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   We now welcome our second panel to the witness table. This 
panel consists of: Dr. Andrew Wakefield, who came all the way 
from merry old England, and we appreciate him being here; 
Professor John O'Leary, whom I am sure you will notice after he 
starts talking is from Ireland; Dr. Vijendra Singh, I 
appreciate you being here; Dr. Coleen Boyle, Dr. Paul Offit, 
and Dr. Brent Taylor.
    Would you all please rise and be sworn?
    [Witnesses sworn.]
    Mr. Burton. Please have a seat.
    Dr. Wakefield, would you like to start this panel?

 STATEMENTS OF DR. ANDREW WAKEFIELD, ROYAL FREE AND UNIVERSITY 
  COLLEGE MEDICAL SCHOOL, LONDON, ENGLAND; DR. JOHN O'LEARY, 
 COOMBE WOMEN'S HOSPITAL, DUBLIN, IRELAND; VIJENDRA K. SINGH, 
  UTAH STATE UNIVERSITY; COLEEN A. BOYLE, CENTERS FOR DISEASE 
  CONTROL AND PREVENTION, U.S. DEPARTMENT OF HEALTH AND HUMAN 
  SERVICES, ACCOMPANIED BY DR. BEN SCHWARTZ, ACTING DIRECTOR, 
EPIDEMIOLOGY AND SURVEILLANCE DIVISION, CDC; DR. PAUL A. OFFIT, 
 UNIVERSITY OF PENNSYLVANIA SCHOOL OF MEDICINE; AND DR. BRENT 
   TAYLOR, ROYAL FREE AND UNIVERSITY COLLEGE MEDICAL SCHOOL, 
                        LONDON, ENGLAND

    Dr. Wakefield. Yes, thank you, Mr. Chairman, members of the 
committee. It is a great privilege to be here.
    The purpose of my testimony is to report the results of the 
clinical and scientific investigation of a series of children 
with autism. Nothing in this testimony should be construed as 
anti-vaccine; rather, I advocate the safest vaccination 
strategies for the protection of children and the control of 
communicable disease. I am also here on my behalf representing 
the children who have come to me for investigation.
    I would like you to look at the screen if you would, 
please, and I will take you through the presentation.
    Next slide, please.
    Just as a little bit of background, this represents 12 
years of intensive clinical and scientific research, 
collaborative research, into the causes and mechanisms of bowel 
inflammation. I am a gastroenterologist.
    The principal authors of this work have contributed to over 
1,500 peer-reviewed and published scientific papers and 
abstracts. Again, these represent my views.
    Next slide, please.
    I want to report the results today from the first 60 
children that we have investigated. We have now investigated 
over 150 children, and the results that I am going to describe 
are pertinent to all those children bar about four.
    As far as the range of psychiatric assessments, the great 
majority had autism, but there was a spectrum of 
neuropsychiatric problems including Asperger's Syndrome and 
Attention Deficit Disorder. By far and away the most important 
investigation has been direct visualization of the bowel and 
taking biopsies by the procedure of ileocolonoscopy. This is a 
flexible instrument introduced into the bottom end to take a 
biopsy.
    Next slide, please.
    What you have heard this morning is a classical description 
of two different types of autism from the parents. You have 
heard about the children that we have seen, those who have gone 
off after a period of normal development, many of them in the 
face of multiple vaccine exposures with severe gastrointestinal 
symptoms.
    The other type, described very articulately, was of an 
insidious failure to acquire skills at an extremely important 
point. The essence of what I am going to present today is based 
upon conventional clinical medicine. It is listening to the 
patient.
    Here is a child who was entirely normal for the first year 
of life and went off a week after receiving his MMR vaccine. He 
is exactly as the four children were described earlier.
    Next slide, please.
    The classical features in these children are pain--there is 
a radiograph here of the abdomen, and there is fecal impaction. 
When these children came to us, the feature was of diarrhea, 
but in fact this turned out to be what we call spurious or 
overflow diarrhea. There was soiling, loss of contents, 
fastidious eating habits, reflux and nighttime wakening. They 
get heartburn, and they wake up very distressed. These symptoms 
are the same wherever you go. If I listen to parents from 
Canada, from the States, from Europe, and from Australia, the 
story is the same.
    Next slide, please.
    The associated features that we have in these children are 
of atopy--asthma, eczema, and hay fever. There are refractory 
upper respiratory tract infections. They do not deal well with 
common childhood infections, colds, and there is a very high 
level of autoimmune disease in the family--thyroid disease, 
diabetes, for example.
    Next slide, please.
    This is the insider's view of the small intestine. The 
panel on the top left is of what it should look like in a 
child. The bottom left of is lymphoid nodular hyperplasia. 
There is a swelling of the lymph glands in the bowel. These are 
rather like tonsils, and when they swell, they cause pain and 
symptoms.
    Mr. Waxman asked about the reproducibility. He is 
absolutely right. Up on the top right-hand panel, you see a 
child who was scoped in the United States with exactly the same 
symptoms. So this is reproducible in two different continents. 
We have compared it with controls, and the graph on the bottom 
right shows that even children who come to us with 
gastrointestinal symptoms who are scoped, the finding of 
lymphoid nodular hyperplasia is relatively uncommon. In the bar 
on the left, 85 percent of them show no evidence of it, but 
virtually all of our autistic children show evidence of 
lymphoid hyperplasia, either mild, moderate, or severe.
    Next slide, please.
    There are histological changes under microscopy which show 
there is a definite disease. The top left-hand panel is normal; 
the bottom right-hand panel, for example, shows what is called 
a crypt abscess, that is, puss in the bowel wall, and this is a 
feature that we see in children and adults with ulcerative 
colitis. There is a clear and demonstrable, albeit subtle, 
pathology.
    Next slide, please.
    A further paper that is due to be published soon has taken 
this to one further level and asked is this disease distinct 
from classical inflammatory bowel disease, Crohn's and colitis, 
or is it something new. And the data, at least, so far, suggest 
that it is something new.
    Next slide, please.
    We have described this feature in the gut, lymphoid 
hyperplasia, and colitis in children with autism. From this 
same city, from Georgetown University, Professor Joe Bellanti 
has described it in children with attention deficit disorder, 
coming back to the question, is this a spectrum of disorders 
which have at their heart some gastrointestinal abnormality.
    Next slide, please.
    Lymphoid nodular hyperplasia classically occurs in the 
presence of immunodeficiency. We do see it during acute 
infection, but it is classically associated with 
immunodeficiency. Are our children immunodeficient? As a group, 
the answer is yes, they are.
    This graph just shows you a particular count of a certain 
type of immune cell in the blood. The green line is the upper 
limit for normal, the red line is the lower limit for normal, 
and each blue dot represents a child. You can see that the 
great majority sit at or below the lower limit of normal. Not 
only are they numerically deficient, their immune system does 
not respond appropriately to common recall antigens when 
compared with normal age-matched children. In other words, if 
you give them a skin-prick test for pertussis or diphtheria, 
they mount no response.
    Next slide, please.
    So the key features of the syndrome are developmental 
regression, ileocolonic lymphoid hyperplasia, swelling of these 
tonsil tissues, enterocolitis--that means inflammation of the 
small and large intestines--and immunodeficiency.
    Next slide, please.
    So it is a real syndrome, there is a remarkably consistent 
pattern of bowel inflammation, and it provides us with vital 
clues. What are those clues?
    Next slide, please.
    The story as told to us and which we have an obligation to 
report is that the majority of children regressed following a 
period of normal development in the face of MMR vaccination. 
That does not mean it is the cause of the disease.
    We also had two children who regressed after classical 
measles infection--one after the monovalent measles vaccine and 
one after a rare vasculitic rash. Thirty-six percent of parents 
could contemporaneously identify no particular environmental 
hit.
    Next slide, please.
    Have measles and common childhood infections been linked to 
autism before? Is there a reason to go into this and look at 
it? The answer is yes, there is. There is a paper that came 
from the Harvard School of Public Health, and it showed that 
atypical patterns of exposure to common childhood infections--
measles, mumps, chicken pox, rubella--were a risk for autism in 
the child. By ``atypical,'' I mean maternal exposure when 
pregnant or neonatal exposure.
    What was intriguing about this, which we may come to later, 
is that if you were a pregnant mother who was exposed to more 
than one of these common infections at the same time, or 
indeed, an infant child, then your risk of autism was both 
greater, and the severity of the autism was greater. Question: 
Was there a compound effect of more than one infection?
    It has also been shown that children born in and around 
epidemics of measles and rubella have higher rates of this 
disease.
    Next slide, please.
    What about vaccines? There is a paper from the Vaccine 
Damage Compensation Board in the United States--acute 
encephalopathy followed by permanent brain injury or death 
associated with further attenuated measles vaccine. What was 
intriguing in this cohort of children who fulfilled rather 
strict criteria was that 43 out of 48 underwent developmental 
regression as part of their syndrome. So we have this other 
pattern of exposure to measles as the further attenuated 
vaccine children undergoing developmental regression.
    Next slide, please.
    To summarize, unusual patterns of exposure to common 
childhood infections are associated with autism and 
developmental regression.
    Next slide, please.
    Here is the clue. This is the important image, and here, 
you see the insider's view again--these swollen tonsilar 
tissues. If you are looking for an infection, this is where you 
should be looking.
    Next slide, please.
    When you look down the microscope, this is what that 
swollen tonsil tissue looks like, and you are looking in the 
center of that for the infection. This is a response to a 
foreign agent, a foreign antigen, usually an infection. So if 
you are looking for the cause of that, that is where you are 
looking.
    Next slide, please.
    This is a very high-powered micrograph of a single cell 
called a follicular dendritic cell, and this is crucial, 
because if you are looking for the source of that infection, 
not only are you looking in that lymphoid follicle, not only in 
the center of the lymphoid follicle, but in this specific cell.
    Next slide, please.
    When we look in that specific cell using an antibody which 
picks up measles protein and only measles protein, we find it 
in that cell. We do not find it in other cells or other tissue, 
we find it in that cell.
    Next slide, please.
    You look for other viruses. You ask the question: Is this 
just a nonspecific response? Do we find other viruses in there? 
So you look for adenovirus, herpes simplex I and II, rubella, 
mumps, HIV, and other crucial controls that Mr. Waxman referred 
to early, and you do not find them. They are not there.
    So at least within the context of this study, this appears 
to be specific for measles virus.
    Next slide, please.
    The next question: Is there an antibody; is there an immune 
response to the virus in these children? The mere presence does 
not make it the cause. Is there an immune response?
    We take the autistic children, and we compare them with 
age-matched controls, and we look at measles antibody titers. 
We also look at controls of mumps, rubella, and cytomegalur 
virus, or other common childhood infections. The only one for 
which there is a statistically significant difference between 
the cases and the controls is for the measles virus.
    Next slide, please.
    We had failed completely to identify this virus by 
molecular amplification technology. In my laboratory, we had a 
reaction that was sensitive to about 10,000 copies. Anything 
less, we could not find it.
    The Japanese had succeeded, so we sent nine blood samples 
from our children to the Japanese laboratory, and we also sent 
21 other patients. We mixed them up. We did not tell them what 
they were getting. They just had a control label. And they 
identified measles virus in three of those nine children in the 
peripheral blood. That is an intriguing finding. This is 
consistent with; but not definitely, vaccine strain. One can 
only say that this is consistent with, but there it is, and 
this was a blinded control study.
    Next slide, please.
    Very briefly, to finish up, what is the link between the 
gut and the brain? This is one of the most difficult things for 
people to understand. How can the gut influence the brain? I 
come from a liver unit where we see patients with chronic liver 
failure, acute liver failure, all the time, and one of the 
classical manifestations of that--next slide, please--is 
hepatic encephalopathy. This is where the liver is damaged, is 
diseased, and fails to degrade the chemical constituents of the 
bowel that come through. It fails to mop them up and clear them 
out; they impact upon the brain. This is largely reversible. If 
you are hit with these for long enough, it becomes 
irreversible.
    The question is, therefore--at least we have biologically a 
plausible hypothesis, a testable hypothesis that elements from 
the gut, undegraded chemicals from the gut, including the 
opiods that were referred to by Shelley Reynolds, may be 
getting through, may not be metabolized, may be impacting upon 
the rapidly developing brain during the first few years of life 
and producing residual cognitive deficit, which we recognize as 
autism.
    Next slide, please.
    So finally, in summary, we have an environmental insult in 
perhaps a genetically susceptible child. The problem is that if 
you go to Sweden now, autism affects over 1.2 percent of the 
pediatric population. So if there is a genetic background, it 
is clearly widely distributed within the population. We believe 
that in many children, clearly, the subset of autistics, it 
leads to gut infection and damage; that leads to an ingress, an 
impaired metabolism, degradation of these chemicals from the 
gut which then get through and impact upon the brain. And the 
disregulated immune system which measles classically can 
produce also encourages immune diseases, atopic diseases, and 
immuno disregulation.
    Thank you, Mr. Chairman.
    Mr. Burton. Thank you, Doctor.

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Note/Warning:

Autistic people have fought the inclusion of ABA in therapy for us since before Autism Speaks, and other non-Autistic-led autism organizations, started lobbying legislation to get it covered by insurances and Medicaid. 

ABA is a myth originally sold to parents that it would keep their Autistic child out of an institution. Today, parents are told that with early intervention therapy their child will either be less Autistic or no longer Autistic by elementary school, and can be mainstreamed in typical education classes. ABA is very expensive to pay out of pocket. Essentially, Autism Speaks has justified the big price tag up front will offset the overall burden on resources for an Autistic’s lifetime. The recommendation for this therapy is 40 hours a week for children and toddlers.

The original study that showed the success rate of ABA to be at 50% has never been replicated. In fact, the study of ABA by United States Department of Defense was denounced as a failure. Not just once, but multiple times. Simply stated: ABA doesn’t work. In study after repeated study: ABA (conversion therapy) doesn’t work. 

What more recent studies do show: Autistics who experienced ABA therapy are at high risk to develop PTSD and other lifelong trauma-related conditions. Historically, the autism organizations promoting ABA as a cure or solution have silenced Autistic advocates’ opposition. ABA is also known as gay conversion therapy.

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[Note: Autism is NOT a disease, but a neurodevelopmental difference and disability.]

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Fact: Vaccines Do Not Cause Autism.

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