Fix a research papper

2

The relationship between vaccination and autism spectrum disorder

The relationship between vaccination and autism spectrum disorder

Stephanie Henao Jaramillo

Miami Regional University

ENC 2201: Report Writing and Research Methods

Uliana Gancea, PhD

April 12, 2021

Abstract

The abstract: Autism rate have increased remarkably in the past few years in many developed countries. Increased rate of autism is due to increased changing of definition, reports and diagnoses. However, some people have raised concern that autism might be linked or caused by the vaccines that children receive (Davidson, M. 2017). This has led to many parents denying their children vaccines since some vaccines contain components like mercury, therefore refuse to vaccinate their children for protection. The concept that autism results from the brain damage that can be caused by vaccine preservatives (thimerosal) or MMR vaccine (DeStefano, F., & Shimabukuro, T. T. 2019), has led to a lot of research about the relationship of MMR vaccine or vaccination and autism disorder. However, other studies suggest autism maybe caused by postnatal brain development. The object of this study is to connect vaccination with autism and if autism is really caused by postnatal brain development. The method used is used for this study was identification of articles for analysis from different sources.  Data relating autism with MMR vaccine and mercury vaccine preservative collected from different selected articles of study were compared and analyzed. However, different information about brain abnormality connectivity with autism individuals was compared. Results: articles or publications that met the criteria show a significant possibility of autism been caused by postnatal brain development. However, the evidence does not support relationship between autism and vaccination (MMR vaccine and mercury preservative). This study help show the link between autism and vaccination. However, it will help a lot of individual vaccinate their children since there no proof or evidence on connection of vaccines to autism. In addition, in most articles the evident supported that there is a higher possibility for autism to be caused by brain abnormalities. It is recommended that, more tests to be done on children who have autism both vaccinated and unvaccinated for assurance.   

The relationship between vaccination and autism spectrum disorder

Hook: The relationship between vaccination and autism spectrum disorder. Background Information: Autism and vaccines are now two very big problems in society because there are many articles and research about the relationship Autism has with vaccines. There are many parents who decide not to give their children vaccines and do not protect it because they think that they are going to create more problems if they give him vaccines and not only with autism but with other diseases such as his central system. Problem Statement:  These are some of the searches that they are doing with much more frequency because there are many parents who no longer want to vaccinate their children and what they do is an extension through religion, or they refuse. They are for almost all vaccines but there is one in particular that they say, and it has not yet been scientifically proven that it is the one that develops autism, which is MMR. Research Question :  Why do parents refuse to vaccinate without a scientific demonstration Hypothesis:   It may not be true that vaccines cause autism disorder, but out of 1000 children who get vaccinated, it may be one child who gets autism because vaccines are created with antibodies to take care of ourselves and children with more than 200 diseases. Thesis: The purpose of this paper is to analyze the impact of vaccine of children's health. 

Literature Review

The link between vaccination and autism spectrum disorder (ASD) remains a controversial topic. After a child receives an ASD diagnosis, it is not yet clear whether these children receive the remaining scheduled vaccines. It also remains unclear whether the younger siblings of these children are vaccinated based on the vaccine recommendations.

According to Zerbo et al (2018), children with ASD do not complete the recommended vaccinations between 4 years and 6 years.  Likewise, their younger siblings do not complete rthe recommended vaccines at the recommended ages. Parents with ASD children are more likely to reject one or more of the recommended vaccines for the children’s younger sibling and even restrict the vaccinations given in their first year. Thus, children with ASD and their younger siblings are highly under-vaccinated in comparison to the general population.

Measles, mumps, rubella (MMR) vaccine has been associated with an increased risk of ASD, which has significantly affected vaccine uptake. However, Hviid et al. (2019), states that there is no increased risk for autism following MMR vaccination. While comparing MMR-vaccinated children with MMR-unvaccinated children, there was no increased risk for ASD after consistent observation in subgroups of children identified based on their history of ASD, childhood vaccinations, and ASD risk factors (Hviid et al., 2019). The study supports prior studies that propose MMR vaccination has no risk for ASD.

Childhood vaccinations have been linked with subsequent development of ASD. A study by Taylor et al. (2014), revealed that there is no relationship between childhood vaccination and ASD. Similarly, the study’s case-control data indicated no proof for a higher risk of developing ASD after MMR vaccination. The study’s findings propose that there is no correlation between vaccinations and ASD development. Additionally, the study ruled that the components of vaccines such as; mercury and thimerosal or multiple vacinnes do not increase the risk of ASD.

While child vaccination rates still remain high, there are a number of parental cncerns that the vaccies can cause ASD. A meta-analysis study by Gerber & Offit (2009), indicates that MMR vaccine or thimerosal does not cause ASD. The study  dispute the opinion that vaccines devastate the immune system of a child exposing them to the risk of developing ASD. The study contributes to studies that suggest more-promising leads on the causes of autism.

Autism has been linked with an increased level of immunologic stimulation obtained from vaccines given during the initial 2 years of life. in a case-control study conducted by DeStefano et al. (2013), there was no increased risk found for ASD or austic disorder with regression. Hence, the study concluded that an enhancing exposure to polysaccharides and antibody stimulating proteins in the first years of life was not linked to a higher risk for developing austic disorder or ASD. 

Method

For this study, a meta-analysis method was used to synthesize the different results found between various studies. The researcher accessed the virtual library through the MRU home page. The researcher then accessed the EBSCO host's databases. Once there, the researcher selected both MEDLINE Complete and CINAHL Complete. An advanced search was performed, and the following keywords were entered in the Boolean search: ¨Vaccination",  and "Autism spectrum". The search was limited to references providing full text, peer-reviewed academic journals, and available abstracts. A limitation was established for research published in the last five years, from February 2016 to February 2021. Furthermore, the researcher consulted only articles published in English and Spanish. The search provided access to a total of 16 articles, of which five (5) studies were selected based on their relevance to the topic; the other 11 were discarded.

Results

The selected topic is the relationship between vaccination and autism spectrum disorder. The discussion involves the provision of the outcome of the results following the search process of the selected topic. The results are presented in the table below.

Articles	Objectives	Results
Hviid et al. (2019)	The aim was to asses whether the MMR vaccine leads to the increase in the risk for autism in children, sub-groups of children, or the time periods after vaccination.	The MMR-vaccinated with the MMR-unvaccinated children yielded a full adjusted autism hazard ratio of 0.93 percent. There was no increased risk for autism after the vaccination among the subgroups of children that were defined based on the sibling history of autism, autism risk factors, other childhood vaccination, or during the specified time periods following after vaccination.
Zerbo et al. (2017)	To find out the relationship between influenza infection and vaccination during pregnancy and the Autism Spectrum Disorder (ASD) risk	Following the control of maternal and child covariates, it was discovered that maternal influenza infection anytime during pregnancy was not associated with the increase in ASD risk. There was no link between maternal influenza infection during the first, second, and the third trimester and the ASD risks. The percentage of the unadjusted ASD was slightly high in the entire follow-up period among children of women who received influenza vaccination during pregnancy as compared to children of unvaccinated women. The maternal influenza vaccination in the second and third trimesters was not linked with increased ASD risk.
Becerra-Culqui et al.  (2018)	Investigating the relationship between prenatal tetanus, diphtheria, acellular pertussis (Tdap) vaccination and the autism spectrum disorder (ASD) risk in offspring.	Getting vaccinated with Tdap during pregnancy is not linked to the increased risk of ASD in children. The result is based on the outcome of the IPTW-adjusted analyses which shows that the Tdap vaccination is not directly linked to the increase in the risk of ASD.
Ludvigson et al. (2020)	To examine the risks of the ASD in offspring of mothers vaccinated against Influenza (H1NA) pdm09 (swine flu) in pregnancy	There was no association between the maternal H1N1 vaccination during pregnancy and the risk for ASD in the offspring

 

Discussion The table formulated to give the results shows that according to Hviid et al. (2019) MMR-vaccinated and MMR-unvaccinated offspring from families that showed autism before showed 0.93 percent hazardous ratio. Zerbo et al. (2017) said that maternal influenza infection in the pregnancy period did not accelerate autism spectrum disorder but the percentage of autism was in excess among babies of women who received influenza vaccination during their pregnancy while those who did not are low. Becerra-Culqui et al. (2018) looked at the common thing between diphtheria, parental tetanus, acellular pertussis (Tdap) vaccination and Autism Spectrum Disorder (ASD) therefore discovered that being vaccinated with acellular pertussis during pregnancy is not associated with the risk of (ASD) on offspring. Ludvigson et al. (2020) investigated how much exposed are mothers vaccinated against influenza (HINA) pdm09 (swine flu) in pregnancy are to (ASD).

According to the above data, MMR-vaccine does not increase the risk of Autism Spectrum Disorder even on children of family autism in the past, those who have been vaccinated during there childhood and even if given a period of time. Maternal influenza infection during pregnancy was not in any way related in the risks of (ASD) whereas those who were vaccinated with maternal influenza vaccine showed high risks compared those who were not vaccinated therefore maternal influenza vaccine does not accelerate ASD. Tdap vaccination does not relate at all to excessive risk of ASD and the same with HINA vaccination.

After posting the result, the feedback was that vaccination does not increase the risk of offspring getting Autism Spectrum Disorder. Parents who do not vaccinate their children with a mindset of protecting them from autism are exposing them to a greater risk of health problems. According to the results of the research, recommendation for vaccination should be of concern because autism maybe caused by something else and discovering it early in a great way helps for intensive intervention.

Limitation and implication

This research study of relationship between vaccination and Autism Spectrum Disorder suffered from different limitation and implications, which needed to be improved. Lack of laboratory was one of limitations in the research. The laboratory would help in relevant tests of patients of have been vaccinated and who have not been vaccinated to determine if there is any link of vaccines used or any preservatives used in the vaccines which is injected to children when they are small has anything to do with causing Autism spectrum disorder (Zerbo, O., et al, 2018). The preservative in question is thimerosal and combination of vaccines – where three vaccines combined to one injection. To reduce numerous test which were conducted to find any link between the vaccination and autism spectrum disorder, conducting developmental monitoring- where the patients parent has to answer questions about the patients development habits-will be a valuable source of information. It will be easier when doing developmental screening tests for both vaccinated and unvaccinated patient.

The research only depended on patient’s guardian subjective report on their symptoms. Checking the patient’s history if there is any family member with autism or any behavior associated with it and whether they were vaccinated or not would make a change in the research. In cases where the patient has a higher risk for autism due to low birth weight, environmental risks or preterm birth addition screening would help thus qualitative information (Glickman, G., et al, 2017). Finally, increasing the number of patients to undertake a research both vaccinated and unvaccinated in order the results obtain be verified based on a large scale.

The conclusion

Parents are nowadays shunning away from vaccinating their children because they fear they might end up developing autism among other diseases instead they rely on religion or completely refuse to vaccinate their children. These parents fear this one vaccine that has been scientifically proven to develop autism. The vaccine goes by the initial MMR. Why do parents refuse to vaccinate their children without a scientific demonstration?

It may not be true that vaccines cause autism but out of 1000 kids who get vaccinated, it may be one child who gets autism because vaccines are made of antibodies to take care of ourselves and our children against 200 more diseases. The reason for this research is to inform parents that not all vaccines can make their children sick.

Some people have had concerns that ASD could be linked to the vaccines children receive at their early age but that is not the case. Research has shown that there is no link between administering a vaccine and developing ASD.  This is according to institutional research in 2011 where eight vaccines were administered to children and adults found that these vaccines were very safe. Safety Review Committee. (2004).  There has been a vaccine ingredient that has been studied specifically ‘thimerosal which is a mercury-based preservative used to prevent contamination of multidose vials of vaccines. Research shows that thimerosal does not cause ASD. Safety Review Committee. (2004). As years went by more and more tests were done on thimerosal to determine if it was harmful and all tests came out positive. The tests were done as a precaution to reduce all types of mercury exposure to children. Besides thimerosal, people have had their concerns about other vaccine ingredients just as ASD, however no links have been found between the ingredients and ASD.

Many scientific and medical experts conclude that there is no connection between vaccines and ASD, but critics are always questioning the issue. They believe that MMR and thimerosal and ASD are related in some way despite there being no evidence of their relations. Autism researchers conclude that Autism is caused mainly by environmental and genetic factors.

 

                                             

Reference

Davidson, M. (2017). Vaccination as a cause of autism—myths and controversies. Dialogues in clinical neuroscience, 19(4), 403.

DeStefano, F., & Shimabukuro, T. T. (2019). The MMR vaccine and autism. Annual review of virology, 6, 585-600.

Glickman, G., Harrison, E., & Dobkins, K. (2017). Vaccination rates among younger siblings of children with autism. New England Journal of Medicine, 377(11), 1099-1101.

Zerbo, O., Modaressi, S., Goddard, K., Lewis, E., Fireman, B. H., Daley, M. F., ... & Klein, N. P. (2018). Vaccination patterns in children after autism spectrum disorder diagnosis and in their younger siblings. JAMA pediatrics, 172(5), 469-475.

Becerra-Culqui et al. (2018). Prenatal tetanus, diphtheria, acellular pertussis vaccination and autism spectrum disorder. Pediatrics, 142(3). 

Hviid, A., Hansen, J. V., Morten, F., & Melbye, M. (2019). Measles, mumps, rubella vaccination and autism: a nationwide cohort study. Annals of Internal Medicine, 170(8), 513-20. 

 Ludvigson, J. F., Winell, H., & Sandin, S. (2020). Maternal Influenza A(H1N1) Immunization During Pregnancy and Risk for Autism Spectrum Disorder in Offspring. Annals of Internal Medicine, 173(8). 

 Zerbo, O., Qian, Y., & Yoshida, C. (2017). Association Between Influenza Infection and Vaccination During Pregnancy and Risk of Autism Spectrum Disorder. JAMA Pediatrics, 171(1), e163609. doi:10.1001/jamapediatrics.2016.3609

 

 

                                           

Becerra-Culqui, T. A., Getahun, D., Chiu, V., Sy, L. A., & Tseng, H. F. (2018). Prenatal tetanus, diphtheria, acellular pertussis vaccination and autism spectrum disorder. Pediatrics, 142(3). https://doi.org/10.1542/peds.2018-0120

Hviid, A., Hansen, J. V., Morten, F., & Melbye, M. (2019). Measles, mumps, rubella vaccination and autism: a nationwide cohort study. Annals of Internal Medicine, 170(8), 513-20. https://doi.org/10.7326/M18-2101

Ludvigson, J. F., Winell, H., & Sandin, S. (2020). Maternal Influenza A(H1N1) Immunization During Pregnancy and Risk for Autism Spectrum Disorder in Offspring. Annals of Internal Medicine, 173(8). https://doi.org/10.7326/M20-0167

Zerbo, O., Qian, Y., & Yoshida, C. (2017). Association Between Influenza Infection and Vaccination During Pregnancy and Risk of Autism Spectrum Disorder. JAMA Pediatrics, 171(1), e163609. doi:10.1001/jamapediatrics.2016.3609

 

DeStefano, F., Price, C., & Weintraub, E. (2013). Increasing exposure to antibody-stimulating proteins and polysaccharides in vaccines is not associated with risk of autism. The Journal of Pediatrics , 163 (2), 561-567.

Gerber, J., & Offit, P. (2009). Vaccines and Autism: A Tale of Shifting Hypotheses . Clin Infect Dis , 48 (4), 456-461.

Hviid, A., Hansen, J., Frisch, M., & Melbye, M. (2019). Measles, Mumps, Rubella Vaccination and autism: a nationwide cohort study. Annals of Internal Medicine , 170 (8), 513-520.

Taylor, L., Swerdfeger, A., & Eslick, G. (2014). Vaccines are not associated with autism: An evidence-based meta-analysis of case-control and cohort studies. Vaccine , 32 (29), 78-85.

Zerbo, O., Modaressi, S., & Goddard, K. (2018). Vaccination Patterns in Children After Autism Spectrum Disorder Diagnosis and in Their Younger Siblings. JAMA Pediatr , 172 (5), 469-475.