May 6, 2008 - By Spyros Andreopoulos
A recent outbreak of measles has demonstrated that unvaccinated children can be vulnerable to the virus spread from other countries.
Should parents have their children vaccinated? Decades of research show that vaccines are extremely safe and an inevitable weapon for fighting disease, so the answer should be a clear yes.
But many parents remain confused. Much of the blame lies in reports about the safety of the measles, mumps and rubella vaccine. A vocal group of families and their allies are prolonging uncertainty by continuing to insist that thimerosal, a preservative in vaccines that contains ethyl-mercury, has caused their children autism. California has banned ethyl-mercury in childhood vaccines since 2004.
The group is particularly vociferous at the moment because the U.S. government has agreed to pay a father and a mother from a federal fund that compensates people injured by vaccines. The parents claim that their daughter developed autism as a result of the vaccine. The government said that the daughter suffered from mitochondrial disease, which was a complicating factor, and that the decision to compensate the parents should not be used to draw conclusions that the measles, mumps and rubella vaccine causes autism.
But the anti-vaccination campaigners are using this case as proof to proclaim that the government has finally admitted that vaccines cause autism. Talk radio hosts, some journalists and members of Congress have joined their anti-vaccination cause. And not to be outdone, Sen. John McCain has entered the fray by blaming autism on childhood vaccines, a move that to me indicates his need of a better-informed science adviser.
The Centers for Disease Control and Prevention, the Institute of Medicine and the American Academy of Pediatrics have concluded that the scientific evidence does not support a causal tie between autism and the measles, mumps and rubella vaccine.
That autism is increasing is not a matter of dispute, but scientists believe it is because of better diagnosis and other factors, not because of vaccinations. New research has suggested that heredity and early development as well as parental psychiatric history and socioeconomic status play key roles and increase the risk for autism.
In reality, nothing has changed, and parents have nothing to fear in allowing their children to be vaccinated. Although no medical intervention is without risk, on balance, the record shows that the risk-benefit ratio has been sharply favorable for vaccinated children. But if the anti-vaccine campaigners have their way, the implications for public health are grim.
An example is measles, which has been eliminated in the United States as a result of wide acceptance of the vaccine. A recent outbreak in Indiana demonstrates the vulnerability of unvaccinated youngsters when the virus is introduced from another country. Similarly, a measles outbreak in a London neighborhood with the lowest immunization rates in Britain illustrates how ignorance about the value of vaccinations in children can spread a preventable disease.
Autism is a complex neurological disorder. It affects children in the first few years of life and involves a deficiency of typical social skills and behavior. The disorder is difficult to treat, requires very expensive services and takes a toll on families that become frustrated and an easy prey to costly remedies of quacks and charlatans, and ambulance-chasing lawyers who are in for the buck.
Anti-vaccine activists are doing both harm and a disservice to the families of autistic children by diverting scarce reserves of energy and research funds into the pursuit of implausible theories. Rather than trying to silence the vaccination critics, the medical community needs to put its energy, as the Wall Street Journal has suggested, in convincing these parents to support the funding of legitimate autism research and treatment, not demoralizing our vaccination program.
In the Bay Area, Stanford is affiliated with Lucile Packard Children's Hospital, one of the finest children's hospitals in the nation, and UC-San Francisco is also affiliated with a top-tier children's hospital. I suggest that that they join forces to lead an education campaign about vaccinations and public health. The aim would be to encourage doctors to increase their level of involvement in the effort by listening to parents' concerns; by explaining the benefits of vaccinations and the consequences of childhood infections, and by providing written information to support the measles, mumps and rubella vaccine.
It would be important to the success of the program that doctors acknowledge the adverse publicity about the vaccine and that they avoid being judgmental or coercive by letting parents decide what they feel is best for their child.
About Stanford Medicine
Stanford Medicine is an integrated academic health system comprising the Stanford School of Medicine and adult and pediatric health care delivery systems. Together, they harness the full potential of biomedicine through collaborative research, education and clinical care for patients. For more information, please visit med.stanford.edu.