Vaccines and autism are not linked or associated according to real science, published in real scientific journals written by real scientists and physicians. But this false claim that vaccines and autism are related is repeated by anti-vaxxers nearly every day.
Probably as a result of reports that more and more children are being diagnosed with autism, people seem to be creating a false correlation (let alone causation) between vaccines and autism. So let’s take a look at the science.
CDC study– autism spectrum disorder rates
In April 2018, the US Centers for Disease Control and Prevention (CDC) announced that data showed a continued rise in the number of children diagnosed with autism spectrum disorder (ASD). ASD is considered to be a disorder of neural development, usually appearing before the age of 3 years, characterized by impaired social interaction and verbal and non-verbal communication, and by restricted, repetitive or stereotyped behavior.
Predictably, the anti-vaccine community jumped on this information (despite their hatred of the CDC) to make unfounded claims, not backed by science, that this was all the fault of vaccines. Of course, they did that.
The report, published in the peer-reviewed Morbidity and Mortality Weekly Report Surveillance Summary, utilized data from the Autism and Developmental Disabilities Monitoring (ADDM) Network, which is an active public health surveillance system that provides estimates of the prevalence of ASD among children aged 8 years who reside within 11 ADDM sites in the United States. Those sites are in Arizona, Arkansas, Colorado, Georgia, Maryland, Minnesota, Missouri, New Jersey, North Carolina, Tennessee, and Wisconsin (see Note 1). This study updated results from a similar study published in 2010.
ADDM surveillance is done in two separate phases:
- The first phase consists of analyzing anonymized comprehensive evaluations of children performed by professional healthcare providers in that community. They use data sources from general pediatric health clinics along with specialized programs for children with developmental disabilities. Additionally, the ADDM network may also review records of special education students in public school
- The second phase determines if the child’s case meets the definition of ASD. A child meets the definition if a comprehensive evaluation by a qualified healthcare professional describes behavior consistent with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) (see Note 1). They included diagnoses for the following conditions – autistic disorder, pervasive developmental disorder-not otherwise specified (including atypical autism), or Asperger disorder.
For 2014, the overall prevalence of ASD among the 11 ADDM sites was 16.8 per 1,000 (one in 59) children aged 8 years. Overall ASD prevalence estimates varied among sites, from 13.1-29.3 per 1,000 children aged 8 years.
This study from the CDC updated autism statistics to a level that seems that autism is growing quickly in the USA. But is it really?
Myths about vaccines and autism
Of course, there is a ridiculous belief that increased vaccinations and poorly designed vaccines, that contained thiomersal, the major villain of some of the story, has led to the increased rates of ASD. This legend is based upon a retracted and fraudulent paper authored by Mr. Andy Wakefield who alleged a connection between the MMR vaccine and autism. If you want to read all about Wakefield’s despicable deceit, you can read it here, here, and here, a series of articles written by award-winning journalist Brian Deer and published in the British Medical Journal (now known as BMJ), a respected peer-reviewed publication.
Despite the fact that the CDC is unsure of why there is an increase (speculating on how we gather data rather than an environmental cause), despite the fact that Andy Wakefield lied, and despite the fact that 100s of vaccine studies have established no link between vaccines and autism, the anti-vaccine cult cannot help themselves in creating conspiracies or outlandish claims that vaccines cause autism.
They relish in fear, uncertainty, and doubt to push their pro-disease agenda.
One anti-vaccine religious zealot, Ginger Taylor, who appears to lack any formal education in science or any critical thinking skills, cherry-picked 80 (give or take) studies that seem to support the hypothesis that vaccines cause autism. Except, of the 80, at least 20-25 do not make the conclusion that the author wants us to believe. Either the researchers are talking about a whole different topic, or the data was so weak that there’s barely a statistical difference in the autism and non-autism groups.
Ginger is pandering to her uneducated sycophants who don’t actually know how to read scientific articles. Lucky for humanity and the health of children who won’t have to suffer from vaccine-preventable diseases, some of us know how to read and refute Ginger’s list of bogus studies.
What’s particularly laughable is that she uses numerous citations from Lucija Tomljenovic and Christopher Shaw, both of whom could be generously described as real shills for the anti-vaccine movement. Very well paid shills in fact. Their articles are based on ludicrous science, published in terrible open access, and in some cases, cursory (or even non-existent) peer-reviewed journals. Shaw and Tomljenovic are perfect examples of anti-vaccine shills whose articles get retracted. And retracted. And retracted again.
If these two anti-vaccine shills actually had real data, why don’t they published the research in top-notch journals that relish the publicity of cutting-edge science? Like Lancet. Or the New England Journal of Medicine. I guess if you have bogus data published in bad journals, you get what you get.
The real science
By cherry picking a handful of poorly designed articles in poor journals, the anti-vaccine religious order tends to find anything that supports the a priori conclusion that vaccines are horrific and they cause autism.
Proper scientifically skeptical thinking says that you review all evidence, giving more weight to the quality and quantity of evidence – then you follow that higher quality and quantity of evidence to a conclusion.
These vaccine deniers ignore the vast weight of evidence of real science published in real journals. They search for the “evidence” that supports their preconceived conclusions.
Real science shows that not only do we lack evidence that vaccines cause autism, but we also have affirmative evidence that vaccines do not cause autism.
One example, published in the journal Vaccine, is a meta-analysis of five cohort studies involving 1,256,407 children, and five case-control studies involving 9920 children. As I’ve written before, meta-analyses form the basis, the deep foundation, of the scientific consensus, and they are the highest quality scientific evidence available. This study is like a gigantic clinical trial because it rolls up the highest quality data from those millions of subjects to develop solid conclusions.
The authors concluded that,
Findings of this meta-analysis suggest that vaccinations are not associated with the development of autism or autism spectrum disorder. Furthermore, the components of the vaccines (thimerosal or mercury) or multiple vaccines (MMR) are not associated with the development of autism or autism spectrum disorder.
This was a powerful, large, and well-constructed meta-review. This study takes all of the evidence and data that had been developed previously and rolled it up into one huge cohort and clinical trial. And once again, we find that vaccines don’t cause autism.
Below is a list of over 140 peer-reviewed articles, published in the best journals across the world. This isn’t a list of every article published over the past 20 years that rejects the hypothesis that vaccines or its ingredients are linked to autism. There are probably 1000 more than reject the belief that vaccines cause autism.
However, I’m not a fool. The zombie vaccine myths continue to rise from the dead.
- The DSM-IV-TR was replaced by the DSM-5 in 2013, which meant that this 2014 study was right on the cusp of the changeover to the new diagnostic criteria, which changed some aspects of the ASD diagnosis. Probably most psychiatrists and psychologists had made the change during the timeframe of this study. Starting in 2016, the ADDM network will use the DSM-5 criteria.
- Editor’s note – this article was originally published in April 2014. It has been and will continue to be regularly updated as new research is published that dismisses any causal link (or correlation for that matter) between vaccines and autism.
Vaccines and autism citations
Here is a list of 146 peer-reviewed articles, published in relatively high impact factor or specialized journals, that document the lack of correlation (and therefore causation) between vaccines and autism. If I missed any key ones, please tap me on the shoulder and tell me.
- Abu Kuwaik G, Roberts W, Zwaigenbaum L, Bryson S, Smith IM, Szatmari P, Modi BM, Tanel N, Brian J. Immunization uptake in younger siblings of children with autism spectrum disorder. Autism. 2014 Feb;18(2):148-55. doi: 10.1177/1362361312459111. Epub 2012 Oct 8. PubMed PMID: 23045216.
- Albizzati A, Morè L, Di Candia D, Saccani M, Lenti C. Normal concentrations of heavy metals in autistic spectrum disorders. Minerva Pediatr. 2012 Feb;64(1):27-31. PubMed PMID: 22350041.
- Afzal MA, Ozoemena LC, O’Hare A, Kidger KA, Bentley ML, Minor PD. 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 May;78(5):623-30. PubMed PMID: 16555271.
- Ahearn WH. What Every Behavior Analyst Should Know About the “MMR Causes Autism” Hypothesis. Behav Anal Pract. 2010 Spring;3(1):46-50. PubMed PMID: 22479671; PubMed Central PMCID: PMC3004684.
- Allan GM, Ivers N. The autism-vaccine story: fiction and deception? Can Fam Physician. 2010 Oct;56(10):1013. PubMed PMID: 20944043; PubMed Central PMCID: PMC2954080.
- Andrews N, Miller E, Grant A, Stowe J, Osborne V, Taylor B. Thimerosal exposure in infants and developmental disorders: a retrospective cohort study in the United kingdom does not support a causal association. Pediatrics. 2004 Sep;114(3):584-91. PubMed PMID: 15342825.
- Andrews N, Miller E, Taylor B, Lingam R, Simmons A, Stowe J, Waight P. Recall bias, MMR, and autism. Arch Dis Child. 2002 Dec;87(6):493-4. PubMed PMID: 12456546; PubMed Central PMCID: PMC1755823.
- Aps LRMM, Piantola MAF, Pereira SA, Castro JT, Santos FAO, Ferreira LCS. Adverse events of vaccines and the consequences of non-vaccination: a critical review. Rev Saude Publica. 2018;52:40. doi: 10.11606/s1518-8787.2018052000384. Epub 2018 Apr 12. Review. Portuguese, English. PubMed PMID: 29668817; PubMed Central PMCID: PMC5933943.
- Baio J, Wiggins L, Christensen DL, Maenner MJ, Daniels J, Warren Z, Kurzius-Spencer M, Zahorodny W, Robinson Rosenberg C, White T, Durkin MS, Imm P, Nikolaou L, Yeargin-Allsopp M, Lee LC, Harrington R, Lopez M, Fitzgerald RT, Hewitt A, Pettygrove S, Constantino JN, Vehorn A, Shenouda J, Hall-Lande J, Van Naarden Braun K, Dowling NF. Prevalence of Autism Spectrum Disorder Among Children Aged 8 Years – Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014. MMWR Surveill Summ. 2018 Apr 27;67(6):1-23. doi: 10.15585/mmwr.ss6706a1. PubMed PMID: 29701730.
- Baird G, Pickles A, Simonoff E, Charman T, Sullivan P, Chandler S, Loucas T, Meldrum D, Afzal M, Thomas B, Jin L, Brown D. Measles vaccination and antibody response in autism spectrum disorders. Arch Dis Child. 2008 Oct;93(10):832-7. doi: 10.1136/adc.2007.122937. Epub 2008 Feb 5. Erratum in: Arch Dis Child. 2008 Dec;93(12):1079. PubMed PMID: 18252754.
- Berger BE, Navar-Boggan AM, Omer SB. Congenital rubella syndrome and autism spectrum disorder prevented by rubella vaccination–United States, 2001-2010. BMC Public Health. 2011 May 19;11:340. doi: 10.1186/1471-2458-11-340. PubMed PMID: 21592401; PubMed Central PMCID: PMC3123590.
- 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 Aug 24;325(7361):419-21. PubMed PMID: 12193358; PubMed Central PMCID: PMC119436.
- Black SB, Cimino CO, Hansen J, Lewis E, Ray P, Corsaro B, Graepel J, Laufer D. Immunogenicity and safety of measles-mumps-rubella, varicella and Haemophilus influenzae type b vaccines administered concurrently with a fourth dose of heptavalent pneumococcal conjugate vaccine compared with the vaccines administered without heptavalent pneumococcal conjugate vaccine. Pediatr Infect Dis J. 2006 Apr;25(4):306-11. PubMed PMID: 16567981.
- Blake J, Hoyme HE, Crotwell PL. A brief history of autism, the autism/vaccine hypothesis and a review of the genetic basis of autism spectrum disorders. S D Med. 2013;Spec no:58-65. Review. PubMed PMID: 23444593.Blake J, Hoyme HE, Crotwell PL. A brief history of autism, the autism/vaccine hypothesis and a review of the genetic basis of autism spectrum disorders. S D Med. 2013;Spec no:58-65. Review. PubMed PMID: 23444593.
- Bower H. New research demolishes link between MMR vaccine and autism. BMJ. 1999 Jun 19;318(7199):1643. PubMed PMID: 10373156; PubMed Central PMCID: PMC1116011.
- Campisi L, Imran N, Nazeer A, Skokauskas N, Azeem MW. Autism spectrum disorder. Br Med Bull. 2018 Sep 1;127(1):91-100. doi: 10.1093/bmb/ldy026. PubMed PMID: 30215678.
- Chang LV. Information, education, and health behaviors: Evidence from the MMR vaccine autism controversy. Health Econ. 2018 May 2. doi: 10.1002/hec.3645. [Epub ahead of print] PubMed PMID: 29717799.
- Chen W, Landau S, Sham P, Fombonne E. No evidence for links between autism, MMR and measles virus. Psychol Med. 2004 Apr;34(3):543-53. PubMed PMID: 15259839.
- Christie B. Scottish expert group finds no link between MMR and autism. BMJ. 2002 May 11;324(7346):1118. PubMed PMID: 12008724; PubMed Central PMCID: PMC1172158.
- Clements CJ, McIntyre PB. When science is not enough – a risk/benefit profile of thiomersal-containing vaccines. Expert Opin Drug Saf. 2006 Jan;5(1):17-29. Review. PubMed PMID: 16370953.
- Committee to Review Adverse Effects of Vaccines, Institute of Medicine; Stratton K, Ford A, Rusch E, Clayton EW, editors. Adverse Effects of Vaccines: Evidence and Causality. Washington (DC): National Academies Press (US); 2011 Aug 25.PubMed PMID: 24624471.
- Dales L, Hammer SJ, Smith NJ. Time trends in autism and in MMR immunization coverage in California. JAMA. 2001 Mar 7;285(9):1183-5. PubMed PMID: 11231748.
- Davidson M. Vaccination as a cause of autism-myths and controversies. Dialogues Clin Neurosci. 2017 Dec;19(4):403-407. PubMed PMID: 29398935; PubMed Central PMCID: PMC5789217.
- de Los Reyes EC. Autism and immunizations: separating fact from fiction. Arch Neurol. 2010 Apr;67(4):490-2. doi: 10.1001/archneurol.2010.57. PubMed PMID: 20385917.
- DeWilde S, Carey IM, Richards N, Hilton SR, Cook DG. Do children who become autistic consult more often after MMR vaccination? Br J Gen Pract. 2001 Mar;51(464):226-7. PubMed PMID: 11255906; PubMed Central PMCID: PMC1313956.
- Demicheli V, Rivetti A, Debalini MG, Di Pietrantonj C. Vaccines for measles, mumps and rubella in children. Cochrane Database Syst Rev. 2012 Feb 15;2:CD004407. doi: 10.1002/14651858.CD004407.pub3. Review. PubMed PMID: 22336803.
- The MMR Vaccine and Autism. Annu Rev Virol. 2019 Apr 15;. doi: 10.1146/annurev-virology-092818-015515. [Epub ahead of print] PubMed PMID: 30986133.
- DeStefano F, Bodenstab HM, Offit PA. Principal Controversies in Vaccine Safety in the United States. Clin Infect Dis. 2019 Feb 12. doi: 10.1093/cid/ciz135. [Epub ahead of print] PubMed PMID: 30753348.
- 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 Feb;113(2):259-66. PubMed PMID: 14754936.
- DeStefano F. Vaccines and autism: evidence does not support a causal association. Clin Pharmacol Ther. 2007 Dec;82(6):756-9. Epub 2007 Oct 10. Review. PubMed PMID: 17928818.
- DeStefano F. MMR vaccine and autism: a review of the evidence for a causal association. Mol Psychiatry. 2002;7 Suppl 2:S51-2. Review. PubMed PMID: 12142951.
- DeStefano F, Chen RT. Autism and measles, mumps, and rubella vaccine: No epidemiological evidence for a causal association. J Pediatr. 2000 Jan;136(1):125-6. PubMed PMID: 10681219.
- DeStefano F, Price CS, Weintraub ES. Increasing exposure to antibody-stimulating proteins and polysaccharides in vaccines is not associated with risk of autism. J Pediatr. 2013 Aug;163(2):561-7. doi: 10.1016/j.jpeds.2013.02.001. Epub 2013 Mar 30. PubMed PMID: 23545349.
- DeStefano F, Thompson WW. MMR vaccine and autism: an update of the scientific evidence. Expert Rev Vaccines. 2004 Feb;3(1):19-22. Review. PubMed PMID: 14761240.
- DeStefano F, Thompson WW. MMR vaccination and autism: is there a link? Expert Opin Drug Saf. 2002 Jul;1(2):115-20. Review. PubMed PMID: 12904145.
- DeStefano F, Chen RT. Negative association between MMR and autism. Lancet. 1999 Jun 12;353(9169):1987-8. PubMed PMID: 10376608.
- DeStefano F, Chen RT. Autism and measles-mumps-rubella vaccination: controversy laid to rest? CNS Drugs. 2001;15(11):831-7. Review. PubMed PMID: 11700148.
- Di Pasquale A, Bonanni P, Garçon N, Stanberry LR, El-Hodhod M, Tavares Da Silva F. Vaccine safety evaluation: Practical aspects in assessing benefits and risks. Vaccine. 2016 Nov 8. pii: S0264-410X(16)30974-4. doi: 10.1016/j.vaccine.2016.10.039. [Epub ahead of print] PubMed PMID: 27836435.
- D’Souza J, Todd T. Measles-mumps-rubella vaccine and the development of autism or inflammatory bowel disease: the controversy should end. J Pediatr Pharmacol Ther. 2003 Jul;8(3):187-99. doi: 10.5863/1551-6776-8.3.187. PubMed PMID: 23118678; PubMed Central PMCID: PMC3469143.
- 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 Oct;118(4):1664-75. Erratum in: Pediatrics. 2006 Dec;118(6):2608. PubMed PMID: 17015560.
- Doja A, Roberts W. Immunizations and autism: a review of the literature. Can J Neurol Sci. 2006 Nov;33(4):341-6. Review. PubMed PMID: 17168158.
- Elliman D, Bedford H. MMR: where are we now? Arch Dis Child. 2007 Dec;92(12):1055-7. Epub 2007 Jul 11. Review. PubMed PMID: 17626143; PubMed Central PMCID: PMC2066086.
- Farrington CP, Miller E, Taylor B. MMR and autism: further evidence against a causal association. Vaccine. 2001 Jun 14;19(27):3632-5. PubMed PMID: 11395196.
- Fitzpatrick M. The end of the road for the campaign against MMR. Br J Gen Pract. 2007 Aug;57(541):679. PubMed PMID: 17688775; PubMed Central PMCID: PMC2099687.
- Fombonne E, Chakrabarti S. No evidence for a new variant of measles-mumps-rubella-induced autism. Pediatrics. 2001 Oct;108(4):E58. PubMed PMID: 11581466.
- 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 Jul;118(1):e139-50. PubMed PMID: 16818529.
- Gadad BS, Lia W, Yazdani U, Grady S, Johnson T, Hammond J, Gunn G, Curtis B, English C, Yutuc V, Ferrier C, Sackett GP, Marti N, Young K, Lewiston L, German DC. Administration of thimerosal-containing vaccines to infant rhesus macaques does not result in autism-like behavior or neuropathology. PNAS; Sept 2015. doi: 10.1073/pnas.1500968112.
- García-Fernández L, Hernández AV, Suárez Moreno V, Fiestas F. [Addressing the controversy regarding the association between thimerosal-containing vaccines and autism]. Rev Peru Med Exp Salud Publica. 2013 Apr;30(2):268-74. Spanish. PubMed PMID: 23949514.
- Gentile I, Bravaccio C, Bonavolta R, Zappulo E, Scarica S, Riccio MP, Settimi A, Portella G, Pascotto A, Borgia G. Response to measles-mumps-rubella vaccine in children with autism spectrum disorders. In Vivo. 2013 May-Jun;27(3):377-82. PubMed PMID: 23606694.
- Gerber JS, Offit PA. Vaccines and autism: a tale of shifting hypotheses. Clin Infect Dis. 2009 Feb 15;48(4):456-61. doi: 10.1086/596476. Review. PubMed PMID: 19128068; PubMed Central PMCID: PMC2908388.
- Glasper EA. New evidence reaffirms the safety of the MMR vaccine. Br J Nurs. 2002 Jun 27-Jul 10;11(12):794. PubMed PMID: 12131827.
- Glickman G, Harrison E, Dobkins K. Vaccination Rates among Younger Siblings of Children with Autism. N Engl J Med. 2017 Sep 14;377(11):1099-1101. doi: 10.1056/NEJMc1708223. PubMed PMID: 28902586.
- Goin-Kochel RP, Mire SS, Dempsey AG, Fein RH, Guffey D, Minard CG, Cunningham RM, Sahni LC, Boom JA. Parental report of vaccine receipt in children with autism spectrum disorder: Do rates differ by pattern of ASD onset? Vaccine. 2016 Mar 8;34(11):1335-42. doi: 10.1016/j.vaccine.2016.02.008. Epub 2016 Feb 8. PubMed PMID: 26868082.
- Halsey NA, Hyman SL; Conference Writing Panel. Measles-mumps-rubella vaccine and autistic spectrum disorder: report from the New Challenges in Childhood Immunizations Conference convened in Oak Brook, Illinois, June 12-13, 2000. Pediatrics. 2001 May;107(5):E84. Review. PubMed PMID: 11331734.
- Hayney MS. Vaccine safety: no link between thimerosal and autism. J Am Pharm Assoc (2003). 2004 Nov-Dec;44(6):725-6. PubMed PMID: 15637857.
- Hertz-Picciotto I, Green PG, Delwiche L, Hansen R, Walker C, Pessah IN. Blood mercury concentrations in CHARGE Study children with and without autism. Environ Health Perspect. 2010 Jan;118(1):161-6. doi: 10.1289/ehp.0900736. PubMed PMID: 20056569; PubMed Central PMCID: PMC2831962.
- Hensley E, Briars L. Closer look at autism and the measles-mumps-rubella vaccine. J Am Pharm Assoc (2003). 2010 Nov-Dec;50(6):736-41. doi: 10.1331/JAPhA.2010.10004. Review. PubMed PMID: 21071320.
- Heron J, Golding J; ALSPAC Study Team. Thimerosal exposure in infants and developmental disorders: a prospective cohort study in the United kingdom does not support a causal association. Pediatrics. 2004 Sep;114(3):577-83. PubMed PMID: 15342824.
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Note: In almost every case in the list above, I’ve linked to the PubMed abstract, which often has limited information and lacks detailed analyses of methods, statistics and results. It is always preferred that you read the full article, but many of these publications sit behind expensive paywalls (I hate paywalls, they limit free access to scientific data). Students, especially in scientific fields and most academic physicians have access to the full article through their schools’ journal search engine. I have personal access to many, if not most, of the actual articles, and have read them in detail.
PubMed occasionally links to a “free” full version of the article. It can be found on buttons on the top right of the PubMed page, which says “Free Full Text” or something similar. These links may direct you to the actual journal, who graciously makes some articles free for the public, or to PubMed Central, a US National Institutes of Health library of full text medical and biological articles (although you can find the occasional article in other areas of science). I do not link, usually, to the free version of an article because it changes all the time, so I have found it better to go to PubMed. If there is a PubMed Central version of the article, you will see “PubMed Central PMCID:” in the standardized citation (which I always use for scientific journal articles). Using the PMC number, you can search for it through Google or the PMC website.
Also, many thanks to the brilliant folks at a pro-vaccine Facebook Page who put many hours into creating this list. I can’t link to the group or the individuals publicly, but they know who they are, and they made this blog post relatively easy. I’ve adapted the list to the scientific citation style that I prefer to use and added a few additional articles that support the scientific consensus.
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