand in danger of passing into the limbo of forgotten things. Actually I believe the medical profession will survive, but to do so will require a higher level of vision with issues surrounding childhood autism and environmental illness than has been the norm until now.

For practicing physicians to recognize the nature of their patients' problems and treat them properly, the physicians must be provided with valid science by those engaged in research, science realistically directed at the genuine health needs of the public.

References:

(1) On April 25, 2001 James J Bradstreet, M.D., F.A.A.F.P gave testimony before the U.S. House of Representatives, Committee on Government Reform recalling his own experiences with an autistic son as well as providing a broad review of issues surrounding childhood autism. In a written supplement to the oral presentation, which can be accessed on the website: http://www.gnd.org/Testimony/Congressional.htm, Dr. Bradstreet provided current statistics on autism, pages 3-7.
(2) Ibid
(3) NIH/ACC 2001 Conference: Potential Cellular and Molecular mechanisms in autism and Related disorders Sponsored by NICHD and NIEHS, Co-Sponsored by NIMH, NINDS, and NIDCD, September 6-7, 2001, Bethesda, Maryland. (Having personally had the privilege of attending the meeting, there were very excellent presentations having to do with neuro-anatomical findings as well as genetics of autism, areas constituting basic science for the field. A portion of the meeting was also devoted to the possible roles of pesticides and other neurotoxicants in causing autism, but even these were of an academic nature. Clinical studies of potential value in either the prevention or treatment of autism were notable by their absence.)
(4) Annual hearings specifically dealing with questions about vaccine safety have been taking place in the U.S, House of Representatives since 1999. This is only one of many indications of growing public and professional concern on this issue.
(5) Edelson SB & DS Cantor, Autism: xenobiotic influences, Toxicology and Industrial Health, 1998; 14(4):553-563. (This study, which appears to be the first of its kind, points out that the breathing of toxic, chemical-laden air in sick buildings by women during their pregnancies may be a contributing cause of brain damage to the fetus and a common factor in the rising incidence of childhood autism).
(6) Among the many works dealing with the adverse health consequences of "fast foods," which form an increasing pattern in the diets of American children, two books are recommended here: Nourishing Traditions, by Sally Fallon with Pat Connolly and Mary G Enig, Ph.D., ProMotion Publishing, San Diego, 1995 and Special Diets for Special Kids, by Lisa Lewis, Ph.D., Future Horizons, Arlington, Texas, 1998.
(7) No reference is needed here – the overuse of antibiotics in medicine and the food industry is now universally recognized and is being taught at leading medical centers.
(8) Stratton KR, CJ Howe and RB Johnston, Jr., Editors, Adverse Events Associated with Childhood Vaccines; Evidence Bearing on Causality, Institute of Medicine, National Academy Press, Washington D.C., 1994, pp 211-236.
(9) Wakefield AJ & S Montgomery, Measles, mumps, rubella vaccine: through a glass darkly, Adv Drug React Toxicol Rev, January, 2001; 19(3):1-19.
(10) Hurley DR, DW Vere, A P Fletcher, Referee 1, 2, 3, & 4, Adverse Drug React Toxicol Rev, 2001; 19(4):1-2.
(11) Eibl M et al, Abnormal T-lymphocyte subpopulations in healthy subjects after tetanus booster immunization, (letter), NEJM, 1984; 310(3):198-199.
(12) American Academy of Environmental Medicine, with headquarters at American Financial Center, 7701 East Kellogg, Suite 625, Wichita, Kansas 67207-1705, phone (316) 684-5500, Fax (316) 684-5709.
(13) Pesticides in the Diets of Infants and Children, National Research Counsel, National Academy Press, Washington D.C., 1993. (Although this book deals with foods rather than air, it provides further evidence of concern in leading scientific circles about the potential impact of toxic chemicals on human health).
(14) Neurotoxicity, Identifying and Controlling Poisons of the Nervous System, Superintendent of Documents, Government Printing Office, Washington D.C., GPO Stock # 052-003-01184-1, April, 1990.
(15) Environmental Hazards in Your School, A Resource Handbook, US Environmental Protection Agency, Washington D.C., Publication # 201-2001, October, 1990.
(16) The Healthy School Handbook, Norma L Miller, Ed.D., Editor, a National Education Association professional Library Publication, National Education Association, Washington D.C., 1995.
(17) Multiple Chemical Sensitivities at Work, Produced by The Labor Institute, NYC, 853 Broadway, Room 2014, New York, NY 10003, 1993 (funded by a grant from the New York State Department of labor, Occupational Safety and Health Training and Education Program).
(18) Multiple Chemical Sensitivities, National Research Counsel, National Academy Press, Washington D.C., 1989.
(19) Ibid, page 2.
(20) Callender TJ, L Morrow, & K Subramanian, Evaluation of chronic neurological sequelae after acute pesticide exposure using SPECT brain scans, J Toxicol Environm Health, 1994; 41:275-284.
(21) Morrow LA, CM Ryan, & M Hodgson, Cacosmia and neurobehavioral dysfunction associated with occupational exposure to mixtures of organic solvents, Am J Psychiatry, 1988; 145:1442-1445.
(22) Morrow LA, MJ Hodgson, & N Robin, Assessment of attention and memory efficiency in persons with solvent neurotoxicity, Neuropsychologia, 1992; 30(10):911-922.
(23) Morrow LA, CM Ryan, MJ Hodgson, & N Robin, Risk factors associated with persistence of neuropsychological deficits in persons with organic solvent exposure, J Nervous & Mental Dis, 1991; 179:540-545.
(24) Michelle Conlin, Is your office killing you?, Business Week, June 5, 2000, pages 114-125. (In this article the authoress stated, "Experts predict that the 5% to 10% of the population that is allergic to chemicals will grow to 60% by 2020." She did not state where she obtained these figures, but a general observation of the American scene tends to support their validity.)
(25) Simon TR, DC Hickey, CE Fincher et al, Single photon emission computed tomography of the brain in patients with chemical sensitivity, Toxicol Industr Health, 1994, 10(4/5):573-577.
(26) Hannan KL, DE Berg, W Baumzweiger, HH Harrison et al, Activation of the coagulation system in Gulf War Illness: a potential pathophysiologic link with chronic fatigue syndrome – a laboratory approach to diagnosis, Blood Coagulation and Fibrinolysis, 2000; 11:673-678.
(27) Buist RA, Chronic fatigue and chemical overload, Intern Clin Nutrition Rev, Oct., 1988, 8(4):173-175.
(28) Beaune P et al, Autoantibodies against cytochrome P-450; role in human disease, Adv Pharmacol, 1994; 30:199-245. (Note: detoxification in the body is centered around two enzyme systems. The first is the P-450 system which, by a process of oxidization, converts the lipid-soluble state of volatile organic compounds into a more water soluble form, in which form they are more readily excreted by the kidneys. There is a price to pay, in that the water-soluble forms of VOCs may be more toxic than their parent compounds. In health the second phase of detoxification, that of conjugation, takes place immediately to neutralize the toxicity in which process the toxic product is combined with various natural substances in the body, predominantly glutathione. In many instances in chemical sensitivity there appears to be a relative deficiency of the conjugation enzyme activity which results in an accumulation of the more toxic products of phase I oxidation.
(29) Chemical Sensitivity, Volumes I – IV, William J. Rea, M.D., Lewis Publishers, Boca Raton, FL , Vol I, 1992, Vol II, 1994, Vol III, 1995, Vol IV, 1997.
(30) The Case for Preconception Care of Men and Women, Margaret and Arthur Wynn, AB Academic Publishers, PO Box 42, Bicester, Oxon, 0X6 7NW England 1991.
(31) Among the parents with autistic children, a significant portion of these parents believe that their children have been damaged by vaccines. A common story in such instances is that the child was developing normally into his or her second year, was beginning to speak a few words, was affectionate with parents and playful with siblings until a vaccination took place, after which the child lost all speech and regressed into a world of its own, no longer responding to parents or playmates.

As further evidence of such a pattern, during October, 1999 an autism conference was held in Cherry Hill, New Jersey sponsored by the Autism Research Institute, referred to as a DAN conference. Over 1,000 people were in attendance, the great majority of whom were parents of autistic children. At one point in the meeting, when the chairman asked those in the audience who believed that their child's autism was caused by vaccines to stand, a large majority of the audience rose to their feet. Reportedly there was much the same response when the same question was asked at the DAN conference in San Diego during October, 2000.

And yet, this writer has read many evaluations of autistic children from major medical centers without finding a single instance where vaccines were mentioned or considered as a possible cause. In those instances in which parents mentioned their suspicions about the vaccines, apparently they were ignored.

Francine Yurko (NMW)
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