The Controversy That Will Not Go Away: Vaccines and Autism

  • Archana ChatterjeeEmail author


It is generally accepted that the number of new autism diagnoses is increasing. It is unclear whether this is due to a true increase in cases, increasing awareness of autism spectrum disorders (ASDs), or differences in the methods used to diagnose these conditions and assess their prevalence. The burden of ASDs for families and communities is considerable both monetarily and emotionally. In the first few decades after autism was described, it was thought to be a consequence of bad parenting, particularly by the mother. Despite decades of research, a specific scientific cause or definitive treatment for ASDs remains elusive in most cases. This lack of evidence has led to much speculation about the etiology of ASDs. Early reports of associations between the MMR vaccine and autism have been shown to be based on flawed and perhaps fraudulent studies. Similarly, reports linking the mercury-containing preservative thimerosal with autism have been refuted by several rigorously conducted scientific studies. The third theory that vaccines either “weaken” or “overwhelm” the immature immune system in young children and lead to autism is also not supported by credible scientific data. Emerging research indicates the genetic underpinnings of ASDs, but a small, vocal minority of parent groups and even a few physicians and scientists continue to support the hypothesis that vaccines cause autism. Unsubstantiated media reports and litigation sponsored by some parent advocacy groups continue to keep the controversy alive. Vaccines have been phenomenally successful in eliminating diseases such as smallpox, measles, and polio. Fear of these deadly scourges has been replaced with concerns about vaccine safety among some members of the public. Declining vaccination rates have caused a reemergence of some of these diseases. In order to reestablish the public’s trust in vaccination, it is imperative that rigorously researched scientific information on the issue of vaccines and autism is accurately collected and appropriately disseminated.


Autism Spectrum Disorder Pervasive Developmental Disorder General Medical Council Vaccine Adverse Event Reporting System Childhood Vaccine 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Williams R. Autism through ages baffles science. Available at: Accessed 10 Feb 2012.
  2. 2.
    Kanner L. Autistic disturbances of affective contact. Nerv Child. 1943;2:217–50.Google Scholar
  3. 3.
    Weintraub K. The prevalence puzzle: Autism counts. Nature. 2011;479(7371):22–4.CrossRefPubMedGoogle Scholar
  4. 4.
    Pervasive Developmental Disorders. In: American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th edition, text revision (DSM-IV-TR). American Psychiatric Association, Washington, DC 2000. p. 70
  5. 5.
    DSM-5 proposed criteria for autism spectrum disorder designed to provide more accurate diagnosis and treatment. Available at: Accessed 30 Jan 2012.
  6. 6.
    Refrigerator Mothers. Available at: Accessed 30 Jan 2012.
  7. 7.
    Kanner L. Problems of nosology and psychodynamics in early childhood autism. Am J Orthopsychiatry. 1949;19(3):416–26.CrossRefPubMedGoogle Scholar
  8. 8.
    Bettenheim B. The empty fortress: infantile autism and the birth of the self. New York: The Free Press; 1967.Google Scholar
  9. 9.
    Laidler JR. The “Refrigerator Mother” hypothesis of autism. Available at: Accessed 30 Jan 2012
  10. 10.
    Rimland B. Infantile autism: The syndrome and its implications for a neural theory of behavior. New Jersey, NJ: Prentice Hall; 1964.Google Scholar
  11. 11.
    Rutter M, Greenfeld D, Lockyer L. A five to fifteen year follow-up study of infantile psychosis. II. Social and behavioural outcome. Br J Psychiatry. 1967;113(504):1183–99.CrossRefPubMedGoogle Scholar
  12. 12.
    Rutter M. Concepts of autism: a review of research. J Child Psychol Psychiatry. 1968;9(1):1–25.CrossRefPubMedGoogle Scholar
  13. 13.
    Lotter V. Epidemiology of autistic conditions in young children. Soc Psychiatry Psychiatr Epidemiol. 1966;1:124–37.Google Scholar
  14. 14.
    Autism and Developmental Disabilities Monitoring Network Principal Investigators. Prevalence of autism spectrum disorders -Autism and developmental disabilities monitoring network, United States, 2006. MMWR. 2009;58(SS10):1–24.Google Scholar
  15. 15.
    Brugha TS, McManus S, Bankart J, et al. Epidemiology of autism spectrum disorders in adults in the community in England. Arch Gen Psychiatry. 2011;68(5):459–65.CrossRefPubMedGoogle Scholar
  16. 16.
  17. 17.
    Fombonne E. Epidemiology of autistic disorder and other pervasive developmental disorders. J Clin Psychiatry. 2005;66 Suppl 10:3–8.PubMedGoogle Scholar
  18. 18.
    Rutter M. Incidence of autism spectrum disorders: changes over time and their meaning. Acta Paediatr. 2005;94(1):2–15.CrossRefPubMedGoogle Scholar
  19. 19.
    Shattuck PT. The contribution of diagnostic substitution to the growing administrative prevalence of autism in US special education. Pediatrics. 2006;117(4):1028–37.CrossRefPubMedGoogle Scholar
  20. 20.
    Jick H, Kaye JA. Epidemiology and possible causes of autism. Pharmacotherapy. 2003;23(12):1524–30.CrossRefPubMedGoogle Scholar
  21. 21.
    Taylor B. Vaccines and the changing epidemiology of autism. Child Care Health Dev. 2006;32(5):511–9.CrossRefPubMedGoogle Scholar
  22. 22.
    Ludlow A, Skelly C, Rohleder P. Challenges faced by parents of children diagnosed with autism spectrum disorder. J Health Psychol. 2012;17(5):702–11.CrossRefPubMedGoogle Scholar
  23. 23.
    Johnson N, Frenn M, Feetham S, Simpson P. Autism spectrum disorder: parenting stress, family functioning and health-related quality of life. Fam Syst Health. 2011;29(3):232–52.CrossRefPubMedGoogle Scholar
  24. 24.
    Autism and family stress. Personal Best Healthlines. 2011. Available at: Accessed 31 Jan 2012.
  25. 25.
    Montes G, Halterman JS. Association of childhood autism spectrum disorders and loss of family income. Pediatrics. 2008;121(4):e821–6.CrossRefPubMedGoogle Scholar
  26. 26.
    Montes G, Halterman JS. Child care problems and employment among families with preschool-aged children with autism in the United States. Pediatrics. 2008;122(1):e202–8.CrossRefPubMedGoogle Scholar
  27. 27.
    O’ Brien I, Duffy A, Nicholl H. Impact of childhood chronic illnesses on siblings: a literature review. Br J Nurs. 2009;18(22):358, 1360–5.Google Scholar
  28. 28.
    Rao PA, Beidel DC. The impact of children with high-functioning autism on parental stress, sibling adjustment, and family functioning. Behav Modif. 2009;33(4):437–51.CrossRefPubMedGoogle Scholar
  29. 29.
    Paul R, editor. Natural history. In: Handbook of Autism and Pervasive Developmental Disorders. John Wiley & Sons, Inc.; 1987. p. 121–3.Google Scholar
  30. 30.
    Ganz ML. The lifetime distribution of the incremental societal costs of autism. Arch Pediatr Adolesc Med. 2007;161(4):343–9.CrossRefPubMedGoogle Scholar
  31. 31.
    Knapp M, Romeo R, Beecham J. Economic cost of autism in the UK. Autism. 2009;13(3):317–36.CrossRefPubMedGoogle Scholar
  32. 32.
    Wassink TH, Brzustowicz LM, Bartlett CW, Szatmari P. The search for autism disease genes. Ment Retard Dev Disabil Res Rev. 2004;10(4):272–83.CrossRefPubMedGoogle Scholar
  33. 33.
    Orsmond GI, Seltzer MM. Siblings of individuals with autism spectrum disorders across the life course. Ment Retard Dev Disabil Res Rev. 2007;13(4):313–20.CrossRefPubMedGoogle Scholar
  34. 34.
    Barton M, Volkmar F. How commonly are known medical conditions associated with autism? J Autism Dev Disord. 1998;28(4):273–8.CrossRefPubMedGoogle Scholar
  35. 35.
    Eapen V. Genetic basis of autism: is there a way forward? Curr Opin Psychiatry. 2011;24(3):226–36.CrossRefPubMedGoogle Scholar
  36. 36.
    Ratajczak HV. Theoretical aspects of autism: causes–a review. J Immunotoxicol. 2011;8(1):68–79.CrossRefPubMedGoogle Scholar
  37. 37.
    Becker KG, Schultz ST. Similarities in features of autism and asthma and a possible link to acetaminophen use. Med Hypotheses. 2010;74(1):7–11.CrossRefPubMedGoogle Scholar
  38. 38.
    Lawler CP, Croen LA, Grether JK, Van de Water J. Identifying environmental contributions to autism: provocative clues and false leads. Ment Retard Dev Disabil Res Rev. 2004;10(4):292–302.CrossRefPubMedGoogle Scholar
  39. 39.
    Schultz ST, Klonoff-Cohen HS, Wingard DL, Akshoomoff NA, Macera CA, Ji M, et al. Breastfeeding, infant formula supplementation, and autistic disorder: the results of a parent survey. Int Breastfeed J. 2006;1:16.CrossRefPubMedGoogle Scholar
  40. 40.
    Demirjian A, Levy O. Novel vaccines: bridging research, development and production. Expert Rev Vaccines. 2008;7:1321–4.CrossRefPubMedGoogle Scholar
  41. 41.
    Oxford JS. The end of the beginning: vaccines for the next 25 years. Vaccine. 2008;26:6179–82.CrossRefPubMedGoogle Scholar
  42. 42.
    Plotkin SL, Plotkin SA. A short history of vaccination. In: Plotkin SA, Orenstein W, Offit P, editors. Vaccines. 5th ed. Philadelphia, PA: Saunders-Elsevier; 2008. p. 1–16.Google Scholar
  43. 43.
    Hinman AR, Orenstein WA, Schuchat A. Vaccine-preventable diseases, immunizations, and MMWR — 1961–2011. MMWR. 2011;60:49–57.PubMedGoogle Scholar
  44. 44.
    Jana L. Don’t take the benefits of vaccines for granted. Omaha World Herald. 2011(April 12).Google Scholar
  45. 45.
    Gupta VB. Communicating with parents of children with autism about vaccines and complementary and alternative approaches. J Dev Behav Pediatr. 2010;31:343–5.CrossRefPubMedGoogle Scholar
  46. 46.
    Chatterjee A, Moffatt K. Vaccines and autism—an unlikely connection. In: Eapen V, editor. Autism—A neurodevelopmental journey from genes to behaviour. Rijeka, Croatia: Intech; 2011. p. 319–42.Google Scholar
  47. 47.
    Coulter HL, Fisher BL. A shot in the dark. Why the P in the DPT vaccination may be hazardous to your child’s health. Garden City Park, NY: Avery Pub. Group; 1991.Google Scholar
  48. 48.
    Wakefield AJ, Murch SH, Linnell J, et al. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children [retracted]. Lancet. 1998;351:637–41.CrossRefPubMedGoogle Scholar
  49. 49.
    Kawashima H, Mori T, Kashiwagi Y, Takekuma K, Hashika A, Wakefield A. Detection and sequencing of measles virus from peripheral mononuclear cells from patients with inflammatory bowel disease and autism. Dig Dis Sci. 2000;45:723–9.CrossRefPubMedGoogle Scholar
  50. 50.
    Chen RT, DeStefano F. Vaccine adverse events: causal or coincidental? Lancet. 1998;351:611–2.CrossRefPubMedGoogle Scholar
  51. 51.
    Payne C, Mason B. Autism, inflammatory bowel disease, and MMR vaccine. Lancet. 1998;351:907.CrossRefPubMedGoogle Scholar
  52. 52.
    Madsen KM, Hviid A, Vestergaard M, Schendel D, Wohlfahrt J, Thorsen P, et al. A population-based study of measles, mumps, and rubella vaccination and autism. N Engl J Med. 2002;347:1477–82.CrossRefPubMedGoogle Scholar
  53. 53.
    Taylor B, Miller E, Lingam R, Andrews N, Simmons A, Stowe J. Measles, mumps, and rubella vaccination and bowel problems or developmental regression in children with autism: population study. BMJ. 2002;324:393–6.CrossRefPubMedGoogle Scholar
  54. 54.
    Black C, Kaye JA, Jick H. Relation of childhood gastrointestinal disorders to autism: nested case–control study using data from the UK General Practice Research Database. BMJ. 2002;325:419–21.CrossRefPubMedGoogle Scholar
  55. 55.
    Honda H, Shimizu Y, Rutter M. No effect of MMR withdrawal on the incidence of autism: a total population study. J Child Psychol Psychiatry. 2005;46:572–9.CrossRefPubMedGoogle Scholar
  56. 56.
    Peltola H, Patja A, Leinikki P, Valle M, Davidkin I, et al. No evidence for measles, mumps, and rubella vaccine-associated inflammatory bowel disease or autism in a 14-year prospective study. Lancet. 1998;351:1327–8.CrossRefPubMedGoogle Scholar
  57. 57.
    Taylor B, Miller E, Farrington CP, Petropoulos MC, Favot-Mayaud I, et al. Autism and measles, mumps, and rubella vaccine: no epidemiological evidence for a causal association. Lancet. 1999;353:2026–9.CrossRefPubMedGoogle Scholar
  58. 58.
    Patja A, Davidkin I, Kurki T, Kallio MJ, Valle M, et al. Serious adverse events after measles-mumps-rubella vaccination during a fourteen-year prospective follow-up. Pediatr Infect Dis J. 2000;19:1127–34.CrossRefPubMedGoogle Scholar
  59. 59.
    Dales L, Hammer SJ, Smith NJ. Time trends in autism and in MMR immunization coverage in California. JAMA. 2001;285:1183–5.CrossRefPubMedGoogle Scholar
  60. 60.
    Smeeth L, Hall AJ, Fombonne E, Rodrigues LC, Huang X, et al. A case–control study of autism and mumps-measles-rubella vaccination using the general practice research database: design and methodology. BMC Public Health. 2001;1:2.CrossRefPubMedGoogle Scholar
  61. 61.
    Takahashi H, Arai S, Tanaka-Taya K, Okabe N. Autism and infection/immunization episodes in Japan. Jpn J Infect Dis. 2001;54:78–9.PubMedGoogle Scholar
  62. 62.
    Fombonne E, Chakrabarti S. No evidence for a new variant of measles-mumps-rubella-induced autism. Pediatrics. 2001;108:E58.CrossRefPubMedGoogle Scholar
  63. 63.
    Kaye JA, del Mar M-MM, Jick H. Mumps, measles, and rubella vaccine and the incidence of autism recorded by general practitioners: a time trend analysis. BMJ. 2001;322:460–3.CrossRefPubMedGoogle Scholar
  64. 64.
    Farrington CP, Miller E, Taylor B. MMR and autism: further evidence against a causal association. Vaccine. 2001;19:3632–5.CrossRefPubMedGoogle Scholar
  65. 65.
    Makela A, Nuorti JP, Peltola H. Neurologic disorders after measles-mumps-rubella vaccination. Pediatrics. 2002;110:957–63.CrossRefPubMedGoogle Scholar
  66. 66.
    Lingam R, Simmons A, Andrews N, Miller E, Stowe J, et al. Prevalence of autism and parentally reported triggers in a north east London population. Arch Dis Child. 2003;88:666–70.CrossRefPubMedGoogle Scholar
  67. 67.
    Smeeth L, Cook C, Fombonne E, Heavey L, Rodrigues LC, et al. MMR vaccination and pervasive developmental disorders: a case–control study. Lancet. 2004;364:963–9.CrossRefPubMedGoogle Scholar
  68. 68.
    Chen W, Landau S, Sham P, Fombonne E. No evidence for links between autism, MMR and measles virus. Psychol Med. 2004;34:543–53.CrossRefPubMedGoogle Scholar
  69. 69.
    Klein K, Diehl E. Relationship between MMR vaccine and autism. Ann Pharmacother. 2004;38:1297–300.CrossRefPubMedGoogle Scholar
  70. 70.
    DeStefano F, Bhasin TK, Thompson WW, Yeargin-Allsopp M, Boyle C. Age at first measles-mumps-rubella vaccination in children with autism and school-matched control subjects: a population-based study in metropolitan Atlanta. Pediatrics. 2004;113:259–66.CrossRefPubMedGoogle Scholar
  71. 71.
    Fombonne E, Zakarian R, Bennett A, Meng L, McLean-Heywood D. Pervasive developmental disorders in Montreal, Quebec, Canada: prevalence and links with immunizations. Pediatrics. 2006;118:e139–50.CrossRefPubMedGoogle Scholar
  72. 72.
    Richler J, Luyster R, Risi S, Hsu WL, Dawson G, et al. Is there a ‘regressive phenotype’ of Autism Spectrum Disorder associated with the measles-mumps-rubella vaccine? A CPEA Study. J Autism Dev Disord. 2006;36:299–316.CrossRefPubMedGoogle Scholar
  73. 73.
    Uchigama T, Kurosawa M, Inaba Y. MMR-vaccine and regression in autism spectrum disorders: negative results presented from Japan. J Autism Dev Disord. 2007;37:210–7.CrossRefGoogle Scholar
  74. 74.
    Mroz˙ek-Budzyn D, Kiełtyka A, Majewska R. Lack of association between measles-mumps-rubella vaccination and autism in children. A case–control study. Pediatr Infect Dis J. 2010;29:397–400.CrossRefGoogle Scholar
  75. 75.
    DeStefano F. Vaccines and autism: evidence does not support a causal association. Clin Pharmacol Ther. 2007;82:756–9.CrossRefPubMedGoogle Scholar
  76. 76.
    Gerber JS, Offit A. Vaccines and autism: A tale of shifting hypotheses. Clin Infect Dis. 2009;48(4):456–61.CrossRefPubMedGoogle Scholar
  77. 77.
    Miller L, Reynolds J. Autism and vaccination-The current evidence. J Spec Pediatr Nurs. 2009;14:166–72.CrossRefPubMedGoogle Scholar
  78. 78.
    Hensley E, Briars L. Closer look at autism and the measles–mumps–rubella vaccine. J Am Pharm Assoc. 2010;50:736–41.CrossRefGoogle Scholar
  79. 79.
    Weibel RE, Caserta V, Benor DE, Evans G. Acute encephalopathy followed by permanent injury or death associated with further attenuated measles vaccines: A review of claims submitted to the National Vaccine Injury Compensation Program. Pediatrics. 1998;101:383–7.CrossRefPubMedGoogle Scholar
  80. 80.
    Wakefield AJ, Montgomery SM. Measles, mumps, rubella vaccine: Through a glass, darkly. Adverse Drug React Toxicol Rev. 2000;19:265–83.PubMedGoogle Scholar
  81. 81.
    Geier MR, Geier DA. Pediatric MMR vaccination safety. International Pediatrics. 2003;18:203–8.Google Scholar
  82. 82.
    Murch SH, Anthony A, Casson DH, Malik M, Berelowitz M, Dhillon AP, et al. Retraction of an interpretation. Lancet. 2004;363:750.CrossRefPubMedGoogle Scholar
  83. 83.
    D’Souza Y, Fombonne E, Ward BJ. No evidence of persisting measles virus in peripheral blood mononuclear cells from children with autism spectrum disorder. Pediatrics. 2006;118:1664–75.CrossRefPubMedGoogle Scholar
  84. 84.
    Afzal MA, Ozoemena LC, O’Hare A, Kidger KA, Bentley ML, et al. Absence of detectable measles virus genome sequence in blood of autistic children who have had their MMR vaccination during the routine childhood immunization schedule of UK. J Med Virol. 2006;78:623–30.CrossRefPubMedGoogle Scholar
  85. 85.
    Baird G, Pickles A, Simonoff E, Charman T, Sullivan P, Chandler S, et al. Measles vaccination and antibody response in autism spectrum disorders. Arch Dis Child. 2008;93(10):832–7.CrossRefPubMedGoogle Scholar
  86. 86.
    Hornig M, Briese T, Buie T, Bauman ML, Lauwers G, Siemetzki U, et al. Lack of association between measles virus vaccine and autism with enteropathy: a case–control study. PLoS One. 2008;3(9):e3140.CrossRefPubMedGoogle Scholar
  87. 87.
    Institute of Medicine. Immunization safety review: vaccines and autism. Available at: Accessed 12 Feb 2012.
  88. 88.
    Fisher BL. Vaccines, autism & chronic inflammation: The new epidemic. Inc: PB Industries; 2008.Google Scholar
  89. 89.
    BBC News. MMR immunisation rate falls again. Available at: Accessed 14 Feb 2012.
  90. 90.
    McIntyre P, Leask J. Improving uptake of MMR vaccine. BMJ. 2008;336:729–30.CrossRefPubMedGoogle Scholar
  91. 91.
    Murphy JF. Fallout of the enterocolitis, autism, MMR vaccine paper. Ir Med J. 2011;104(2):36.PubMedGoogle Scholar
  92. 92.
    Asaria P, MacMahon E. Measles in the United Kingdom: can we eradicate it by 2010? BMJ. 2006;333:890–5.CrossRefPubMedGoogle Scholar
  93. 93.
    Gupta RK, Best J, MacMahon E. Mumps and the UK epidemic 2005. BMJ. 2005;330:1132–5.CrossRefPubMedGoogle Scholar
  94. 94.
    Centers for Disease Control and Prevention (CDC). Mumps epidemic--United Kingdom, 2004-2005. MMWR 2006;55:173-5.Google Scholar
  95. 95.
    Editorial team. Measles once again endemic in the United Kingdom. Euro Surveill 2008;13(27):pii=18919. Available at: Accessed 14 Feb 2012.
  96. 96.
    Pepys MB. Science and serendipity. Clin Med. 2007;7:562–78.CrossRefPubMedGoogle Scholar
  97. 97.
    McBrien J, Murphy J, Gill D, Cronin M, O’Donovan C, Cafferkey MT. Measles outbreak in Dublin, 2000. Pediatr Infect Dis J. 2003;22(7):580–4.PubMedGoogle Scholar
  98. 98.
  99. 99.
    Smith MJ, Ellenberg SS, Bell LM, Rubin DM. Media coverage of the measles-mumps-rubella vaccine and autism controversy and its relationship to MMR immunization rates in the United States. Pediatrics. 2008;121:e836–43.CrossRefPubMedGoogle Scholar
  100. 100.
    Parker Fiebelkorn A, Redd SB, Gallagher K, et al. Measles in the United States during the postelimination era. J Infect Dis. 2010;202:1520–8.CrossRefPubMedGoogle Scholar
  101. 101.
    Centers for Disease Control and Prevention. Update: Measles --- United States, January--July 2008. MMWR 2008;57:893-896.Google Scholar
  102. 102.
    Centers for Disease Control and Prevention (CDC). Hospital-associated measles outbreak—Pennsylvania, March-April 2009. MMWR Morb Mortal Wkly Rep. 2012;61:30-2.
  103. 103.
    Hampton T. Outbreaks spur measles vaccine studies. JAMA. 2011;306(22):2440–2.CrossRefPubMedGoogle Scholar
  104. 104.
    Centers for Disease Control and Prevention (CDC). Notes from the field: Measles outbreak--Indiana, June-July 2011. MMWR Morb Mortal Wkly Rep 2011;60(34):1169.
  105. 105.
    Moss WJ, Griffin DE. Measles. Lancet. 2012;379(9811):153–64.CrossRefPubMedGoogle Scholar
  106. 106.
    Chen SY, Anderson S, Kutty PK, et al. Healthcare-associated measles outbreak in the United States after an importation: challenges and economic impact. J Infect Dis. 2011;203:1517–25.CrossRefPubMedGoogle Scholar
  107. 107.
    Centers for Disease Control and Prevention (CDC). Notes from the field: Measles outbreak--Hennepin County, Minnesota, February-March 2011. MMWR Morb Mortal Wkly Rep 2011;60(13):421.
  108. 108.
    Centers for Disease Control and Prevention (CDC). Measles: United States, January--May 20, 2011. MMWR Morb Mortal Wkly Rep. 2011;60(20):666-8.
  109. 109.
    Godlee F, Smith J, Markovitch H. Wakefield’s article linking MMR vaccine and autism was fraudulent. Clear evidence of falsification of data should now close the door on this damaging vaccine scare. BMJ. 2011;342:c7452.Google Scholar
  110. 110.
    Deer B. Secrets of the MMR scare. How the case against the MMR vaccine was fixed. BMJ. 2011;342:c5347.Google Scholar
  111. 111.
    Deer B. Secrets of the MMR scare. How the vaccine crisis was meant to make money. BMJ. 2011;342:c5258.Google Scholar
  112. 112.
    Deer B. Secrets of the MMR scare. The Lancet’s two days to bury bad news. BMJ. 2011;342:c7001.CrossRefPubMedGoogle Scholar
  113. 113.
    Office of Research Integrity. Definition of research misconduct. Available at: Accessed 14 Feb 2012.
  114. 114.
    Deer B. Revealed: MMR research scandal. Sunday Times 2004 February 22. Available at: Accessed 17 Apr 2011.
  115. 115.
    The editors of the Lancet. Retraction—Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet 2010;375:445.Google Scholar
  116. 116.
    Transcripts of hearings of fitness to practice panel (misconduct) in the case of Wakefield, Walker-Smith, and Murch, 16 July 2007 to 24 May 2010. GMC; 2010.Google Scholar
  117. 117.
    General Medical Council. Dr Andrew Jeremy Wakefield. Determination on serious professional misconduct (SPM) and sanction. 24 May 2010. Available at: Accessed 17 Apr 2011.
  118. 118.
    General Medical Council. Professor John Angus Walker-Smith. Determination on serious professional misconduct (SPM) and sanction. 24 May 2010. Accessed 17 Apr 2011.
  119. 119.
    Offit PA. Autism’s false prophets. Bad science, risky medicine, and the search for a cure. New York, NY: Columbia University Press; 2008.Google Scholar
  120. 120.
    Offit PA. Deadly choices. How the anti-vaccine movement threatens us all. Basic Books, NY, USA; 2011.Google Scholar
  121. 121.
    Mnookin S. The Panic Virus. A true story of medicine, science and fear. New York, USA: Simon and Schuster; 2011.Google Scholar
  122. 122.
    Dillner L. Regulating research. BMJ. 2010;341:c5128.Google Scholar
  123. 123.
    Wager L. Wakefield: should we demand public access to raw data? BMJ. 2011;342:135.CrossRefGoogle Scholar
  124. 124.
    Opel DJ, Diekema DS, Marcuse EK. Assuring research integrity in the wake of Wakefield. BMJ. 2011;342:179–80.CrossRefGoogle Scholar
  125. 125.
    Brown KF, Kroll JS, Hudson MJ, Ramsay M, Green J, Long SJ, et al. Factors underlying parental decisions about combination childhood vaccinations including MMR: a systematic review. Vaccine. 2010;28(26):4235–48.CrossRefPubMedGoogle Scholar
  126. 126.
    Casiday R, Cresswell T, Wilson D, Panter-Brick C. A survey of UK parental attitudes to the MMR vaccine and trust in medical authority. Vaccine. 2006;24(2):177–84.CrossRefPubMedGoogle Scholar
  127. 127.
    Freed GL, Clark SJ, Butchart AT, Singer DC, Davis MM. Parental vaccine safety concerns in 2009. Pediatrics. 2010;125(4):654–9.CrossRefPubMedGoogle Scholar
  128. 128.
    Brown KF, Long SJ, Ramsay M, Hudson MJ, Green J, Vincent CA, et al. UK parents’ decision-making about measles-mumps-rubella (MMR) vaccine 10 years after the MMR-autism controversy: A qualitative analysis. Vaccine. 2012;30(10):1855–64.CrossRefPubMedGoogle Scholar
  129. 129.
    Baker JP. Mercury, vaccines, and autism: one controversy, three histories. Am J Public Health. 2008;98:244–53.CrossRefPubMedGoogle Scholar
  130. 130.
    United States Environmental Protection Agency. Implementation of the Mercury-Containing and Rechargeable Battery Management Act. Available at: Accessed 14 Feb 2012.
  131. 131.
    United States Environmental Protection Agency. Methyl mercury. Available at: Accessed 14 Feb 2012.
  132. 132.
    United States Enviromental Protection Agency. Health Effects. Mercury. Available at: Accessed 14 Feb 2012.
  133. 133.
    Mahaffey KR, Rice G, et al. An assessment of exposure to mercury in the United States: Mercury study report to Congress. Washington, DC: US Environmental Protections Agency; 1997. Document EPA-452/R097-006.Google Scholar
  134. 134.
    Mahaffey KR. Methylmercury: A new look at the risks. Public Health Rep. 1999;114:397–413.CrossRefGoogle Scholar
  135. 135.
    Agency for Toxic Substances and Disease Registry. Toxicological profile for mercury. Atlanta, GA: Agency for Toxic Substances and Disease Registry;1999.Google Scholar
  136. 136.
    Federal Register, January 19, 1979;44;3990.Google Scholar
  137. 137.
    World Health Organization. Trace elements and human nutrition and health. Geneva: World Health Organization; 1996. p. 209.Google Scholar
  138. 138.
    United States Food and Drug Administration. Thimerosal in vaccines. Available at: Accessed 14 Feb 2012
  139. 139.
    21 USC 397 Section 413, 1997.Google Scholar
  140. 140.
    Ball LK, Ball R, Pratt RD. An assessment of thimerosal use in childhood vaccines. Pediatrics. 2001;107(5):1147–54.CrossRefPubMedGoogle Scholar
  141. 141.
    Centers for Disease Control and Prevention. Notice to Readers: Thimerosal in Vaccines: A Joint Statement of the American Academy of Pediatrics and the Public Health Service. MMWR. 1999;48:563–5.Google Scholar
  142. 142.
    Centers for Disease Control and Prevention. Notice to Readers: Summary of the Joint Statement on Thimerosal in Vaccines. MMWR. 2000;49(27):622–31.Google Scholar
  143. 143.
    Offit PA. Thimerosal and vaccines–a cautionary tale. N Engl J Med. 2007;357(13):1278–9.CrossRefPubMedGoogle Scholar
  144. 144.
    Rimland B. The vaccine-autism connection-Part I (Thimerosal). Available at: www.Autism Research Accessed 14 Feb 2012.
  145. 145.
    Nelson KB, Bauman ML. Thimerosal and autism? Pediatrics. 2003;111:674–9.CrossRefPubMedGoogle Scholar
  146. 146.
    Blood and hair mercury levels in young children and women of childbearing age—United States, 1999. MMWR 50(8):140–143.Google Scholar
  147. 147.
    Institute of Medicine. Thimerosal-containing vaccines and neurodevelopmental disorders. Washington, D.C: National Academy Press; 2001.Google Scholar
  148. 148.
    Mutter J, Naumann J, Schneider R, Walach H, Haley B. Mercury and autism: accelerating evidence? Neuro Endocrinol Lett. 2005;26(5):439–46.PubMedGoogle Scholar
  149. 149.
    Geier MR, Geier DA. Neurodevelopmental disorders after thimerosal-containing vaccines: a brief communication. Exp Biol Med. 2003;228:660–4.Google Scholar
  150. 150.
    Geier DA, Geier MR. An assessment of the impact of thimerosal on childhood neurodevelopmental disorders. Pediatr Rehabil. 2003;6(2):97–102.PubMedGoogle Scholar
  151. 151.
    Geier DA, Geier MR. A comparative evaluation of the effects of MMR immunization and mercury doses from thimerosal-containing childhood vaccines on the population prevalence of autism. Med Sci Monit. 2004;10(3):I33–9.Google Scholar
  152. 152.
    Geier DA, Geier MR. Neurodevelopmental disorders following thimerosal-containing childhood immunizations: a follow-up analysis. Int J Toxicol. 2004;23(6):369–76.CrossRefPubMedGoogle Scholar
  153. 153.
    Geier DA, Geier MR. An evaluation of the effects of thimerosal on neurodevelopmental disorders reported following DTP and Hib vaccines in comparison to DTPH vaccine in the United States. J Toxicol Environ Health. 2006;69:1481–95.CrossRefGoogle Scholar
  154. 154.
    Geier DA, Geier MR. A prospective study of thimerosal-containing Rho(D)-immune globulin administration as a risk factor for autistic disorders. J Matern Fetal Neonatal Med. 2007;20:358–90.CrossRefGoogle Scholar
  155. 155.
    Goodman MJ, Nordin J. Vaccine Adverse Event Reporting System source: a possible source of bias in longitudinal studies. Pediatrics. 2006;117:387–90.CrossRefPubMedGoogle Scholar
  156. 156.
    Hviid A, Stellfeld M, Wohlfahrt J, Melbye M. Association between thimerosal-containing vaccine and autism. JAMA. 2003;290(13):1763–6.CrossRefPubMedGoogle Scholar
  157. 157.
    Madsen KM, Lauritsen MB, Pedersen CB, Thorsen P, Plesner AM, Andersen PH, et al. Thimerosal and the occurrence of autism: negative ecological evidence from Danish population-based data. Pediatrics. 2003;112(3 Pt 1):604–6.CrossRefPubMedGoogle Scholar
  158. 158.
    Stehr-Green P, Tull P, Stellfeld M, Mortenson PB, Simpson D. Autism and thimerosal-containing vaccines: lack of consistent evidence for an association. Am J Prev Med. 2003;25(2):101–6.CrossRefPubMedGoogle Scholar
  159. 159.
    Verstraeten T, Davis RL, DeStefano F, Lieu TA, Rhodes PH, Black SB, et al. Chen RT; Vaccine Safety Datalink Team. Safety of thimerosal-containing vaccines: a two-phased study of computerized health maintenance organization databases. Pediatrics. 2003;112(5):1039–48.Google Scholar
  160. 160.
    Andrews N et al. Thimerosal exposure in infants and developmental disorders: a retrospective cohort study in the United Kingdom does not support a causal association. Pediatrics. 2004;114(3):584–91.CrossRefPubMedGoogle Scholar
  161. 161.
    Heron J, Golding J. Thimerosal exposure in infants and developmental disorders: a prospective cohort study in the United Kingdom does not support a causal association. Pediatrics. 2004;114(3):577–83.CrossRefPubMedGoogle Scholar
  162. 162.
    Jick H, Kaye JA. Autism and DPT vaccination in the United Kingdom. N Engl J Med. 2004;350(26):2722–3.CrossRefPubMedGoogle Scholar
  163. 163.
    Clements CJ. The evidence for the safety of thiomersal in newborn and infant vaccines. Vaccine. 2004;22:1854–61.CrossRefPubMedGoogle Scholar
  164. 164.
    Thompson WW, Price C, Goodson B, et al. Early thimerosal exposure and neuropsychological outcomes at 7 to 10 years. N Engl J Med. 2007;357:1281–92.CrossRefPubMedGoogle Scholar
  165. 165.
    Tozzi AE, Bisiacchi P, Tarantino V, De Mei B, D’Elia L, Chiarotti F, et al. Neuropsychological performance 10 years after immunization in infancy with thimerosal-containing vaccines. Pediatrics. 2009;123(2):475–82.CrossRefPubMedGoogle Scholar
  166. 166.
    Price CS, Thompson WW, Goodson B, Weintraub ES, Croen LA, Hinrichsen VL, et al. Prenatal and infant exposure to thimerosal from vaccines and immunoglobulins and risk of autism. Pediatrics. 2010;126(4):656–64.CrossRefPubMedGoogle Scholar
  167. 167.
    Immunization Safety Review Committee, Board on Health Promotion and Disease Prevention. Immunization Safety Review: Vaccines and Autism. Institute of Medicine of the National Academies. Washington, DC: The National Academies Press; 2004.Google Scholar
  168. 168.
    Harry GJ, Harris MW, Burka LT. Mercury concentrations in brain and kidney following ethylmercury, methylmercury and thimerosal administration to neonatal mice. Toxicol Lett. 2004;154(3):183–9.CrossRefPubMedGoogle Scholar
  169. 169.
    Burbacher TM et al. Comparison of blood and brain mercury levels in infant monkeys exposed to methylmercury or vaccines containing thimerosal. Environ Health Perspect. 2005;113(8):1015–21.CrossRefPubMedGoogle Scholar
  170. 170.
    Pichichero ME et al. Mercury concentrations and metabolism in infants receiving vaccines containing thiomersal: a descriptive study. Lancet. 2002;360:1737–41.CrossRefPubMedGoogle Scholar
  171. 171.
    Aschner M, Ceccatelli S. Are neuropathological conditions relevant to ethylmercury exposure? Neurotox Res. 2010;18:59–68.CrossRefPubMedGoogle Scholar
  172. 172.
    Shultz ST. Does thimerosal or other mercury exposure increase the risk for autism? A review of current literature. Acta Neurobiol Exp. 2010;70:187–95.Google Scholar
  173. 173.
    Fiore AE, Shay DK, Broder K, Iskander JK, Uyeki TM, Mootrey G, et al. Prevention and Control of Influenza. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. 2008;57(RR07):1–60.PubMedGoogle Scholar
  174. 174.
    Biroscak BJ, Fiore AE, Fasano N, Fineis P, Collins MP, Stoltman G. Impact of the thimerosal controversy on hepatitis B vaccine coverage of infants born to women of unknown hepatitis B surface antigen status in Michigan. Pediatrics. 2003;11:e645–9.CrossRefGoogle Scholar
  175. 175.
    Offit PA. Vaccines and autism revisited-the Hannah Poling case. N Engl J Med. 2008;358:2089–91.CrossRefPubMedGoogle Scholar
  176. 176.
    Kennedy JS, Lawrence DA. Coincidental associations do not provide proof for the etiology of autism. J Immunotoxicol. 2011;8(3):198–203.CrossRefPubMedGoogle Scholar
  177. 177.
    Dingle JH, Badger GF, Jordan WS. Illness in the home: a study of 25,000 illnesses in a group of Cleveland families. Cleveland: Press of Western Reserve University; 1964.Google Scholar
  178. 178.
    Offit PA, Quarles J, Gerber MA, et al. Addressing parents’ concerns: do multiple vaccines overwhelm or weaken the infant’s immune system? Pediatrics. 2002;109:124–9.CrossRefPubMedGoogle Scholar
  179. 179.
    King GE, Hadler SC. Simultaneous administration of childhood vaccines: an important public health policy that is safe and efficacious. Pediatr Infect Dis J. 1994;13:394–407.CrossRefPubMedGoogle Scholar
  180. 180.
    Black SB, Cherry JD, Shinefield HR, Fireman B, Christenson P, Lampert D. Apparent decreased risk of invasive bacterial disease after heterologous childhood immunization. Am J Dis Child. 1991;145:746–9.PubMedGoogle Scholar
  181. 181.
    Davidson M, Letson GW, Ward JI, et al. DTP immunization and susceptibility to infectious diseases: is there a relationship? Am J Dis Child. 1991;145:750–4.PubMedGoogle Scholar
  182. 182.
    Storsaeter J, Olin P, Renemar B, et al. Mortality and morbidity from invasive bacterial infections during a clinical trial of acellular pertussis vaccines in Sweden. Pediatr Infect Dis J. 1988;7:637–45.CrossRefPubMedGoogle Scholar
  183. 183.
    O’Brien KL, Walters MI, Sellman J, et al. Severe pneumococcal pneumonia in previously healthy children: the role of preceding influenza infection. Clin Infect Dis. 2000;30:784–9.CrossRefPubMedGoogle Scholar
  184. 184.
    Laupland KB, Davies HD, Low DE, Schwartz B, Green K, McGeer A. Invasive group A Streptococcal disease in children and association with varicella-zoster virus infection. Ontario Group A Streptococcal Study Group. Pediatrics. 2000;105:e60.CrossRefPubMedGoogle Scholar
  185. 185.
    Al-Ayadhi LY. Autoimmunity in autism spectrum disorders. In: Eapen V, editor. Autism—A neurodevelopmental journey from genes to behaviour. Rijeka, Croatia: Intech; 2011. p. 299–318.Google Scholar
  186. 186.
    Morrow EM, Yoo SY, Flavell SW, et al. Identifying autism loci and genes by tracing recent shared ancestry. Science. 2008;321:218–23.CrossRefPubMedGoogle Scholar
  187. 187.
    Muhle R, Trentacoste SV, Rapin I. The genetics of autism. Pediatrics. 2004;113(5):e472–86.CrossRefPubMedGoogle Scholar
  188. 188.
    Hu H, Chung Y. Genome-wide association studies of copy number variation in autism spectrum disorder. In: Eapen V, editor. Autism—A neurodevelopmental journey from genes to behaviour. Rijeka, Croatia: Intech; 2011. p. 165–82.Google Scholar
  189. 189.
    Voineagu I, Wang X, Johnston P, Lowe JK, Tian Y, Horvath S, et al. Transcriptomic analysis of autistic brain reveals convergent molecular pathology. Nature. 2011;474(7351):380–4.CrossRefPubMedGoogle Scholar
  190. 190.
    Sugarman SD. Cases in Vaccine Court-Legal battles over vaccines and autism. N Engl J Med. 2007;357:1275–7.CrossRefPubMedGoogle Scholar
  191. 191.
    Stewart AM. When vaccine injury claims go to court. N Engl J Med. 2009;360(24):2498–500.CrossRefPubMedGoogle Scholar
  192. 192.
    Silverman RD. Litigation, regulation, and education–protecting the public’s health through childhood immunization. N Engl J Med. 2009;360(24):2500–1.CrossRefPubMedGoogle Scholar
  193. 193.
    Riedmann EM. Court finds no Vaccines-autism link. Hum Vaccin. 2010;6:368–72.Google Scholar
  194. 194.
    Supreme Court of the United States. Russell Bruesewitz et al v. Wyeth et al. No. 09-152. Argued October 12, 2010—Decided February 22, 2011.
  195. 195.
    Mnookin S. The media and its messages. In: The Panic Virus. A true story of medicine, science and fear. Simon and Schuster, New York, NY 2011, pp 160–9.Google Scholar
  196. 196.
    Singh J, Hallmayer J, Illes J. Interacting and paradoxical forces in neuroscience and society. Nat Rev Neurosci. 2007;8(2):153–60.CrossRefPubMedGoogle Scholar
  197. 197.
    Poland GA, Jacobson RM. The age-old struggle against the antivaccinationists. N Engl J Med. 2011;364:97–9.CrossRefPubMedGoogle Scholar
  198. 198.
    Offit PA, Moser CA. The problem with Dr. Bob’s alternative vaccine schedule. Pediatrics. 2009;123:e164–9.CrossRefPubMedGoogle Scholar
  199. 199.
    Mnookin S. The mercury moms. In: The Panic Virus. A true story of medicine, science and fear. Simon and Schuster. New York, NY 2011, pp 133–145.Google Scholar
  200. 200.
    Mnookin S. Autism speaks. In: The panic virus. A true story of medicine, science and fear. Simon and Schuster, New York, NY 2011, pp 228–238.Google Scholar
  201. 201.
    Mnookin S. Jenny McCarthy’s mommy instinct. In: The panic virus. A true story of medicine, science and fear. Simon and Schuster, New York, NY 2011, pp 249–264.Google Scholar
  202. 202.
    Wadman M. A voice of science. Nature. 2011;479:28–31.CrossRefPubMedGoogle Scholar
  203. 203.
    Autism Science Foundation. NAAR founder Eric London resigns from Autism Speaks citing disagreement over vaccine research. Available at: Accessed 18 Feb 2012.
  204. 204.
    Lord C. How common is autism? Nature. 2011;474:166–8.CrossRefPubMedGoogle Scholar
  205. 205.
    Scahill L, Bearss K. The rise in autism and the mercury myth. J Child Adolesc Psychiatr Nurs. 2009;22:51–3.CrossRefPubMedGoogle Scholar
  206. 206.
    The mind’s tangled web. Nature 2011;479:5.Google Scholar
  207. 207.
    Mottron L. Changing perceptions: the power of autism. Nature. 2011;479:33–5.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Creighton University School of MedicineOmahaUSA

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