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Community Corner

Are So Many Shots for Baby Safe?

Research published this month by the Journal of Pediatrics found no relationship between autism and the increasing number of recommended vaccines. But skeptics still aren't buying it.

For parents concerned about vaccines and the possibility of harm they may do, the newest research tests the “too many, too soon” theory, and encourages us to put it to rest.

Today the central worry questions the large number of vaccines given, and how many are given at one time, especially when they’re being administered to the vulnerable bodies of very young children. The new study, published online April 1 in the Journal of Pediatrics, found no relationship between the increased exposure to vaccines and autism.

As the number of recommended childhood vaccinations has grown over the decades, so have autism spectrum disorder (ASD) diagnoses – and in the public mind, the two have been difficult to separate.

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Fifteen years ago, a now-discredited paper first started the controversy around vaccines and autism. That study described eight children who developed autism after receiving the measles, mumps, rubella (MMR) vaccine. In big scarlet letters, “RETRACTED” now appears across that paper on the website of the prestigious British medical journal, The Lancet, which refuted the paper in 2010. In 2004, the Institute of Medicine (IOM), the health arm of the nonprofit National Academy of Sciences, concluded from its review of evidence that neither the MMR vaccine nor thimerosal, a preservative that is another focus of parents’ concern, causes autism.

Yet about a third of parents still have doubts about vaccine safety, and one survey found that more than 10 percent of parents delay or refuse vaccinations, most of those believing that it’s safer to delay than to administer them according to the Centers for Disease Control and Prevention’s (CDC) schedule. It’s an issue that’s alive and well in our own community, judging from the discussions on GardenMoms, the 8,700-member strong online parenting group in the Boston metro area. Parents asking for doctors who are sympathetic to alternative vaccination schedules will find that commenters in the group can easily provide those referrals. 

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Consider that two-year-olds today should have received a total of about two dozen shots and as many as five jabs in a visit to the doctor’s office, for protection from 13 separate diseases. In comparison, their parents as babies were likely immunized against seven illnesses. We’ve seen eradication of smallpox and we’re oh, so close on polio, thanks to vaccines. Yet with the volumes of anti-vaccine information available to 21st century parents, it’s no surprise that they’re wondering about the wisdom of that difference.

But according to the new research – which was a secondary analysis of existing data on 1,008 children who were born in the years 1994 to ’99 – there was no increased risk of developing autism, as the babies in the study continued to receive vaccinations from birth to two years of age. At three separate age intervals, the study examined each child’s cumulative exposure to antigens– the substances in a vaccine that stimulate antibody production – not just how many shots were received. Researchers also counted how many antigens were given in one day. The paper points out that some of today’s vaccines contain fewer antigens than before: So even though toddlers today receive as many as a total of 315 antigens in all their vaccines, according to current recommendations, that’s fewer than the several thousand antigens that children in the study received, in cruder vaccines that protected against a smaller number of diseases in the 1990s.

But whether this all seems reasonable proof to you partly depends on what side of the debate you’re already on. Outside the dry, lab-coat language of the actual research paper, there’s a fight still raging between the deniers and the perpetrators of junk science, to use a couple of bad names. In the days since the Journal of Pediatrics article was published, critiques have followed which attack the methodology in detail and accuse the researchers of conflict of interest.   

If you’re undecided on this debate, what’s a typical parent to do? When it takes more than your high-school chemistry class and a lot of time and knowledge you don’t have, how are you to judge which side is speaking the truth?

I wish the ivory tower guys who are trying to tell us not to worry about all these shots would just publicly respond and dissect every argument made against their paper, if they are indeed more right than wrong. But these aren’t the first volleys fired in a long battle, and it seems as if they don’t want to dignify their detractors by coming down out of that tower. It’s easier just to come up with a new study once in awhile.

Earlier this year, the IOM released a report that affirmed the overall safety of the federal childhood vaccination schedule. They also think it’s practically impossible to perform randomized controlled trials that would compare the health of vaccinated and unvaccinated (or alternatively vaccinated) children. (That’s the kind of thing that would help quell the doubts of some skeptics who, bottom-line, likely have as much regard for children’s health as their opponents.) However, the report did say that while “studies have repeatedly shown the health benefits associated with the recommended schedule, including fewer illnesses, deaths, and hospital stays … the elements of the schedule – the number, frequency, timing, order, and age at which vaccines are given – are not well-defined in existing research and should be improved.” In other words, no one’s claiming the system is perfect.

Then, in March, the CDC said that parent-reported ASDs for school-aged children is now 1 in 50 kids. It’s a sobering number, but any increase over the well-known "1 in 88" figure is mostly attributed to better counting and more mild cases of ASD being included in the count of a wider age range of kids, not an epidemic of ASD.

The subjects in the study published April 1 were 256 ASD and 752 control children. It wasn’t part of the study design to follow up with the parents of the autistic children and get their reactions to the finding that vaccinations aren’t responsible for ASD. But I’m sure some of those families might remain convinced that vaccination was related to their children’s disorders. And as long as the doubters hold the feet of the conventional medical community to the fire, we can expect more debate on vaccines.

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