Dr. Bob Sears, Author of "The Vaccine Book": If A Vaccine/Autism Link is Proven, Will Vaccine Policy Change?

[neonds13]

June 01, 2009

Dr. Bob Sears, Author of "The Vaccine Book": If A Vaccine/Autism Link is Proven, Will Vaccine Policy Change?

Managing Editor's Note: You can purchase a copy of The Vaccine Book by Dr. Bob Sears HERE.  Thanks to Dr. Sears for sharing this discussion with our Age of Autism readers. KS 

By Dr. Bob Sears

This may sound like a rhetorical question, but I submit that the answer isn't going to be as clear cut as one might believe.  Before I dive into my opinion on this, allow me to introduce myself (for those of you who don't know me).  I'm a pediatrician, a DAN doctor, and a writer.  I've been researching vaccines for about 15 years now.  While I'm not anti-vaccine, I do acknowledge there are problems with our current vaccine system, there are potential very serious side effects, and I view the decision that some parents make to not vaccinate their babies as an understandable choice.  I have always openly accepted such patients into my practice and have never come down on such parents.  I believe parents should be well informed about vaccine risks versus benefits before they vaccinate.  You are probably wondering, "Why the preface?"  Is it because there's going to be some sort of "But" that I'm going to write about and I feel I have to soften the blow or butter you up a bit before I say something you aren't going to like?  Maybe.  I'll let you decide. 

As the autism epidemic continues to rage on, everyone is searching for a cause or causes.  Many parents and some medical professionals believe there is already enough evidence to show a link between vaccines and autism, and they are calling for a change, even a halt, in vaccine protocol.  They hope and pray that someday mainstream research will give them vindication and make a clear declaration that "vaccines cause autism."  Not that this would help any children who have already been affected (except for easing the financial burden these families have to endure), but it would bring peace and closure to families who have been trying to find why their child regressed into autism.  And it would help protect future children.  For many parents, such a ruling would also create renewed anger and a demand for accountability.  Is such a day ever going to come?  It may or may not.  That's not the purpose of my discussion here.  The question that I want to address is this:  If a link is proven, will the routine use of vaccinations change dramatically?  I actually don't think it will.  Now, should it change?  Yes.  But will it?  I'm not so sure.  And before you get angry at me for making sure an outrageous suggestion, allow me to explain my reasoning.  If you still doubt my prediction at the end, I look forward to your responses. 

Most doctors believe that the disease-preventing (and therefore life-saving) value of vaccines is so all-encompassing, that they are willing to accept some drawbacks, such as the very occasional severe, life-threatening, or even fatal, reaction (and some still live in denial that such reactions are even possible).  Some doctors would even be willing to accept the occasional case of autism (if such a connection were proven) in the interest of disease prevention for the nation's children.  This mindset would make any parent whose child suffered such a reaction very angry.  But let's explore what most doctors believe could happen if we stopped vaccinating all babies.  Right now there are five childhood diseases that kill infants:  Pertussis (whooping cough) kills about 20 babies each year, Rotavirus (vomiting, diarrhea, and dehydration) about 50, HIB meningitis kills around 10, Pneumococcal disease approximately several hundred (precise numbers aren't known), and the flu kills around 100 infants and young kids each year.  Those are just the most serious diseases.  And these numbers are probably this low because most parents vaccinate.  What would these numbers look like if we didn't? 

There are also some diseases that are usually harmless for most people, or extremely rare.  Measles almost never kills anyone, but that's because there are only about 150 cases each year in the U.S.  How many would die if measles ran rampant?  Chickenpox used to kill about 50 people each year, and now it only kills around 5 because the disease is disappearing.  Mumps and Rubella don't kill and are very rare, but they can cause the occasional complication.  Hepatitis A (food poisoning) doesn't kill.  Hepatitis B (an STD) isn't an infant or childhood diseases, but does kill many adults each year.  And finally, Polio hasn't existed in the U.S. for almost 30 years now, but we'd sure like to keep it that way.  Meningococcal disease (a type of meningitis that we vaccinate teens for) kills about 300 kids and teens and HPV disease causes thousands of cervical cancer deaths each year, but these are teenage vaccines and not something parents would consider for a young baby or child.  The medical community is so afraid of regressing to the days when these diseases were an everyday part of American life (and death), that halting the vaccine system just wouldn't be viewed as an option (although I hope and pray that individual parents will continue to have the option to choose for their own children).  

Vaccines and disease prevention is so ingrained into our nation's healthcare policy that I really don't think the government's answer is going to be to stop vaccinating, or even alter the schedule to any significant degree, if a definite link to autism is found.  The very thought of stopping routine vaccines in all children would give most doctors a heart attack.  Infectious disease specialists and public health officials would probably have a stroke right before their coronary.  And the stockholders of the pharmaceutical companies?  Well, they can probably afford to have their bodies cryo-preserved right before their own attacks, so they'll be alright.  Although I poke fun, this is a fairly accurate assessment of how the medical community would react if anyone tried to put a halt to vaccinations. 

(Allow me to pause briefly to remind you that this isn't what I'm saying should be done, I'm just predicting what will be done.  So don't shoot the messenger.  I would also mention that while I am writing statements such as "if" and "when" medical research concludes that vaccines do cause autism, many of you who are reading this are of the opinion that research has already proven exactly that, and you may be annoyed with me for suggesting otherwise.  I would ask you to remember that the mainstream medical community doesn't see it that way.  I know there is some research that shows there is a connection, but the majority of research that is being published, read by mainstream doctors, and trusted by our nation's healthcare policymakers, shows there is no connection.  And lastly, I know that some people believe vaccines don't even work and don't buy into the idea that the disease numbers I quote are so low because of vaccines, but again, I am just presenting the mainstream medical viewpoint here.  If you are still angry with me, read the preface again, then come on back and read some more.)

So, how will the government and medical community react if a link between vaccines and autism is proven?  I predict that what they will conclude in their research is that yes, vaccines can cause autism, but they will find that it seems to only happen to a small percentage of children with some sort of genetic and autoimmune susceptibility to vaccine chemicals and germ ingredients.  The focus will then become (and somewhat already is) to determine how to screen every newborn baby to figure out which ones have such susceptibility.  We would then vaccinate such babies more carefully (or perhaps not at all, at the parent's discretion).  I also think that vaccine manufacturers would also begin studying other ways to make vaccines that limit or remove such risks, even for susceptible individuals, so that even they can get vaccinated (because, after all, everyone must get their shots, right?).  But research like that takes decades.  And there's no way the medical community is going to stop vaccinating in the meantime. 

The U.S. Vaccine court has already determined that such a rare susceptibility to autism is possible.  Although the court said "no" to the 5000 Omnibus families who claimed thimerosal and/or the MMR vaccine caused their childrens' autism, two cases have come to light in the past two years in which the vaccine court did find that vaccines caused "autism" in two children.  In the case of Hannah Poling, it ruled that vaccines caused her to become very ill and develop autistic-like symptoms due to an underlying and previously unapparent mitochondrial disorder.  Everyone then tried to discount the autism-vaccine connection by saying "autistic-like" is completely different than actual autism.  The court also ruled last year that Bailey Bank's Acute Demyelinating Encephalomyelitis (latin for brain inflammation and nerve degeneration/dysfunction) and decline into PDD-NOS was also caused by vaccines.  But that's not autism either (insert sarcastic tone of voice here).  So, while the court is saying no to autism and vaccines in general, they are allowing for the possibility that, in some susceptible individuals, vaccines could trigger a child to develop autistic symptoms. 

But many parents, and some researchers, believe that vaccine susceptibility isn't a rare condition.  However, those who are trying to prove a link between vaccines and autism are fighting an uphill battle.  Here is why:  Most medical research is supposed to begin on neutral ground, then study a subject to determine a yes, no, or we-don't-know answer to a hypothesis.  Well, when the autism/vaccine debate first came to light in the 90s, virtually every doctor and health care official said, "No way!  Impossible.  There is no way vaccines could possibly cause autism."  I've actually been to medical meetings where doctors sit around and laugh, literally laugh, at the very idea.  Seeing that made me embarrassed to be a doctor.  I always took the position, "Well, how do we really know until we study it?"  But the medical community doesn't think that way.  Standard operating procedure is to assume vaccines are safe, unless someone finds and proves a problem with one.  And vaccine safety research is designed to look for noticeable immediate side effects that cause significant harm.  Long-term safety research isn't nearly as thorough.  As long as initial safety studies don't yield any immediate problems, the vaccine is released to the public.  And it stays there unless a major problem is then proven.  In essence, vaccines are assumed safe unless proven otherwise.  I don't mean to bash the vaccine safety research system, because they do try to be as thorough as possible.  But it isn't a perfect system, and it could be better. 

So, the burden of proof is put on trying to find that vaccines do cause autism.  Researchers and the vaccine manufacturers don't have to try to prove that they don't, because it is already assumed that they don't. Plus, virtually all doctors already passed judgment on this idea back in the 90s before any research began.  So, in order to convince the medical community, research would have to shift the thinking of an entire nation of doctors from a "No way" mindset to at least a neutral mindset of "We don't know - we better research it," and then eventually to a "Yes, vaccines can cause autism" belief.  This task is much more difficult than if everyone had started off neutral on the whole idea in the first place.  Now, about 15 years after the debate began, the vast majority of research has failed to prove a link.  Yes, there is some research that has found otherwise, but that's in the minority.  I know that many parents feel that there is already enough proof, but when you line up all the research side by side, the "nays" have it for now according to the mainstream medical establishment.

Meanwhile, as this battle rages on, 5 million babies are born each year in the U.S., and 33,000 of them are destined for autism (1 in 150).  Since we don't yet have valid screening tests, should parents just accept that risk without at least thinking about it?  If there is a connection to vaccines, is that simply an unavoidable risk that every parent has to take?  Or is there a way to lower the theoretical vaccine-autism risk?  What can parents do today in light of all the uncertainty and debate?  Well, not vaccinating is certainly an option, although a parent would have to feel comfortable with the disease risk.  And if too many parents make that decision, we could see many diseases increase.  Another way to approach vaccines would be to only vaccinate against diseases that are potentially fatal to infants and young children, like HIB and PC meningitis, whooping cough, rotavirus, and the flu, but delay vaccines for diseases that don't pose much risk to babies.  Hepatitis B (a sexually-transmitted disease) could easily be delayed until a child is at least a few years old.  Polio, although very serious, doesn't exist in the U.S., so a baby could go for a year or two without it.  The MMR?  Parents could delay it at least until their child is a few years old and past the age of regressive autism.  Hepatitis A vaccine could easily be put off for a few years, since it's a harmless disease for young kids.  Chickenpox could be delayed until school age, if you don't mind your child catching it (some parents actually want their kids to catch it while young). 

That's what I do in my office, and what I promote in my vaccine writing and speaking.  I offer parents a way to vaccinate that spreads the shots out, limits vaccines to two-at-a-time instead of the usual 6, concentrates on the more important ones first, and delays some less important vaccines until a baby is a little older.  I believe this approach reduces the risks of a vaccine reaction, but if a reaction does occur, it's easy to determine which vaccine was the culprit (which is impossible to do if you've given a baby 6 shots at once).  I also watch very carefully for mild to moderate reactions and take them seriously.  I don't like to repeat any shots that a baby doesn't seem to handle well.  Parents who are concerned about autism, but want to vaccinate, can consider using an approach such as mine.  It's not easy to find a doctor who will work with you to do this, but if it's important to you, keep looking.  The AAP doesn't like doctors offering alternative vaccine schedules, so most doctors are hesitant to do so.  But in my opinion, us doctors are here to serve parents (not the other way around, although I've heard in the old days it used to be that way).  I think parents have the right to vaccinate in any way they choose, and it's up to the doctor to work with them to find a vaccine approach they are comfortable with.  I have over 100 doctors nationwide registered on my Vaccine Friendly Doctor's List who feel the way I do about vaccines and are willing to offer options, or are willing to happily provide healthcare for families who choose not to vaccinate (HERE).  There may be one on the list near you, so check it out. 

Here is what I think every new parent with a new baby needs to think about:

1. If you have a family history of autism or severe autoimmune disease, you need to approach vaccines very carefully.

2. Realize that severe reactions CAN happen.  They may not be common, and there hasn't been enough research to determine just how common they are, but they can occur. 

3. Understand that there is disease risk as well.  Several hundred infants die each year of what should be vaccine-preventable diseases. 

4. If you do vaccinate, consider doing so using an alternative vaccine schedule that spreads the shots out.  I've provided a couple of suggested schedules in my writing.  Also consider delaying vaccines if you feel comfortable with disease risk.

5. Although some doctors are studying ways to pre-screen newborns for genetic or immune susceptibilities to vaccine reactions, no one really yet knows how to accurately screen out all such babies or exactly what types of screening tests are a useful predictor of vaccine susceptibility.  Hopefully this technology will become available soon.

6. Do I think that all parents should stop vaccinating, or delay all shots for a couple years, until more research is done?  Parents certainly have the right to do so.  I don't take a position on what parents should or shouldn't do, except that I insist they educate themselves first. 

The vaccine/autism debate isn't over (despite the U.S. Omnibus Vaccine court ruling), and research will continue.  We need to find the cause (or causes) of autism, and we need to find a way to screen babies for genetic and immune susceptibilities.  What types of changes in vaccine policy might occur if a link is proven, only time will tell.  But I don't think the government will ever bring the vaccine system to a halt.  Changes in the schedule may occur, possibly similar to what I propose can be done now, and this may help limit vaccine risk.  But if any parents are hoping for the day when the government admits that vaccines do cause autism and decides to stop recommending them altogether, I don't think that day will ever come. 

Dr. Bob Sears, Pediatrician and author of The Vaccine Book: Making the Right Decision for Your Child, The Vaccine Book.

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[neonds13]

Jun. 4, 2009 at 3:19 AM

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