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RESULTS: THERE IS NOT A LINK BETWEEN BETWEEN THE MMR VACCINE AND AUTISM!

✓ The sources used to locate literature were “Google” and “PubMed.” Key words such as ‘MMR vaccine’ and ‘Autism’ were used.

✓ The myth of MMR vaccines causing Autism began in 1998 when the Lancet article by Wakefield et al. published a report stating that it was indeed linked, and was retracted in 2010 due to ethical and methodological issues (Uto, Uchiyama, Kurosawa, Aleksic, Ozaki,2012).

✓ According to Uto, et al. (2012): “In this study, we could not find the evidence that MMR vaccination increases the risk of ASD onset.”

✓ Poland (2011) states “No credible scientific evidence, however, supports the claim that the MMR vaccine causes autism, and indeed, national medical authorities and scientific professional societies have unanimously denounced that claim.” (p 869)

Poland, G. (2011). MMR Vaccine and Autism: Vaccine Nihilism and Postmodern Science. Mayo Clinic

Proceedings, (9), 869-871.

 Uno, Y. (2012). The combined measles, mumps, and rubella vaccines and the total number of

vaccines are not associated with development of autism spectrum disorder: The first case–control

study in Asia. Vaccine, (28), 4292-4298.

SELECTED ARTICLES

RATIONALEA R T I C L E 1 :

“ M M R V A C C I N E A N D A U T I S M : V A C C I N E N I H I L I S M A N D P O S T M O D E R N S C I E N C E ”

Disproves Wakefield’s clam that MMR vaccines are linked to autism using several different research studies and sources

Discusses the importance of moving forward by ensuring the safety of public health by vaccinating children and to quit spending copious amounts of money to prove there is a link between MMR and autism when there is none.

Vast amount of qualitative data

A R T I C L E 2 :

“ T H E C O M B I N E D M E A S L E S , M U M P S , A N D R U B E L L A V A C C I N E S A N D T H E T O T A L N U M B E R O F V A C C I N E S A R E N O T A S S O C I A T E D W I T H D E V E L O P M E N T O F A U T I S M S P E C T R U M D I S O R D E R : T H E F I R S T C A S E – C O N T R O L S T U D Y I N A S I A ”

Performed a case-control study that concluded there were no significant differences between cases and controls regarding ASD, MMR vaccination and a number of other vaccine injections.

The statistical and scientific findings elude to there being no reason to avoid vaccinations out of concern for ASD

Vast amount of quantitative data

“MMR Vaccine and Autism: Vaccine Nihilism and Postmodern Science”

Theory: There isn’t a specific theory listed within the claims of this article, but it is stated repeatedly that this is based upon scientific evidence and knowledge that has been completed through experimentation and evidence.

Type: Qualitative- it openly discusses various viewpoints regarding MMR-Autism and instructs how we can move forward and prevent an unnecessary and very real risk of outbreak in the U.S. due to lack of vaccinations due to uninformed parents.

“The combined measles, mumps, and rubella vaccines…”

Theory: This article was based upon the use of a specific conditional logistic model that was applied to evaluate the Odds Ratios of MMR vaccine after adjusting accordingly for other risk factors.

Type: Quantitative- this article contains several statistical analysis variables and compares to a control group, as well as other studies done in this subject area. It was completed very methodically and contains many statistical references that disprove the correlation between MMR and ASD.

THEORY & TYPE OF STUDY

DESIGN & METHODS“ M M R V A C C I N E A N D A U T I S M : V A C C I N E N I H I L I S M A N D P O S T M O D E R N S C I E N C E ”Design: Descriptive- this article provides

answers to the questions about MMR and ASD, it identifies the false literature that began the notion that these two variables are linked, and it has obtained data that concerns the current status of the phenomenon of MMR and ASD. It does describe that there is not any valid evidence that proves this link and could easily be used as a precursor to a more quantitative design study.

Method: Descriptive-Qualitative- this article provides detailed descriptions specifically regarding MMR and ASD. It uses past documents and explains things as they are. It points out that people have a notion that MMR causes ASD because of an article that was published and revoked, and the fact that some people are unwilling to research this issue on their own to realize that numerous studies have contraindicated this thought.

“ T H E C O M B I N E D M E A S L E S , M U M P S , A N D R U B E L L A V A C C I N E S … ”Design: Causal- this article attempts to

understand the MMR-ASD phenomenon by performing studies that seek causal explanations such as ‘if a child receives the MMR vaccine, then a higher incidence of ASD occurs.’’ This case-control study provided no causal association, and corresponded with outside studies conducting the same research on other populations (Caucasians, Hispanics, etc).

Method: Quasi-experimental- this article frequently compares its findings with similar studies performed on other ethnic groups, as well as the control population. It shows that the results of this study on Japanese children also supports the findings on the other ethnic groups, that there is not a connection between MMR and ASD.

RESEARCH F

INDIN

GS:

The incidence of ASD continued to rise after MMR vaccines were discontinued

Autism in the absence of MMR vaccine. (2007, January 1). Retrieved October 1, 2014, from http://www.medicine.ox.ac.uk/bandolier/booth/ vaccines/nommr.html

“MMR Vaccine and Autism: Vaccine Nihilism and Postmodern Science”

Findings:

• “Measles is the most transmissible human disease known. Even with modern medical care, approximately 1 of every 3000 infected persons die, and many more are hospitalized or otherwise harmed as a result. Population coverage (herd immunity) needs to be in excess of 96% to prevent outbreaks. In addition, measles is a disease for which eradication is both possible and planned, a goal that obviously cannot be met given current vaccine coverage levels.”

• No credible scientific evidence, however, supports the claim that the MMR vaccine causes autism, and “national medical authorities and scientific professional societies have unanimously denounced that claim. More than 20 studies have found no evidence of connection between receipt of the MMR vaccine and autism disorders. “

“The combined measles, mumps, and rubella vaccines…”

Findings:

• “In this study, we could not find the evidence that MMR vaccination increases the risk of ASD onset. The present results support the findings from the previous case–control studies conducted in Caucasian populations. Furthermore, we could not find any evidences that other types of vaccines or a combined effect of multiple vaccines was associated with ASD onset. Therefore, this study did not support the theory that vaccinations should be avoided to reduce the risk of ASD onset. We should be more concerned about acquiring infectious diseases by avoiding vaccinations.”

• For each vaccination, the ORs of cases versus controls were as follows (no significant differences were found): MMR, 1.04 (95% CI, 0.65–1.68); Measles, 1.18 (95% CI, 0.77–1.80); Mumps, 1.44 (95% CI, 0.96–2.17); Rubella, 1.16 (95% CI, 0.77–1.74)

RESEARCH FINDINGS

RESEARCH FINDINGS CONT’D.

This table demonstrates through statistical analysis, the absence of the connection between ASD and MMR, as well as several other common vaccinations.

ETHICAL CONSIDERATIONS“ M M R V A C C I N E A N D A U T I S M : V A C C I N E N I H I L I S M A N D P O S T M O D E R N S C I E N C E ”

This study mainly addresses the Beneficence and Justice considerations. It frequently states the importance of massive outbreaks if the rate of childhood vaccinations begins to decline. It also strongly states at the end of the article that it should be a crime not to vaccinate children due to the unnecessary risk parents are exposing them to by not vaccinating them.

“ T H E C O M B I N E D M E A S L E S , M U M P S , A N D R U B E L L A V A C C I N E S … ”

This study meets the requirements of ethical considerations in every facet. It respects its testing population by fully disclosing all testing measures (and receiving informed consent) and treating them autonomously, it also addresses beneficence by maximizing benefits (providing these children with vaccines) and minimizing risks of potential harm. Justice is seen in this study by the fairness in distribution, the homogenous testing population, and equal treatment of all participants.

“MMR Vaccine and Autism: Vaccine Nihilism and Postmodern Science”

• The subject matter of this article is relevant and pertinent to the topic of MMR and Autism. The author does treat the reader as an equal for the majority of the article, but does throw in a biased opinion every now and then.

• The article is well-organized and written in a way that it is easily read and understood. The facts are stated clearly and the concept is easily comprehended. It does make good points concerning counter-arguments, but does not really go into great depth concerning the subject matter.

• I would rate this article as mediocre. It does have some very pertinent information, but it is not purely unbiased and does not perform any tangible/quantitative scientific data, only stating the results of other studies.

“The combined measles, mumps, and rubella vaccines…”

• The subject matter of this article is very precise and directly relates to the topic of the relationship between MMR and Autism. The authors have a neutral approach that merely states their findings, without any opinions or bias.

• The article and the completed research was well-organized and presented. The tables and charts were easy to understand and all of the statistical variables were defined. It has very good scientific evidence that refutes the idea of MMR vaccinations causing ASD.

• I would rate this article as very strong. The information is accurate and very applicable to the subject matter. There are several scientific values that justify their claim of MMR not being linked to Autism.

ARTICLE STRENGTH

“MMR Vaccine and Autism: Vaccine Nihilism and Postmodern Science”

This article is published from a credible source, the Mayo Clinic, which is renown and highly respected for it’s medical technology and advances.

The minimal research that was completed in this article is backed up by other studies, or at the least, mentioned.

I would rate the level of research as appropriate, however, I would note that it is not a neutrally written piece.

The author is reputable and founded and directs a Vaccine Research Group at Mayo Clinic. He has written several articles concerning this topic.

“The combined measles, mumps, and rubella vaccines…”

This article is published from a credible source, Elsevier, which is a major education group that not only has a scientific journal, but also publishes educational materials.

The research in this article was evidenced by other similar studies, as well as the results of the specific testing that was accomplished throughout the study.

The level of research is very appropriate and written in a neutral tone stating only facts.

The authors are reputable and work for educational research facilities. Several of these authors have written other pieces concerning vaccinations as well.

ARTICLE QUALITY

ARTICLE CREDIBILITY

Both articles were found in peer-reviewed scholarly journals, and the authors of both articles are affiliated either with a University or a major Clinic/Medical Facility

Both pieces were written within the past 5 years and are relevant to the current time period. Both articles were also written to a scholarly audience with references and credentials listed for further research if need be.

Both pieces would qualify as EBP based upon meeting these criteria. The “The combined measles, mumps, and rubella vaccines…” article illustrates specificities (analysis, control group, confidence intervals, etc.) of EBP that could be further studied or repeated.

RELEVANCY TO PRACTICE The findings of these studies would be communicated on a couple

different levels. Most importantly, an individual level, which would be accomplished through some form of education. This would also be accomplished on the professional level, as health care professionals educate and inform about the importance of vaccinations.

The implications for practice change related to safety and quality of care would be to increase the herd immunity in our local communities to reduce the risk of a major breakout of these diseases. These vaccinations are offered through local health departments and clinics for a reasonable fee, or free, and would increase the generalizability and provide safety against an outbreak of these diseases in schools and neighborhoods.

There are several potential barriers on utilization of the research findings, such as: misinformation, lack of mode of transportation, illiteracy, education level, access to health care facility, financial, certain religious or cultural values.

An additional PICO question that could be derived from these studies could be: In children, are the health risks of not getting the MMR vaccine greater than getting the MMR vaccine?

CONCLUSION!! Both research articles determined that

there is not any scientific evidence that proves a link between the MMR vaccine and Autism.

If parents continue to not vaccinate their children against MMR, there is a great possibility of an outbreak occurring that could potentially cause swelling of the brain, or even death.

There is valid scientific evidence that validates the effectiveness of the MMR vaccine, and none that increases the risk of developing Autism in various ethnic populations.