Re: AJC - CDC Response - Post your comments

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Autism claim shouldn't deter parents

By ANNE SCHUCHAT

Published on: 03/26/08

Kirby's March 20 opinion column, " Give Us Answers on Vaccines, "

misinterpreted available information about a case before the National

Vaccine Injury Compensation program and may have parents wondering

what is best for their child when it comes to immunizations. That is

unfortunate, given that our nation's childhood vaccines are very safe

and are proven to protect and save lives.

Parents should know that the Centers for Disease Control and

Prevention, along with other agencies in the U.S. Department of Health

and Human Services and the wide range of scientists and health

professionals involved in the nation's immunization programs take

seriously questions and concerns related to vaccine safety.

Furthermore, our efforts in vaccines, developmental disabilities and

the health of children go far beyond our professional interests, as

many of the dedicated professionals involved are also parents and

grandparents.

Kirby's column included many inaccuracies related to childhood

vaccines. As such, it illustrates that when it comes to immunizations,

child development and specific medical conditions, the best source of

guidance is the child's health care provider. Parents should not be

reluctant to ask their child's doctors or nurses about any health

concerns, including immunizations. Vaccines are often given early in

life in order to protect against diseases that can seriously harm

infants and young children. The joint immunization recommendations of

CDC, American Academy of Pediatrics and American Academy of Family

Physicians do recognize there are instances when a child should not

receive a recommended vaccine or when a recommended vaccination should

be delayed. Those decisions, however, are best made in consultation

with the child's doctor.

As the column correctly noted, vaccine injury cases are often handled

through the National Vaccine Injury Compensation program administered

by HHS' Health Resources and Services Administration. This program is

charged with determining whether a claimed injury meets

pre-established criteria or if vaccination may have contributed to a

child's serious medical or health condition. If such a determination

is made, the program works to provide timely and compassionate

compensation.

Since 1988, HRSA's vaccine injury program has provided compensation in

about 2,100 cases, including some that have involved vaccines and

encephalopathy (injury to the brain). While Kirby's column suggested

otherwise, to date, this program has never determined in any case that

autism was caused by a vaccine. In comparison, during this same time

period, about 100 million American children received recommended

childhood vaccinations, and cases of vaccine-preventable diseases in

the U.S. have decreased to record or near-record lows.

Recently, mitochondrial disorders have become the focus of media

attention with respect to vaccine injury compensation. Mitochondrial

disorders, which occur very rarely in children, are believed to be

genetic. Children born with these disorders often appear normal

through the first years of life. When placed under severe stress from

such things as infections, fever, dehydration, malnutrition or lack of

sleep, children with these disorders often experience loss of some

brain and nervous system functions.

Some have suggested that infants and children be screened for

mitochondrial disorders before getting recommended vaccinations.

Unfortunately, mitochondrial diseases are very difficult to diagnose

and it is usually not possible to identify children with such

disorders until there are signs of developmental decline. A definitive

diagnosis often requires multiple blood tests and may also require a

muscle or brain biopsy (removal of a portion for testing, usually

under anesthesia). Therefore, providing routine screening tests on

children who have no symptoms would bring other medical risks and

raise many ethical questions.

At present, we do not know definitively if vaccines can trigger

neurological or developmental declines among children with

mitochondrial disorders. We do know, however, that infections can

cause neurological and developmental declines among these children —

and we also know that childhood vaccinations protect children against

some of the same infections known to cause developmental decline among

children with mitochondrial disorders. These include

vaccine-preventable diseases like measles, chickenpox and influenza.

In the case of children with mitochondrial disorders, we do not yet

have sufficient evidence to make general immunization recommendations.

Physicians who care for children with these disorders usually

recommend that these children receive their childhood vaccines, but,

depending on the child's health status or medical condition, they may

change when those vaccinations are provided.

We recognize that developmental disorders, whether related to

mitochondrial disease, autism or other causes, are a serious challenge

for many families. In the case of autism, CDC has actively supported

vaccine safety research in this area. To date, the best science

indicates that there is no association between vaccines and autism. As

part of our efforts to foster understanding of autism, CDC is

currently conducting the largest study to date designed to identify

potential autism causes and risk factors.

We recognize that much of the success of our nation's immunization

efforts comes from the trust of parents. We do not take that trust

lightly. Rather, CDC, FDA and other HHS agencies are continually

working to expand efforts in vaccine safety research and science as

well as clinician and parent input and involvement. Like parents, we

want the best information possible when it comes to protecting and

ensuring children's health.

Our nation's high immunization rates are the reason why very few

children suffer from vaccine-preventable diseases that in the past

used to harm them in large numbers. These high rates show that parents

realize the importance of childhood vaccinations. CDC is committed to

maintaining that high level of support as well as making sure all our

efforts are working to foster the health of children.