A sympathetic note to the antivaxxers of the world

3.3.5_vaccination

I have two healthy children who make friends easily and excel at most tasks put before them.  Children with autism may be healthy but life may be anything but easy.  WIth the receipt of any bad news comes different phases of emotion but one common reaction is search for answers.  Today I experienced an exchange of comments on Twitter from someone who disagreed with some comments I made with respect to giving the MMR vaccine.  The gist of it was that they had been the responsible parent, listened to the doctors of the world and given the MMR vaccine only to find out some time later that their child was diagnosed with autism.  I feel for this person and every other parent touched by this diagnosis.  It is devastating and life changing although with time and a lot of work such children can make great strides but sadly not all.

I understand then the fear of receiving such a diagnosis is a compelling reason to avoid getting vaccinated if there is even a chance that your child could develop autism.  You are wanting to protect your child and I commend you for that.  Unfortunately while trying to protect them you are in fact leaving them unprotected and for that matter the rest of the children in your community.  The aruguments against vaccinating with MMR centre around three major arguments. The first is that parents often recall receiving the vaccine shortly before the diagnosis of autism was given, the second that the literature supports that autism is caused by vaccines and the last that when the MMR vaccine was brought into existence autism rates started to rise.  Below I will address each point with factual information that I hope in some way will make an impact on those who hold onto the beliefs which is all they are that their child developed autism due to the vaccine.

Timing of the vaccine

Definition of autism (from Wikipedia):Autism is a neurodevelopmental disorder characterized by impaired social interactionverbal and non-verbal communication, and restricted and repetitive behavior. Parents usually notice signs in the first two years of their child’s life.[2] The signs typically develop gradually, but some children with autism will reach their developmental milestones at a normal pace and then regress.

Under a year of age language is fairly limited.  Social interaction, language and repetitive behaviours are typically noted after the first year of life.  Given the timing of the diagnosis and the provision of MMR at a year of age it is no wonder that parents will attribute the vaccine to the diagnosis.  Let’s think about this though for a minute.  What is happening here is confirmation bias.  As a parent you have heard that MMR can cause autism although thankfully it is quite rare but when you get the diagnosis you immediately jump to the conclusion that this is the true cause.  What you have is an association and nothing more but your mind has convinced you otherwise.  It equally could have been the new cookie you gave your child that month, the fumes from the car in a traffic jam or any other possible influence or it could be that it was always going to happen but as humans we need to make sense of things.  Its in our genes but it causes us to make a dangerous link that to be frank just doesn’t exist.

Autism is caused by the MMR vaccine

This argument centres around a extremely well cited paper that has been refuted. Andrew Wakefield published a link between autism and the MMR vaccine that set the world on fire.  The paper though was shown to be fraudulent and has been the subject of many publications since. retraction: http://bit.ly/1wb3Xjn

 Let’s think about this for a second.  What if this paper had never been published in the first place?  A link between vaccines and autism would not have been put in the minds of people such as Jenny McCarthy and other people outspoken against vaccines (she has since softened her stance).  In fact most people would not have even thought of such a link.  In essence the argument would not have even been present in pop culture and the wave of anti-vax literature would not exist.  Those young people who weren’t alive in the 1970s which is the time of our last point would not even be aware of the argument.  So the question is, if the lie had never been told would we even need to write pieces like this today?  Hard to believe people stand on an argument that was never meant to be in the first place.  To put it another way, if I published a paper that I confirmed a sample from the moon contained cheese and it spread throughout the media outlets of the world, if it was refuted would anyone actually cite it?  The fact is these people who are either scared of vaccines or have a child with autism need something to hang onto and this is it.

Autism rates increased after MMR came along

Again this is an association that people have attributed to be causative.  For a wonderful explanation of this phenomenon in the 1970s please read the article at this link: http://1.usa.gov/1MajxDf

Autism diagnoses did in fact rise but that had more to do with a change in the way doctors classified autism than any external factor.

What all three points have in common is that we as parents need to find order where there is disorder.  We also have the same drive as physicians to do no harm.  It is compelling and strong in all of us.  Each and every person who writes anti-vax literature I believe is not out to harm us but they truly believe that the reading they have done or the simple beliefs they have are the right ones.

What I ask is that people read a blog such as this and open themselves up to a paradigm shift.  If you can read what I have written and convert your thinking to one where you realize that all you have believed was based on poor information and switch to one in which your drive is protect your child by immunizing them your children and our children will all be better for it.

A word of caution about Kristin Bell's recent statement on pro-vaccination

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What?!  A doctor speaking out against pro-vaccination?  No I haven’t switched to the other side but a recent headline caught my eye due to its potential to create a social crisis.

Imagine you have just had a baby and friends of yours who you know have not vaccinated her children want to come by for a visit. (see link)  Do you freak out and deny them entry as Kristin Bell would suggest or do you ask a few questions (more delicately than “do your children have measles” and allow the visit to happen?

It seemed like a good opportunity to calm people’s nerves by reminding them of why it is that your Pediatrician will not offer the MMR vaccine prior to the age of 1 year.  If you have been vaccinated as a child then you generally will have lifelong immunity to measles.  The Centre For Disease Control claims that the immunity is 95% after one dose and virtually 100% after the booster dose to measles, mumps and rubella.  If the vaccine though is so effective why not give it before a year to protect your vulnerable infant? The answer lies in the natural immunity that is passed from mother to fetus in the form of IgG antibodies that cross the placenta.  These antibodies offer protection to the fetus and then newborn and may circulate in the infants bloodstream until 1 year of age.  In essence your infant is protected from measles by virtue of your parents being sensible and vaccinating you when you were a child.  The benefits of breastfeeding by passing on further antibody protection are additive (see link)!

So before anyone accuses me of being careless let me restate that I would not expose my own child under a year of age to a child that was suspected of having measles but I often worry about the effect of one celebrity sharing information such as this and the social isolation that may ensue for those parents who choose for whatever reason not to immunize.  Let us also not forget that there are legitimate reasons for not immunizing your children and should these children be ostracized?

Links:

http://www.huffingtonpost.com/2015/02/17/kristen-bell-vaccinations_n_6699368.html

http://www.ncbi.nlm.nih.gov/pubmed/19133867