6.21.2008

Leelo Gets His MMR Booster

Leelo got his MMR booster yesterday morning. Longtime readers will know what a huge deal this is. It took three of us to hold him down after I asked the nurse to be quick and she said "I'm always fast" -- as she held the syringe in front of Leelo's face.

It has been more than five years since his last dose of MMR.

Mali got her DTaP. This is only her second vaccination. She was sad, but perked up when I made her a "hand balloon" out of an exam glove purloined from the box on the wall. I tried getting her back on schedule earlier in the year, but she had some kind of runny nose or coughing ook for months. She is now better, and as Summer is the time when young children frolic barefoot and step on rusty nails, I figured the Tetanus-comprising DTaP was the way to go.

Mali With Her Hand Balloon

Snarks aside, the vaccination issue is still a very complicated one for me, still makes my stomach do flips. I have a child who is disabled for reasons no one can explain, and some professionals argue very strenuously that the MMR vaccination will exacerbate that disability.

Why would I believe those arguments? Five years ago the support for families of children with new autism diagnoses wasn't nearly as extensive as it is now. There was no Autism Speaks 100 Day kit. There were no local online support communities. There was only Google, and the Golden Gate Regional Center telling me that my son had autism, and they'd put him in group speech classes two times per week. Everything else, we found on our own.

So, five years ago I was doing the New Diagnosis Freakout and would have done practically anything to help my son. I believed a lot of people, some of whom I now think were earnestly misguided, and some of whom I believe were riding the autism gravy train.

Five years later I have read through landslides of scientific arguments rebutting the vaccine/autism link. I continue to see so many autistic children who look Just Like Leelo that I suspect my son was who he is from conception. I no longer feel some sort of environmental trigger caused his autism. And I try not to focus on why he is the way he is, but rather on helping him gain skills, feel loved, and deal with the world -- and making damn sure the world deals with him.

As for my public stance on vaccination, here is what I recently wrote to the local Mothers Club and its community of wide-eyed parents with children under five:

Short version: Unless your family has a history of neurological or immunological disorders, vaccination is a social obligation.

Long version: In order to be very clear about any effects vaccines may have on your child, try to vaccinate on a slower than standard schedule, with only one vaccination per visit, at least one month between vaccinations, and only when your children are absolutely healthy. Finding a pediatrician who will agree to a delayed/spaced schedule is not always easy, but I have found that many pediatricians at PAMF.org are flexible. (Also, it is possible that not all insurance companies will cover this approach, that it may lead to excessive co-pays, and that it may be truly unrealistic to those who pay out of pocket or depend upon clinics.)

Here are some reasonable vaccination guidelines mixed in with a bit of sensationalism:
http://tinyurl.com/2lbqtu
(I found Stephanie Cave's book What Your Doctor May Not Tell You About Children's Vaccinations [cited] to be helpful and measured in its positions.)

Most people pondering whether or not to vaccinate worry about the risk of autism. This is a legitimate concern. Not so much about the mercury-based preservative Thimerosal, as it is no longer contained in most vaccines (flu shots excepted) and the link between Thimerosal and autism has been debunked (
http://www.sciencedaily.com/releases/2008/01/080107181551.htm), but because no one yet knows what causes many forms of autism, and the vaccines themselves cannot be entirely ruled out:
"Does this mean that we can say without a doubt that vaccines do not cause autism in some children? The answer to this question is “no.” There is emerging evidence that some children are immunologically compromised and therefore may respond in an atypical way to vaccinations. We do not currently understand how atypical immune responses might influence the developing nervous system or how commonly such adverse effects occur."
-From the vaccine position statement of the MIND Institute, one of the leading research centers for autism and other neurological disorders: http://www.ucdmc.ucdavis.edu/mindinstitute/newsroom/vaccineposition.html
You may also have heard talk in the news about a legal ruling in favor of a girl who developed autistic-like symptoms after being immunized. What is not always clarified is that the girl had a rare mitochondrial disorder that may have been aggravated by the vaccine. She was not just a regular kid who regressed into autism after being vaccinated. Here is a link: http://tinyurl.com/2u332f

So, yes, vaccination carries a risk. But in my opinion is comparable to the risk of air travel. If your family does not have a history of autism, Aspergers, or immunological issues, then you should vaccinate your kids. Thoughtfully. And with the guidance of a pediatrician who is equally thoughtful.

And while I don't think anyone should swallow the vitriol proffered by either side in the vaccination wars, you should know what people are saying:
http://scienceblogs.com/insolence/2008/03/antivaccinationists_flood_the_ajc_blog_c.php

Regards,
Squid

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8 comments:

  1. One known risk factor for autism and many other disorders is older paternal age. Sperm cells collect mutations that lead to schizophrenia, autism, type 1 diabetes etc as a man ages and is exposed to toxins. Sperm are not made fresh they come from other cells through division. It is during these divisions that DNA errors take place. http://autism-prevention.blogspot.com/2008/06/autism-speaks-rakes-in-money-but-never.html

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  2. Hmmm. Well, Seymour was thirty when Leelo was conceived.

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  3. Er, actually sperm *are* made fresh. That's why guys don't go through menopause. Women are born with a limited supply of ova, and when they're gone they're gone, but men... they just keep creating those little suckers.
    That's not to take away from the aging father theory - I think it's very interesting to look at all the statistics and the various factors that may influence such a complex disease as autism. But, as my old statistics professor loved to remind us, correlation does not imply causation.
    Re: the link - I think that one reason why the aging dad theory may not get as much press is the same reason that age does not get much press as a risk factor for heart disease, hypertension, diabetes, etc. - it's an unmodifiable risk factor. A person can (theoretically) change what they eat, where they live, whether they expose their child to various substances, etc. but they can't change certain things. They can't change their genes, they can't change their ethnic background, and they can't change their age. If someone found out tomorrow that children of blondes were at higher risk of autism, it would be interesting to hear, but I doubt it would be as widely heralded as if someone were to find that there was a higher risk of autism in children who ate broccoli before their third birthday.
    (Sorry, that was a bit of a tangent, but I find this stuff really interesting.)

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  4. 30 isn't old though for a father. And sperm are made fresh unlike eggs.

    I have two kids on the spectrum both not vaccinated. As they are getting older now, I am looking at how we will vaccinate for all the diseases they didn't bother to catch and gain immunity.

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  5. My two cents:

    The "older paternal age" contributing to autism study is not universally accepted. Also, just a data point, my husband's age was below that study's "older" threshold when our daughter was conceived.

    I am not rabid about the subjects of vaccines and autism, might/might not be true... but I am tired of the general press pretty much ignoring studies that indicate a link, while playing up studies that indicate no link. That bias alarms me. I do know that CDC Director Dr. Julie Gerberding, regarding the famous study based on their vaccine data base has been touted as the biggest and most thorough of the "vaccines don't cause autism" side, has just recently formally apologized to congress for how that study was done, and stated that no conclusions could be reached using their data. here's one link discussing that, although i had to type it in rather than copy it for easy use: www.huffingtonpost.com/david-kirby/cdc-vaccine-study-design_b_108398.html

    Who really knows. if vaccines are the culprit, could be thimerasol had an effect, could be the other basic vaccine ingredients that our kids are now more exposed to as the recommended # of vaccinations increases. The MMR had no thimerasol, the concern was the measles part - a group of autistic kids who had lower GI scopes were found to have that exact strain of measles present in their colon, when it shouldn't exist outside the vaccine labs. My daughter tested positive for this presence in her bloodwork, though we never did a lower GI scope on her.

    As a mom with a child on the spectrum, i feel no social obligation to vaccinate anymore. i will probably pick and choose vaccinations and schedule them carefully, as per Squid's excellent advice. But I do remember, before our daughter was born, there was absolutely no sign of ASD on either side of our families. so we could not have used that as a warning.

    just some thoughts.

    mb

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  6. I think the vaccine issue is difficult for many parents. My daughter had a neurological reaction to the MMR at 15 months. She would stare vacantly and then blink hard. Fortunately it went away a few days later. It was documented in her medical records and she will never get that again.

    It was terrifying to think that we had damaged our baby by giving her the vaccine. I will not risk my other kids either. I have a five-year old and a baby who will not get the MMR.

    The bottom line is that you have to do your own research and go with what makes you comfortable. I also pick and choose, which is reasonable for an informed, educated parent.

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  7. mb and all, I appreciate the tone of respectful disagreement. I hope you will always feel you can express your views safely here.

    Thanks for your input.

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  8. squid - it's lovely that you have provided such a safe place for discussion. thank you.

    mb

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Respectful disagreement encouraged.

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