Should My Kid Get Vaccinated
Although the American Academy of Pediatrics, the Centers for Disease Control and Prevention, and many other reputable organizations agree that vaccines do not cause autism, there are still small but vocal groups who believe they do. And amid that conflicting information, some parents might opt not get their children vaccinated“just to be safe,” because they worry about other possible reactions, or because of religious or other beliefs.
“But if you choose not to vaccinate your child, you are increasing his risk of contracting serious diseases that can lead to complications, hospitalization, and even death,” says Dr. Fombonne. For example, after the MMR vaccine was first linked to autism in England, many parents stopped vaccinating their childrenand several children died during a measles outbreak in Ireland soon afterward. And a recent measles outbreak in the United States has infected hundreds of people.
For all the major childhood vaccinations , most experts agree that the many, many benefits from getting vaccinated far outweigh any possible side effects or risks.
Thimerosal And Autism: What’s The Link
Thimerosal was removed from most vaccines by 2001 . That’s because researchers worried that children were being exposed to too-high levels from receiving multiple vaccinations in a short timeframe. This decision was based on what levels were considered safe for methyl mercurythe kind in fish, which is structurally very different from the ethyl mercury found in thimerosal. Although scientists suspected that thimerosal was much safer than methyl mercury, they decided to remove it anyway, just to be super-careful.
However, a large study published in Archives of General Psychiatry in 2008 found that cases of autism continued to increase in California long after 2001, when thimerosal was removed from most vaccines. “If thimerosal in vaccines were causing autism, we’d expect that diagnoses of autism would decrease dramatically after the chemical was removed from vaccines,” says Eric Fombonne, M.D., director of the psychiatry division at Montreal Children’s Hospital and a member of the National Institutes of Health advisory board for autism research programs. “Not only did cases not decrease, but they continued to rise. That tells us that something else must be responsible for rising rates of autism in this country.”
A series of many studies in other countries and populations drew similar conclusions. “Thimerosal was removed from vaccines in Canada in 1996 and in Denmark in 1992,” says Dr. Fombonne. “Autism is still on the rise in those countries as well.”
Are Vaccines Linked To Autism
The topic of childhood vaccines leading to autism spectrum disorder is one that never seems to fades away.
Concerns about vaccines leading to autism surfaced in 1999 and initially involved the measles, mumps and rubella vaccine.
Because the MMR vaccine is usually given at age 12 to 15 months, and the first signs of autism often appear at this time, concerns were raised about a link between the MMR vaccine and the development of autism.
The Centers for Disease Control and Prevention has conducted 9 studies that have found no association between thimerosal-containing vaccines and ASD, or between the measles, mumps, and rubella vaccine and ASD in children.
In 2019, in the largest study ever published on this topic, investigators found no evidence that the measles, mumps and rubella vaccine causes autism when looking at over 650,000 Danish children. This result held true even when researchers focused on children at greater risk for developing autism. The results were published in the Annals of Internal Medicine.
Unfortunately researchers are skeptical the new data will change the mind of so-called “anti-vaxxers”. However, they feel the large study might provide reassurance to certain parents who are willing to listen to science.
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Academy Experts Offer Advice For Fps
March 18, 2020 10:01 am — Understandably, news headlines around the country — and, indeed, around the globe — are currently being dominated by the coronavirus disease 2019 pandemic, and the AAFP has been leading the charge to keep family physicians up to date with the latest COVID-19 developments.
It’s critical to remember, though, that outbreaks of infectious diseases such as influenza and measles continue — and that although a vaccine for coronavirus is still a year or more away, vaccines for other known preventable diseases already exist and are readily available.
Unfortunately, as the results of a recent Gallup survey indicate, public support for vaccines continues to trend in the wrong direction. The survey found that fewer people today say it’s important for parents to get their children vaccinated than in 2001, while more people now think that vaccines cause autism in children and are more dangerous than the diseases they are designed to prevent.
The Danger Of Medical Myths
People want and need to be able to make informed decisions about their own health care and the health care of their family. And when armed with the correct, science-based information, people can make very effective health decisions for themselves and their loved ones.
Other vaccine myths have cropped up as well.
One myth is that we dont need to vaccinate against diseases that are no longer endemic. But the only time we can safely stop using a vaccine is when a disease is eradicated worldwide. So far, thats only happened with smallpox.
Other people have raised fears that vaccines weaken the immune system and that natural immunity is better. However, thats not the case. Vaccines strengthen the immune system by providing a challenge to the immune system against a very particular antigen or group of antigens.
Medical myths are not benign. They have the potential to do the most harm.
People want and need to be able to make informed decisions about their health care and the health care of their families. When armed with the correct, science-based information, people can make very effective health decisions for themselves and their loved ones.
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Is Thimerosal Still Found In Vaccines
Thimerosal has been removed or reduced to trace amounts in most vaccines, with the exception of the multi-dose vial of the seasonal flu shot. Thimerosal is added to multi-dose vials to help prevent overgrowth of bacteria.
For parents who prefer, preservative-free versions of the flu shot are available all you have to do is request it from your doctor or pharmacist. You may need to check with your insurance first to be sure they’ll pay for the preservative-free form.
Thimerosal used to be found in the hepatitis B, Haemophilus influenzae type B and diphtheria, tetanus, and pertussis vaccines, among others. The U.S. Food and Drug Administration has worked with vaccine manufacturers to eliminate thimerosal from vaccines recommended for children 6 years and younger. In many common childhood vaccines, thimerosol was never present.
Thimerosal is not present in any COVID vaccine issued for emergency use authorization in the U.S. To see a full list of ingredients for COVID-19 vaccines in the U.S., follow this link.
At this time, the only COVID-19 vaccine authorized for use in children is the Pfizer-BioNTech vaccine, and it is only used in children 16 years or older. Studies in younger populations are ongoing.
What Are The Most Common Risk Factors For Autism
ASD occurs among all racial, ethnic, and socioeconomic groups.
Common risk factors for autism spectrum disorder include:
- Having a twin with ASD, or other family history.
- Boys are about 4 times more likely to develop ASD than girls.
- Parents who have had a child with ASD have a 2% to 18% chance of having another child with the disorder.
- Children born to older parents also seem to have a higher risk, but more research is necessary.
- About 10% of children with autism also have certain genetic disorders like Rett Syndrome or fragile X syndrome, or tuberous sclerosis, where benign tumors develop in the brain.
- Preterm babies born before 26 weeks of gestation may have an elevated risk of autism spectrum disorder.
- Over 80% of children diagnosed with ASD also have a psychiatric, neurologic, chromosomal, or genetic diagnosis.
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Myth #: Vaccines Cause Autism
The widespread fear that vaccines increase risk of autism originated with a 1997 study published by Andrew Wakefield, a British surgeon. The article was published in The Lancet, a prestigious medical journal, suggesting that the measles, mumps, rubella vaccine was increasing autism in British children.
The paper has since been completely discredited due to serious procedural errors, undisclosed financial conflicts of interest, and ethical violations. Andrew Wakefield lost his medical license and the paper was retracted from The Lancet.
Nonetheless, the hypothesis was taken seriously, and several other major studies were conducted. None of them found a link between any vaccine and the likelihood of developing autism.
Structural Abnormalities Of The Nervous System
Toxic or viral insults to the fetus that cause autism, as well as certain central nervous system disorders associated with autism, support the notion that autism is likely to occur in the womb. For example, children exposed to thalidomide during the first or early second trimester were found to have an increased incidence of autism. Thalidomide was a medication that used to be prescribed to pregnant women to treat nausea. However, autism occurred in children with ear, but not arm or leg, abnormalities. Because ears develop before 24 days gestation, and arms and legs develop after 24 days gestation, the risk period for autism following receipt of thalidomide must have been before 24 days gestation. In support of this finding, Rodier and colleagues found evidence for structural abnormalities of the nervous system in children with autism. These abnormalities could only have occurred during development of the nervous system in the womb.
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How Can A Caregiver Prepare Their Loved One With Autism For The Covid
Many people with ASD have already faced isolation, changes to their routines, and disruptions to their therapeutic care and education, says Banks. The process of getting a vaccination poses an added challenge, especially since many times the shots arent being given in a typical doctors office setting. Depending on where you live, getting a vaccine might mean going to a large stadium or convention center.
For some people with autism, experiences that are outside a typical daily routine can be upsetting, Banks explains. Theyll need to be introduced to the idea that they’re going to drive somewhere in their car, roll down their window, and somebody in medical equipment gear a face mask, shield, and gloves is going to give them an inoculation.
Hendrens advice: Depending on the person with ASDs ability to understand and express language, caregivers should try to explain the reason for the shot what will happen, step-by-step and perhaps even do a practice run with the person with ASD with the caregiver providing the example of what to expect.
The Autism Society of America has published visual explainers on its website that may be received and understood well by someone with autism. You can download them and show them to your loved one in preparation for COVID-19 vaccines, testing, and more.
What About All Vaccinations Combined
Researchers have also looked to see if all the vaccines required before age 2 somehow together triggered autism. Children receive 25 shots in the first 15 months of life. Some people feared that getting all those shots so early in life could lead to the development of autism, but there is no evidence that this is true.
But the CDC compared groups of children who received vaccines on the recommended schedule and those whose vaccines were delayed or didnât get them at all. There was no difference in the autism rate between the two groups.
In 2004, the Immunization Safety Review Committee of the Institute of Medicine published a report on the topic. The group looked at all the studies on vaccines and autism, both published and unpublished. It released a 200-page report stating there was no evidence to support a link between vaccines and autism.
Still, studies continue to look at the issue. In 2019, the largest study to date looked at almost 660-thousand children over a course of 11 years and found no link between the vaccine and autism.
Indian Journal of Psychiatry: âThe MMR Vaccine and Autism: Sensation, Refutation, Retraction, and Fraud.â
Offit, P., and Moser, C., Vaccines and Your Child: Separating Fact from Fiction, Columbia University Press, 2011.
American Journal of Medical Genetics: âComorbidity of Intellectual Disability Confounds Ascertainment of Autism: Implications for Genetic Diagnosis.â
BMJ: âHow the Case Against the MMR Vaccine Was Fixed.â
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Vaccine Experts Share Perspective
AAFP News asked Madalyn Schaefgen, M.D., of Allentown, Pa., a 2019-2020 AAFP Vaccine Science Fellow, and John Epling Jr., M.D. M.S.Ed., professor and medical director of research in the Department of Family and Community Medicine at Virginia Tech Carilion School of Medicine in Roanoke, member of the CDC’s Advisory Committee on Immunization Practices, and a 2011-2012 AAFP Vaccine Science Fellow, to comment on the survey’s findings. They share their reactions and provide useful information on educating patients about vaccinations in the following Q& A.
AAFP News: What was your first impression after reading the survey results?
John Epling: The important thing to keep in mind is that most Americans agree that vaccination is very important. However, some of our neighbors and friends are not as sure about vaccines as they used to be, so I think we can all do more to discuss this important issue and try to find and spread the correct information about vaccines.
Madalyn Schaefgen: I was surprised that 46% of Americans are still unsure as to whether vaccines can cause autism despite multiple studies with thousands of participants proving that this is not the case.
AAFP News: The percentage of people who said they had heard about the possible disadvantages of vaccinations for children more than doubled between 2001 and 2019. Where do you think this information is coming from?
AAFP News: What role can FPs play in educating parents about the importance of childhood vaccinations?
Timing Of First Symptoms
Using a sophisticated movement analysis, videos from children eventually diagnosed with autism or not diagnosed with autism were coded and evaluated for their capacity to predict autism. Children who were eventually diagnosed with autism were predicted from movies taken in early infancy. This study supported the hypothesis that very subtle symptoms of autism are present in early infancy and argues strongly against vaccines as a cause of autism.
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Is There A Link Between Covid
No, says Halladay. But an infection of any kind in the mother during pregnancy has been linked to a greater risk of ASD in children another incentive to be vaccinated, she says.
Halladay points to a study of U.S. participants published in Autism Research in October 2019, which found that maternal infection that included fever in the second trimester of pregnancy was associated with a twofold risk of ASD in children. A Swedish longitudinal study published that same year in JAMA Psychiatry found that fetal exposure to maternal infection was linked to a greater risk of an autism diagnosis in children. For many reasons, you do not want to get very sick from COVID-19 or any other type of infection when you are pregnant.
Is Vaccination Opposition New
Vaccination opposition isnt a new concept. As long as there have been vaccines, there have been people who objected to them.
Refusing vaccines started back in the early 1800s when the smallpox vaccine started being used in large numbers. The idea of injecting someone with a part of a cowpox blister to protect them from smallpox faced a lot of criticism. The criticism was based on sanitary, religious, and political objections. Some clergy believed that the vaccine went against their religion.
In the 1970s, the DTP vaccine received a wave of opposition when it was linked to neurological disorders. have found that the risks are very low.
To combat vaccination opposition, laws have been passed that require vaccinations as a measure of public health.
There are a variety of reasons behind vaccine opposition. Some people have to forgo different vaccinations due to a high risk of potential allergic reactions. But for most who refuse vaccines it should be known that there is little risk.
There are some common reasons that lead to vaccine opposition. Some cite religious beliefs as the reason behind their refusal to get vaccinated, though most mainstream religions do not condemn vaccines.
There was a belief that diseases were disappearing due to better sanitation and hygiene, not vaccines. This has been proven false by the resurgence of previously eradicated infectious diseases.
The most common reasons that parents oppose vaccinations are medically unfounded. These include:
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Problems With Herd Immunity
Parents who have relied on herd immunity, which takes place when the vast majority of a population is immune to a highly contagious disease like measles, can no longer do so.
To the parents who don’t trust the AAP, saying it is in the pockets of the vaccine industry, consider this. Of all the medical societies, it is the one which consistently lobbies for the benefit of moneyless patients: children. It doesn’t lobby for the pediatricians. Like child psychologists and psychiatrists, pediatricians have the best interests of the child, not the vaccine company, at heart. The huge amount of time they spend trying to convince parents to have their children vaccinated is unreimbursed. The amount they are paid for administering a vaccine is negligible.
Even Autism Speaks, a well-known autism advocacy group which in the past has not helped encourage vaccinations, in 2015 urged parents to vaccinate their children with MMR. Over the last two decades, extensive research has asked whether there is any link between childhood vaccinations and autism, said Bob Ring, Chief Science Officer, in a statement at that time. The results of this research are clear: Vaccines do not cause autism. We urge that all children be fully vaccinated.