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Autism—Why the Increased Rates? a One- Year Update AUTISM—WHY THE INCREASED RATES? A ONE- YEAR UPDATE HEARINGS BEFORE THE COMMITTEE ON GOVERNMENT REFORM HOUSE OF REPRESENTATIVES ONE HUNDRED SEVENTH CONGRESS FIRST SESSION APRIL 25 AND 26, 2001 Serial No. 107–29 Printed for the use of the Committee on Government Reform ( Available via the World Wide Web: http://www.gpo.gov/congress/house http://www.house.gov/reform U.S. GOVERNMENT PRINTING OFFICE 76–856 PDF WASHINGTON : 2001 For sale by the Superintendent of Documents, U.S. Government Printing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512–1800; DC area (202) 512–1800 Fax: (202) 512–2250 Mail: Stop SSOP, Washington, DC 20402–0001 VerDate 11-MAY-2000 09:23 Feb 22, 2002 Jkt 000000 PO 00000 Frm 00001 Fmt 5011 Sfmt 5011 C:\DOCS\76856.TXT HGOVREF1 PsN: HGOVREF1 COMMITTEE ON GOVERNMENT REFORM DAN BURTON, Indiana, Chairman BENJAMIN A. GILMAN, New York HENRY A. WAXMAN, California CONSTANCE A. MORELLA, Maryland TOM LANTOS, California CHRISTOPHER SHAYS, Connecticut MAJOR R. OWENS, New York ILEANA ROS-LEHTINEN, Florida EDOLPHUS TOWNS, New York JOHN M. MCHUGH, New York PAUL E. KANJORSKI, Pennsylvania STEPHEN HORN, California PATSY T. MINK, Hawaii JOHN L. MICA, Florida CAROLYN B. MALONEY, New York THOMAS M. DAVIS, Virginia ELEANOR HOLMES NORTON, Washington, MARK E. SOUDER, Indiana DC JOE SCARBOROUGH, Florida ELIJAH E. CUMMINGS, Maryland STEVEN C. LATOURETTE, Ohio DENNIS J. KUCINICH, Ohio BOB BARR, Georgia ROD R. BLAGOJEVICH, Illinois DAN MILLER, Florida DANNY K. DAVIS, Illinois DOUG OSE, California JOHN F. TIERNEY, Massachusetts RON LEWIS, Kentucky JIM TURNER, Texas JO ANN DAVIS, Virginia THOMAS H. ALLEN, Maine TODD RUSSELL PLATTS, Pennsylvania JANICE D. SCHAKOWSKY, Illinois DAVE WELDON, Florida WM. LACY CLAY, Missouri CHRIS CANNON, Utah ——— ——— ADAM H. PUTNAM, Florida ——— ——— C.L. ‘‘BUTCH’’ OTTER, Idaho ——— EDWARD L. SCHROCK, Virginia BERNARD SANDERS, Vermont ——— ——— (Independent) KEVIN BINGER, Staff Director DANIEL R. MOLL, Deputy Staff Director JAMES C. WILSON, Chief Counsel ROBERT A. BRIGGS, Chief Clerk PHIL SCHILIRO, Minority Staff Director (II) VerDate 11-MAY-2000 09:23 Feb 22, 2002 Jkt 000000 PO 00000 Frm 00002 Fmt 5904 Sfmt 5904 C:\DOCS\76856.TXT HGOVREF1 PsN: HGOVREF1 C O N T E N T S Page Hearing held on: April 25, 2001 ................................................................................................... 1 April 26, 2001 ................................................................................................... 307 Statement of: Bradstreet, James J., M.D. FAAFP; Cindy Kay Schneider, M.D. FACOG; Jeff Segal, M.D.; and Sharon G. Humiston, M.D. ...................................... 38 McCormick, Marie, MDSCD, chair, Committee on Immunization Safety Review, Institute of Medicine, accompanied by William Colglazier, exec- utive officer, National Academy of Sciences; and Susanne Stoiber, exec- utive officer .................................................................................................... 202 McDougle, Christopher J., M.D., Riley Children’s Hospital, Indiana Uni- versity School of Medicine; Andrew Wakefield, M.D.; Walter Spitzer, M.D., Faculty of Medicine, McGill University, Montreal, Canada; Boyd E. Haley, Department of Chemistry, University of Kentucky; David G. Amaral, MIND Institute, University of California, Davis; Dr. Eliza- beth Miller, Public Health Laboratory, England; and Dr. Michael D. Gershon, Department of Anatomy and Cell Biology, Columbia Univer- sity .................................................................................................................. 89 Rennert, Owen M., M.D., Scientific Director, National Institute of Child Health and Human Development, National Institutes of Health; Karen Midthun, M.D., Director, Office of Vaccine Research and Review, Food and Drug Administration, accompanied by Susan Ellenberg, M.D., Di- rector, Office of Vital Statistics and Epidemiology; Norman Baylor, M.D., Associate Director, Regulatory Policy, Office of Vaccines; and Dr. Colleen Boyle, Acting Associate Director, Science and Public Health, Center on Birth Defects and Developmental Disabilities, Cen- ters for Disease Control and Prevention ..................................................... 314 Smith, Hon. Christopher H., a Representative in Congress from the State of New Jersey; and Hon. Michael F. Doyle, a Representative in Con- gress from the Commonwealth of Pennsylvania ........................................ 25 Letters, statements, etc., submitted for the record by: Amaral, David G., MIND Institute, University of California, Davis, pre- pared statement of ........................................................................................ 160 Boyle, Dr. Colleen, Acting Associate Director, Science and Public Health, Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, prepared statement of ........................... 354 Burton, Hon. Dan, a Representative in Congress from the State of Indi- ana: Letter dated April 24, 2001 ...................................................................... 4 Prepared statements of ............................................................................. 7, 310 Clay, Hon. Wm. Lacy, a Representative in Congress from the State of Missouri, prepared statement of .................................................................. 22 Doyle, Hon. Michael F., a Representative in Congress from the Common- wealth of Pennsylvania, prepared statement of ......................................... 33 Gershon, Dr. Michael D., Department of Anatomy and Cell Biology, Co- lumbia University, prepared statement of .................................................. 178 Gilman, Hon. Benjamin A., a Representative in Congress from the State of New York, prepared statement of ........................................................... 378 Haley, Boyd E., Department of Chemistry, University of Kentucky, pre- pared statement of ........................................................................................ 137 Humiston, Sharon G., M.D., prepared statement of ...................................... 77 McCormick, Marie, MDSCD, chair, Committee on Immunization Safety Review, Institute of Medicine, prepared statement of ............................... 205 (III) VerDate 11-MAY-2000 09:23 Feb 22, 2002 Jkt 000000 PO 00000 Frm 00003 Fmt 5904 Sfmt 5904 C:\DOCS\76856.TXT HGOVREF1 PsN: HGOVREF1 IV Page Letters, statements, etc., submitted for the record by—Continued Midthun, Karen, M.D., Director, Office of Vaccine Research and Review, Food and Drug Administration, prepared statement of ............................ 336 Miller, Dr. Elizabeth, Public Health Laboratory, England, prepared state- ment of ........................................................................................................... 164 Rennert, Owen M., M.D., Scientific Director, National Institute of Child Health and Human Development, National Institutes of Health, pre- pared statement of ........................................................................................ 318 Schneider, Cindy Kay, M.D. FACOG, prepared statement of ...................... 45 Segal, Jeff, M.D., prepared statement of ........................................................ 68 Smith, Hon. Christopher H., a Representative in Congress from the State of New Jersey, prepared statement of ......................................................... 28 Wakefield, Andrew, M.D., prepared statement of .......................................... 96 Weldon, Hon. Dave, a Representative in Congress from the State of Florida, prepared statement of Mr. and Mrs. Middlebrook, Indialantic, FL ................................................................................................................... 219 VerDate 11-MAY-2000 09:23 Feb 22, 2002 Jkt 000000 PO 00000 Frm 00004 Fmt 5904 Sfmt 5904 C:\DOCS\76856.TXT HGOVREF1 PsN: HGOVREF1 AUTISM—WHY THE INCREASED RATES? A ONE-YEAR UPDATE WEDNESDAY, APRIL 25, 2001 HOUSE OF REPRESENTATIVES, COMMITTEE ON GOVERNMENT REFORM, Washington, DC. The committee met, pursuant to notice, at 11:07 a.m., in room 2154, Rayburn House Office Building, Hon. Dan Burton (chairman of the committee) presiding. Present: Representatives Burton, Morella, Ros-Lehtinen, Horn, Davis, Weldon, Waxman, Maloney, Norton, Cummings, Kucinich, Blagojevich, Tierney, Schakowsky, and Clay. Staff present: David A. Kass, deputy counsel and parliamen- tarian; Mark Corallo, director of communications; John Callendar, counsel; S. Elizabeth Clay, Nicole Petrosino, and John Rowe, pro- fessional staff members; Robert A. Briggs, chief clerk; Robin Butler, office manager; Michael Canty and Toni Lightle, legislative assist- ants; Scott Fagan, staff assistant; Leneal Scott, computer systems manager; John Sare, deputy chief clerk; Corinne Zaccagnini, sys- tems administrator; Phil Barnett, minority chief counsel; Kate An- derson and Sarah Despres, minority counsels; Ellen Rayner, minor- ity chief clerk; and Jean Gosa, minority assistant clerk. Mr. BURTON. Good morning. A quorum being present, the Committee on Government Reform will come to order. I ask unanimous consent that all Members’ and witnesses’ written and opening statements be included in the record. Without objection, so ordered. I ask unanimous consent that all articles, exhibits, or extraneous or tabular material referred to be included in the record. Without objection, so ordered. During the 106th Congress, I initiated oversight investigations to look at the dramatic rise in autism rates and the many
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