Elevate Your Health Colorado Vaccines and Autism--What is the latest?

When an article about vaccines and autism hits Popular Mechanics, you know you have a hot topic.  Several weeks ago, the Lancet, an important British medical journal, retracted the article that was published in 1998 that claimed there was a link between the MMR vaccine and autism.  Even more importantly, the lead author, Dr Andrew Wakefield, has been discredited by Britains’ physician regulation agency for his “unethical” and “dishonest” actions in conducting the study.  If you read the Popular Mechanics article, it is very clear that there is sharp disagreement between proponents of vaccines and their opponents.  So what is a reasonable parent to do?  A few thoughts first:

First, I cannot explain Dr Wakefield’s behavior.  I tend to be a glass-half-full sort of guy, so I think it is likely that he was so convinced that vaccines had something to do with autism that he crossed the line of unbiased research.  While his study made many people worry that vaccines cause autism, there is no study that shows a using a different schedule of vaccine or skipping vaccines altogether lowers rates of autism. 

Second, it is true that some vaccine preventable diseases became less common as we improved public hygiene–cleaner communities led to less infections.  But vaccines also contributed to the reduction in these diseases.  People who say vaccines had nothing to do with it are distorting the truth, in my judgement.  In my professional lifetime, the rates of Hemophilus influenza type B infections and Pneumococcal infections, both of which caused meningitis in young children, dropped like a rock, because of the use of the vaccines.

Third, I think no one has a really good explanation for why we are seeing more autism.  At least part of the increase is probably related to an increased awareness of the disorder, and so an increased tendency to diagnose it.  A recent study showed a correlation between the diagnosis of autism and parents who are white, highly educated, and older.  The study’s authors were quick to say that these parental characteristics did not cause autism, but made it more likely that someone would think of it.  Many people think we are seeing more autism than we ought to, even when we account for increased awareness.  I don’t think we really understand why, though most scientists and doctors don’t think vaccines are the culprit, based on the evidence we have.

Fourth, my heart goes out to every parent with a child with autism.  It is hard to have a child who may not be the perfect successful child you saw in your heart when you learned you were going to be a parent, and it is a huge amount of work to get everything your child needs.  The last thing a parent needs is to think they made a decision that harmed their child.

Lastly, we do know that identifying children with autism as early as possible allows us to start treatments to help them function as well as possible in society.  So the American Academy of Pediatrics has put forth guidelines to encourage every doctor who takes care of kids to screen them for signs of autism at 18 months of age.  It is reasonable to expect your child’s doctor to do an autism screen when your child is 18 months old.

So coming back to the original question–what is a reasonable parent to do? 

1. Do discuss your concerns with your child’s doctor.  I am a strong proponent of vaccines for children, and I know each parent has to make the decision that they feel is best for their children.  I try to work with families to get their children vaccinated, and I do respect their right to disagree with me.  Most families I work with do get their children vaccinated, and I think that is the right choice.
2. Do research the question.  You always have to be careful about your sources, whether you are using the internet or other sources.  Be sure to look at multiple sources.  Sources for information on vaccines that is trusted by many pediatricians are the Immunization Action Coalition, the Centers for Disease Control and Prevention, the American Academy of Pediatrics, the National Network for Immunization Information, and the Vaccine Education Center.
3. Much research suggests that parents are aware of unusual behaviors in their children long before 18 months of age.  If you see any of these red flags be sure to talk  to your child’s doctor about them.
4. Do expect your child’s doctor to screen for signs of autism at 18 months, and to be screening your child’s development at his or her well visits.