Healthy Living: A Shot or Not
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This uncertainty has led to an increasingly pitched battle within the autism community itself—those who blame vaccines versus those who believe the focus on vaccines has led to a counterproductive “hijacking” of autism research. In the latter camp is Michael J. Carley, executive director of the Global and Regional Aspberger Syndrome Partnership (GRASP), who was diagnosed with Aspberger’s at 36 in 2001, the same day as his then 4-year-old son. Not only does he believe autism is “primarily genetic,” he says, “Even if all this nonsense about vaccines were true, the language that’s being used leaves GRASP’s audience feeling as though we’re all chemical accidents. And it signifies a belief on the part of these parents that their real child is not the one who’s before them—that they have to find a way to ‘cure’ that child.”
Stagliano outright rejects the genetics argument, laughing off a study, published in the journal Pediatrics, which suggested that having babies close together in time might increase the risk of autism (“I mean, what about twins? Are you kidding me?”), and is not alarmed by the fact that measles outbreaks in the U.S. are occurring more frequently, fueled by parents fear of giving their children the MMR (“The Brady Bunch had measles—I’ll take measles any day of the week over autism”).
What she’d like to see is a research study that would compare groups of unvaccinated children to vaccinated ones, to see which group develops more cases of autism. “I bet a lot of parents would volunteer for that,” she says, unconcerned that what she’s proposing violates at least one principle of reputable scientific research—that subject groups must be randomized, not to mention that a study structured to deny a large population of people protection from potentially deadly diseases would be unethical. “It’s also not ethical to mandate vaccines when the question isn’t answered as to whether they’re safe for your individual child,” she counters.
Some worry that this kind of vaccine paranoia has become so immune to reason and scientific data that it’s almost a religion. Seth Kalichman, assistant professor of psychology at the University of Connecticut in Storrs and author of Denying AIDS: Conspiracy Theories, Pseudoscience and Human Tragedy, sees it as another form of “denialism”—much like global warming, Holocaust and evolution denial—fueled by junk science, conspiracy theories and pseudoexperts, as well as an antiauthoritarian refutation of true experts (Age of Autism, which is notably filled with ad hominem attacks on vaccine experts and advocates like the Children’s Hospital of Philadelphia’s Paul Offit and impassioned defenses of Wakefield, certainly seems to fit the bill). “I think it’s a mental-health issue,” he says. “Certainly, dealing with autism is incredibly devastating—I’ve worked with some of these families—and faced with the responsibility and uncertainty of it all, anyone would experience denial. But what we’re seeing here is a perpetual state of denial.”
Connecticut doctors in the trenches are well-accustomed to dealing with patient anxiety over the “individual” safety of vaccines. One strategy some of them use with parents concerned about “vaccine overload” is to follow a lengthier alternative schedule to the CDC protocol, as laid out by Southern California pediatrician Bob Sears in his compendium The Vaccine Book: Making the Right Decision for Your Child. While researchers have pointed out that there’s no advantage to Sears’ schedule—“All it does is leave children susceptible to infectious disease for longer periods of time,” says Novella—and it requires a greater number of doctor visits to complete, East Hartford pediatrician Larry Scherzer finds it useful in winning patients’ trust. “To me, the issue is getting the vaccines done,” he says. “If that means parents want to come in every month, that’s fine with me.”
Efforts to improve and monitor vaccines are being made all the time. Eric Secor, a naturopathic doctor and research fellow at the UConn Health Center in Farmington’s Center for Integrative Immunology and Vaccine Research, is currently looking at the potential of bromelain—a pineapple enzyme often used as a natural anti-inflammatory—as an effective adjuvant. “One of the controversies surrounding vaccines is whether the adjuvants we use, like aluminum hydroxide, predispose people to asthma,” he says. “Certain botanical products might work as effectively without producing worrisome side effects.”
Meanwhile, Yale School of Medicine’s Eugene Shapiro, professor of pediatrics, epidemiology and investigative medicine, and Marietta Vazquez, assistant professor of pediatrics, have focused on evaluating the effectiveness of vaccines in clinical practice. One ongoing area of research concerns the varicella, or chicken pox vaccine; recently, they published a study in the Journal of Infectious Diseases demonstrating that two doses, as currently recommended by the CDC, really are better than one. “While the first dose is 85 percent effective, later on vaccinated children may still experience outbreaks—which, while mild, can spread the disease,” says Shapiro. “The two-dose regimen raises the efficacy of the vaccine to 98 percent.”
As our vaccination options grow, even vaccine proponents wonder if we aren’t going too far. Waterbury pediatrician Diane Fountas suggests that, perhaps, the drive to vaccinate has become more a matter of “business” than care. Hers is “a ‘must-vaccinate’ office,” she says, that gives no quarter to the paranoia surrounding the MMR or influenza vaccines, but she admits she questions certain newer vaccine recommendations by the CDC—particularly the one concerning the double-shot of varicella (her practice has participated in Shapiro’s and Vazquez’s research). What particularly concerns her is the development of shingles she’s noticed—a consequence of chicken pox more often seen in later life—in a couple of her young, two-dose varicella recipients.
“I believe that vaccines are one of the few things in medicine that have made a difference in people’s lives,” she says. “But to me, the reason to vaccinate is to prevent permanent disability and death. Chicken pox is a nuisance illness, and the single shot seems to be eradicating the toughest aspects of it. I think medicine sometimes gets carried away with ‘good’ initiatives, until it becomes apparent we have to pull back. It’s like antibiotics: They’re truly wonderful, but overuse of them is not good for your body. There’s no question in my mind that vaccines are safe. But are they always what’s best for someone?”