Immunization (Vaccination) – My opinion
There is little doubt in my mind that vaccination can serve as a trigger for autism spectrum disorders in genetically predisposed individuals, in the context of additional as yet undefined environmental factors. Unfortunately, mainstream medicine continues to deny a link between vaccination and autism spectrum disorders. This is due to (1) lack of clear delineation of the precise genetic polymorphisms which predispose certain children, (2) lack of precise understanding of the environmental factors which increase the likelihood of developing autism spectrum disorders, and (3) lack of an association between immunization and autism spectrum disorder in clinical trials. As a result of lack of data, and in part due to misinformation, the decision as to whether or not to vaccinate ones child becomes an emotional issue for some.
Immunization is based on the principle of stimulating the immune system by administering a tiny amount of a substance which in an active or larger quantity would cause disease. Homeopathy is based on the same general principle. Nothing in life is risk free, and that includes immunizations. Unfortunately, some of the risks of immunization have not been adequately studied. When the medical profession discounts the observation of a parent whose child has become ill after an immunization, this can lead to polarization, which is counterproductive.
A premise of “alternative medicine” is that an anomaly repeatedly observed is not necessarily an aberration, but rather an important observation which demands further study. Historically, many of the advances in medicine have arisen from observations. Centuries ago, long before bacteria and viruses could actually be identified, the germ theory of disease was formulated based upon observations. More recently, individuals with myofascial pain were considered for years to be hypochondriacs, since their description of the pain did not match scientific understanding of neuroanatomy. Eventually the observation led to the discovery that pain can “travel” along fascial planes in the body, and this led to a form of therapy, myofascial therapy, which helps some suffering from myofascial pain syndrome.
While it is reassuring that recent large, rigorous medical trials have failed to show an association between immunization and neurodevelopmental abnormalities, the observation that some children become ill after an immunization and sometimes are subsequently diagnosed with autism requires further study. If 1% of children have a genetic polymorphism such that they react differently at a biochemical level to an immunization, this could explain the observations of some parents regarding the sudden onset of illness in their child following an immunization. A large, population-based, randomized, controlled trial is the wrong methodology for evaluating the possibility that a small percentage of the population is uniquely sensitive to a specific immunization. The scientific methodology I believe is required is intensive investigation of the individual who becomes ill after an immunization, searching for abnormalities of immune system function, inflammation, oxidative stress and/or gastrointestinal function. The adoption of this type of scientific approach likely would reduce the polarization which currently characterizes the debate over immunization. Hopefully, visionary researchers will pursue this type of novel research.
Thimerosal, which has been removed from all vaccines except multi-dose vials of influenza vaccine, is not the only potential culprit. There are other preservatives in vaccines which conceivably could trigger illness in genetically predisposed individuals. It might not even be a preservative that causes problems in a few susceptible individuals; it may be that a temporary disruption of a delicate balance between cell mediated immunity and humoral immunity somehow triggers illness.
In the meantime, each of us needs to make decisions regarding immunization in the face of some uncertainty. The parents currently making decisions about immunization of their children are of a generation which has not personally experienced the death of a loved one from measles, diphtheria or other “vaccine-preventable” diseases. This significantly shifts the perception of risk versus benefit. We need to acknowledge this. Perception of risk of adverse effects of vaccination is magnified when benefit is not readily apparent.
Statistics show that the annual death rate from measles prior to widespread immunization was 500,000 deaths per year! Measles vaccine is statistically effective at preventing measles in only approximately 95% of recipients. When community protection against measles falls below 94% (and this means a 99% vaccination rate, due to the 5% failure rate with this vaccine) there is a risk of measles outbreaks. As long as the community protection rate for measles is greater than 94%, a phenomenon referred to as “herd immunity” protects the few individuals who are not immune. If a very small number in society decide against immunization of their children, those children will be protected by herd immunity. However, when larger numbers decide against immunization, individual decisions, when viewed in aggregate, create a situation in which society is at risk. Each individual decision not to immunize a healthy child with the measles vaccine contributes to a lower community immunization rate. This places not only your healthy child at risk, but also places your neighbor’s chronically ill child at a high risk of disease or death.
It is imperative for parents to consider this societal risk when making individual decisions about immunization. The societal risk is real. In England, after publication of a scientific paper suggesting that MMR vaccine might cause autism, immunization rates dropped substantially, and 5 years later the number of reported cases of measles skyrocketed, as did the number of deaths from measles.
For those with concerns about immunization, the schedule suggested in a book written by Dr Robert Sears, a pediatrician, offers a compromise between forgoing vaccination for ones children and giving multiple vaccines at one time. The book is entitled The Vaccine Book: Making the Right Decision for Your Child.
About the author: Dr Levy is Board Certified in Internal Medicine and Integrative Holistic Medicine. His two children have had all of their childhood immunizations. Dr Levy publishes an educational web site, www.buffalo.edu/~shlevy/ which includes a ‘page’ on ‘Immunization’ facts and figures on the potential benefit of various vaccines.
[Updated January 7, 2012] [Return to Home Page]