HJAR Mar/Apr 2025

HEALTHCARE JOURNAL OF ARKANSAS I  MAR / APR 2025 21 autism increases with the amount of shared genome with an autistic family member. For example, the prevalence among siblings is 10-20%, compared to a general population prevalence of 2.8%. 2 Overall, hereditability contribution was well established in the 1970s when twin studies showed a higher concordance rate among monozygotic ver- sus dizygotic twins. 1 Family studies support a genetic component; the chance of having Autism is heterogenous, both in pheno- type and etiology. While the cause is not completely understood, it is widely accepted that autism is due to a combination of envi- ronmental and genetic factors. The genetic Over the past few decades, the contro- versy of vaccines, or components in vac- cines, causing autism has been the impetus of a tremendous amount of scientific study. The vaccines that have received the most attention are the MMR (measles, mumps, rubella) vaccines; the vaccines that con- tained thimerosal such as diphtheria, tet- anus, pertussis (DTP); and vaccines that contained mercury. 1 While a host of studies over the past several years have proven that there is no association between autism and vaccines, it is important to discuss the his- tory and evidence behind this controversy. The current climate of our country is bring- ing the questions of vaccines, autism and otherwise, to the forefront again. It is impor- tant to provide information and resources that point to evidence-based information about this important medical topic. The study that began the controversy of vaccines causing autism were published in The Lancet in 1998 by Andrew Wakefield, MD, and colleagues. Describing 12 children with developmental delay — 8 with autism — he hypothesized that the MMR vaccine caused the medical events that led to the children being diagnosed with autism. Flaws in the study such as no control group, small sample size, and over-reaching conclu- sions were found. Subsequent studies pub- lished on this topic began to refute the link between the MMR vaccine and autism. 2,3 The Lancet eventually found that Wakefield had not disclosed financial interests in this study. His research had been funded by lawyers who had been hired by the parents with chil- dren in this study who had a lawsuit against The MMR Debate and Autism: Unraveling a Disproven Theory By Jayne Bellando, PhD& Jaimie Flor, MD a company producing vaccine. The article was retracted from The Lancet in 2010 4,5,6 , and Wakefield lost his medical license in the U.K. 5,6 This concern about vaccines causing autism yielded many scientific studies to understand if a relationship existed between vaccines and autism. The data consistently shows that vaccines are not a cause of autism. Two articles are of primary impor- tance. A population-based study of MMR vaccine and autism in Denmark on 537,303 children showed no association between the child’s age at the time vaccine was given, the time period elapsed since vaccine was given, the date vaccine was administered, and the development of autism. 7,8 One meta- analysis conducted by Taylor, Swerdfeger, and Eslick, included five cohort studies with 1,256,407 children and five case-controlled studies involving 9,920 children in this data. 9 These authors also reported no rela- tionship between vaccination and autism. Regardless of the overwhelming evi- dence that there is no connection between vaccines and autism, the lay literature often continues this myth. It is unfortunate because fearful families are misled and second guess themselves when it is time to vaccinate their young children against devastating diseases. This can cause pro- found, and possibly fatal, consequences for children. It is important for our state leaders, pri- marily in the medical and political commu- nities, to educate themselves on the history of immunizations and autism to help dis- pel myths that continue. Providing clear evidence-based information is essential to help give families good choices for their children’s healthy future. Helpful websites about immunizations are provided below: • World Health Organization — Vaccines and immunization: https://www.who. int/health-topics/vaccines-and- immunization#tab=tab_1 • American Academy of Pediatrics — Immunizations: https://www.aap.org/ en/patient-care/immunizations/ • American Academy of Pediatrics — Common Immunization Questions from Parents: https://www.aap.org/ en/patient-care/immunizations/ communicating-with-families-and- promoting-vaccine-confidence/ common-immunization-questions- from-parents/ • Centers for Disease Control — Childhood Vaccines: https://www.cdc . gov/vaccines-children/index.html • Association for Science in Autism Treatment —Autism and Vaccines: The evidence to date: https://asatonline. org/research-treatment/resources/ topical-articles/autism-and-vaccines- the-evidence-to-date/ • Children’s Hospital of Philadelphia Vaccine Education Center — Vaccines and Autism Q&A: https://www.chop . edu/vaccine-education-center/ vaccine-safety/vaccines-and-other- conditions/autism n The Genetic Puzzle of Autism: Understanding Heritability and Syndromic Links By Tiffany Lepard, MS, LCGC