By Carol Cole-Frowe
The Norman Transcript
July 23, 2008 11:52 pm
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For pediatrician Dr. Tadgy Stacy, autism is not just a professional issue. It’s a personal one.
Stacy has an autistic nephew.
“And despite that, I immunized my children. My sister continued to immunize my autistic nephew. And I continue to recommend immunizations for all of my patients because I believe that immunizations are safe,” Stacy said. “I think there is good evidence out there that there is no link between autism and vaccines.
Pediatricians are fielding hard questions daily from parents about whether autism could be linked to immunizations. The physicians, as a group, said they feel strongly that there is no evidence of a link. And they are wary of the possible consequences coming from the fear they see in parents who don’t want to immunize their children because of it.
“We are going to see worse disease and childhood deaths, worse than what we already had,” said Dr. Thomas Kuhls, a pediatric infectious disease specialist.
Kuhls said he’s not passionate about immunizations. For Kuhls, it’s more of a scientific decision.
“I give vaccines because it’s the best medicine. It prevents diseases,” he said. “And if the United States stops giving vaccines, we’re going to have the same problems as they have overseas. And it’s happened (already) in small areas in the United States.”
Pediatrician Dr. Victor Wilson said more than half of parents quiz him about immunizations when they come into his office. But only a small minority opt out of having immunizations, after he educates them on the risks of childhood diseases.
“I don’t find it to be a very productive policy,” Wilson said, of some pediatricians’ policies of not seeing patients who don’t get immunizations. “It gives me the opportunity to start working on them. I at least have the opportunity to talk to them.”
He said even when parents opt out of getting immunizations, the vast majority of parents eventually make the decision to have their children immunized. Wilson said with the current climate of some parents becoming afraid to give their children vaccines, it’s a matter of time before there is an outbreak of highly contagious measles. Another threat is pertussis, also known as whooping cough.
“We’ve been very lucky,” said Wilson, about disease outbreaks.
He said it’s extremely unfortunate that some parents are more afraid of the unproven link with autism than they are of the diseases.
Thimerisol, a mercury-based additive formerly blamed for autism, was discontinued in childhood immunizations in 2001. It is still used in some flu vaccines. It has since been discredited as a possible source for autism.
“We haven’t had mercury in vaccine since 2001,” Stacy said. “Argentina still uses thimerisol in their vaccines and they have lower incidences of autism.”
Stacy said she believes the increased autism numbers are a result of better diagnosis.
“In significant part, not because there are more cases of autism, but because we’ve changed the way we evaluate these children and in the way we classify our diagnosis as autistic spectrum disorder,” Stacy said. “For many years, autism was a very narrowly defined diagnosis. And over time, we started including lots of children with developmental disorders that had different labels. And so the term autistic spectrum disorder encompasses a whole host of developmental disorders.”
She said pediatricians have been working hard to identify the children with autism so they can be more aggressive about getting them services.
What the pediatricians said they believe will happen as a result of the current controversy is childhood diseases that can be fatal could come surging back.
That could include measles, with pockets of outbreaks across the country.
Nine states had outbreaks earlier this year, with 64 reported cases between Jan. 1 and April 25 among people from five months old to 71 years old. Fourteen were hospitalized from the outbreaks, although no deaths were reported.
But massive measles outbreaks are still lodged in fairly recent memory, with the last large outbreak in the early 1990s when more than 50,000 were sickened. That resulted in more than 11,000 hospitalizations and 120 deaths.
One out of 17 children with measles gets pneumonia, according to the Centers for Disease Control. For every 1,000 children who get the disease, one or two children will die of it.
Meningitis, swelling of the lining of the brain, can also be contracted by unvaccinated children; also bloodstream infections caused by pneumococcus, deafness caused by mumps and liver cancer caused by hepatitus B virus.
Chickenpox can be serious for children and even more serious for adults. About 50 kids nationally died every year from chicken pox before vaccine was available, with about one in 500 children who got chickenpox hospitalized, according to CDC numbers.
One group of Norman pediatricians, the Norman Pediatric Associates of which Stacy and Kuhls are members, has taken a stronger stand on immunizations.
The NPA physicians, which also includes Dr. Donna Jackson and Dr. Michael Milligan, refuse to accept new patients if parents won’t give the OK for immunizations.
“This office is very passionate about the belief that vaccinations being safe and they are beneficial. And they are necessary to be safe and healthy. Our stance that we choose not to continue to care for children who choose not to get immunizations … is not to be punitive to those families who choose that,” Stacy said. “It’s to protect the other people that are here.”
Jackson said those parents who don’t want to get immunizations have no right to put other children at risk.
“There may be immunodeficient kids in our waiting room. There may be cancer patients,” Jackson said. “All of those are at risk from people who don’t get immunizations. And so we feel like that’s too much of a risk to take.”
Kuhls said the United States has the best system in the world to detect problems with vaccines.
A rare consequence of the first rotavirus vaccine was abdominal blockage and resulted in it quickly being discontinued.
When polio was still a threat, health authorities recommended a change from the oral vaccine, which was a rare cause of paralysis, to the polio shot.
“There really is no evidence at all of any problems,” Kuhls said of vaccines currently being used. He said he’s done extensive research on the subject. “The safety net works.”
Stacy said just because we don’t see those diseases here, doesn’t mean they are not out there.
“We have become more complacent. They are still in the world,” she said. “They are just a plane ride away.”
The pediatricians urge parents wanting to research the issue on the Internet to visit well-researched, well-sourced sites, not the unsubstantiated Web sites that seem to be proliferating.
“I think that there’s been so much misinformation in the media and myths that get perpetuated that families aren’t getting good information and credible sources and places to go,” Stacy said.
Some Web sites they recommended include the Centers for Disease Control, www.cdc.gov/nip; American Academy of Pediatrics, www.aap.org; The Children’s Hospital of Philadelphia, www.vaccine.chop.edu; Immunization Action Coalition, www.immunize.org; and Every Child by Two, www.ecbt.org.
One of the casualties of the controversy is the trust that patients had with their physicians. That trust has been eroded by Internet rumors and the unfounded allegations, Jackson said.
“Why would we give vaccines to someone if we thought they would cause autism,” Stacy said.
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