Kevin told me about an article about the vaccine debate in the Detroit News which appeared while I was traveling, (http://www.detnews.com/apps/pbcs.dll/article?AID=2008805230376). I have always been a big supporter of vaccines based on their proven safety and efficacy and felt that this article tried to present a balance between the parental concerns and the science but didn’t come across strongly enough regarding the LACK of association between vaccines, thimerisol, and autism. No doubt there have been many more kids recognized as having conditions on the autism spectrum and no doubt there are more vaccines given to children now than were given in the past but this does not equal a causal relationship. Thimerisol was removed from vaccines in 2002 and there has been NO DECREASE in the rate of autism so clearly thimerisol is not the culprit. The MMR vaccine has been given (and in much higher doses than given today) for well over thirty five years and yet the rate of autism has been rising only for the last two decades. Seventeen studies have been published that refute the association between the MMR and autism as well so I feel the data to make a connection is very weak. That leaves only one possible connection between vaccines and autism: that the sheer number of vaccines children receive and the antigen load they confer somehow damages some children in this unexpected way. The problem with that theory is that back in the 70s and early 80s even though there were many fewer vaccines given, each was so much stronger that the antigen load given during the first two years of life is actually LESS NOW even though a larger number of shots is given today.
Having said all of this, I have some families in my practice who prefer to vaccinate on an alternate schedule. Some choose to do one vaccine a month and still get all of the required vaccines in by age 2; others choose to delay the start of vaccination until a child is somewhat older or choose to delay certain vaccines because the risk of contracting the diseases is small. In the article in the Detroit News, I felt that the quote from Dr. Dorsey was likely edited by the reporter and as such came across as if to say that delaying vaccines is no big deal. Of course the decision if and when to vaccinate lies with the parents but I would be remiss not to mention that delaying or foregoing vaccines is risky. If many families decide not to vaccinate it puts not only their own children at risk but all of ours because the diseases become more prevalent again. In 2005 (the last year that we have data), there were more cases of whooping cough (more than 24,000) in the US than have been in decades and infants under one year of age are at the greatest risk for death if they contract it. Whooping cough is the ‘P’ in DTP and over 25% of infants who contract it end up hospitalized and nearly 5% die if under a year of age. We have also seen outbreaks of mumps and measles which are both serious diseases and in Great Britain where the vaccination rate is low, this year there was a child who contracted diphtheria (a life threatening throat infection) and nearly died. I work with families to feel comfortable about vaccination and am happy to support an alternate schedule of vaccines and support families who opt not to have their child receive them at all but as the evidence mounts, the benefits of vaccines are more and more apparent and the risk of vaccines as a cause or even exacerbator of autism is shrinking. Food for thought…..
Molly O’Shea, MD