Patrick Holford, MMR and What Passes for Hard Evidence

Patrick Holford is remarkably generous about sharing his insights and knowledge. The science and politics of autism spectrum disorders (ASD) concern substantial numbers of people. There is a significant research effort to investigate numerous potential aetiologies that might contribute to ASD. ASD can have a significant impact on family life, education, social life etc. Today, the Autism Omnibus starts in the US and several commentators (here and here) have expressed misgivings that the outcome may persuade the pharmaceutical industry to pull out of vaccinations altogether with potentially significant consequences for Public Health and our ability to withstand threats of bio-terrorism.

But Patrick Holford has the solution. If you accept the invitation to Meet the Author of the co-authored Optimum Nutrition for your Child’s Mind then you are in for a startling revelation:

We’ve learned about what it is that makes some kids develop autism and also how to bring them back.

One of the sections in the book has the heading: The big debate – MMR and autism. You might expect an extensive and authoritative overview of the extensive literature concerning this topic. Not so much. Holford and Colson deal with this contentious issue with remarkable economy.

But is there any hard evidence against MMR? Firstly, studies have shown a high incidence of autism in children whose mothers had received live virus vaccines (particularly the MMR or rubella vaccine) immediately before conception, or immediately following birth. [ref.1] Secondly, there are two classifications of autism; one where autistic traits are noted from birth, and one where symptoms are noted at 18 months plus. The onset of autism at 18 months was uncommon until the mid-1980s, when the MMR vaccine came into wide use. After that, the incidence shot up. [ref.2] [My emphasis.]

Now, what did you expect to read as part of this hard evidence in this deeply contentious area? If you had guessed that you would be referred to URLs rather than journals you might find in Entrez PubMed, then you are familiar with Holford’s research and cite style.

Yes, ref.1 is for a URL that no longer exists: there is a typo in the URL but that is neither here nor there. I’m going to make a plea here; if you publish a book and give URLs as the references, then I think that it would be helpful if you were to keep a dedicated page on your site where you check and update these references and post alternate sites, as appropriate. A page for each book; it would save a lot of frustration. Maintaining a page with the references might even help people who want to research further if you provide links to any papers that you cite.

Holford’s URL may not work but I located another source for Dr. Yazbak’s Autism: Is there a vaccine connection? Part 1. You will note that the methodology involved case studies solicited from “vaccine and parent groups” and that further notes on the methodology and questionnaire are missing. This absence is unfortunate as I am interested in how you work around the problem of asking one particular sample of people for their anecdotal experience and then extrapolate from that to the more general population. The exchanges appear to have been conducted over email. The case studies do not all involve MMR. Holford and I may differ on our understanding of relevance or “hard evidence”.

I could not locate the journal for Rimland’s ref.2 on Entrez Pubmed; even on the journal’s own website, there is no abstract for a paper that resembled the reference. It is difficult to track this reference because the journal reference states that page numbers are 261-266 but the reference in the book does not give the name of the paper/comment, but has the page numbers as 267-269, which seems more like a follow-up comment. The book reference does helpfully tell you that you can probably find it on the website of the law firm that is the representative for some families in legal proceedings around the claim of harm from mercury in vaccines. However, I tried to google this and rapidly lost the will to search any further when I came across the following Rimland quotation:

When the link between the use of unsafe, mercury-laden vaccine and autism, ADHD, asthma, allergies and diabetes becomes undeniable, mainstream medicine will be sporting a huge, self-inflicted and well-deserved black eye.

Then will come the billion-dollar awards, by enraged juries, to the children and their families. I can’t wait.

Holford and Colson’s use of Rimland in a section about MMR is a little odd: Rimland is commonly associated with the argument that it is the presence of thiomersal (US thimerosal) in some vaccines that contributes to autism (and much more, according to the above quotation). MMR does not contain thiomersal, so I do not understand what Rimland’s work is doing in this section. Some people mistakenly believe that MMR contains thiomersal: I hope that that doesn’t account for the odd inclusion of Rimland in this MMR section of the book. What does Holford say when he discusses Rimland’s work in this section on MMR?

[T]he problem may not be the vaccine itself, but a preservative used in multi-dose vials of many childhood vaccines till very recently. Thimerosal, a preservative containing high levels of mercury, was used in many vaccines up until 2001. Before this, each vaccine injection exposed the child to levels of toxic mercury in excess of the US Federal Government’s own safety guidelines, and a child receiving all their jabs could have received a total of 187.5 mcg of mercury – enough to give them heavy-metal poisoning.

This is a separate argument (and one that has been reviewed by the Institute of Medicine, among others, and found to have no merit). It has nothing to do with MMR. Yet, both this and unsubstantiated claims about allergies, toxic overload and nutritional deficiences are included in Holford’s conclusion to this section:

So, although it is not easy to say yea or nay conclusively, it is entirely possible that late onset autism may be triggered by multiple vaccination, allergies, toxic overload or nutritional deficiencies – and especially a combination of any of these that send a child’s gut and brain into distress.

Does any of this look like the quality of “hard evidence” that you might expect to see in such a fraught area? I will look further into the Holford and Colson claims about:

what it is that makes some kids develop autism and also how to bring them back.

However, judging by the quality of the discussion about MMR and autism, I have misgivings as to the quality of the evidence either for the contributory factors or the proposed treatment.

Edited: Arthur Allen’s account of the opening day of the Autism Omnibus is worth reading for the latest revision to the MMR/Mercury/Autism theory.

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5 Comments

Filed under autism, Colson, Deborah Colson, Holford, immunization, mercury, MMR, Optimum Nutrition for Your Child's Mind, patrick holford, thimerosal, thiomersal, vaccination, vaccines

5 responses to “Patrick Holford, MMR and What Passes for Hard Evidence

  1. Jon

    thanks Shinga – v interesting post. Did you get a sense of what Holford’s recommendations would be re. vaccination? Whereas publications like the Cochrane Review [PDF] make pretty explicit recommendations after analysing the evidence (in the case of the Cochrane review, they emphasise that the evidence does not support a link to autism, and that vaccination is important) I’m not entirely clear what Holford thinks parents ought to do…

  2. Claire

    I wonder what Mr. Holford makes of the following paper:

    No effect of MMR withdrawal on the incidence of autism: a total population study

    Authors: Honda, Hideo1; Shimizu, Yasuo1; Rutter, Michael2

    Source: Journal of Child Psychology and Psychiatry and Allied Disciplines, Volume 46, Number 6, June 2005 , pp. 572-579(8)

    Publisher: Blackwell Publishing

    Abstract:
    Background:

    A causal relationship between the measles, mumps, and rubella (MMR) vaccine and occurrence of autism spectrum disorders (ASD) has been claimed, based on an increase in ASD in the USA and the UK after introduction of the MMR vaccine. However, the possibility that this increase is coincidental has not been eliminated. The unique circumstances of a Japanese MMR vaccination program provide an opportunity for comparison of ASD incidence before and after termination of the program. Methods:

    This study examined cumulative incidence of ASD up to age seven for children born from 1988 to 1996 in Kohoku Ward (population approximately 300,000), Yokohama, Japan. ASD cases included all cases of pervasive developmental disorders according to ICD-10 guidelines. Results:

    The MMR vaccination rate in the city of Yokohama declined significantly in the birth cohorts of years 1988 through 1992, and not a single vaccination was administered in 1993 or thereafter. In contrast, cumulative incidence of ASD up to age seven increased significantly in the birth cohorts of years 1988 through 1996 and most notably rose dramatically beginning with the birth cohort of 1993. Conclusions:

    The significance of this finding is that MMR vaccination is most unlikely to be a main cause of ASD, that it cannot explain the rise over time in the incidence of ASD, and that withdrawal of MMR in countries where it is still being used cannot be expected to lead to a reduction in the incidence of ASD.

  3. Shinga

    Indeed, Claire. If you are going to cover this area in a book, I think that it would be relevant to provide an even-handed overview of the literature in this field, or even to give a summary of the literature and sense of which side has the most scientific support. In fact, you might do anything other than cite the references that he did and call them “hard evidence”…

    No, Jon. I didn’t read enough of the book, but, believe me, it is on the list. After I have finished with homocysteine and other running topics.

    Regards – Shinga

  4. Pingback: Ben Goldacre Usually Gets The Science Wrong: Patrick Holford Speaks From His Own Reality « Holford Watch: Patrick Holford, nutritionism and bad science

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