Miracles or menaces?

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Miracles or menaces?

Tuesday, October 28, 2008

BY PEGGY O'CROWLEY

Star-Ledger Staff

Are childhood vaccines saving hundreds of lives a year or are they behind a

surge of neurological disorders, such as autism, and chronic conditions,

such as asthma? Should vaccines be mandated or should parents have a choice

whether their kids get the shots?

Those questions were fiercely debated at a forum on infant and child

vaccines last week hosted by Deirdre Imus, president of the Deirdre Imus

Environmental Center for Pediatric Oncology at Hackensack University Medical

Center.

" We will lose faith in the immunization process if we don't address this now

" said Imus, an environment and child health advocate, who moderated a panel

of experts. " There's a disconnect in vaccine safety. We are ignoring the

toxicity of them, the formaldehyde, aluminum and thimerosal. "

Some panelists questioned the safety of vaccines at the same time as the

medical community is recommending more and more vaccines for children, at

younger and younger ages.

New Jersey is the first state in the nation to mandate that children 6

months to 5 years old who attend child-care centers or preschools receive a

flu and pneumoccocal vaccine. Children in the sixth grade must receive

meningococcal/diptheria and tetanus/pertussus vaccines.

The mandate has raised objections from parents, many of whom were at the

forum. A bill pending in the state Legislature would allow parents to opt

out of the vaccines.

" Parents desire flexibility and want to weigh the risks. Ten years ago, I'd

talk to a parent once a week (about vaccines), and now I do with every

single family who comes in, " said Lawrence Rosen, vice chair of the American

Academy of Pediatrics Section on Complementary Holistic and Integrative

Medicine. Today, he said, vaccines are the " third rail " of pediatric

politics.

For example, Rosen said the need for a mandated flu vaccine for babies

should be weighed against the risks: There was only 1 pediatric death

related to flu in New Jersey in 2006 and only two reported deaths in the

last four years, he said.

Boscamp, the state chair of the American Academy of Pediatrics'

Infectious Disease Committee, defended vaccines as " miracles " that have

eradicated diseases that took thousands of lives in the past.

In the 1920s, for instance, there were 100,000 to 200,000 cases of diptheria

in the United States, with a 5 percent death rate. In 1999, there was one

case, said Boscamp, who is chairman of the ph M. Sanzari Children's

Hospital at the Hackensack medical center.

" There is no method to determine what kid will have an adverse reaction.

What are our choices? Don't immunize anyone? " he asked.

If widespread immunization is abandoned, he predicted, life-threatening

diseases will become more common. " If a significant proportion opts out of

the immunization program, these diseases will re-emerge and children will

die, " he said.

Margaret C. Fisher, chair of the Section of Infectious Diseases of the

American Academy of Pediatrics, defended the safety and content of childhood

vaccines.

" Every vaccine is extensively tested, and there is an outlined procedure for

approving vaccines in clinical trials, " said Fisher, medical director of the

Children's Hospital at Monmouth Medical Center.

She said the schedule of vaccines for infants was based on medical evidence

of their effectiveness: For example, an adult who contracts hepatitis B has

a 10 percent chance that he or she will retain the virus in the body. But an

infant has a 90 percent chance of retaining the virus, which can lead to

increased risk for liver cancer.

Vaccines for pneumococcal meningitis are administered when a child is

between 12 and 15 months old because that's when the baby's immunity from

the mother subsides, she said.

Fisher also said that certain substances that worry parents, such as

aluminum and formaldehyde, are necessary for vaccines' effectiveness.

" Aluminum in vaccines acts as an adjuvant, a substance that makes the immune

system better react to the vaccine so you don't need as high a dose, " she

said. Formaldehyde is used in the tetanus vaccine as part of a detoxified

toxin, leaving a trace amount.

Kirby, a journalist and author of " Evidence of Harm: Mercury in

Vaccines and the Autism Epidemic: A Medical Controversy, " said he believed

that thimerosal, which still exists in trace amounts in some childhood

vaccines, was no longer the " smoking gun. " Several national studies have

found no connection, and a California study found that, even after

thimerosal was removed from vaccines, diagnoses of autism continued to rise.

But, he said, the links between vaccines and conditions like autism are

still strong and more research is needed. One area to look at is to

determine which children might have a genetic propensity for a condition

such as autism, for which vaccines may act as a trigger.

Children with mitochondrial disorders -- mitochondria are structures that

serve as centers of enzyme activity needed to power cells -- might be at

particular risk, he said. He cited the case of Hannah Polling, a child with

such a disorder who then received nine vaccines in one day. She was

subsequently diagnosed with autism.

Kirby said environmental factors also were probably involved, pointing to

New Jersey's high rate of autism, one in 94 children compared to one in 150

nationwide.

" New Jersey is lousy with mercury, " he said, much of it from air pollution

that is spread in rain.

But he also pointed to the " universality of vaccines " as an explanation for

so many children's contracting chronic illnesses.

" Not everybody lives near cell phone towers, uses the same baby food or

household products, but everyone gets vaccines, " he said. He cited the

example of the immigrant Somali population in Milwaukee. Pregnant women,

mothers and babies were given up to 10 vaccines " and the autism rates among

Somali refugees are through the roof, " he said.

The speakers agreed that more research is needed, not just about the

quantity and quality of vaccines, but also into genetic markers that could

serve as red flags for at-risk kids. Revising recommended vaccine schedules

so they are spread out and given to children when they are older should also

be considered.

In the meantime, said Imus, parents are desperate for answers.

Peggy O'Crowley may be reached at pocrowley@... or at (973) 392-5810.