Dana Salsbury - We're still looking for a vaccine that we feel would do more good than harm and haven't found one yet. It's not about conspiracy fears, but we do recognize the political and economical influences. I don't believe anyone wants to harm children -- it's more like nobody wants to tip the sacred cow, and when someone does, the political machine sets them aside as 'fringe'. It's not that they're 'evil', they just can't/won't swim against the currents that corrupt governments. Pete, you mentioned some fatal diseases; what vaccines would you recommend we reconsider? BTW, I respect and know that physicians work impressively hard to bring aid and care -- far, far more study than I've done.
Melissa Jill :) - Hi Pete - Looks like we're going to have to agree to disagree for now on the vaccine issue. After hearing and reading about case after case of children having severe reactions to vaccines - seizures, gut issues and loss of eye contact/speech - it becomes very hard to trust the medical establishment who ignore the evidence given by parents who are closest to these children and insist that vaccines are safe.
Desiree - Someone once told me that vaccinations are necessary because of polio. I'd rather my child have polio then lose the proper use of their brain. I know folks who've had polio and went on to live, marry, and have children. How many autistic children do you know who have gone on to do these things?
denise karis - this is perfect. this is perfect. this is perfect. i am linking to all three vaccine posts next week!!! Thank you so much!!
Pete - Sorry- one more thing- The Autism Speaks website has some great information addressing all of the things I just talked about (including vaccine safety). This is a very good resource that combines parent advocacy and good scientific literature. It's counterproductive for the group with the most scientific experience (the medical community) and the group with the most passion (the families of children with autism) to butt heads. This website makes a nice bridge. For the vaccine discussion and policy statement of Autism Speaks please see the follwing links: http://www.autismspeaks.org/science/overview/policies/information_about_vaccines_and_autism.php http://blog.autismspeaks.org/2010/03/12/statement-vaccine-court/
Pete - Thanks for the response Melissa- I agree, there should be more collaboration as well as a more robust response from everyone to find the cause(s) and potential therapies for/prevention of autism. To throw vaccines "under the bus" is a bad thing though, since morbidity and mortality in vaccinated kids has dramatically decresaed since the early 1960's. Andrew Wakefield unfortunately has stirred up a hornet's nest in both the professional medical community and autism community; now that his initial work has been retracted I was hoping people would see some of the flaws in his ideas and means of gathering evidence. In response to alumminum and adjuvant safety, the following link is helpful: http://www.immunizationinfo.org/issues/vaccine-components/aluminum-adjuvants-vaccines If it helps, I know many people in the medical community are listening and increasing research in ASD. The last joint session of my specialty (which includes the American Society of Human Genetics and the Society for Inherited Metabolic Disease) devoted a very large part of their meeting this year to ASD, highlighting centers of research excellence across the nation as well as multispecialty discussions regarding patient management. This isn't new- we've been talking about it in every subspecialty from Developmental Peds to Genetics to Neurology for nearly a decade. Research in places like the MIND Institute at UCDavis continue to do pioneering research. With better funding now that there is a national spotlight on the disorder this should only get better. So the way I see it there are 2 issues: first, the need to know more about autism. Without a doubt research, evolution of medical practice, and parent advocacy need to continue to push the boundaries and figure this disease out. Second, there is the issue of vaccine safety and efficacy. This is separate from the first issue, and science has overwhelmingly refuted the link between vaccines and autism. While the immune system may play a role in developing autism there is not evidence to say vaccines cause autism. Modifying the schedule is fine in my mind- more needles for the child, but as long as they get immunized somehow that's ok. The sticky part here comes with timing and opting out of certain ones. Without getting into too much detail some of these illnesses are lethal mainly in younger kids (under 5yo). Things like pertussis don't kill school-age kids, but can cause an infant to stop breathing and die. So while being cautious about when these immunizations are given is fine, delay (in order of months to years) may not be. There are some like Hep B that most young kids won't be at risk for- in this one specifically the CDC recommends getting it early because of the fear of not being able to give it to kids when they'll actually need it (eg when they start having sex at 13 or 14yo and refuse to come see a doctor). Otherwise, for picking and choosing, vaccines like the MMR, DTaP, VZV, HiB, and pneumococcal vaccine in my mind are not optional. These are potentially fatal diseases that are still around (and in some places common) in the US today. You know us well Melissa, and Dawn and I both research everything to death. Granted, as physicians we're bias by what sources we trust and don't trust (that's part of our training). That said, we did not hesitate for a second to vaccinate Elly, and we won't for Russell either when he's born. Thanks for getting this info out there and opening up lines of communication. I'm pretty passionate about it as well, and I don't hear the physician perspective very often, at least not in a straight forward way.
Lanette - First of all I love your photography!! But secondly, thank you for posting things like this. My husband and I have a 3 month old daughter and it's so hard to know what to do when it comes to her vaccinations. At this point she hasn't received any but my husband wants her to be vaccinated and I don't... so it's definitely a point of contention in our house. It's scary what the gov't is asking us to put into their beautiful little bodies and society makes us afraid that something bad will happen to them if we don't. Thank you for raising more awareness on this issue.
Melissa Jill :) - Hi Pete, I appreciate you contributing to the discussion. I value the fact that you are a pediatrician and are willing to engage in this conversation. The reasons I don't trust the CDC and AAP are many and varied. Autism has reached EPIDEMIC levels.  The AAP and CDC have done much more for other diseases at earlier stages.  The level of research being done by government organizations has been delayed and ignored for so long, and the issue isn't getting any better.  Whether the issue is vaccine safety or not, much of the autism community as well as myself are not trusting in the government because they have done little to help. Also, it would be great to see more of a friendship and working relationship between the DAN doctors and the CDC and AAP. I'm sure that would inspire more confidence in the autism community that the heart of the CDC and AAP are in the right place. But the truth is that they have a lot to lose if vaccines are proven to be a cause of autism. I am not advocating against vaccines, but for safer vaccines and vaccine schedules. How would you respond to the fact that there are such high, toxic doses of aluminum still in vaccines? While some parents may choose to not vaccinate, most parents of children with autism understand that vaccines have their place. We all just want the medical community to listen and be willing to respond to our cries for help which is something they have yet to do.
noah worden - Lis, love you lis, Thx, Noah
Eunice - Thank you so much for these! I have several friends that I have referred to your blog as they battle this debate for their own children. As you say, the decision is up to you, but I have encouraged friends to make an informed choice, not an emotional one. I think the information you are putting out there helps them to do that. One thing that I was blown away about was the Hep B vaccine being given to kids. I didn't even get this vaccine until I was headed off to COLLEGE. So why would a child, much less a newborn be getting this? I skipped this one with my daughter and she'll get it when I did - when she's a full grown adult.
Pete - I'm curious, Melissa- You would rather trust an unregulated, unsupervised body of "experts" who may have little more than a bachelor's degree versus several large, well regulated, well respected professional groups because of conspiracy theories about "The Pharmaceutical Industry"? As if some group of drug tycoons are plotting in a dark room "how can we make tons of money AND hurt children? I know, let's bribe a group of professionals with millions of dollars to keep quiet about 'toxins' we're using to make our product." Really? I personally think it is a cop-out to blanketly not trust government or officialy organizations, but be perfectly ok with relying on the truth and efficacy of anectdotes from individuals (with emotions, agendas, and ulterior motives). As a physician it is an insult to the years of work I have put in to take the best care of kids that I know how. I encourage you or anyone else who have question about the AAP to visit their website- they are not part of a government machine, nor do they profit from kickbacks from drug companies (http://www.aap.org/about.html). I know people at the CDC, NIH, and AAP- while not infallible (who is?) they are some of the brightest and most altruistic people I know. They have cummulative decades of education between them, and are doing their best to keep kids safe. Jackie C- there are plenty of threats to kids' health in this country right now. I've seen kids die (right in front of me) from pneumococcal sepsis, pertussis, and hemophilus and there are more and more reports of measles and pertussis outbreaks across the country every year. That's fact... sorry. As a parent it is your decision, but understand that it is a decision. To not vaccinate is an active choice that is (not could be) placing your child at risk.
Jackie C - Thanks so much for the timely blog posts. My husband and I are expecting our first in October and are talking about this right now. We want to not vaccinate at all, and of all the research and reading I've done I can come up with not one good reason to vaccinate a child, other than future overseas travel. From what I can see, the risks and side effects of the vaccines themselves far outweigh the risks and side effects from the actual diseases, many of which are all but nonexistent. I know you're going to talk about this in the next post, but do you have any contacts/resources for "vaccine-friendly" pediatricians in the SF Bay Area? It's tough to find them.
Natalie - What a great post! I just think caution should be the key when considering a vaccination schedule for your children. Although most doctors, like the one who commented here, push a "normal" schedule, there is still so much to learn regarding the causes of autism. All of the recommendations here come from well recognized doctors as well and it doesn't hurt to be extra careful. Also, regarding Andrew Wakefield's study, I haven't seen anything like it out there yet. I would love to see it duplicated by other sources that some would consider more trustworthy. But for now, his study seems inovative and interesting. Although he made some mistakes early in his career, I would think he would need to be extra careful now that he has been scrutinized so much in order to avoid further criticism.
Jennifer - I loved this post. It wasn't 'preachy'. My family has chosen not to vaccinate. I have three children ages 7, 8 and 11 and they rarely get sick. If they get a cold, it lasts for not even 24 hours usually. I am so thankful that our pediatrician understands our wishes, I know so many don't even want to have you as a client unless you vaccinate. Will keep reading each week for sure! :)
Melissa Jill :) - Hi Matt - thanks for your comment. I definitely think it's important to take all research with a grain of salt. Unfortunately, with this complex of a subject, there will likely be no perfect study. And although the thimerosal has been taken out of shots for kids under 2, doctors didn't throw out all the old vaccines but continue to use them until they run out and there is still "trace amounts" of thimerosal in some of the vaccines. Everything I wrote here is backed by good sources including scientists, doctors and parents who are all working hard to understand and find the cause and cure for autism. In addition, I don't trust the FDA, CDC or AAP for various reasons not least of which is that they are more strongly connected to pharmaceutical companies than most research groups are. They are certainly not infallible.
Pete - Sorry- Have to say something. As a pediatrician and a father I have spent considerable thought on childhood vaccinations and autism. While the professional medical community has been widely stigmatized by anti-vaccine groups, the lay public needs to understand vaccine development, safety, and administration have been very well studied. Delaying or refusing vaccination places the responsibility of the childs health squarely on the parent. While anecdotal evidence tells parents it is perfectly safe to do (in fact it would be harmful to do otherwise), there are growing numbers of outbreaks (in the US) of preventable, debilitating, and potentially lethal illnesses because of refusal to vaccinate. If as a parent you are willing to take that chance, based on anecdotal evidence and against long-understood medical evidence, the results and consequences are your responsibility. It is very true, people need to educate themselves on vaccines- As physicians we have been educating ourselves for decades, and the professional opinions of the CDC and American Academy of Pediatrics is that vaccines are safe and effective, and are not linked to autism. This is supported by several recent, large, well performed studies. I know that many of you who read this blog disagree with the above, that is if you read past the first line. Understand that pediatricians like myself want the best for your children, and would never consciously do anything to hurt them. I'm sorry if the above is harsh, but I feel it is based on strong scientific evidence and not saying something would be irresponsible of me.
Mary - Great info, Melissa! Vaccines are definitely not a one size-fits-all.
Kadie Pangburn - This series has been an amazing read Melissa! I just wanted to chime in with your statement at the bottom about abstaining from vaccines all together as living proof it won't kill you. My parents never immunized me and I've never had a shot in my life. And schools sometimes make it a little difficult but if you are firm they can't turn you away for it. I am 24 years old and I've only been "sick" about twice in my life. Once with chicken pox as a child and then freshman year of highschool for about a week with some kind of flu. Other than that I rarely even come down with a cold. So if there is anybody reading this considering not vaccinating there children all together, I just wanted to say that it has given me an amazing healthy life and no to be scared or bullied into something they aren't 100% comfortable with by doctors.
Andrea - I've been reading The Vaccine Book by Dr. Sears and highly recommend it! It gives an unbiased view of vaccines and allows you to formulate your own opinions on things. I did find out that the MMR is only available as a compound here in AZ (annoying!)...so it's probably best to delay that one until at least 2 years old, unless your child has to be in a group childcare setting.
Kim McDowell - This is really scary to read right now having a 3 month old baby girl. All this super huge decisions to make and educate our family on and its in such a short amount of time. In a few weeks her 2nd round of vaccines are coming up and I really need to approaches this with white gloves on!!
Meredith Nelson - Dr. Sears is the best. I always recommend his books to parents who need some guidance. Thanks again Melissa for being a voice!
Matt Bowker - I'm going to take any study that has been touched in any form by Andrew Wakefield with a large grain of salt. In case you haven't heard, his first study "proving" a link between autism and vaccinations was completely and thoroughly debunked and subsequently retracted by the scientific journal which originally published it. Additionally, the study that you've linked to is testing vaccines that contain Thimerosol in them. No vaccines on the standard vaccination schedule for children under 6 have contained Thimerosal since 2001. If you want to write about Autism that's great, I think it's a worthy cause that needs to be investigated, but you need to hold yourself to a higher standard of research. Spreading misinformation is far worse than not saying anything. You can read the FDA's full take on Thimerosal at http://www.fda.gov/biologicsbloodvaccines/safetyavailability/vaccinesafety/ucm096228.htm
audra little - Great information! Thanks for sharing this with everyone! People need to become more educated on vaccines :)