Vaccine fears
Recently our office like many other primary care offices have been seeing more and more parents refusing to allow their children to receive the recommended vaccinations because of fears particularly related to autism.
In our science minded culture, there is ample evidence that contradicts the relationship between autism and immunizations, but this is overcome by fears, hearsay and inaccurate information.
The Centers for Disease Control devotes a lot of time and energy on this topic because of the significant public health concerns. They along with several other institutions of academic excellence all have valuable information listed at the sites below:
[NIP: Vacsafe/Concerns/Autism/FAQs-Autism and MMR]
http://www.immunizationinfo.org/search_results.cfv?search=autism
http://www.pkids.org/index2.htm
http://www.chop.edu/consumer/jsp/microsite/microsite.jsp?id=75918
[NIP: Vacsafe/Concerns/Autism/Research-Vaccines and Autism]
[NIP: Data & Stats/Main page]
Many parents as well as physicians in this generation have never seen a case of measles, mumps, rubella, or pertussis. But those of us who have can verify the severity of the diseases and associated complications.
The fact that many have never had first hand experience with these diseases has led to complacency and allowed unsubstantiated fears to overcome better judgment.
Here are some statistics:
Diphtheria
Diphtheria is a serious disease caused by a bacteria. This germ produces a poisonous substance or toxin which frequently causes heart and nerve problems. The death rate is 5 percent to 10 percent, with higher death rates (up to 20 percent) in the very young and the elderly. In the 1920's, diphtheria was a major cause of illness and death for children in the U.S. In 1921, a total of 206,000 cases and 15,520 deaths were reported. In 2001 only two cases were reported.
Mumps
Before the mumps vaccine was introduced, mumps was a major cause of deafness in children, occurring in approximately 1 in 20,000 reported cases. Serious side effects of mumps are more common among adults than children. Swelling of the testes is the most common side effect in males past the age of puberty, occurring in up to 20 percent to 50 percent of men who contract mumps. An increase in miscarriages has been found among women who develop mumps during the first trimester of pregnancy. An estimated 212,000 cases of mumps occurred in the U.S. in 1964. If we were to stop vaccination against mumps, we could expect the number of cases to climb back to pre-vaccine levels, since mumps is easily spread among unvaccinated persons
Pertussis
Pertussis can be a severe illness, resulting in prolonged coughing spells that can last for many weeks. These spells can make it difficult for a child to eat, drink, and breathe. Because vomiting often occurs after a coughing spell, infants may lose weight and become dehydrated. In infants, it can also cause pneumonia and lead to brain damage, seizures, and mental retardation. Before pertussis immunizations were available, nearly all children developed whooping cough. In the U.S., prior to pertussis immunization, between 150,000 and 260,000 cases of pertussis were reported each year, with up to 9,000 pertussis-related deaths. Pertussis cases occur throughout the world. If we stopped pertussis immunizations in the U.S., we would experience a massive resurgence of pertussis disease. A recent study* found that, in eight countries where immunization coverage was reduced, incidence rates of pertussis surged to 10 to 100 times the rates in countries where vaccination rates were sustained.
*Reference for study: Gangarosa EJ, et al. Impact of anti-vaccine movements on pertussis control: the untold story. Lancet 1998;351:356-61.
Measles
In the U.S., up to 20 percent of persons with measles are hospitalized. Pneumonia is present in about six percent of cases and accounts for most of the measles deaths. Although less common, some persons with measles develop encephalitis (swelling of the lining of the brain), resulting in brain damage. As many as three of every 1,000 persons with measles will die in the U.S. In the developing world, the rate is much higher, with death occurring in about one of every 100 persons with measles. If vaccinations were stopped, each year about 2.7 million measles deaths worldwide could be expected.
Polio
Polio virus causes acute paralysis that can lead to permanent physical disability and even death. Before polio vaccine was available, 13,000 to 20,000 cases of paralytic polio were reported each year in the United States. These annual epidemics of polio often left thousands of victims--mostly children--in braces, crutches, wheelchairs, and iron lungs. The effects were life-long.
Haemophilus
Before Hib vaccine became available, Hib was the most common cause of bacterial meningitis in U.S. infants and children. Before the vaccine was developed, there were approximately 20,000 invasive Hib cases annually. Approximately two-thirds of the 20,000 cases were meningitis, and one-third were other life-threatening invasive Hib diseases such as bacteria in the blood, pneumonia, or inflammation of the epiglottis. Hib meningitis once killed 600 children each year and left many survivors with deafness, seizures, or mental retardation. Since introduction of conjugate Hib vaccine in December 1987, the incidence of Hib has declined by 98 percent. From 1994-1998, fewer than 10 fatal cases of invasive Hib disease were reported each year.
Traffic Accidents
Traffic accident deaths account for 41% of all accidental deaths in children. In the US, an average of 6 children 0-14 years old were killed and 694 injured every day in motor vehicle crashes. Traffic accidents are the leading cause of accidental deaths in children. How many parents allow there children to ride in cars?
Fires
Fires kill more than 600 children ages 14 and under each year and injure approximately 47,000 other children. How many of families keep and maintain smoke detectors in their homes and keep fire hazards away from children?
Drownings
In 2003, there were 3,306 unintentional fatal drownings in the United States, averaging nine people per day. This figure does not include drownings in boating-related incidents (CDC 2005). 67% of all drowning deaths occur in their own backyard pool, spa or hot tub. The majority of drowning incidents occur while the caretaker assumed the child was safely indoors. For every drowning, an additional five near drowning cases are treated in the emergency room. Irreversible brain damage occurs in 3 to 5 minutes. How many have swimming pools in their backyards or neighborhoods?
CDC Statements on Autism
It is not known how many children in the United States currently have autism or a related disorder. Studies done in Europe and Asia indicate as many as 2 out of every 1,000 children have some type of autism.
A recent investigation by CDC in Brick Township, New Jersey, found a prevalence rate for the autism of 4.0 per 1,000 children and a rate of 6.7 per 1,000 children for the more broadly defined category of autistic spectrum disorders. Although the rates obtained in Brick are high compared to other published reports, it is important to keep in mind that there are no current rates for autism from the United States.
Furthermore, investigators in other countries who used intense case finding methods in small communities are finding rates of autism in the range of those found in Brick Township. The interpretation of the results from the Brick prevalence investigation will not be fully understood until additional prevalence rates have been obtained from other communities and compared to those in Brick Township.
CDC runs the Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP), one of the few programs in the world that conducts active and ongoing monitoring of the number of children with developmental disabilities in the multiracial Atlanta area. CDC added autism to the program in 1998 and anticipates having prevalence rates for autism in the fall of 2000.
Autism is a spectrum of disorders that are complex and lifelong. Individuals with autism have problems with social interaction, communication difficulties, and restrictive or repetitive interests/behaviors. Autism Spectrum Disorders (ASD) includes autistic disorder, pervasive developmental disorder - not otherwise specified (also known as atypical autism), and Asperger’s disorder as defined by the American Psychiatric Association’s Diagnostic and Statistical Manual - Fourth Edition (DSM-IV).
Children with autism require long-term care and services. Special education costs for a child with autism are more than $8,000 per year, with some specially structured programs costing about $30,000, and care in a residential school costing $80,000 - $100,000 per year.
Little is known about causes of autism, although genetic and early prenatal exposures have been suggested. There is no cure for autism. However, early and intensive education can help children develop skills and reach their potential. Although available medicines cannot cure autism, some may relieve symptoms associated with the disorders.
Summary
While, it is clear that more children than ever before are being classified as having an Autism Spectrum Disorder, it is unclear how much of this increase is due to changes in how we identify and classify ASDs in people, or whether this is due to a true increase in prevalence.
Autism is real and for those affected it can be devastating. But to allow a resurgence of these other diseases is not a good choice when the current evidence does not substantiate the fears.
In our science minded culture, there is ample evidence that contradicts the relationship between autism and immunizations, but this is overcome by fears, hearsay and inaccurate information.
The Centers for Disease Control devotes a lot of time and energy on this topic because of the significant public health concerns. They along with several other institutions of academic excellence all have valuable information listed at the sites below:
[NIP: Vacsafe/Concerns/Autism/FAQs-Autism and MMR]
http://www.immunizationinfo.org/search_results.cfv?search=autism
http://www.pkids.org/index2.htm
http://www.chop.edu/consumer/jsp/microsite/microsite.jsp?id=75918
[NIP: Vacsafe/Concerns/Autism/Research-Vaccines and Autism]
[NIP: Data & Stats/Main page]
Many parents as well as physicians in this generation have never seen a case of measles, mumps, rubella, or pertussis. But those of us who have can verify the severity of the diseases and associated complications.
The fact that many have never had first hand experience with these diseases has led to complacency and allowed unsubstantiated fears to overcome better judgment.
Here are some statistics:
Diphtheria
Diphtheria is a serious disease caused by a bacteria. This germ produces a poisonous substance or toxin which frequently causes heart and nerve problems. The death rate is 5 percent to 10 percent, with higher death rates (up to 20 percent) in the very young and the elderly. In the 1920's, diphtheria was a major cause of illness and death for children in the U.S. In 1921, a total of 206,000 cases and 15,520 deaths were reported. In 2001 only two cases were reported.
Mumps
Before the mumps vaccine was introduced, mumps was a major cause of deafness in children, occurring in approximately 1 in 20,000 reported cases. Serious side effects of mumps are more common among adults than children. Swelling of the testes is the most common side effect in males past the age of puberty, occurring in up to 20 percent to 50 percent of men who contract mumps. An increase in miscarriages has been found among women who develop mumps during the first trimester of pregnancy. An estimated 212,000 cases of mumps occurred in the U.S. in 1964. If we were to stop vaccination against mumps, we could expect the number of cases to climb back to pre-vaccine levels, since mumps is easily spread among unvaccinated persons
Pertussis
Pertussis can be a severe illness, resulting in prolonged coughing spells that can last for many weeks. These spells can make it difficult for a child to eat, drink, and breathe. Because vomiting often occurs after a coughing spell, infants may lose weight and become dehydrated. In infants, it can also cause pneumonia and lead to brain damage, seizures, and mental retardation. Before pertussis immunizations were available, nearly all children developed whooping cough. In the U.S., prior to pertussis immunization, between 150,000 and 260,000 cases of pertussis were reported each year, with up to 9,000 pertussis-related deaths. Pertussis cases occur throughout the world. If we stopped pertussis immunizations in the U.S., we would experience a massive resurgence of pertussis disease. A recent study* found that, in eight countries where immunization coverage was reduced, incidence rates of pertussis surged to 10 to 100 times the rates in countries where vaccination rates were sustained.
*Reference for study: Gangarosa EJ, et al. Impact of anti-vaccine movements on pertussis control: the untold story. Lancet 1998;351:356-61.
Measles
In the U.S., up to 20 percent of persons with measles are hospitalized. Pneumonia is present in about six percent of cases and accounts for most of the measles deaths. Although less common, some persons with measles develop encephalitis (swelling of the lining of the brain), resulting in brain damage. As many as three of every 1,000 persons with measles will die in the U.S. In the developing world, the rate is much higher, with death occurring in about one of every 100 persons with measles. If vaccinations were stopped, each year about 2.7 million measles deaths worldwide could be expected.
Polio
Polio virus causes acute paralysis that can lead to permanent physical disability and even death. Before polio vaccine was available, 13,000 to 20,000 cases of paralytic polio were reported each year in the United States. These annual epidemics of polio often left thousands of victims--mostly children--in braces, crutches, wheelchairs, and iron lungs. The effects were life-long.
Haemophilus
Before Hib vaccine became available, Hib was the most common cause of bacterial meningitis in U.S. infants and children. Before the vaccine was developed, there were approximately 20,000 invasive Hib cases annually. Approximately two-thirds of the 20,000 cases were meningitis, and one-third were other life-threatening invasive Hib diseases such as bacteria in the blood, pneumonia, or inflammation of the epiglottis. Hib meningitis once killed 600 children each year and left many survivors with deafness, seizures, or mental retardation. Since introduction of conjugate Hib vaccine in December 1987, the incidence of Hib has declined by 98 percent. From 1994-1998, fewer than 10 fatal cases of invasive Hib disease were reported each year.
Traffic Accidents
Traffic accident deaths account for 41% of all accidental deaths in children. In the US, an average of 6 children 0-14 years old were killed and 694 injured every day in motor vehicle crashes. Traffic accidents are the leading cause of accidental deaths in children. How many parents allow there children to ride in cars?
Fires
Fires kill more than 600 children ages 14 and under each year and injure approximately 47,000 other children. How many of families keep and maintain smoke detectors in their homes and keep fire hazards away from children?
Drownings
In 2003, there were 3,306 unintentional fatal drownings in the United States, averaging nine people per day. This figure does not include drownings in boating-related incidents (CDC 2005). 67% of all drowning deaths occur in their own backyard pool, spa or hot tub. The majority of drowning incidents occur while the caretaker assumed the child was safely indoors. For every drowning, an additional five near drowning cases are treated in the emergency room. Irreversible brain damage occurs in 3 to 5 minutes. How many have swimming pools in their backyards or neighborhoods?
CDC Statements on Autism
It is not known how many children in the United States currently have autism or a related disorder. Studies done in Europe and Asia indicate as many as 2 out of every 1,000 children have some type of autism.
A recent investigation by CDC in Brick Township, New Jersey, found a prevalence rate for the autism of 4.0 per 1,000 children and a rate of 6.7 per 1,000 children for the more broadly defined category of autistic spectrum disorders. Although the rates obtained in Brick are high compared to other published reports, it is important to keep in mind that there are no current rates for autism from the United States.
Furthermore, investigators in other countries who used intense case finding methods in small communities are finding rates of autism in the range of those found in Brick Township. The interpretation of the results from the Brick prevalence investigation will not be fully understood until additional prevalence rates have been obtained from other communities and compared to those in Brick Township.
CDC runs the Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP), one of the few programs in the world that conducts active and ongoing monitoring of the number of children with developmental disabilities in the multiracial Atlanta area. CDC added autism to the program in 1998 and anticipates having prevalence rates for autism in the fall of 2000.
Autism is a spectrum of disorders that are complex and lifelong. Individuals with autism have problems with social interaction, communication difficulties, and restrictive or repetitive interests/behaviors. Autism Spectrum Disorders (ASD) includes autistic disorder, pervasive developmental disorder - not otherwise specified (also known as atypical autism), and Asperger’s disorder as defined by the American Psychiatric Association’s Diagnostic and Statistical Manual - Fourth Edition (DSM-IV).
Children with autism require long-term care and services. Special education costs for a child with autism are more than $8,000 per year, with some specially structured programs costing about $30,000, and care in a residential school costing $80,000 - $100,000 per year.
Little is known about causes of autism, although genetic and early prenatal exposures have been suggested. There is no cure for autism. However, early and intensive education can help children develop skills and reach their potential. Although available medicines cannot cure autism, some may relieve symptoms associated with the disorders.
Summary
While, it is clear that more children than ever before are being classified as having an Autism Spectrum Disorder, it is unclear how much of this increase is due to changes in how we identify and classify ASDs in people, or whether this is due to a true increase in prevalence.
Autism is real and for those affected it can be devastating. But to allow a resurgence of these other diseases is not a good choice when the current evidence does not substantiate the fears.
Information sources: CDC, NIH
posted by Anonymous at 6:25 AM
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