And of course....he didn't mention Banks

[Guest guest]

The Vaccine Dilemma: Many families, some fearing autism risk, choose

to avoid children's immunizations

Sunday, March 01, 2009

By Mark Roth, Pittsburgh Post-Gazette

Tricia Baum, of Canonsburg, suspects that vaccines may have triggered

autism in her son, . She recently switched to a pediatrician

who agreed to measure the 5-year-old's blood antibody levels before

deciding whether to give him a measles-mumps-rubella booster.

After Jayden Naughton lost his speech when he was 2 and was diagnosed

with autism, his mother, , made a crucial decision.

When the Avalon woman gave birth to her second son, Duncan, two years

ago, she decided he would not be vaccinated, because she believed

vaccinations might have had something to do with Jayden's regression.

Duncan is now 2, has never had a vaccination, and also has been

diagnosed with autism.

Some might say that this suggests his autism has a genetic cause, but

Mrs. Naughton doesn't buy it. In fact, she fears that starting to

vaccinate him now could make his symptoms worse. And she's not

particularly worried about him getting sick from the diseases the

vaccines protect against.

" My grandparents had a lot of these diseases and they're fine, " she

said last week. " I think these childhood diseases are there for a

reason. They're there to build up the immune system. "

Whether you agree with her or not, Mrs. Naughton is part of a small

but growing subset of parents who either won't vaccinate their

children or want to space out their shots. Most of them believe there

may be a connection between the vaccines and autism, despite a growing

list of scientific studies that contend otherwise.

Even if they aren't worried about autism, some parents are bothered by

what they see as an increasing assault on babies' immune systems.

" We do vaccinate, but they do scare me, " one mother wrote on the

Pittsburghmom.com Web site, which is owned by the Pittsburgh

Post-Gazette. " [it's] not necessarily because of autism but just

because they get so many of them now and I just wonder if they truly

know that they are safe. "

While many pediatricians and infectious disease experts feel that

doctors should stand their ground in the face of such fears, there is

an increasing number of doctors who are willing to accommodate these

parents.

Tony Kovatch is one of them. Dr. Kovatch, of the Pediatric Alliance's

Arcadia office in McCandless, doesn't agree with avoiding vaccinations

altogether, and doesn't know any other pediatricians who do. But he is

willing to delay certain vaccinations.

Under the standard schedule promulgated by the federal Centers for

Disease Control and Prevention, children can get up to 27 doses of 14

different vaccines before they are 2. They often get up to six shots

per visit.

Melinda Wharton, acting director of the immunization safety office at

the CDC, said she sees no medical or scientific rationale for spacing

out those inoculations.

But Dr. Kovatch responded that " I also don't see any biomedical

justification for having to give so many all in one day. " He said he

believes the schedule was set up " to work into the template of the

pediatric well-child visits at 2 months and 4 months and 6 months. But

I think the anxiety and concerns of the well-informed public have

trumped the convenience on the timing. "

One physician who disagrees is Nowalk, an infectious disease

specialist at Children's Hospital of Pittsburgh.

" One of the reasons we are so hot on the vaccination schedule as it

is, is that otherwise, you can put your child at risk for some of

these diseases, many of which are quite serious. My response to

parents who say 'what's the harm in spacing them out' is that many of

these diseases are quite devastating. "

While they don't see eye to eye on the vaccination schedule, Dr.

Kovatch and Dr. Nowalk do agree that some of the diseases the vaccines

protect against are more of a threat than others.

Before age 1 children should get the diphtheria-pertussis-tetanus shot

and those for haemophilus influenzae B (also known as Hib) and

pneumococcal infections, Dr. Kovatch said.

The Hib and pneumococcal vaccines are designed to guard against

bacterial meningitis, which used to infect 18,000 children in the

United States each year and kill 1,000 of them in the era before the

vaccines were available, Dr. Nowalk said.

The pertussis vaccine protects against whooping cough, which has not

been eradicated in the United States. Before scientists developed a

pertussis vaccine for older children in 2005, there were about 10 to

20 deaths from whooping cough in the country annually, and most were

in young children, the CDC's Dr. Wharton said.

For those vaccines, Dr. Kovatch said, he will sometimes suggest to

parents who are concerned about the frequency of immunizations that

they come into the office more often, and get one vaccine each month

rather than three at a time.

He's willing to delay past age 1 the hepatitis B vaccine and the polio

vaccine, especially if the family isn't planning overseas travel.

Some doctors follow the schedule advocated by Dr. Bob Sears, a

California pediatrician and author of " The Vaccine Book -- Making the

Right Decision for your Child. "

In his " selective schedule, " Dr. Sears never gives more than two

vaccinations per visit and delays vaccinations for measles, mumps,

rubella, chickenpox and hepatitis A until age 10, and then only if a

child's blood tests show a lack of immunity to these diseases.

Spacing out vaccines, he wrote in an e-mail, " allows parents who would

otherwise refuse all vaccines to get their babies protected, and helps

protect our nation as a whole by raising vaccination rates among

worried parents. "

Dr. Wharton said she is not a fan of spacing out immunizations, but

isn't unalterably opposed.

The problem, she said, is that if too many parents avoid or delay

vaccinations, it can allow clusters of childhood diseases to erupt.

Outbreaks of measles in the Southwest last year and of haemophilus

infections in Minnesota this year were both traced in part to families

with unvaccinated children.

Underlying the vaccine delay is the idea that the current schedule

puts too much stress on children's immune systems.

But Dr. Wharton offered two arguments against that.

First, she said, children's immune systems are exposed to far more

challenges from daily living than they are from all the vaccinations

combined.

Second, even though children get far more vaccinations today than they

did 40 years ago, they are exposed to far fewer substances in those

vaccines that trigger an immune reaction.

The particles in vaccines that build up immunity are called antigens.

A 2002 study in the Journal Pediatrics said that the 11 vaccines

children were getting in 2000 contained 123 to 126 antigens, while the

five that children got in 1960 -- smallpox, diphtheria, tetanus,

pertussis and polio -- contained 3,217 antigens.

The major reason for the huge decrease was eliminating the smallpox

vaccine from the schedule after that disease was eradicated (it

contained 200 antigens), and devising a new pertussis vaccine that

dropped the antigen count from 3,000 to about five.

Tricia Baum, of Canonsburg, the mother of a 5-year-old son with

autism, said she had not heard that information before -- but it still

doesn't change her suspicion that vaccines may have triggered her

son's condition.

When she took for his 16-month doctor's visit, she said, he

was sick and fussy, " and I asked whether he should get his shots, but

the doctor checked his ears, and then he said, 'I'm his physician and

we're going to go ahead with his vaccinations today and we're going to

give him his flu shot as well.' "

She said had been developing normally until then, except for

a delay in his vocabulary, but not long after that visit, he began to

lose what words he had and retreat into himself.

Ms. Baum recently switched to a pediatrician who agreed to measure

' blood antibody levels before deciding whether to give him a

measle-mumps-rubella booster.

hasn't had any booster shots yet, she said, and won't as long

as his antibody measurements stay high enough.

Elliot , who has a teenage son diagnosed with Asperger's

syndrome, is the chairman of local support group ABOARD -- Advisory

Board on Autism and Related Disorders.

Although he doesn't believe vaccines cause autism, he knows many

families in his organization who do, and he understands the emotions

that are driving that idea. " We talk to our parents about how you

can't blame yourself for what has happened, but I think it's human

nature that you've got to blame something, because you had this image

of what your child would grow up to be and at a very young age it's

taken away from you, and you've got to blame somebody for life being

that unfair. "

Dr. Nowalk, who has a child with Down syndrome, understands that as

well, but said, he can't abandon his principles as a doctor over the

vaccine issue.

" I know they work because I've seen them in my lifetime as a physician

protect children against diseases. And they are safe. "