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Thursday, June 30, 2011

Vaccines, Autism, and the Amish

The various vaccine manufactroversies that have spread in the wake of the Andrew Wakefield’s bogus claims that the measles component of the MMR vaccine might be linked to autism are too numerous to unpack in one brief blog post. One of the most persistent has been the Amish fallacy: Most Amish don’t vaccinate; there’s almost no record of autism in Amish communities; ergo, vaccines cause autism. (This argument has also been used, time and time and time again, to illustrate the efficacy of a proposed vaccinated-versus-unvaccinated study.)

Not surprisingly, no part of the Amish fallacy — which has been kicking around for over a decade and gained new prominence and attention with this, purely anecdotal 2005 dispatch* — is true. Over the years, Ken Reibel at Autism News Beat has documented the problems with the Amish report, although the myth still persists.

Yesterday, Reuters Health reported on a recent study in Pediatrics titled “Underimmunization in Ohio’s Amish: Parental Fears Are a Greater Obstacle Than Access to Care.” The study found that majority of Amish parents do, in fact, vaccinate their children…and among the minority that don’t, the most common reasons cited were the same anti-vaccine fueled fears that have infected people around the country.

The abstract:
Objective: Holmes County, Ohio, one of the largest Amish communities in the world, has persistently low immunization rates. Studies of other Amish communities have revealed that parents do not immunize their children because of lack of access to immunizations. Our study explored reasons that Amish parents in the previously uninvestigated Holmes County population exempt themselves from immunizations.

Methods: In January 2007, questionnaires for assessing attitudes regarding immunizations were mailed to a random sampling of 1000 Amish parents in Holmes County.

Results: Thirty-seven percent of the parents responded. Among the 359 respondents, 68% stated that all of their children had received at least 1 immunization, and 17% reported that some of their children had received at least 1 immunization. Only 14% of the parents reported that none of their children had received immunizations. Eighty-six percent of the parents who completely exempted their children from vaccines stated that the main reason they do not vaccinate their children is concern over adverse effects. Many parents indicated that they allow their children to receive only some vaccines because of concern about the way certain vaccines are produced.

Conclusions: The reasons that Amish parents resist immunizations mirror reasons that non-Amish parents resist immunizations. Even in America's closed religious communities, the major barrier to vaccination is concern over adverse effects of vaccinations. If 85% of Amish parents surveyed accept some immunizations, they are a dynamic group that may be influenced to accept preventative care. Underimmunization in the Amish population must be approached with emphasis on changing parental perceptions of vaccines in addition to ensuring access to vaccines.

Seth Mnookin tried to dismiss the argument about unvaccinated Amish not having autism. What does it prove anyway? It was hardly science in the first place. Since Mnookin is so convinced that there is no link between vaccines and autism, then why isn’t he out there publicly demanding a carefully conducted, independent study comparing the health of never-vaccinated children with fully-vaccinated ones. If never-vaccinated kids also have the same health problems, including a one percent autism rate, that would finally settle the issue. With so many parents now too afraid to vaccinate, the study group is out there.


Quibbling about whether the Amish really vaccinate proves nothing.