Dr. Price’s Medical Note of the Month-Autism and Children’s Vaccine-still puzzling?

One of the joys of being a Family Physician is I have the opportunity to care for the entire family. With this, I care for many babies and children in my practice, giving physicals, providing school vaccinations, and seeing them when sick. So, of course, the conversation arises often of potential side effects of vaccines, and the most recent concern is that of Autism. It’s a difficult and passionate debate to have, and I try to present the information that I know and come to an agreement with the parents of my patients. I’ll try to briefly explain where the debate comes from below.

Autism is a devastatingly difficult mental condition that affects approximately 1 in 150 children per year in the United States (stats from www.cdc.gov). It is a puzzling condition for all involved, including the families and caretakers of these children. In fact, if you see the ribbon magnets on the cars of people that advocate research for Autism, it’s in the form of a jigsaw puzzle.

I believe that puzzle represents both the variety of signs and symptoms that can occur with this condition and the controversial factors and arguments that surround the causes and treatment of the condition. Autism is described as a “spectrum disorder” in that it breaks down into 5 different types and can vary from minimal to severe ranges of effects on the human brain and psyche. These types include autistic disorder, Asperger disorder, disintegrative disorder, Rett disorder, and pervasive developmental disorder. Studies haven’t shown a clear cause yet, although a genetic link has been found. Autism in general is usually diagnosed by age 3years old and is 4 times more prevalent in boys than in girls. It spans all socioeconomic and racial lines, and lasts a lifetime for both the patients and their families.

And so begins the debate-There has been a lot of controversy surrounding vaccines and Autism. You’ve probably seen or heard the story of actress, Jenny McCarthy, whose son was diagnosed with Autism and her concern with the administration of shots containing the preservative, thimerosal. The vaccine containing antibodies for measles, mumps, and rubella (MMR) is one vaccine that has received the most blame in the argued link. The MMR shot is given at age 12months during a well child physical, and now recently, is repeated at age 4-6years old for kindergarten physicals. As mentioned above, most children are diagnosed with Autism around age 2 or 3 years old. Until 2001, thimerosal was used as a preservative for many vaccines, and it is a mercury-containing chemical. After Jenny McCarthy’s story came out, many parents became worried about the effects of this ingredient and how it might affect their children.

I have had this conversation with some parents in my practice and what we discuss is the following. Studies were done and reviewed on thimerosal by the Institute of Medicine. None showed conclusive evidence that the chemical caused Autism. However, even with these favorable studies, after 2001, levels of mercury and thimerosal were reduced if not taken out of most vaccines altogether.

Because we still don’t know for sure what the etiology of Autism is, the best screening tool we have is the monitoring of development of speech and social interaction by parents at home, along with routine well child physicals done with medical professionals. The discussion of vaccines and possible side effects likely will continue for a while between doctors and patients, particularly about Autism. But, it’s a healthy one to be had, as we continue looking for the key and solution to this huge puzzle.

Be healthy and be blessed,Dr. Price

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