Vaccines and Autism:
This section was put together to help clarify some very confusing and controversial topics about
the possible link of immunizations to autism. My hope is that this will help you sort out the
actual facts and help you to make a better informed decision about immunizations for your baby.
There is so much misinformation about the immunizations and autism on the internet that unless
you have a medical background or have experience with autism, you will find yourself easily
confused, not knowing who to believe.
My Philosophy on Pediatric Immunizations
I recommend the standard immunization schedule and feel very comfortable with the safety of
the vaccines. So comfortable in fact they I have immunized all of my kids with this schedule.
Vaccines have been thoroughly studied and there is no evidence to suggest any link to autismeither in the MMR vaccine or any of the other standard pediatric vaccines.
Overview on Autism
Autism is a delay in the development of multiple basic functions including communication,
language and social interaction. Historically, only severe cases of autism were recognized. As
our understanding of the disorder was heightened, the diagnostic criteria for autism were
changed and in 1994, autism was defined as Autism Spectrum Disorder, comprising a spectrum
of disorders on a continuum. This can range from mild, awkward social skills with no language
deficits (often diagnosed as Asperger’s syndrome) to severe global developmental delays (classic
autism). Since the revision of these diagnostic criteria, autism has been one of the most
commonly diagnosed conditions in the world, affecting one in 150-400 people in all areas of the
world.
Autism may seem like a modern disease but it is not. Reports dating back to the 1700’s can be
found of people now believed to have suffered from autism. It wasn’t until 1950 that the
disorder was officially named and not until 1994 after the revised criteria that rates of autism
began to dramatically rise. Thousands of people previously thought to have learning disabilities,
mental retardation or ill-defined psychiatric illnesses now were recognized as having autism.
Studies suggest that the majority of cases are from increased reporting and better knowledge of
the disorder rather than from a disproportionate increase in number of cases. Over the past 15
years, medical research has shown that genetic links and perinatal insults are the main causative
factors. For instance, identical twins with an autistic sibling have a 75% chance of having the
disorder while fraternal twins have only a 3% chance. Autism is more common in several
genetic syndromes and more common in those with autistic parents. Autism is also 4 times more
likely to occur in boys. Autism is believed to be from several different genes rather than one
single genetic mutation, making it much harder to identify, also explaining why the gene has not
been isolated yet.
How Immunizations got Linked to Autism
In 1998, a study of 12 autistic children was published in Britain hypothesizing that the MMR
vaccine caused intestinal inflammation and an autoimmune reaction which could have caused
autism. This sparked hysteria in Britain about the safety of vaccines which through the internet
and modern media gained rapid momentum. Soon after, the authors of the original paper
recanted their position and a multitude of medical studies were done over the coming years with
tens of thousands of children which independently showed no link between autism and the MMR
shot or any other vaccinations. Despite the multitude of medical data to support the safety of
vaccines, the controversy and hysteria has
spread into the mainstream culture with TV shows on “Oprah”, many books on alternative
schedules and Internet Websites devoted to the dangers of immunizations.
Myths about the Vaccines and Autism
Below I would like to just cover some the main myths or theories about autism and their
relationship to the immunizations.
Does The MMR Vaccine Cause Autism?
No. One of the other reasons for concern over the MMR vaccine is that it is given at 1 year of
age and most cases of autism are diagnosed at 18-24 months of age after children fail to meet
their developmental milestones. One might think that temporarily this could be a link, but almost
always one can go back and usually always see very subtle signs earlier. As a pediatrician having
seen many children with autism, I can attest that the autism was there long before the MMR shot
was given. However, although I have not personally seen this, there is an extremely rare form of
autism called regressive autism where development is normal until a relatively acute onset of an
immune reaction such as an allergic reaction or fever which triggers developmental delay.
Does Thimerasol Cause Autism?
No. Thimerasol is a form of mercury which was used as an antimicrobial in the equipment used
to manufacture vaccines. It was banned from being used as a preservative by state law over 8
years ago. All of our vaccines have NO thimerasol, not even trace amounts. Thimerasol has also
been studied and has never been shown to be related to autism. Regardless, this is no longer an
issue with the modern thimerasol-free vaccines.
Do Too Many Vaccines At Once Cause Autism?
No. This has also been studied. Presently, the standard schedule calls for 6 immunizations (5
intramuscular shots and 1 oral) at 2, 4, and 6 months with 3 immunizations at 12 months and 3
immunizations at 15 months. Many in the holistic and naturopathic community are concerned
that too many shots at once too early could be harmful to the immature immune system. In
theory, this makes sense but in reality infants are exposed to far more in their first year. In the
first year of life, the average infant who is exposed to other children (playgroup or daycare) will
have an average of nine viral infections (including upper respiratory infections, gastrointestinal
infections, and other febrile illnesses). These are live viruses. The standard vaccine schedule in
the first year are purified proteins and not live viruses. It is far less than what they are exposed to
in nature. Giving 5 shots at once is not too much for a baby’s immune system.
Alternate Vaccine Schedules
We would recommend proceeding with the standard vaccine schedule as outlined separately but
we do offer alternate schedules if you feel strongly about certain vaccines.
1) We can give all separate shots for DTap, Hib, PCV, IPV, HBV rather than use the
combination vaccine Pediarix- DTaP, HBV,IPV. This would involve five shots instead of three.
2) We can space out the vaccines- for instance three shots followed by the remainder two shots
one week later.
3) Although not recommended, we can delay the MMR vaccine. In California, you may still
enter Kindergarten without any immunizations as long as you sign a waiver of liability. If you
choose not to vaccinate your child, we will ask you to do the same for our records.
4) Some of our patients have an alternate schedule that they follow from “The Vaccine Book” or
Dr Bob Sears alternate vaccine schedule and we can follow this schedule. The things that we
cannot do are to separate the measles, mumps and rubella vaccine out (as we do not stock these
vaccines)