Italian Health Ministry's concession that MMR causes autism is overturned

12th March 2015 by Chiara Facco

It all began when Dr Wakefield published a paper in The Lancet suggesting that there may be a potential causal effect between the mumps, measles and rubella (MMR) vaccine and the onset of autism spectrum disorder in 12 children – it was 1998. Since then a cascade of events has brought us to a public health crisis and a whole lot of confusion.

Videos and articles of presumed scientists supporting Dr Wakefield’s hypothesis of 1998 go viral on social media, despite the partial and then full retraction (respectively in 2004 and 2010) of the notorious Lancet paper due to Dr Wakefield’s serious professional misconduct that brought him to being struck off the Medical Register in the UK.

I confess I was intrigued, as a woman of science, but reserved judgement as I wasn't sure about the scientific backing of either side of the debate. A few weeks ago I came across an article analysing how the MMR vaccine may indeed be linked with the onset of autism, and a video explaining the vaccine/autism connection.

These sprung my scientific curiosity into action: could there be something in it? I started to dig deeper. The key event the lay media reported is the 2012 concession by the Italian Health Ministry that the MMR vaccine caused autism in nine-year-old Valentino Bocca. The update hasn’t made the UK news yet (as far as I know), but the decision has been overturned by the Appeals Court of Bologna, as reported by the Italian national newspaper La Repubblica on 1st March 2015.

The prosecution barrister declared he would appeal to the Corte Suprema di Cassazione, the highest court of appeal in Italy, so the saga isn’t over yet – but then again you would expect the prosecution barrister to fight to the last, wouldn’t you? A short, and by no means comprehensive, literature search was enough to relax my suspicions towards the MMR vaccine’s alleged role in causing autism spectrum disorders.

The 2009 official publication of the Infectious Diseases Society of America Vaccines and Autism: A Tale of Shifting Hypotheses proved a convincing read. Another more recent review article on intestinal barrier dysfunction and central nervous system disorders validated the conclusion. So I wondered: why do we still keep hearing and talking about it? From a scientific perspective, Wakefield began to investigate the occurrence of gastrointestinal symptoms in children with pervasive developmental disorder.

These happened to be observed shortly after the children had been administered the MMR vaccine. A number of studies have been performed since then to further investigate the correlation between intestinal permeability and central nervous system disorders such as autism, but no general consensus has been reached.

Could it be that children predisposed to developing autism who also present with the gastrointestinal characteristics first described by Wakefield are simply at higher risk of experiencing certain side effects after administration of the MMR and other vaccines?

This wouldn’t mean that the vaccine causes the developmental disorder, and it all remains to be seen. I couldn’t help but wonder: is anyone clearly responsible to have caused this alarming public health crisis? Surely it is reassuring to know that parents are second-guessing the health authorities after the publication of data that may sound alarming to them – this is democracy, right?

In performing this literature search I have realised that I wasn’t aware of the debilitating and even fatal outcomes of the diseases we vaccinate our children against. The memories of sick children dying or becoming disabled due to these viruses are long gone in our social memory.

We no longer see what we are protecting our children from, and have come to take vaccines for granted and perhaps question their necessity. There is no such thing as a “safe” medication, but we should be reminded of the key risk/benefit ratio that our dear doctors have the expertise to assess, both on an individual and public health scale, before jumping to conclusions.

At the same time, we might be witnessing a healthcare revolution: patients and parents want to be more involved in their own and their children’s medical treatment and choices. The era of “do what the doctor tells you” may be over, and we want to make informed decisions with our healthcare professionals instead of blindly following their advice.

Is the western world capable of giving patients what they need, with the extremely short consultation time available for GP appointments? I also think that the scientific community and the media are responsible for reporting information that could impact on public health matters in a balanced way.

If there is one thing that makes me cringe is hearing scientific hypotheses misrepresented as a proven fact. It is so important in science to clearly define what you are talking about: a simple omission can make the difference between a theory someone wants to investigate and an accepted fact that no longer requires looking into.

I guess I can only say that if I had a child of vaccination age, I would agree to the standard childhood vaccinations. I also understand why some parents may have chosen not to vaccinate their kids in recent years. I hope that the events of the last decade will awaken western healthcare systems to adapt their practice style to a changed, more informed population – and would urge the parents to really understand the source of information they are basing their decision on before overruling a physician’s opinion.