I’ve seen this topic discussed more than a few times in the BrillKids Forum, and although I can’t blame some of the mothers panicking due to what-could-be circumstances surrounding immunization, I somewhat believe that they could be missing the whole point behind it.
As I opened my television to watch this morning’s CNN, this specific subject came out as a feature on how Egypt is currently preparing pilgrims before going on their Hajj (did I spell that one right? My P.I. professor would totally kill me if I messed that one up.) The feature lasted about 5 minutes, with more than a handful of ladies (faces covered) in a state of shock as to why they had to go through this immunization project before going on the pilgramage of a lifetime.
I guess I figured that with all of the recent chatter regarding the H1N1 flu vaccination programs, now seemed to be a perfect time to look into the importance of immunization in general. The debate over the usefulness and safety of immunizations has often been fueled by misinformation, so I’m hoping this may provide a few important facts to you who have stumbled upon my blog.
According to immunizations.eu, immunization is “the process by which an individual is exposed to an agent designed to fortify the immune system against that agent. When the human immune system is exposed to a disease once, it can develop the ability to quickly respond to a subsequent infection.”
For most of us, immunizations are so common that we don‘t even think about them. My earliest memory of one was a “booster shot” before starting school. I also remember getting a tetanus shot after some minor injury as a child. I remember, too, asking my mom about the round scar on her upper arm that stamped her safe from smallpox.
(The following are some short articles taken and linked to wherever you can get more information. In no way did I write them, so if you’re interested in learning more, kindly check out the recommended resource links written below.)
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The Controversy over Immunizations
In 1998, a report was published in the Lancet, a respected British medical journal, by physician Dr. Andrew Wakefield and 12 other researches, that alleged a link between autism and the administration of the measles, mumps, and rubella vaccine, (MMR). Thereafter, reports of children regressing to autism after the MMR vaccine began to surface in the media. This analysis provoked a widespread objection to the use of the MMR vaccine.
Further, a causal link was suspected between thimerosal and autism. Thimerosal is a mercury-based preservative that has been used in vaccines since the 1930‘s. The risk assessment of mercury’s toxicity was based on methyl mercury, which could cause neurolodevelopmental disorders. The type of mercury contained in thimerosal, however, is ethyl mercury, a different type, that leaves the body ten times faster than methyl mercury. Nevertheless, as a precautionary measure, the FDA issued a statement with the Centers for Disease Control (CDC) and the American Academy of Pediatrics (AAP) urging manufacturers of childhood vaccines to reduce or eliminate thimerosal in vaccines.
While the multi-dose flu vaccine still contains thimerosal, most childhood vaccines do not. In October 2008, the American Academy of Pediatrics released a report to help parents make informed decisions about immunizations. The report asserts that while thimerosal was removed from most childhood vaccines in 2001, it is still present in some vaccines for influenza. According to this report, thimerosal is still used in the manufacturing process to prevent contamination, but is removed at the end of this process. The remaining amount is so small that it is virtually undetectable. The report goes on to affirm that autism rates have increased since the removal of thimerosal from vaccines.
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A Pediatrician’s View on Immunizations
I’m the mother of a healthy 2 year old boy. I had the opportunity to interview one of his pediatricians, Dr. John Packard, for a television show I hosted for our local hospital system. The subject – immunizations. Of course, I had a vested interest in the interview.
We began by talking about the Wakefield study that stirred up so much debate.
It is important to note that 10 of the 13 original authors withdrew their interpretation that the MMR vaccine could cause autism, though Dr. Wakefield was not among them. To cast further suspicion on the findings, it was discovered that Dr. Wakefield was helping parents gather evidence for a related lawsuit while conducting the study.
To counter claims that the MMR vaccine causes autism, Dr. Packard pointed out two particular studies that disproved that theory. One such study, conducted in Denmark studied the autism rates of all children born there between 1991 and 1998. Of roughly half a million children, 82% received the MMR vaccine, the other 18% did not. The conclusion of the study found no statistically significant difference for autism rates between vaccinated and unvaccinated children.
In a similar study conducted in Yokohoma, Japan, where MMR vaccinations were banned after 1993, rates of autism continued to rise despite the ban.
Next, Dr. Packard and I discussed the realities of the diseases that vaccinations aim to prevent. In the 1960’s, prior to the measles vaccine, 500,000 children per year were affected by measles in the United States. Even more frightening, 10,000 of those children died from the measles. Since then, measles has been almost eradicated. A few cases in the United States have been reported in the last several years, mostly either in infants who were too young to have received the vaccine, or in health workers who had not been immunized.
Tetanus is a another disease Dr. Packard pointed out as one whose incidence is now extremely uncommon. In fact, before the interview, I knew a tetanus booster was administered after a puncture wound but I didn’t know exactly why. The reality of tetanus is startling. Sometimes known by the name lockjaw, tetanus affects the muscles of the jaw first. Tetanus bacteria can grow anywhere. It is only when the bacteria is introduced under the skin that problems arise. When this happens, a toxin causes the muscles of the body to contract. If tetanus develops, there is no antidote to the toxin. Therefore, a patient is put on a ventilator and is in effect paralyzed until the toxin’s effect diminishes, which can take up to two months. After the ventilator is removed, the spine must be X-rayed to ensure that it hasn’t been crushed by the contractions.
Another of my son’s pediatricians, Dr. David Chupp, weighed in on the subject of immunizations. I specifically asked him how he responds to parents who question the safety of vaccines. He replied that he tries to give information that will allow parents to make a correct decision. He said, “I refer them to legitimate websites or books.” He went on to add that he addresses particular concerns which deal with autism by saying, “There is no evidence to support a causal link between immunizations and autism, and a lot of evidence that refutes it.” As to the mercury issue, he reported that “…the amount of mercury in vaccines and the type of mercury turned out not to be of concern. Most offices do not use any vaccine with thimerosal because it is only found in multi-dose vials of vaccines and most have switched to a single dose preparation in pre-filled syringes as these are more convenient to use.”
Dr. Chupp finished by revealing something that, for me, was the most valid statement of all. He said, “I usually conclude by letting parents know that after reviewing all of the information I made the decision to vaccinate my children. I would not have done so if I thought there were any risks to vaccines that outweighed the benefits.”
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Accounting for the Growing Incidence of Autism
The incidence of autism continues to grow despite the reduction or removal of thimerosal from vaccines. Many physicians agree on an explanation. Dr. Packard believes that conditions that were formerly diagnosed differently are now being categorized as Autism Spectrum Disorder. He believes that as diagnoses of autism increase, diagnoses of mental retardation, for example, have decreased.
Dr. Bryna Siegel, developmental psychologist at the University of California, San Francisco, expands on this theory:
“In addition to the term autism, there is increasing reference to autistic spectrum disorders. The concept of a spectrum reflects many descriptive studies that illustrate how each specific sign of autism can be mild or severe, and that the number of overall signs may be numerous or few. The term ‘autistic spectrum has become much more commonly used than the term ‘pervasive developmental disorder’ (PDD) which is the medical-psychiatric term for basically the same thing.”
Dr. Packard called the coincidence of children receiving the MMR vaccine and being diagnosed with autism at about the same age just that; a coincidence. Additionally, a report from Webhelp, reviewed by Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, states that children with the regressive form of autism (a type of autism that develops after a period of normal development) coincidentally tend to start to show symptoms around the time the MMR vaccine is given.
The fact remains that the most respected groups in medicine, pediatric and otherwise, can find no connection between vaccinations and autism. Of course, a lot of information exists to refute this fact. Personally, I don’t believe the American Academy of Pediatrics, the Centers for Disease Control and the FDA to be flimsy sources for information.
To parents who have questions about immunizing their child, I have this advice:
Don’t be swayed by emotion or hearsay. Do your own research, all the while considering the validity of the sources of information about this subject. Ask your pediatrician whether his or her own children have been immunized. Most of all, consider the diseases vaccinations aim to prevent.
I spent today dealing with my two year old son’s fever, cough, and general misery from a cold. At the end of a frazzled day of whining and more than a few tears, I considered my constant fear of serious illness for him. I can’t imagine not utilizing any form of prevention I could beg, borrow, or steal.
Recommended resources:
- AAP’s Childhood Immunization Support Program (CISP)
Information for providers and parents.
www.cispimmunize.org
- Centers for Disease Control and Prevention National Immunization Program
Information about vaccine safety, including Parents’ Guide to Childhood Immunizations
www.cdc.gov/nip/home-hcp.htm
- National Network of Immunization Information (NNii)
Includes the NNii Resource Kit – Communicating with Patients about Immunizations. A guide to help answer patients’ questions and provide the facts about immunizations.
www.immunizationinfo.org
- Institute for Vaccine Safety, Johns Hopkins University
Provides an independent assessment of vaccines and vaccine safety to help guide decision makers and educate physicians, the public and the media about key issues surrounding the safety of vaccines.
www.vaccinesafety.edu
