USNWR: Fighting the Autism-Vaccine War

[Guest guest]

Part of the news herein is that the article is published in US News &

World Report, which generally is quite conservative.

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" Go back 40 or 50 years. The medical literature is replete with reports

of neurological reactions to vaccines, such as mood changes, seizures,

brain inflammation, and swelling. "

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As a trigger, vaccines carry a ring of historical and biological

plausibility.

<http://www.usnews.com/dbimages/master/4333/

FE_DA_080421healy_51606et.jpg>

foto: As a trigger, vaccines carry a ring of historical and biological

plausibility.

(Phil Klein/Reuters/Corbis)

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Fighting the Autism-Vaccine War*

By Bernadine Healy M.D.

Posted April 10, 2008

http://health.usnews.com/articles/health/brain-and-behavior/

2008/04/10/fighting-the-autism-vaccine-war.html

One of the most vitriolic debates in medical history is just beginning

to have its day in court---vaccine court, that is. Without laying blame,

the independent Office of Special Masters of the Court of Federal

Claims---with a 20-year record of handling vaccine matters---recently

conceded that the brain damage and autistic behavior of Hannah Poling

stemmed from her exposure as a toddler to five vaccinations on one day

in July 2000. Two days later, she was overtaken by a high fever and an

encephalopathy that deteriorated into autistic behavior. Even though

autism has a strong genetic basis, and she has a coexisting rare

mitochondrial disorder, I would not be too quick to dismiss Hannah as an

anomaly.

At some level, the decision was a vindication for families who have been

battling with the vaccine community, arguing that some poorly understood

reaction to components of vaccines or their mercury-based preservative,

thimerosal, could cause brain injury. Yes, vaccines are extraordinarily

safe and bring huge public health benefit. (Remember the 1950s polio

epidemics?) But vaccine experts tend to look at the population as a

whole, not at individual patients. And population studies are not

granular enough to detect individual metabolic, genetic, or

immunological variation that might make some children under certain

circumstances susceptible to neurological complications after

vaccination.

A trigger? Families are not alone in searching for a trigger that might

explain why autism and autism spectrum disorders have skyrocketed; now

they reportedly affect about 1 in 150 kids. No doubt some of the

increase is soft, due to broader diagnostic criteria, greater awareness,

and---now that the notion of a detached " refrigerator " mom as a cause

has blessedly fallen by the wayside---greater openness. But the rise of

this disorder, which shows up before age 3, happens to coincide with the

increased number and type of vaccine shots in the first few years of

life. So as a trigger, vaccines carry a ring of both historical and

biological plausibility.

Go back 40 or 50 years. The medical literature is replete with reports

of neurological reactions to vaccines, such as mood changes, seizures,

brain inflammation, and swelling. Several hundred cases of the paralytic

illness Guillain-Barré after the swine flu vaccine were blamed on the

government and gave Gerald Ford heartburn---but eventually led to the

vaccine court.

Pediatricians were concerned enough about mercury, which is known to

cause neurological damage in developing infant and fetal brains, that

they mobilized to have thimerosal removed from childhood vaccines by

2002. Their concern was not autism but the lunacy of injecting mercury

into little kids through mandated vaccines that together exceeded

mercury safety guidelines designed for adults. But as in all things

vaccine, this move too was contentious. Both the Centers for Disease

Control and Prevention and the World Health Organization remain

unconvinced that thimerosal puts young children at risk.

There is no evidence that removal of thimerosal from vaccines has

lowered autism rates. But autism numbers are not precise, so I would say

that considerably more research is still needed on some provocative

findings. After all, thimerosal crosses the placenta, and pregnant women

are advised to get flu shots, which often contain it. Studies in mice

suggest that genetic variation influences brain sensitivity to the toxic

effects of mercury. And a primate study designed to mimic vaccination in

infants reported in 2005 that thimerosal may clear from the blood in a

matter of days but leaves inorganic mercury behind in the brain.

The debate roils on---even about research. The Institute of Medicine in

its last report on vaccines and autism in 2004 said that more research

on the vaccine question is counterproductive: Finding a susceptibility

to this risk in some infants would call into question the universal

vaccination strategy that is a bedrock of immunization programs and

could lead to widespread rejection of vaccines. The IOM concluded that

efforts to find a link between vaccines and autism " must be balanced

against the broader benefit of the current vaccine program for all

children. "

Wow. Medicine has moved ahead only because doctors, researchers, and

yes, families, have openly challenged even the most sacred medical

dogma. At the risk of incurring the wrath of some of my dearest

colleagues, I say thank goodness for the vaccine court.