Neurologic Disorders After Measles-Mumps-Rubella Vaccination
Annamari Mäkelä, MD, J. Pekka Nuorti, MD and Heikki Peltola, MD

The first reaction to the title and authors of this article must be “Oh No! Not again!” After reading the abstract, one has a feeling of déjà vu and a lingering doubt: “Did I see this before?” All these studies from Finland are just so much alike and so predictable.

One must note:

    1. That the original Peltola study, from which all these mini studies sprout at regular intervals,
        was over by 1996, two full years before Wakefield’s first paper.

    2.  That Peltola said on BBC that his main study did not look for autism and IBD and

    3.  That many knowledgeable epidemiologists, including the authors of the latest study
         from Denmark (Medgaard Madsen et al) have criticized the methodology of previous “Peltola Team” studies.

Makela et al. were so intent on criticizing Andrew Wakefield's work that even in a paper titled “Neurologic Disorders after MMR”, they inserted a mention that no hospitalized children with autism had Inflammatory Bowel Disease (IBD). The study did not explain why the number of individuals in Finland who received assistance for IBD from the Social Security Institution doubled in just nine years (1992-2001) from 9,737 to 20,807. http://autismautoimmunityproject.org/ibdcg.html

It was not clear why 352 children with autism were hospitalized during the study period. In the US, affected children are not usually hospitalized with a diagnosis of autism. Indeed, such a diagnosis here, may compromise payment by certain HMOs.

The whole Makela study is based on ONE comparison: ” For encephalitis and aseptic meningitis, the numbers of events observed within a 3-month risk interval after vaccination were compared with the expected numbers estimated on the basis of occurrence of encephalitis and aseptic meningitis during the subsequent 3-month intervals”. If the children in the first group developed symptoms of encephalitis and meningitis within two weeks of vaccination, then causation would be implied, both medically and medico-legally. If so, then the comparison with the control group is meaningless and the author’s conclusion is unwarranted.

This study by Makela, Nuorti and Peltola will not be remembered for any convincing or striking finding. Yet, it is probably going to be quoted for another reason.

By stating, “The aim of this study was to assess whether an association prevails between MMR vaccination and encephalitis, aseptic meningitis, and autism” in an article titled “Neurologic Disorders after Measles-Mumps-Rubella Vaccination” the authors assert that autism is a neurological complication of MMR vaccination.

For certain, no one will forget that!

F. Edward Yazbak, MD, FAAP.
TL Autism Research, Falmouth, Massachusetts
TLAutStudy@aol.com
From a letter to the Editor,  The Schafer Autism Report (SAR 12/14/2002).