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Uncomfortable Questions

When I started hearing about all of these parents deciding against immunizing their kids, I suspected that it eventually would impact us directly. Over the past 16 months, whether we’ve gone to the park, played at Gymboree, attended La Leche League meetings, and even when I’ve taken Ethan to the grocery store, I have fleetingly wondered whether the other parents we meet have immunized their kids.

I realized that at some point — likely when Ethan entered school — I’d have to deal with this issue head on, but I figured that was years away. So, when I read yet another Berkeley Parents Network message from an anti-vax parent decrying insenstive pediatricians and praising Randall Neustader of all people, I felt like the wind had been knocked out of me when I saw that it was written by the woman that I’d selected as Ethan’s child care provider.

For the past three weeks, I have been thrilled to have a limited child care option (six hours per week) with a mother that I truly like and two little boys whose temperments are a perfect match with Ethan’s. The situation could not have been more ideal. And now with that one email, it is wholly unacceptable.

I know that when Ethan starts playing at other kids’ houses on his own, I will ask typical mommy questions like, “is so-and- so’s mom or dad going to be there?” Todd and I also strongly believe that we have the responsibility of asking whether there is a gun in the house. Never in a million years would I have thought that I would need add “do you immunize your kids?” to the list. And yet, it is fundamentally the same thing — it’s about protecting Ethan’s health and well-being.

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The Blame Game

While I can empathize with parents and families whose children are struck by illness, it puzzles me when their energy is expended on finding someone or something to blame.

The more I read about attempts to link thimerosal to autism, the more I am struck by a sense of desperation. Numerous organizations have been created exclusively to promote the theory that thimerosal causes autism — to the exclusion of all other theories. They choose to discount epidemiological studies and elevate parental anecdotes as hard facts — ultimately to the detriment of their cause.

As the Children’s Hospital of Philadelphia writes: “Unfortunately, for current and future parents of children with autism, the controversy surrounding vaccines has caused attention and resources to focus away from a number of promising leads.”

While I support efforts to investigate the possible link, it seems as if the net should be cast more widely. Instead, these activists expend their energy promoting the reports that support their claim and attempting to discredit any study that discounts their theory.

Ironically, these organizations have no qualms in describing the Institute of Medicine (IOM) as a credible resource for calling link between autism and thimerosal “biologically plausible,” but then turn around and decry the same agency as corrupt when its analysis of available research three years later concluded that existing research does not support the theory.

The bottomline is that these advocates seem to refuse to acknowledge the complexity of autism. It simply is not plausible that a single factor, like thimerosal exposure, is responsible for the rising rates we are witnessing.

At least some of the organizations are upfront about the fact that they want to document the link for the sake of litigation efforts. (See Mother Jones: Toxic Tipping Point for more information.) But, if that is the case, how are their efforts any more credible than the parties they are suing?

If these parents and advocates are truly concerned about finding the cause and, presumably a cure, for autism, why would they put all their eggs in this one basket? Is it cynical for me to believe that they are pursuing this narrow avenue of inquiry in the hope of a big payout?

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To learn more about autism from organizations that are casting a wider net, check out UC Davis MIND Institute and Cure Autism Now.

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Of Mice and Mercury

A little over a year ago, if someone had asked me what thimerosal was I would not have had a clue. But since then, I have been exposed to countless Web sites and online forums decrying the evils of this mercury-based preservative once commonly used in childhood vaccines.

A few years ago, as a result of the frightening increases in the incidence of autism as well as suggestions that the increases were due to thimerosal, parents started getting squirmy about vaccinating their kids. In an effort to alleviate parental fears, pediatricians and the public health community rightly asked pharmaceutical companies to remove the preservative from vaccines.

This was done despite a lack of scientific evidence of a causal link between it and autism (or any other problem for that matter). In fact, just last month, the Institute of Medicine released a monumental report that indicated that existing research showed that any link between thimerosal and autism was only theoretical.

Ultimately, for the sake of protecting universal immunization rates, the medical and public health practioners realized it was better to remove the obstacle than to engage in a philosophical debate on the topic on a patient-by-patient basis. The pharmaceutical companies honored the request and since 2000, commonly used vaccinations in the U.S. have been free of the preservative.*

I think we can all agree that we are better off with the removal of the mercury, no matter how trace the amount was. Goodness knows that given all the warnings about mercury in fish,** I am as paranoid as can be. Ahi (tuna) is right up there on my list of favorite foods, but as a breastfeeding mom I feel guilty eating it with the risk of passing the mercury on to my son. So it is nice to be spared the concern when it comes to whether or not to immunize him.

Unfortunately, despite the fact that thimerosal was virtually eliminated nearly four years ago, if you read anti-vaccination Web sites and comments in online forums, you could easily conclude children are still routinely exposed to it. This is where I get frustrated. While I can applaud activists who helped convince doctors and the pharmaceutical companies that it was a good idea to remove the thimerosal, I am sickened by the fact that they continue to frighten parents by implying that it is still used.

Today the Los Angeles Times reported that results of a new study demonstrated that when exposed to thimerosal, a specific strain of mice already predisposed to autoimmune diseases*** exhibited autism-like behaviors. Three additional strains of mice without that genetic predisposition did not exhibit any changes after the thimerosal exposure. This study is fascinating because it reinforces the theory that there is likely a genetic predisposition to autism and that environmental factors could influence the onset of autism among those predisposed.

The study may help deepen our understanding of autism and related disorders and I hope it will lead to additional research. Unfortunately, rather than being seen as a data point for understanding a complex issue, anti-vaccination advocates will tout the study as conclusive and use it to push a social and political agenda challenging universal immunization efforts. Case in point, mercola.com’s headline for the story reads: Thimerosal in Childhood Vaccines Increases Risk of Autism-Like Damage.

This headline is an is a classic example of how those opposed to U.S. immunization policies routinely mislead parents to believe that vaccines are more harmful than the diseases they were designed to prevent. These deceptive practices are the latest addition to the long line of my pet peeves.

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*Commonly used injectable-flu vaccines have thimerosal. Also, while thimerosal is no longer an active ingredient in the vaccines, trace amounts may be present as a result of the production process. Check out the FDA chart detailing amounts present.

**It is important to stress that the mercury in fish (methylmercury) and the mercury in thimerosal (ethylmercury) are NOT the same thing. Check out the CDC’s Web site for more information. While there is significant documentation of the harms of the methylmercury found in fish, there is not a body of evidence indicating harms directly related to ethylmercury.

***Autism is not an autoimmune disease, but some research suggests that those with family history of autoimmune disorders may be predisposed to autism.

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