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Smallpox Alert!

Data in the NEJM "Danish MMR Study" tells different story versus author
For background on the controversy about the The Danish MMR Study, please see the following two links:

Letter from Dr. Wakefield to the New England Journal of Medicine
Re the association between MMR vaccination and autism.

Open letter to the authors of "the Danish MMR report" by Alan Rees

The report is known in English as, "A Population-Based Study of Measles, Mumps, and Rubella Vaccination and Autism" by K.M. Madsen and Others as published in The New England Journal of Medicine November 7, 2002 (Vol. 347 No. 19).
NEJM reprint of "A Population-Based Study of Measles, Mumps, and Rubella Vaccination and Autism" by K.M. Madsen and Others

Opening with this statement, "It has been suggested that the measles, mumps, and rubella (MMR) vaccine causes autism," sets a tone of mis-information which continues throughout the study.

In fact, the DATA within Table 1 contained in the article clearly shows that MMR was associated with increased autism in Denmark in the years studied. To understand this, consider three concepts:

Concept one: Self Contradiction
Newspaper articles and even scientific articles sometimes contradict themselves. The NEJM article clearly states that "...,neither autistic disorder nor other autistic-spectrum disorders were associated with MMR vaccination." However, the DATA included in Table 1 (near page bottom) clearly shows an association between increased autism and MMR.

Concept two: Equal conditions bring equal results.
Equal sized populations living in the same conditions will have equal numbers of healthy and unhealthy children. Let us examine a hypothetical case of two adjacent countries with the same life styles, nutrition, and pollution exposure levels. The government in one country mandates the children receive six vaccines in the first year of life. The government of the second country mandates the same but adds a seventh vaccine, MMR in the second year of life. If the number of Autistic children in the population receiving 6 vaccines is less than the number autistic children who received seven vaccines, this is proof that MMR contributes to Autism. A researcher who tried to cover this fact by "moving" a few autistic children across the border from one country to another would bring cries of 'fraud' upon his head. Yet the data in the actual Danish MMR study, when adjusted for equal sized populations showed the following:

		Children receiving 6 vaccines.	Children receiving 7 Vaccines.
Autistic				214*	269
Other Autistic-spectrum disorders	319*	352 
	(*The actual numbers were 47 and 70 before adjusting for population size.) 
 
Hypothetical case of two adjacent countries with the same life styles, nutrition, and pollution exposure levels.
Country one:
441 Thousand Children receive 6 vaccines.
Number of autistic children = 214.
Number of children with another autistic-spectrum disorder = 319.
6_VAX
214 - 319
214 - 319
214 - 319
214 - 319
214 - 319
214 - 319
214 - 319
214__319
7_VAX
269 - 352
269 - 352
269 - 352
269 - 352
269 - 352
269 - 352
269 - 352
269 - 352
269 - 352
269__352
Country two:
441 Thousand Children receive 6 vaccines plus the MMR vaccine. (7 vaccines)
Number of autistic children = 269.
Number of children with another autistic-spectrum disorder = 352.
So what is the answer to this dilemma, the fact that the MMR group has more autism than the group with only 6 vaccines?

Simple. Boarders are vague things, we will just "move" some autistic children from one country across the boarder to the other country. If you say that in science this cannot be done, then little do you know. Study the NEJM 'Danish MMR Study' and you will find that scientific boundaries are as vague as national borders! At least to the vaccination defenders.

Hypothetical case two: 100,000 children Block 1, 400,000 children Block 2.
Identical conditions until age 15 months when MMR vaccine is typically given.
Six (6) vaccines received in first year of life.   NO MMR vaccine received.
Six (6) vaccines received in first year of life.   MMR vaccine also received in second year of life, typically between 15 and 19 months of age.
Group one:
100,000 400,000 Children Group two:
Age and number
diagnosed with Autism

2 years = 3



1 year = 2



Birth = 1
V___V___V



V___V



V
X X X M_____X X X M____X X X M_____X X X M



XX__________XX_________XX__________XX



X__________X_________X__________X
Age and number
diagnosed with Autism

2 years = 4 x 3 + M



1 year = 4 x 2 = 8



Birth = 4 x 1
  Each letter above in the colored columns, (V or X) symbolizes one (1) autistic child.
You will note that we show the same number of Autistic children diagnosed per each 100,000 children until age 2 years when the effect of the MMR vaccination will cause proportionally more autistic children in the group that receives the MMR vaccine.
So the question for the defenders of MMR is: "How do we hide the fact that that there are more autistic children in the MMR group?"

There is a simple answer. Some parents of the children diagnosed with autism before the age when MMR is given will refuse the MMR vaccine and thus those children will be classified in the non-MMR group. The remainder of the children who receive the MMR vaccine but who were diagnosed with autism before receipt of the MMR vaccine will also be moved into the non-MMR group.

When this "adjustment" is made, notice how the graph looks now. (below)

Age and number
diagnosed with Autism

2 years = 3



1 year = 2



Birth = 1
V___V___V



VVXXXXXXXX



V X X X X
X X X M_____X X X M____X X X M_____X X X M








Age and number
diagnosed with Autism

2 years = 4 x 3 + M



1 year = 4 x 2 = 8



Birth = 4 x 1
This is interesting. Sufficient incorrect data movement has occurred such that the results show more autistic children in the group that received only six vaccines versus the group that received the same six plus the MMR.

This incorrect result shows why proper control groups in scientific studies must be carefully designed, labeled and individuals identified by group correctly.

Concept three: Proper control groups are correctly labeled and contain an unambiguously defined population.
  Ideally, a totally unvaccinated group should have been compared to a vaccinated group. Naturally, the vaccine industry and governments go to all lengths to eliminate the possibility of such a group existing.

In the Danish MMR Study, vaccinated children were labeled as unvaccinated . Some autistic children were removed from the list of MMR vaccinated children and added to the list of non-MMR vaccinated children. Scientifically defined population groups do not allow ambiguity about which group an individual is assigned too. If some parents determine that their children are to get 6 vaccines, while other parents determine that their children are to receive 7 vaccines, then it is improper to take a number of autistic children in one group and 'move' them to the other group. Some children in both groups may be autistic due to background reasons such as mercury pollution. The six vaccinations common to both groups will also be a strong suspect as a contributing cause of autism. However, the effects of background pollution and six vaccines are common to both groups.

What is important is the ratio of autistic children in the group that receives 7 vaccines to the number of autistic children in the group that received 6 vaccines. (269 versus *214)  Six children in the MMR group had been diagnosed with autism before they received the MMR vaccine. Moving six children out of the larger population receiving 7 vaccines, when adjusted for population size difference was actually the equivalent to moving 27 autistic children (population size adjusted) into the group receiving 6 vaccines. On the plea that the data needed 'un-confounding', this improper movement actually produced confounding. True un-confounding may have required a data movement in the opposite direction. There may have been a few parents in the 6 vaccine group that originally planned for their children to receive MMR vaccine but changed their minds when their children showed signs of autism before the age MMR vaccine is typically given at 15 months of age. Even after moving autistic children in the MMR group to the non-MMR group, there was still a higher percentage of autistic children in the MMR group versus the non-MMR group. (263 versus *241) Other allegedly 'un-confounding' data distortion was made until the study became scientifically meaningless but supportive to the financial interests of the vaccine industry.

Conclusion: Government and industry agreed to lie to both the medical profession and parents about the harm continuing to be done by the MMR vaccine.

537,303 CHILDREN IN THE DANISH COHORT.
Received 6 vaccines (No MMR) = 96,648    Received 7 vaccines (Inc. MMR) = 440,655
Ratio of 440,655 to 96,648 = 4.559
96,648 Received 6 vaccines (No MMR)
Note: there were 4.559 times as many children receiving the MMR vaccine as those who received 6 or fewer vaccines.

Number of autistic children 47 x 4.559 = 214.
Number of children with another autistic-spectrum disorder 70 x 4.559 = 319.

6_VAX
(47-70x4.559)
214 - 319
214 - 319
214 - 319
214 - 319
214 - 319
214 - 319
214__319
7_VAX
269 - 352
269 - 352
269 - 352
269 - 352
269 - 352
269 - 352
269 - 352
269 - 352
269 - 352
269__352
Received 7 vaccines = 440,655 (Inc. MMR)
441 Thousand Children receive 7 vaccines which includes the MMR vaccine.
Number of autistic children = 269.
Number of children with another autistic-spectrum disorder = 352.
The study author stated that 6 children were moved from the MMR side of the study to the non MMR side of the study because they had symptoms of autism before they received the MMR vaccine. This movement of data is wrong because the children were 'randomized' to receive MMR by their parents. It can be clearly stated that the MMR vaccine was not the cause of their autism, but moving 6 children has a biasing effect of 6 less on one side + (6 * 4.559) = 27 more on the other side for a total confounding of 33 children. Even this "mistake" only brings the comparison to 47 + 6 x 4.559 = 241 autistic children versus 263 autistic. But have no fear, the author of the study, an expert in statistics, makes more confounding errors until there are slightly more autistic children among those who received only 6 vaccines versus those who received 7 vaccines.

If we assume that all the children who were 'moved' were diagnosed with autism at less than 2 years of age then that makes the ratio of those under 2 years old who were diagnosed with autism = 9 + 6 =15 x 4.559 = 68 on the side of those who received 6 vaccines to compare to only 42 (48-6) autistic children on the side of those who received 7 vaccines. Obviously, this will not 'work' for a comparison. (see bottom of Table 1.)

Another way of checking the correctness of the 'un-confounding' is to simply drop all children under 2 years old, and see how the total numbers compare. That would give 269-48 = 221 versus 47-9 = 38 * 4.559 = 173. So 221 autistic children in the 7 vaccinated versus 173 in the 6 vaccinated, diagnosed over age two shows the correctness of the conclusion, "MMR contributes to Autism". No honest way of double checking the correctness of the methods used in the NEJM study supports their methods of un-confounding the study.

Conclusion:
Clearly, government and industry agreed to lie to both the medical profession and parents about the harm being done by the MMR vaccine. And of course, the other vaccines as well.

Note: this is a scanned document: accuracy is not guaranteed.
TABLE 1. CHARACTERISTICS OF THE 537,303 CHILDREN IN THE DANISH COHORT
CHARACTERISTIC VACCINATED
CHILDREN
(N=440,655)
UNVACCINATED
CHILDREN
(N=96,648)
P VALUE*
number (percent)
Sex
   Male
   Female
Birth weight
   <=2499 g
   2500-2999 g
   3000-3499 g
   3500-3999 g
   >=4000 g
   Data missing
Gestational age
   <=36 wk
   37-41 wk
   >=42 wk
   Data missing§
Socioeconomic status§§
   Manager (very high)
   Wage earner (high)
   Wage earner (medium)
   Wage earner (low)
   Wage earner (minimal)
   Unemployed
   Data missing
Mother's education
   Postgraduate education
   College
   Vocational training
   Secondary school
   Primary school
   Data missing

Age at diagnosis of autistic disorder
   <=2 yr
   3-5 yr
   >=6 yr
Age at diagnosis of another
   autistic-spectrum disorder
   <=2 yr
   3-5 yr
   >=6 yr

226,042 (51.3)
214,613 (48.7)

21,633 (4.9)
53,874 (12.2)
135,630 (30.8)
135,255 (30.7)
66,358 (15.1)
27,905 (6.3)

19,029 (4.3)
272,345 (61.8)
27,349 (6.2)
121,932 (27.7)

41,367 (9.4)
85,772 (19.5)
70,906 (16.1)
116,503 (26.4)
57,408 (13.0)
67,841 (15.4)
858 (0.2)

26,118 (5.9)
67,776 (15.4)
178,553 (40.5)
42,667 (9.7)
114,768 (26.0)
10,773 (2.4)


48 (0.01)
187 (0.04)
34 (0.01)


32 (0.01)
202 (0.05)
118 (0.03)

49,680 (51.4)
46,968 (48.6)

5,164 (5.3)
12,062 (12.5)
29,262 (30.3)
29,143 (30.2)
14,563 (15.1)
6,454 (6.7)

3,129 (3.2)
40,609 (42.0)
3,986 (4.1)
48,924 (50.6)

9,940 (10.3)
16,187 (16.7)
13,753 (14.2)
26,699 (27.6)
10,996 (11.4)
18,519 (19.2)
554 (0.6)

5,856 (6.1)
14,599 (15.1)
34,006 (35.2)
10,164 (10.5)
28,680 (29.7)
3,343 (3.5)


9 (0.01)
31 (0.03)
7 (0.01)


3 (0.003)
37 (0.04)
30 (0.03)
0.55


<0.001






<0.001




<0.001







<0.001







0.87



0.19
*P values are based on the chi-square test of statistical independence.
§Data were available from the Danish Medical Birth Registry only until December 31, 1996.
§§ The employment status of the head of the household was used to indicate socioeconomic status.

N Engl J Med, Vol. 347, No. 19 . November 7, 2002 . www.nejm.orgwww.nejm.org . 1479