Working Nurse

The number of newly diagnosed cases of autism continues to rise while researchers strive to find the cause. Described as a spectrum disorder, autism includes victims severely disabled as well as those who can be described as highly intelligent. What they all have in common
is a combination of three traits. They may have a defect in social behavior with an inability to hold eye gaze; a defect in language or no language ability at all; and an increase in repetitive stereotyped behavior, such as flapping or other forms of self-stimulation.

Some autism advocacy groups have long held that one cause of autism is the vaccinations required for school entry. In the United States, children are vaccinated against at least nine, and in some cases many more, diseases, with immunization beginning as early as birth or six weeks of age. Immunization for some diseases requires multiple doses, with boosters given after a period of years.

Autism advocates point out that, in many cases, patient development may have progressed normally until the age of about two, with regression seeming to follow the vaccinations given at that age. Initially, some autism advocates thought that the cause might be the trace amounts of thimerosal mercury used as a preservative in some vaccines. Since 2001, all thimerosal has been removed from childhood vaccines with no appreciable decrease in the rate of autism. It is the same rate found in other countries where thimerosal continues to be used.

In fact, a recent study done at the University of Rochester and published in the February issue of the journal Pediatrics showed that babies expel thimerosal mercury faster than was previously thought, giving them little opportunity to build up to a toxic level. They actually expel thimerosal mercury 10 times faster than methyl mercury, the type associated with eating contaminated fish.

Is There a Genetic Component?

Scientists believe that there are probably a number of factors relating to the causes of autism, but studies of twins show that genes may play a major role. In May, it was reported in the Journal of Medical Genetics that a gene called contactin 4 is responsible for making proper network connections within the brain. Each child should have two copies of the gene, but disruption could account for as many as 2.5 percent of the autism cases, a significant number according to study leader Dr. Eli Hatchwell of Stony Brook University Medical Center in New York. However, he states that there are most certainly additional causes.

Another gene, identified by researchers at Johns Hopkins University School of Medicine and the University of Illinois at Chicago, is discussed in an online version of the American Journal of Human Genetics. That gene plays an important role in brain development and places infants at increased risk when inherited through the mother.

A teleconference by the Center for Disease Control was held in March in response to media questioning the recent announcement of a settlement reached by a federal vaccine compensation court awarded to Hannah Poling. Hannah’s father, Dr. Jon Poling, was a neurology resident at Johns Hopkins Hospital in 2000 when she received five shots against nine infectious diseases. She suffered a fever two days later and then behavioral regression, eventually receiving a diagnosis of autism.

Or Is It the Vaccine?

Intensive subsequent testing found that she had a disorder of the mitochondria not thought to be caused by vaccines. These are a group of genetic disorders involving disturbed functioning of the mitochondria or “powerhouse of the cells.” When children with these disorders suffer stress, they are unable to meet the energy needs of the developing brain and suffer regression of neurological abilities. These disorders are technically very difficulty to diagnose and scientists are still unsure of the prevalence in the population.

Dr. Thomas Iselin of the National Institute of Mental Health participated in the March teleconference about vaccine safety. He stated, “There are some forms of autism that will occur as part of other…genetic diseases; fragile x, tuberous sclerosis. And there are a few that have autism as part of an overall syndrome. And there are some cases of autism in which we find genetic lesions. But, in fact, most cases are probably due to both genetic and environmental factors.”

Knowing that some vaccines can prompt a high-fever response leaves some parents uneasy about vaccinating their children, and many now claim exemption from the law. Nationwide, 90 percent of those children eligible for vaccination receive their shots. All states allow medical exemptions for those children with medical certification that they could be harmed by vaccines. Some states also allow religious exemption, but now 20 states allow some kind of personal exemption. Fear of autism may fall into that category, and public health officials fear that as rates of immunization fall, diseases once almost extinct will once again surface, causing significant outbreaks.

When most people are immunized, it is the non-vaccinated population at risk of developing disease. These same children, should they get the disease, can then present a very real risk to those who have been vaccinated, because even vaccination doesn’t provide 100 percent immunity to all diseases. Some serum may have been improperly stored, given inaccurately, or some individuals may not produce a vigorous enough antibody response. Babies under six weeks are generally too young to receive vaccination, and live vaccines like MMR and Varivax are not given until the age of 12 months. While circulating maternal antibodies may provide some protection, there remains a long period of possible exposure. Recent outbreaks in American cities of measles, mumps, varicella and pertussis prove that significant risk of disease remains.

Public health officials point to the fact that childhood diseases are nearly a thing of the past. Immunization is one of the greatest health initiatives of the last century and a hallmark of developed nations. Even so, some parents may well remain wary until it can be proved to them that their child will not suffer neurological damage in the quest of the common good.

Christine Contillo, RN, BSN, has worked as a nurse since 1979 and has written extensively for various nursing publications, as well as The New York Times.

4 COMMENTS

• Marie

  I think the jury is still out and it is a risk, especially for kids who are vulnerable. I know several whose children became Autistic right after the same vaccination. Based on what I was taught regarding the function of the immune system, we're not letting it do what it was designed to do in the way it was designed to do it. I chose not to vaccinate my kids after my son was born premature and my husband's family is plagued with immune system problems. (They received more than the average vaccinations going back and forth to Korea when they were children.) Both my kids are strong and healthy even when I was working as a school nurse and pediatrics they rarely went to the doctor's office. Because of our lifestyle and education choices, I think they have a greater risk of a reaction than they do of getting any of the illnesses prevented by the vaccinations. But that's not to say for others it would be different, so in my opinion individual circumstances should be considered before making the decision to vaccinate. Children and their bodies are all different; parents should know their kids and family histories so they can choose wisely when it comes to vaccinations. Now the next article should be about whether or not parents should have a choice. Obviously, I think they should.

  Sep 19, 2008

• Victoria

  I have only been a nurse for 5 years but in the 6 years it took me to aquire a degree(part time nights) I worked for a homeopathic doctor. He was well ahead of his time and never recommended vaccinations. I feel very lucky that I had the time at his office and learned many adverse things they teach in allopathic medicine as when I had my own children I was faced with a hard decision to vaccinate or not. I opted to go both they are vaccinated against Hbv and that is all. This disease was the only one that I felt could not be treated if it became serious. As my children become school age I am still shocked at how many parents still believe that vaccinations are the law and not optional. I just hope that research can identify the cause of the rise in autism.

  Sep 02, 2008

• Sandra James

  I have been a nurse for over 18 years, working primarily in a Family Practice office that saw many children for their immunizations. In all of the thousands of immunizations that were administered, there was not one that was traced or linked to a case of autism. My daughter is diagnosed with Asperger's syndrome (High-functioning autism). She received her immunizations on time. Her diagnosis was not made for years later and no significant changes, associated with autism, were apparent for years later. I, too, agree with other nursing colleagues that there is a strong genetic link to this disorder. I can trace similarities of my daughter to her father and his father as well. Here are my two main thoughts: 1) If a vaccine was proven to cause autism, why would the FDA not take it off the market, as they have done with other vaccines? and 2) If parents are now choosing to NOT immunize their children out of "undocumented and supported fear" are they prepared to face the alternative of being responsible if their child develops, suffers from, passes on and possibly dies from our known problem diseases such as Measles, Mumps, Rubella, Diptheria, Pertusses, Tetanus, Polio, Hepaptitis B, and others? I for one get very frustrated with the emotional hype the media tries to create when it has not fully researched and substantiated its claims. Parents are very vulnerable and would do anything to protect their children. However, are we truly protecting them by not vaccinating them? I would say a hearty, NO!

  Sep 02, 2008

• Susan Kay

  I have been a School Nurse doing preschool assessments for Special Education for a major school district in California for over 10 years. I have met and assessed an increasing number of children who either have the diagnosis of Autism or present with autistic-like behaviors. I understand the need for parents to find an answer to their child's devastating disability but I do not believe that immunizations are the cause of Autism. I have assessed children with autism who either did not have any of the immunizations or whose immunizations were stopped for fear of autism which leaves me to believe there is some other cause. The initial immunization study, done in England was flawed but yet it became the "buzz word" for parents of children with autism. I do believe there is a genetic link and perhaps an environmental trigger, as I have seen many families with siblings (and parents) who exhibit a range of similiar behaviors. For parents who have concerns about the scheduled immunizations overwhelming their child's immune system, they should consider requesting single immunizations, although the American Academy of Pediatrics does not recommend this type of scheduling and it means more visits to the pediatrician's office for injections. Research should continue and the pediatric medical community needs to be more vigilant to signs and symptoms of autistic-like behaviors so that early intervention can be offered before it's too late to help the child.

  Aug 28, 2008