An Autopsy on Hviid et al. 2019’s MMR/Vaccine Science-Like Activities

JUST IN TIME to be sandwiched between two one-sided Senate Hearings, a new cohort study by Hviid et al. has all of the hallmarks of a completely well-done study.  Well done as in overcooked.  Here is my initial assessment.

The burnt ends on this brisket are obvious.  Just like all the past studies on the MMR/autism question, the study focuses on one vaccine.  This is a problem because the variable they call “genetic risk” (having an older sibling), which is the most significant variable, is confounded with health user bias (there is no control over vaccine cessation).  It’s an important variable, but genetic risk of what?  Of autism?  Or of autism following vaccination?  It’s impossible to tell because the study never tests a VACCINE x FAMILY HISTORY interaction term.  Or any other interaction term that includes vaccines.

Were it not such an imporant question for which so much “science-like activities” have occurred, we could just shrug our shoulders, one could argue that defining the data analysis strategy is just about how one like to season their meat.  But there is real evidence Hviid (who did the data analysis) appears to be up real data cookery here.

(1) The smoking gun is the study-wide autism rate of 0.9-1%.  The rate of ASD in Denmark is 1.65%.  Where are the missing cases of ASD?  Given past allegations of this group’s malfeasance and fraud, the rest of the study cannot be accepted based on this disparity alone: the study group is not representative of the population being studied.

(2) They did not consider anything about >1 vaccine per visit when the MMR was given.  Comment below if your child regressed into ASD following receipt of the MMR + other vaccines (“MMR + OTHER”).  Here’s an interesting question: Comment below if your child regressed into ASD following receipt of MMR alone after having received no prior vaccines (“MMR ALONE NO PRIOR”).  Comment below if the situation was “MMR ALONE WITH PRIOR VACCINES”).

Cumulative vaccine exposure is the variable that might reflect risk better, as would “>1 vaccine received on date of MMR vaccination”.  It is meaningless to study a single vaccine exposure in a population that is being vaccinated so many times before the MMR.

(3)  Apparently vaccine risk in immigrants do not matter because the study required that individual have a valid entry in the Denmark birth registry.  Why would that matter?  Because the odds of receiving many vaccines at once upon entry into Denmark is very, very high. Oddly, without explanation, the study excluded 11 people with autism.  To avoid translational failure, the MMR should not be used on any of the clinical groups that were excluded from the study.

(4) While the appear to have learned how to combine risk variables into risk covariates, they did not test models that combine different risk variables (such as vaccine and parent’s age).  Single-variable, 2-variable, 3-variable… etc models should all have been trained on a training set (66% of the data), optimized via internal cross-validation to maximize prediction accuracy, ROC curves produced, and then the generalizability tested on a set-aside (RANDOMLY set-aside) training set (33%) of the data using my Weighted ACE optimization given the high imbalance in the two study groups (ASD vs. no ASD) (see Cures vs. Profits, it’s published in there and will prevent nonsense results).

(5) Association studies do not test causality.  Had this study reported a positive association, it would have fallen short under IOM standards, of providing sufficient evidence for causality.  Thus, it cannot be used rule out causality. It’s not testing that hypothesis.

(6) COIs abound: “Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Pfizer, Johnson & Johnson”. – Thank you John Stone for pointing this out.

Once again, epidemiology is the WRONG TOOL for studying vaccine risk.

Hviid, A et al. 2019. Measles, Mumps, Rubella Vaccination and Autism: A Nationwide Cohort Study. Annals of Internal Medicine. DOI: 10.7326/M18-2101

https://annals.org/aim/fullarticle/2727726/measles-mumps-rubella-vaccination-autism-nationwide-cohort-study

To read my objective evaluation of past association studies, see

Lyons-Weiler, J. [pre-print]. Systematic Review of Historical Epidemiologic Studies Influencing Public Health Policies on Vaccination [pdf, 2018] [supplementary material] (Review) Updated 10/8/2018, typo “+1” -> “+4” in abstract

 

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75 comments

  1. MMR + DTaP at 15 months preceded by all other vaccine on the schedule in 1998. He stopped talking after that visit and clearly regressed into “autism”.

  2. My son developed an acute encephalitis following his MMR, Prevnar (aluminum containing vaccine) and Varivax (another live virus vaccine) given at his one year old Well Child Check. He developed a high fever within hours of getting these vaccines, subsequent head swelling and high pitched crying. Then after the acute illness he lost words, began flapping/spinning, lost eye contact, became antisocial, and developed a slew of medical problems: insomnia, eczema, food allergies, PICA, chronic GI issues, weight loss, and chronic headaches. He had obvious autism at 15 months old. How is it he could be normal at 12 months old at a WCC appointment then severely autistic at 15 months? Acute encephalitis then chronic encephalopathy aka Autism. Different semantics but same disease.
    I wonder if the Aluminum in the Prevnar and the combination of 4 live viruses (Measles, Mumps, Rubella and Varicella) increased his chances of encephalitis. Also, my son was born preterm at 34 weeks. His age was not corrected before getting his vaccines. He was technically not even one year yet when he got these vaccines. And he was still low weight for his uncorrected age. I think his prematurity and low weight was a major factor too. He has improved with an all organic diet and no gluten, no dairy, no soy, no egg, no sugar, mom-makes-everything-from-scratch diet as well as the hyperbaric oxygen chamber. He still is nonverbal and still has autism but he is slowly improving with biomedical treatment.

    1. I have another point to make. Encephalitis is encephalitis whether it is from a wild microbe acquired naturally or from a microbe in a vaccine. We are talking about the SAME microbe. For instance the measles virus can cause an acute encephalitis and SO CAN the live virus measles virus in the MMR. I think the MMR is more likely to cause an acute encephalitis bc it is injected and young children do not have a blood brain barrier yet thus are more likely to get encephalitis. I wonder if my son had had wild measles which is a respiratory illness he may not have developed an acute encephalitis. Respiratory viruses have a better chance of staying in the lungs as opposed to injecting measles right into a baby’s body. I was breastfeeding him. Perhaps he would have not developed autism if he had breast milk and a mere respiratory illness.

      I want to stress that the wild microbe and the vaccine EACH have the risk of causing an acute encephalitis then chronic encephalopathy aka Autism. We are talking about the SAME thing not something different.

      1. Children have a blood brain barrier
        Measles is a systemic infection. That’s how you get rash, encephalitis, all the extra-pulmonary manifestations. It infects B cells all over the body.

        I’m sorry about your child, but autism is almost completely genetic.

      2. Peter, that is incorrect. Anyone who has read the literature on autism genetics (summarized in my book) knows that the genetic studies show that autism is at most 50% environmental, and there is room for more environmental liability because the studies were not designed to include environmental factors, thus the genetic x environment interaction term could not be tested. Here is a 2017 article I wrote explaining G x E. And here is my article on how ASD is an acquired cellular detoxification deficiency syndrome.

        See this article reviewing that California just banned pesticide linked to autism. Clearly, autism is not 100% genetic.

      3. Peter. Are you able to provide me with evidence of an Autism gene? I am a nurse practitioner and my son was never tested for an autism gene. He was diagnosed based on symptoms, behavior and delayed milestones.

        Could you provide me with research articles describing which genes are the reasons why a child develops autism?

  3. And what about the CDC whistle blower who described the destruction of data that showed higher incidence of autism in African American boys after MMR?

    1. They did not analyze their data by race. My assumption is that it is because the population is Denmark is so homogeneous that subgroups of non-Caucasians with autism are too small a group to evaluate separately.

  4. We did a little digging:
    According to the study it’s principle funding is from Novo Nordisk Foundation and Danish Ministry of Health.

    According to Wikipedia https://en.wikipedia.org/wiki/Novo_Nordisk_Foundation, ” The Novo Nordisk Foundation is an international foundation focusing on medical treatment and research. It is situated in Denmark.The Foundation is the primary owner of Novo Nordisk A/S and NovoZymes A/S through its subsidiary company called Novo Holdings A/S.[1] Aside from Novo Nordisk and Novozymes, the foundation is also a major shareholder in more than 75 other companies.”

    If you go to the wiki entry and hover over the two companies they own you will see they are both multinational pharmaceutical corporations.

    Here’s the wiki entry on Novo Nordisk A/S: https://en.wikipedia.org/wiki/Novo_Nordisk
    ” Novo Nordisk A/S is a Danish multinational pharmaceutical company headquartered in Bagsværd, Denmark, with production facilities in eight countries, and affiliates or offices in 75 countries. Novo Nordisk is controlled by majority shareholder Novo Holdings A/S which holds approximately 25% of its shares and a supermajority (75%) of its voting shares.[3]”

    Here’s the section in the wiki article on CONTROVERSY surrounding Novo Nordisk:
    ” Controversy
    In 2010, Novo Nordisk breached the ABPIs code of conduct by failing to provide information about side-effects of Victoza and by promoting Victoza prior to being granted market authorization.[29]
    In 2013 Novo Nordisk had to pay back DKK 3.6 billion to the Danish tax authorities due to transfer mispricing.[30]
    In March 2013, a debate emerged in which scientists questioned whether the incretin class of diabetes medications – the class to which Victoza belongs – had an increased risk of side effects in the pancreas such as pancreatitis and pancreatic cancer. It was concluded that data currently available did not confirm these concerns.[31]
    In October 2013, batches of NovoMix 30 FlexPen and Penfill insulin were recalled in some European countries as their analysis had shown that a small percentage of the products in these batches did not meet the specifications for insulin strength.[32]
    In September 2017, Novo Nordisk agreed to pay $58.7 million to end a United States Department of Justice probe into the lack of FDA disclosure to doctors about the cancer risk for their diabetes drug, Victoza.[33]

  5. The Denmark Vaccine Schedule is not as aggressive as here in the US. How then can we compare the two countries?

  6. MMR + DTaP at 15 months + all prior vaccines given on schedule. He ran a high fever, had a measles rash, knot on his neck, and upper respiratory distress. Then he stopped progressing. He had ZERO new words or skills for a year. What else causes a child to regress or not progress when the ONLY thing that has changed is the vaccine?

  7. My daughter was Vaccine Injured in 2004 by the MMR, DTap and Hib Vaccines! Diagnosed Non Verbal Autism, Intellectually Challenged, Absent Seizures, Auto Immune, Gut Issues, Gross Motor Skills Deficit, Etc! SHE WAS NOT BORN THIS WAY!

  8. How about also offering the choice of “did not regress; autistic symptoms apparent early in infancy”?

  9. If you run the numbers in the study chart that shows how many in both groups got the early vaccines (Dtap, hib+) and using a number of 5% of the total included in the group as unvaccinated with the MMR, this interesting picture emerges. Although the number of children that did received the MMR got the first Dtap+hib+ at a MUCH higher rate than the children who never received the MMR, when it came to getting the 2nd and 3rd rounds of that same shot, the children who did later received the MMR got those 2nd and 3rd round vaccines at a far lower rate roughly half (2nd shot) and 75% (3rd shot), so those parents who later decided to have their children immunized with the MMR, vaccinated at a significantly lower rate after that first round of Dtap and hib+. IOWs tge parents rhat later opted not to use the MMR were actually much more “vaccine compliant” in the early vaccine schedule. So .. the big question is why the MMR compliant parents opted out of earlier vaccines at a MUCH higher rate and how did that lower rate of toxic exposure ultimately affect child development and the decision to vaccinate their infants at an older age with the MMR? That’s a big important question among the other serious flaws and oversights in the conclusion arrived at by this pharma funded study.

  10. Allow me to add a few details that might be of interest:
    The danish vaccination program is taxfunded and follows a relatively strict schedule, so multiple vaccines at the same time will be very rare. Vaccines for diphteria, tetanus, acellular pertussis, polio and hemophilus influenzae is given at 3, 5 and 12 month. MMR is given at 15 month and 4 or 12 years. This was changed from 12 to 4 in 2008. At 5 years diphteria, tetanus and polio is given again.
    For immigrants there are other programs based on the age on arrival and their history of vaccination. Including them in the cohort would thus add a group of children vaccinated following another schedule and on many occassions without a precise knowledge about earlier vaccination. Also one might fear, that children showing early signs of autism has a different chance of surviving in refugeecamps etc.

  11. I think I may found how they got to these numbers
    Population registers used to determine MMR vaccination coverage in the new Danish Autism study have been found to be inaccurate in a 2017 study. “94% of the children had been vaccinated according to the medical records in general practice compared with 86% according to the register-based data.”
    https://annals.org/aim/article-abstract/2727726/measles-mumps-rubella-vaccination-autism-nationwide-cohort-study
    “Measurements:
    Danish POPULATION REGISTERS were used to link information on MMR vaccination, autism diagnoses, other childhood vaccines, sibling history of autism, and autism risk factors to children in the cohort.”
    https://annals.org/aim/article-abstract/2727726/measles-mumps-rubella-vaccination-autism-nationwide-cohort-study
    https://www.ncbi.nlm.nih.gov/pubmed/28157059
    METHODS:
    We conducted a cross-sectional study of 19 randomly selected general practices in the Central Denmark Region including 1,712 children aged 18-42 months. The practices received a registration form listing children with a negative MMR1 vaccination status in the register-based data. The general practices then validated the children’s vaccination status by medical record review.
    RESULTS:
    In total, 94% of the children had been vaccinated according to the medical records in general practice compared with 86% according to the register-based data. Of the 246 children who were unvaccinated according to the register-based data, 135 (55%) had been vaccinated according to the medical records. This discrepancy was due mainly to administrative reimbursement errors.

  12. Dorit Reiss responding to this on Twitter
    “He starts by using a study that addressed a different population to claim the numbers are incorrect. That’s a pretty gross error.”

    1. I did no such thing the study is being interpret it as being relevant for the entire population in the generalization that there is no association between MMR vaccination and autism for the entire population. It is clear that the study population as analyzed is not representative of the population in general. The fact that she acknowleges that the observation I made is about a different population then the study actually ended up studying is an admission of the fatal flaw in the study. It’s junk science.

      1. I remember when her buddy Skeptical Raptor called you out while using equally bad reasoning for “discrediting” your analysis. The more people continue to claim they are wrong the more desperate they get. Solid science doesn’t get flustered when challenged.

    2. It was either lazy or deliberate. There is a figure in the Hviid et al paper of cumulative incidence of ASD by age that would have given the correct rate, and tables in the paper on ASD rate in Denmark would give a better comparison. It looks to me like JWL didn’t read either paper, just the abstract for Hviid et al and the news release for the other. The only other explanation is a deliberate attempt to deceive, he has enough distinguished papers and positions that a lack of understanding of basic statistical concepts cannot be the issue.

      1. Peter, which value of autism rate do you think the cumulative incidence figure matches, the 0.09-1% study-wide rate, or the 1.65% from Denmark? Should be a simple answer, since you have claimed that the figure explains the discrepancy I found. If the latter, 1.65% get us to 12 year not vaccinated, and 13 years vaccinated. If it’s the 0.09-1% study-wide rate, that gets us to about 9 years. Now, if you read the conclusion of the study “The study strongly supports that MMR vaccination does not increase the risk for autism, does not trigger autism in susceptible children, and is not associated with clustering of autism cases after vaccination. It adds to previous studies through significant additional statistical power and by addressing hypotheses of susceptible subgroups and clustering of cases.” Odd, I don’t see any caveats on ages, or on populations excluded. As I said, unwarranted generalizations are par for the course in vaccine safety science-like activities.

      2. I have to reply to my own comment as JLW’s comment has the reply option shut off.

        I disagree with your estimates from that figure – it looks closer to 1.2% for 10 years, getting closer to 1.65%, but thanks for acknowledging that it was not appropriate to compare the study cohort of varying ages to 10 year danes in 2016.

        We then turn to the research letter you got 1.65% from, and note that is 10 years in 2016 figure. Not all the Hviid et al participants were 10 in 2016 of course, some were older, some younger. The point of the research letter is that ASD diagnosis increased with age, and has increased over time, so the figure in 2013 would have been lower for those 10 years old because diagnoses have increased over time, lower for those younger than 10 (because diagnoses increase with age) and for that small group older than 10, lower than estimate according to the 2016 cohort in that research letter, because they were not 10 in 2016 (and diagnoses have increased over time).

        Integrating those different rates brings us right into 1.2% by me. No difference in rates, no smoking gun.

  13. Regression at 12 mths coincided with varicella vaccine alone, two months prior to receiving only MMR vaccine.

  14. Before my son got the MMR vaccine he was a normal baby. Hit all of his milestones early, was starting to say mama and dada and trying to form words. Was very active and coordinated. When he had the MMR vaccine he got a fever, and I remember feeling worried but what do you do? The doctors say it’s normal and to give them Tylenol. From that point on he stopped trying to form words. He became really fussy and picky with food. I watched my son regress in to Autism and there was nothing I could do. Throughout this whole time the pediatrian assured me that everything was normal. We finally got a diagnoses a few months before my sons 4th Birthday, even though we already new. It’s heartbreaking. My son was in the special needs preschool last year and now this year, my observation is that the majority of the children are white. What are the ratios for every race? That’s what I would like to know.

    1. Our stories are very similar. I don’t know what the role race plays in it but the MTHFR gene mutation is a mutation that does not allow a person to clear heavy metals well such as Aluminum in many of the vaccines. My son has a MTHR gene mutation. It is very common. Estimated 30% of population. If a child is burdened with heavy metals and thus is immunocomprimised gets a live virus vaccine they are more likely to get an acute encephalitis than chronic encephalopathy aka Autism.

      Thus there may be something about white race and the MTHFR gene mutation. But again it us a very common mutation and that is why I theorize Autism is an epidemic.

    2. Dear Sharla,

      I’m very sorry to hear of your child’s illness, but you should not feel guilty that you did anything wrong. Signs of autism can be seen very early in life, as in this paper https://www.nature.com/articles/nature21369
      Well before any of the events you describe. Don’t let cranks make you think you harmed your son.

      1. Peter,
        I suppose you think that vaccinations that occur during pregnancy including TdaP and influenza with thimerosal and HepB on day 1 of life with 250 mcg of aluminum are not vaccinations?

        And I agree 100% that Sharla should not feel guilty. She was not provided free, prior and informed consent as required under the law. Someone who drives over a bridge at night that is out who is not warned by those whose job it is to warn them is not at fault.

  15. Are u sure argument no 1 is right? They coulsnt cover the whole ASD rate in Denmark in this study as they took only cases of older sibling with autism plus younger sibling. So they excluded all ASD cases with 1 child in family no matter if it had autism. If I understood correctly.

    1. When the clinical community and the media in the authors of the study began to interpret studies like this as restricted to the population under study then we can say that translational failure is not occurring. Details matter, and that is my point. Generalizations to an entire population from a sub population being studied is unscientific and it happens in too many studies and in the execution of policy by the FDA. As for this study look at the exclusion criterion see if they’re justified. Then look closely at the exclusion criteria of other studies where they have removed individuals who have a seizure disorder which is known comorbid condition with autism. Translational failure is a hallmark of vaccine safety research.

  16. MMR at 18 months, with 2 prior 5-in-1s at 2 and 4 months.
    Instant eczema started immediately after 2 month, exacerbated after 4 month and lasted till the present.
    Instant regression after MMR lasting months: physical, emotional, mental.

  17. The missing cases of ASD are to be found in this comment in the paper “…we conducted a main analysis with a case definition requiring at least 2 autism diagnosis registrations; an event was defined at date of second autism diagnosis”
    So if there was only one diagnosis they weren’t counted in this study. How many diagnoses does the average ASD afflicted child usually receive?

    1. Exactly. Exclusions with no justification. So the MMR is safe but only for people who are going to have 2 diagnoses of autism?? I will be very interested the results if those exclusions are not made. Also contrary to modern practice I noticed they didn’t publish the data analysers plan before they executed the analysis’s the data are not available for download for re analysis’s all hallmarks of them hiding something and consistent with their past M.O.

    2. The diagnosis is recorded countless times in the medical record. Sometimes one possible diagnosis of autism is noted but not repeated.

      The other paper uses the same method. The rates are comparable.

      1. The concern is not whether another paper is equally badd as this one the concern is that they mis representing the population under study. Any study must use data from samples that are representative of the population. Let me give you an example. If the study was going to compare the height of basketball players to hockey players and the average basketball player height in a sample was significantly less then the known average basketball player’s height in the population because those conducting the study decided to exclude players who played only 3/4 of a season, It would be absolutely correct to say that their sample was non representative and that their sampling procedure induced a bias. People in Denmark don’t have the luxury of having their children removed from group people who have autism simply because they only had one diagnosis. The study is bull. Any study that uses that criterion is also garbage.

  18. MMR, DTap/HIB, and Varicella at 14 1/2 months. Regression started after this combo.

  19. The rate you quote is of 10 year old danes in 2016. The study refers to a group born 1999-2010 followed until 2013. They are not all 10 year old, on average they are younger. Autism diagnoses in the paper you quote increase with age.
    This accounts for the difference in rates you call “a smoking gun”.
    Its right there in the two papers you quoted.

    1. Are you arguing that an old cohort with a different rate is somehow relevant today? It is not representative, and this is why prospective randomized inert placebo controlled trials of the vaccination schedules are needed, not observational studies.

      1. You say the rate of ASD in Denmark is 1.6%. That is the rate in 10 year old danes in 2016.

        The Hviid et al paper has a rate of 1%. That is not in 10 year olds. Many of participants in the Hviid group are younger. The rate of ASD is lower in younger groups.

        That is why there is a difference in rates.

        You also have not considered whether the two studies used different definitions of ASD diagnosis.

        You also have not considered changing rates of ASD diagnosis over time.

        You say that is the biggest problem with the paper. It’s on the image to the title of the article.

        There is no problem.

  20. “(5) Association studies do not test causality.”
    You seem to indicate that an absence of correlation cannot rule out causation. If that is correct, please provide an explanation, perhaps with an example or two, where there is no correlation, but causality. Ie A does goes with B, but A causes B. It must be very, very poor causation.

    1. 1. Low statistical power due to small sample size (false negative)
      2. Non-representative sample groups (bias)
      3. Unintentional p-hacking toward loss of significance
      4. Fraud

      If the science is poor, or falls outside of bona fide science, it is not the correlation that is poor.

  21. Where is your conflict of interest statement? You make money selling the idea vaccines are harmful. That is a direct conflict of interest you should declare.

    1. My income is from doing objective science and work as an expert witness on cases in the NVICP. Your bias gives you the impression that I am selling something. I am sorry you have been so misled that you can no longer recognize an objective scientist. I routinely offer my statements on potential COIs in formal publications and presentations. They often include the statement that I make no income from the sale, manufacture, or distribution of vaccines. Thus my objectivity.

      1. Neither you nor the entity that pays your salary and/or expenses derives income from sales of books, speaking engagements, other paid activities promoting vaccine harm?

      2. I’m in the hole on the books. Of course I get paid for speaking engagements. But neither my books nor speaking enagagement promote vaccine harm. The only thing I promote is the need for objectivity in vaccine safety science.

  22. Another drawback of those epidemiological studies : it’s now known that some autism risk factors include immune stimulation during pregnancy (caused by infectious diseases or vaccines).
    There was a signal in women who received influenza vaccination in the first trimester of pregnancy. Now pregnant women are immunized against whooping cough / pertussis. Are those vaccines been integrated in the confounding factors ? No.
    Association Between Influenza Infection and Vaccination During Pregnancy and Risk of Autism Spectrum Disorder” ; et c’est publié dans JAMA Pediatr 2017;171(1):e163609

  23. Are you arguing that an old cohort with a different rate is somehow relevant today? It is not representative, and this is why prospective randomized inert placebo controlled trials of the vaccination schedules are needed, not observational studies.

    1. even if they perform RCT with true saline placebo, manufacturers make the duration of follow up so short that it’s designed to hide / misreport delayed adverse events.

      Look to Engerix B : safety has been assesses for 4 days post dose, Gardasil : 14 days…

    2. No, you are comparing that with a different cohort and making an arguement the difference is significant.

      1. So are you saying the difference in rates of a key outcome over time is NOT important? If so, that’s an interesting position on the question of generalizability.

    3. No you are: “(1) The smoking gun is the study-wide autism rate of 0.9-1%. The rate of ASD in Denmark is 1.65%. Where are the missing cases of ASD?” – JLW
      there are none, the cohorts are different.

      Your biography states: “he does not tolerate unethical or lazy practices in research” comparing two different cohorts and making no effort to account for the differences before drwaing conclusions is lazy.

      1. That’s my criticism of the study, nice attempt to turn it around on me. The samples that were studied are not representative by any measure. The study has other major flaws as well, such as only (again) studying MMR so we’re looking at the effects of one vaccine. And why is the rate of ASD only 1% in the first place, when it’s so much higher in the US? You can do the math: “Followed until end of study (n=650943) No autism: 644,426, Autism 6,514 = 0.010048 or 1.0048% . Why so low??? Maybe because the Danes use a different schedule?

  24. “The results of this study show that underreporting of the TdapIPV booster in the childhood vaccination database does exist. The extent of this underreporting among those not registered in the childhood vaccination database with the Tdap-IPV vaccination is conservatively estimated to be 20.2%, but may be as high as 71.2%”
    https://www.ncbi.nlm.nih.gov/pubmed/23246264
    “Of the 246 children who were unvaccinated according to the register-based data, 135 (55%) had been vaccinated according to the medical records. This discrepancy was due mainly to administrative reimbursement errors.”
    https://www.ncbi.nlm.nih.gov/pubmed/28157059

  25. Dear Sharla,

    I’m very sorry to hear of your child’s illness, but you should not feel guilty that you did anything wrong. Signs of autism can be seen very early in life, as in this paper https://www.nature.com/articles/nature21369
    Well before any of the events you describe. Don’t let cranks make you think you harmed your son.

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