The No-Vax universe is always looking for “incontrovertible” tests of the dangers of vaccines, and in particular of the link between vaccinations and autism. A blossomed hoax for more than two decades, born from a fraud perpetrated for commercial purposes by the former English doctor Andrew Wakefield, and without any feedback in the scientific literature. Which, however, returns periodically on the crest of the wave. The most recent case is an image that in these days circulates on social networks: a “map of autism in the world” between 1990 and 2019 presented as evident that the countries in which the rich ones are vaccinated, are also those in which cases of autism spectrum disorders are concentrated. Therefore, the indication of a direct link between the two phenomena. Obviously, it is as always a bale, beautiful and good.
The map
The image in question comes from a study published in Nature Neuroscience in 2022, which estimated the incidence, prevalence and consequences in terms of disability of autism in 204 nations, using the data from the Global Burden of Diseases, Injuries, and Risk factors Study, an initiative that produces estimates of the dissemination and impact of many diseases, collecting the data available in literature. and periodically updating the results.
The image in question reports prevalence (in the upper image) and gravity (expressed in terms of waiting for correct life for disabilities, that is, of years lost due to the disease and the consequent disability) of the autism spectrum disorders in 2019. It is therefore not, in hindsight, not even a map of the incidence, or the new diagnoses, but rather a representation of the prevalence, that is, how many people have a diagnosis of disturbance of the autism spectrum.
Pignorie aside, the study in question says nothing of the vaccination status of the investigated populations, nor does it take into any way the possibility that the vaccinations are linked to the incidence of the disorder. Indeed: one of the purposes of research is to identify areas of the world where autistic spectrum disorders are probably under diagnosed. And this is, in fact, the most obvious explanation of the differences that can be seen between high and low income countries, and therefore between more or less developed health systems: where there are the necessary resources, the skills and attention to the problem, the diagnoses are more frequent. Elsewhere, unfortunately, autism is currently probably the last of the problems, at least in terms of public health.
It is also good to dispel another myth: many of the countries where the prevalence of autistic spectrum disorders seems very low they do not actually have pediatric vaccination rates then so different from ours. Vaccinations are an efficient and economic method to avoid very serious diseases, and there are many international programs that help the least rich nations to vaccinate their children. The result is that in many African countries the covers for the main pediatric vaccines are not so different from those seen in Europe. In medium -income countries such as Morocco and Egypt are practically comparable (if not better) to those of nations such as Italy. Yet the cases of autism remain in appearance a lot, but much, rarer.
There are increasing cases?
Another matter is what concerns the increase in autism diagnosis in the West in recent decades. The phenomenon is real, but nothing has to do with vaccines. The scientific community has long investigated the situation, and at the moment there are two most likely explanations, not mutually exclusive. The first concerns the changes that the diagnostic criteria between 1943 have undergone, when autism was described for the first time by the Austro-Stanitense psychiatrist Leo Kanner, and the present day. It was initially described as a psychiatric syndrome with very specific symptoms, and it was a relatively little known disorder, and consequently not very diagnosed. Starting from 1994, with the fourth edition of the Diagnostic and Statistical Manual of Mental Dysorders (DSM-4), the so-called “psychiatrist Bible” the definition has evolved towards the current one, of disorders that fall into an autistic “spectrum”, and consequently very enlarged, pushing the diagnosis, at least in the countries with more attentive health systems.
The phenomenon is confirmed by different research. For example, a 2015 study analyzed the number of American minors inserted in special education programs with a diagnosis of autism between 2000 and 2010, showing that the diagnoses are actually tripled in the period in question, but that two thirds of this increase are justifiable by a parallel decline of the other diagnosis of “intellectual disability”. Many cases that first received a different psychiatric diagnosis today are included in the autistic spectrum.
If the incidence of autism has increased, it has done so much less percentage of what the official statistics say. And certainly, for reasons very different from vaccines. It is the second of the two explanations that we mentioned: to make the autistic spectrum disorders more common could have been the changes that occurred in the western lifestyle, since characteristics such as the advanced age of mothers and fathers to conception, hypertension, overweight and maternal obesity, are considered risk factors for autism spectrum disorders, and are increasingly widespread problems in almost all high income nations. With all due respect to the no-vax.