Clear Answers & Smart Advice
About Your Baby’s Shots
By Ari Brown, MD, FAAP
Dr. Brown received her medical degree from Baylor College of Medicine in Houston, Texas; she did her pediatric
residency at Harvard Medical School/Boston Children’s Hospital. In private practice since 1995, Dr. Brown is
perhaps best known as the coauthor of Baby 411: Clear Answers & Smart Advice for Your Baby’s First Year
(Windsor Peak Press).
In response to the recent media attention given to vaccines, autism, and other controversies concerning vaccines,
the Immunization Action Coalition (IAC) has reprinted a special excerpt from Baby 411 that answers these
questions and more. IAC is grateful to Dr. Brown for these clear answers and smart advice, but mostly, we are
grateful for her continued advocacy for safe and effective vaccines.
Vaccines. Autism. Controversy. As a new parent (or parent-
tardation (measured by an IQ score of under 70). Yet, in 2000, that
to-be), it’s hard not to hear the great debate in parenting circles these
number DROPPED to 1 in 83. Why? Were there suddenly much
days—do vaccines cause autism? If not, what causes autism? Why is it
fewer kids with mental retardation? No, many of these kids are now
on the rise? And what is autism anyway?
diagnosed with autism instead of mental retardation.1 In other words,
Let’s start at the beginning—just what is autism?
autistic kids were there in the 80’s and 90’s—we just didn’t call them
What is autism?
In 1991, the Individuals with Disabilities Education Act (IDEA) re-
Autism Spectrum Disorder (ASD) is really a collection of several dis-
quired children with developmental disabilities to receive school ser-
orders that have three abnormal areas in common: social skills, com-
vices and be integrated into a mainstream classroom setting as much
munication skills, and repetitive or obsessive traits. There’s a broad
as possible. Autism was added as a new diagnosis for which a child
range from mildly to severely affected. Specialists use the terms ASD
could be eligible to receive educational services. In 1993, two years
and Pervasive Developmental Disorders (PDD) interchangeably. And,
after this code was added, the Department of Education reported a
to get even more confusing, Asperger’s syndrome, and “pervasive de-
23% rise in autism. Prior to the coding change, kids with autism were
velopmental disorder, not otherwise specified” (PDD-NOS) are other
often labeled with non-specific developmental delay, brain dysfunc-
categories that fall under the ASD heading. Here is a brief explanation
tion, or mental retardation.
2. Changing criteria, broader diagnosis. The definition of autism
Autism Spectrum Disorder (ASD) or Pervasive Developmental
has changed over the years. The Diagnostic and Statistical Manual
Disorder (PDD): These terms describe the entire group of conditions
of Mental Disorders (DSM) is the authoritative bible for psychiatric
that include autism, Asperger’s Syndrome, and PDD-NOS:
disorders in the U.S. The first two editions never even listed autism as
• Autism: These children are the most severely impaired. They have
little or no social and communication skills and have repetitive, ob-
Dr. Leo Kanner first diagnosed autism in the 1940’s. Yet it was not
until 1980 when psychologists recognized autism. That’s when the
• Asperger’s Syndrome: These children have normal intelligence
DSM for the first time listed criteria for diagnosis of autism.
and language development but have trouble reading social cues and
The autism diagnosis broadened again in 1994 when several more
making conversation. Asperger’s kids often obsess about certain in-
disorders were officially added to the DSM: Pervasive Developmen-
tal Disorder (PDD), PDD-NOS (not otherwise specified), Asperger’s
• PDD-NOS (Pervasive Developmental Disorder—Not Otherwise
Syndrome, Childhood Disintegrative Disorder, and Rett’s Disorder.
Specified) is the default diagnosis for a child who has problems with
By expanding the definition of autism, suddenly many more kids
social and communication skills, but does not fit into either of the
were declared autistic. Case in point: looking at recent autism di-
agnoses, up to 75% of these kids are high-functioning children with
Autism affects one in 150 children. It is four times more common in
PDD-NOS or Asperger’s.
males, and seems to run in families.
Unfortunately, many states don’t break out where kids are on the au-
tism spectrum. California’s autism rate is often cited in the media as
I’ve heard autism is on the rise. Why?
example of the “autism epidemic”—yet California doesn’t specify
The first question we have to ask is, do we really have an epidemic or are
where kids are on the autism spectrum, so it’s hard to get solid num-
more children just being diagnosed? Is it better detection due to better
awareness? Are we displacing one diagnosis for another? Here are some
Not long ago, kids who were smart but socially awkward had no di-
explanations for the large rise in autism:
agnosis. Today, those kids are often diagnosed with Asperger Syn-
1. Displacing one diagnosis for another. In previous generations,
many children were diagnosed with mental retardation, schizophre-
3. Better awareness, better and earlier diagnosis. Popular diagno-
nia, or some other psychiatric disorder. Today, many of these same
ses rise and fall like skirt lengths. Think about it—ten years ago, had
kids are diagnosed with severe autism.
you ever heard of Restless Leg Syndrome?
For example, in 1996, 1 in 63 kids were diagnosed with mental re-
www.immunize.org/catg.d/p2068.pdf • Item #P2068 (9/08)
Immunization Action Coalition • 1573 Selby Ave. • St. Paul, MN 55104 • (651) 647-9009 • www.immunize.org • www.vaccineinformation.org
Clear Answers & Smart Advice About Your Baby’s Shots
page 2 of 6
When it comes to autism, this newfound awareness is actually a posi-
Denmark, Finland, Iceland, Japan, and Sweden also report a discon-
tive step. More people—parents and doctors alike—are on the look-
out for children with autism.
Okay, so what causes autism?
Making a diagnosis and starting therapy earlier in life improves kids’
The million dollar question. There appear to be four chief suspects:
longterm outcomes. But it also looks like autism is on the rise. Why?
Because kids were previously diagnosed with autism after age five or
1. Genetics. We know genetics plays a role. Studying twins is an obvi-
six. Today, kids are diagnosed as early as 18 months of age. This adds
ous way to detect genetic disorders. If one identical twin has autism,
many more kids to the rolls . . . but is autism really increasing? Or is
up to 96% of the time, so will the other twin. And siblings of ASD
there just an earlier diagnosis?
kids have a 5% risk of having an autistic disorder.6 To date, the exact
4. Why does the U.S. have so many autism cases? Autism is not
gene has not been identified, but it may reside on the X chromosome,
just an American disease—it happens worldwide. But why do the
which may explain the prevalence of autism in boys.7 In fact, there
U.S. and United Kingdom have such high autism rates? That’s be-
is a genetic syndrome (called Fragile X) that is one known cause of
cause the U.S. and U.K. have done the lion’s share of research and
studies into autism.
In 2008, researchers identified a specific gene in some kids with au-
Other countries are just starting to look into autism. For instance, in
tism. This gene is involved in controlling brain cell communication.8
South Korea, kids are diagnosed with Reactive Attachment Disorder
It appears that some kind of mutation in this gene causes a risk of
(RAD) . . which is really what we call Autism Spectrum Disorder
autism within families.
(ASD) here in the U.S. We suspect that South Korea will report an
Other researchers have found abnormalities on chromosomes of au-
alarming rise in autism when they figure out their RAD kids are the
tistic kids. Hence it appears that autism is caused by several differ-
same as our ASD kids.
ent genetic defects, although researchers haven’t quite figured out the
And counting autistic kids is a relatively recent phenomenon. Before
recent legislation led to schools labeling more kids as autistic, re-
One study has shown that dads over the age of 40 have SIX times
searchers just looked at either medical or school records to determine
greater risk of having a child with an autistic disorder than dads who
autism rates. This was imprecise to say the least.3
are younger than 30.10 Hence, autism has eerie echoes of Down Syn-
5. Prevalence vs. Incidence. If you’ve ever taken a statistics class
drome, a genetic defect that is more common when a mother has “ad-
(or tried hard to forget anything you learned if you did), here is a
vanced maternal age” (over age 35).
little review. Most of what we know about autism rates are based on
All of these studies show that genetic defects are a strong suspect in
prevalence studies: these are a sampling of a population at one point
in time used to estimate overall rates. By contrast, incidence studies
2. Abnormal brain growth. Although the cause is unknown, autistic
identify the ACTUAL number of autism cases over a period of time.
children have problems with brain growth. Babies are born with im-
The only way to know if autism is really an epidemic is to see a rise
mature brains that grow rapidly and make nerve connections called
in the incidence of autism.
synapses…like an information superhighway. In the normally grow-
Unfortunately, there are very few incidence studies of autism. That’s
ing brain, some branches of this superhighway get “pruned.” In the
because it is extremely difficult to do this research. Only one inci-
autistic child’s brain, the pruning process is defective. This may ex-
dence study on autism is available—that 2005 report found that rates
plain why babies with autism have abnormally rapid head growth
of PDD in the 90’s were unchanged. So even though PREVALANCE
under one year of age. Boys with ASD seem to have higher levels of
studies seem to show autism is increasing, the incidence proof is
hormones (insulin-like growth factors), which may contribute to the
larger head size, weight, and body mass index.11
6. Social acceptance. We’ve come a long way since autism was first
3. Environmental trigger. Is there some environmental exposure that
identified as a disorder. Orignally, experts thought autism was caused
sets off abnormal brain development in a genetically predisposed
by poor parenting—namely, the mother. These “Refrigerator Moms”
baby? Maybe. And that exposure may happen at or shortly after
were blamed for rejecting their kids, causing the kids to have social
conception—before a mother even knows she is pregnant. There is a
critical period of fetal brain development that occurs at 20-24 days after
Of course, this was WRONG. What we’ve learned over the past 70
conception where the brain is most sensitive to injury.
years is that autism is not the mom’s fault. But in the old days, no
Here are just a few theories that scientists are exploring as a cause for
mother wanted their kid labeled autistic since that would imply HER
autism: flu exposure during pregnancy, and folic acid levels in Dad-
to-be’s sperm (possibly a too-high level can lead to problems). Stud-
Today, we realize it is not mom’s fault—and thus parents are more
ies done by the Environmental Working Group have found about 280
willing to accept an ASD diagnosis. And the diagnosis now allows
environmental toxins in umbilical cord blood—could one of these be
for special education services, which many parents realize can help
There is also a growing body of evidence that newborns who are later
7. Over or misdiagnosis? There is so much awareness now of Au-
diagnosed with ASD already have abnormal levels of certain proteins
tism Spectrum Disorders, that perhaps clinicians are overdiagnosing
in their brains. So, having an environmental trigger in the womb dur-
it. One reputable study suggests that kids who actually have anxiety
ing a critical period of brain development seems a plausible explana-
disorders, obsessive compulsive disorders, and personality disorders
tion for autism.
may be misdiagnosed now with ASD.5
What about vaccines? There has been much talk about this theory,
specifically that trace amounts of mercury used as a preservative in
These are possible explanations for the “autism epidemic”—but we
many vaccines prior to 2001 caused a spike in autism. We discussed
don’t have all the answers yet. The bottom line: in the 1980’s, one
this issue in depth in Baby 411, but just to sum up: the scientific evi-
in 10,000 kids were diagnosed with autism. Today, it’s one in 150.
dence does not support this theory. Research during the past ten years
The U.S. is not the only country seeing this trend. Australia, Canada,
Clear Answers & Smart Advice About Your Baby’s Shots
page 3 of 6
has taken a long hard look at vaccines and found conclusive evidence
cury-containing vaccines to those who did not. The ones who had the
that vaccine exposure is NOT the turn-on switch for autism.12 And no,
mercury-free shots had HIGHER rates of autism.
despite what you might read online from fringe groups or plaintiff
• A study in 2007 showed that children between seven and ten years
lawyers, there is no conspiracy among pharmaceutical companies to
of age who got those mercury containing vaccines (before 2001) had
inflict autism on unsuspecting children.
no significant differences in tests of attention and processing infor-
The U.S. Centers for Disease Control and Prevention (CDC) has
mation.14 Although the study did not look specifically at autism, it
long-term studies underway to examine vaccines and autism. The
showed that mercury preservatives did not make much of an impact
most recent results, published in the New England Journal of Medi-
on brain functions in general.
cine, showed that the mercury preservative previously present in vac-
Do vaccines still contain mercury? What about the
cines had no significant effect on either intelligence or developmental
delays in kids ages seven to 10. The results of the CDC’s study on
mercury preservative and autism specifically will be published after
In 2001, the FDA required manufacturers to discontinue using mercury
this booklet goes to print. Stay tuned on our website for updates.
preservative for ALL routine childhood vaccines. Period.
4. Premature birth. A recent study in the journal Pediatrics found that
Many vaccines, like that for measles, mumps and rubella (MMR), have
premature babies born at 25 to 26 weeks gestation have a 25% chance
NEVER contained mercury preservatives. Nor is mercury used in the
of developing an autism spectrum disorder.
production process for MMR. However, there are four vaccines on the
market that still use mercury preservative in the manufacturing pro-
Researchers don’t know what causes autism, although
cess—the mercury is then REMOVED from the final vaccine.
the above factors provide clues. The goal is to find a way to PREVENT
autism . . . but we aren’t there yet.
Because the flu vaccine is reformulated each year for the upcoming sea-
Is it possible that autism is actually mercury poisoning?
son, manufacturers need to move as efficiently as possible to produce large
quantities of vaccine. The best way to do this is to produce vaccine in
No. Mercury poisoning, also known as Mad Hatter’s Disease, is very
multi-dose vials, which requires a preservative. There are, however, sin-
different from autism. Symptoms of mercury poisoning include exces-
gle-dose preparations that are FREE of mercury preservatives that can be
sive sweating, tremors and kidney problems. Sufferers also talk and
given to young children and pregnant women, if available.
walk like they have had a stroke.
Let’s do a reality check here: a tuna sandwich has FIVE TIMES more
How do we know this? The information known about mercury poisoning
mercury than one dose of flu vaccine.
comes from unfortunate communities that have experienced it. There is
a large amount of data from the Faroe Islands, near Iceland. The people
As a doctor, I am much more concerned about mercury exposure in the
there would eat whale blubber contaminated with toxic levels of methyl
environment—particularly in food (like that tuna fish sandwich). So if
mercury and polychlorinated biphenyls (PCBs). Children, especially
you are worried about mercury exposure, consider this: there’s mercury
those exposed as fetuses during their mother’s pregnancy, seemed to
in breast milk.
have lower scores on memory, attention, and language tests than their
A baby gets 25 times more mercury by breastfeeding for six months
than in a single dose of flu vaccine. Breast milk contains between 1.4
Here’s the rub: despite all those problems, these children with mercury
and 1.7 micrograms of methyl mercury per liter. If you assume that a
poisoning were NOT diagnosed with autism.
baby is breast-fed exclusively up until six months of age, that baby will
consume about 360 micrograms of methyl mercury. That’s twice the
Another key point: mercury preservative was taken out of required vac-
amount of mercury that was ever contained in vaccines and 25 times the
cines SEVEN years ago. But autism rates are still going up.
quantity of mercury contained in the influenza vaccine.
Did the mercury in vaccines cause autism?
A quick chemistry lesson: certain compounds have completely different
No. Here is the scientific evidence:
properties even though they have similar sounding names. For instance,
• The Institute of Medicine spent four years studying this issue. Their
there are TWO types of mercury: methyl mercury and ethyl mercury.
conclusion, issued in 2004: mercury preservatives in vaccines did
The type of mercury that has raised health concerns is methyl mercury.
NOT cause autism . . . and the Institute said it was time to move on
Methyl mercury is a small molecule that can get into the brain and takes
to look at other possible causes. Several other leading medical orga-
almost TWO MONTHS to break down. High concentrations of methyl
nizations (both nationally and internationally) agree with this conclu-
mercury can be found in tuna, swordfish and shark from contaminated
• Mercury preservative (thimerosal) was removed from vaccines com-
Now, let’s contrast that with ETHYL mercury, which is/was the type of
monly given to infants and young children in the U.S. in 2001, but the
mercury used in vaccine preservatives. Ethyl mercury (thimerosal is an
rates of children being diagnosed with autism are still skyrocketing.
example) is rapidly eliminated from the body within a WEEK. Com-
A survey of autism rates in California in 2008 confirms that mercury
pared to methyl mercury, ethyl mercury is a much larger molecule that
is out and autism rates are still going up.13 If thimerosal was the cause
cannot enter the brain.
of autism, and it was taken out SEVEN years ago, autism rates should
Ideally, it would be nice to remove ALL mercury preservatives from
be going down by now. That’s because autism spectrum disorders are
flu vaccines—so we could put this controversy to rest. The problem: at
usually diagnosed by three years of age.
this time, the only way to manufacture the huge quantity of flu vaccine
• Mercury preservatives were removed from vaccines in Denmark in
needed each year requires using mercury preservatives. Hopefully, vac-
1992. Canada and the European Union have followed suit. Their au-
cine makers will figure out a way to eliminate mercury from all vaccines
tism diagnosis rates are still going up, too.
in the future—so any concerns can finally be put to rest.
• Mad Hatter’s Disease (mercury poisoning) and autism are very differ-
What do you think of delaying vaccines or using
ent disorders, as discussed above.
an alternative vaccination schedule?
• A study of 100,000 kids in England compared those receiving mer-
The CDC publishes a recommended vaccine schedule for all children
Clear Answers & Smart Advice About Your Baby’s Shots
page 4 of 6
in the U.S.—this schedule wasn’t created from thin air . . . doctors, sci-
them protect your un-vaccinated child.
entists and researchers work together to decide what is the best time to
Just look at the recent measles outbreak in 2008 in San Diego. It all start-
give shots. The goal: protect as many babies as soon as possible from
ed with a child, who was unvaccinated by parent choice. He returned
from a trip to Switzerland with measles. He went on to infect TEN other
Now, one of the popular myths about autism is that somehow kids are
unvaccinated children—his siblings, school friends, and three babies
getting “too many shots, too soon.” Despite the scientific evidence that
who were too young to be vaccinated who were exposed to that child in
shows vaccines do NOT cause autism, some parents think that if they
a doctor’s waiting room. Of the 11 cases, one baby was hospitalized.
space out their kids’ vaccines in an “alternative schedule” this is some-
And this outbreak may be a trend. During the period January through
July of 2008, the highest year-to-date cases of measles were reported in
Adding to this notion are blogs, books, and web sites that promote alter-
the U.S. since 1996: 131 cases from 15 states and the District of Colum-
native vaccine schedules, delaying critical shots months or years after a
bia. Over 90% were unvaccinated or had unknown vaccination status
child can safely receive them.
and two-thirds of these cases that were eligible for vaccination were
not vaccinated because of philosophical or religious beliefs. There were
Here’s a nasty little truth about alternative vaccination schedules: they
also 16 babies who were too young to be vaccinated. Babies, who are
are all fantasy. There is absolutely no research that says delaying certain
the most vulnerable to serious infection, do rely on other vaccinated
shots is safer. Doctors who promote these schedules are simply guessing
children in the community to protect them when they are not old enough
when to give which shots.
to be immunized.
What we know for certain is that delaying your child’s shots is playing
So, when people argue that kids get too many shots today, I ask them if
Russian Roulette. The simple truth is you are leaving your child unpro-
they’d rather their child get meningitis. And what about vaccines in the
tected. Who knows what disease (preventable from a simple vaccine) will
pipeline? If we’ve already got too many shots, would you decide to skip
crop up next? Deadly diseases like measles are only a plane flight away.
a future vaccine to prevent HIV? Probably not. That’s because you know
Also: spreading out vaccinations creates new challenges. Live vaccines
that vaccine might be the one that saves your child’s life.
must be given at least four weeks apart to mount an active immune re-
sponse. Take the MMR (measles, mumps, and rubella) vaccine—your
Didn’t the government recently concede that
child could get one combo shot and take care of all three deadly diseases
vaccines caused autism?
at once. If you get three separate shots, however, it would take at least
As you may have heard on the news, the government recently decided to
three months (because each is a live vaccine). That leaves kids unpro-
compensate a child whose autism was allegedly triggered by a vaccine.
tected until the series is completed.
Here’s the background behind the headline:
When families demand a spaced out vaccination schedule, this is what
The Vaccine Injury Compensation Program has been holding special
I tell them as their doctor: “At the end of the day, I just want your child
hearings called the Omnibus Autism Proceedings. This “Vaccine Court”
vaccinated. If you want to give two shots today and two next week, that’s
is looking at allegations that 4900 children developed autism from vac-
okay. Just come back. And promise me you will do it in a timely manner
cines. The court is first looking at nine cases to form opinions about the
(that means you return in weeks, not months or years, to finish vaccina-
tion).” The goal: make sure the child is protected.
One child, Hannah Poling, was awarded a monetary settlement. Hannah
One important point to remember: despite all the media attention to this subject,
was born with a rare genetic disorder (mitochondrial disorder, which is
very few parents actually choose to delay or opt out of vaccinations.
a dysfunction in basic cell metabolism). This is the equivalent of being
born with an undetected heart defect—a ticking time bomb that could
Are vaccines really necessary?
go off at any time.
Yes. As a doctor, I am greatly worried when parents decide to delay or
For rare kids like Hannah, any stress could have caused her to devel-
not to vaccinate their child. That’s because vaccine-preventable diseases
op autism. In fact, having a vaccine-preventable disease like the flu or
chickenpox could have far worse health consequences—a disease like
I have watched a child die from a vaccine-preventable disease while
that could have killed her. Although she was not diagnosed prior to be-
I helplessly stood by. I’ve cared for several babies gasping for breath
ing vaccinated, experts recommend that even children with known mito-
with whooping cough. These diseases kill children. Respect them. Last
chondrial disorders still be vaccinated.
year alone vaccines prevented 14 million infections and 33,000 deaths
So even though the headlines screamed that (in this case) a vaccine
in the U.S.
caused autism, the facts of the case show this isn’t true. Hannah’s under-
Our grandparents remember diseases like polio. And how folks lined up
lying disease caused her deterioration and autism. The case was settled
to get vaccinated. Yet, you’ve probably never even heard of anyone with
and determined that it did not represent a test case for the 4899 other
polio today. The great irony of vaccine success is that parents today are
unfamiliar with the diseases they prevent.
Experts on mitochondrial disorders do NOT think this disease is the
In the past 10 years, I have seen two forms of bacterial meningitis basi-
“smoking gun” that triggers autism. That’s because many folks have
cally disappear, thanks to vaccines. Before the HIB (Haemophilus in-
similar dysfunctional cells but never become autistic.
fluenzae type b) vaccine was developed, there were about 20,000 U.S.
And there is no simple test for mitochondrial disorders. Instead, you
children a year who suffered or died from this infection. Now there are
must do a difficult and painful muscle biopsy and a spinal tap. As a re-
less than 200 cases per year. Before the pneumococcal conjugate vac-
sult, testing all kids for mitochondrial disorders is not necessary, ethical
cine, which protects against streptococcal meningitis, 17,000 American
or practical. And even if your child is diagnosed with a mitochondrial
children per year had invasive infections with strep. And, about 200 kids
disorder, the recommendation is still to vaccinate.
died of this each year. Since vaccination, serious infections have been
reduced by 90%. That’s pretty amazing.
Does the MMR vaccine cause autism?
And no, you can’t just let everyone else vaccinate their kids—and let
One small study of only eight patients in 1998 led a British research
Clear Answers & Smart Advice About Your Baby’s Shots
page 5 of 6
group to conclude that the combination MMR vaccine might cause au-
and carries NO chance of transmitting the disease.
tism.15 But in March 2004, after questions were raised about the study,
So, here’s the irony: YOUR parents took much greater risk when getting
ten of the 13 researchers of the study withdrew their claim of having
vaccinated back in the 50’s, 60’s, and 70’s. Today, even though we have
found a possible connection between MMR and autism. They said, “In
many more vaccines, the risk is much lower.
this paper, NO CAUSAL LINK was established between MMR vaccine
and autism as the data were insufficient…now is the appropriate time
Our children are really getting smarter, safer vaccines today and better
that we should together formally retract the interpretation of the data
protection than we ever got as kids.
suggesting a link.”16
BOTTOM LINE: Vaccines do not weaken the immune system, they boost it.
Numerous major studies (at least 17 so far) since 1998 also soundly
Are there other toxins in vaccines that could cause
refute this alleged link. The most prominent: the Institute of Medicine’s
2004 report clearly dispelled any link between MMR and autism.
Are there additives in the vaccines? Yes. And you should know about them.
Perhaps the most compelling argument that the MMR vaccine does
NOT cause autism is Japan—in 1993, that country stopped using the
Vaccines contain the active ingredients that provide immunity. However,
combination MMR vaccine. Instead, Japanese children were given three
there are inactive ingredients that improve potency and prevent contami-
separate shots for these diseases. Despite this change, autism rates in
nation. Here is a list of additives and why they are there.
Japan continue to rise.17
1. Preservatives—prevent vaccine contamination with germs (bacte-
The hysteria surrounding the MMR vaccine and the false 1998 report
ria, fungus): 2-phen-oxyethanol, phenol.
did have one serious consequence in England: a sharp rise in measles,
2. Adjuvants—improve potency/immune response: aluminum salts.
mumps, and rubella after parents stopped giving their kids the vaccine.
3. Additives—prevent vaccine deterioration and sticking to the side of
In 2004, only 80% of children in the U.K. were vaccinated against
the vial: gelatin, albumin, sucrose, lactose, MSG, glycine.
MMR. And look at the rise in cases of mumps: 1995: 1936 cases; 2003:
4265 cases; 2004: 15,503 cases.
4. Residuals—remains of vaccine production process: formaldehyde,
antibiotics (neomycin), egg protein, yeast protein.
And remember, autism rates are rising in the U.K. as well. So, now
they’ve got both autism AND vaccine-preventable diseases. It’s a lose-
Now, after reading the above list, you might be freaking out—alumi-
lose battle—and the casualties are kids.
num salts? MSG? Formaldehyde? We should point out that only TRACE
amounts of most of these additives are in vaccines. None have been
Here’s the bottom line: as a doctor who sees a large volume of kids, I
proven harmful in animals or humans in these amounts.18
have never seen a perfectly normally developing kid walk into my of-
fice, get his MMR vaccine . . . and come back next week with autism.
Reality Check: Should vaccines be “greener”?
It doesn’t happen.
If vaccines contain ingredients like aluminum or formaldehyde, wouldn’t
it be better if vaccine makers got rid of these additives?
Are we giving too many vaccines today, too soon?
More vaccines are actually a GOOD thing! Every new vaccine protects
We agree that this sounds reasonable—but it doesn’t mean that current
more kids from getting sick . . . expensive hospital stays . . . and perhaps
vaccines are UNSAFE.
death or permanent injury. More kids are prevented from getting devas-
Here’s the key point: additives like aluminum in vaccines are in EX-
tating diseases than ever before, thanks to vaccines. What about getting
TREMELY SMALL amounts (often, just a trace). We are all exposed
several shots at once? Is that dangerous? Could you overload a child’s
to significantly higher levels of environmental toxins in our everyday
immune system with these vaccine germs?
Look at it this way: your child is exposed to thousands of germs on a
Let’s look at aluminum. Babies ingest 50 micrograms of aluminum per liter
daily basis (even if he is not in daycare). Exposing your child to five
of breast milk . . . and 500 micrograms of aluminum per liter of formula. By
or eight different germs in the form of vaccines is a spit in the bucket.
contrast, the amount of aluminum in a vaccine is much smaller.
And young kids have a better immune response to vaccines than older
children and adults.
Do you wear antiperspirant? That’s got aluminum in it too. And alumi-
num is found in most food, soil, and water. So, to avoid aluminum ex-
Before a vaccine is approved for use by the government, its safety is ex-
posure, you’d have to stop wearing antiperspirant—and basically leave
tensively studied. These studies look at how kids respond to the vaccine.
And so-called “combo” vaccines that incorporate several shots at once
also consider the combined effect. Even if your child got 11 shots at the
And aluminum poisoning does not cause symptoms of autism, either.19
same time, he would need to use only about 0.1% of his immune system
Trace amounts (far less than what your baby eats everyday) of alumi-
to respond to the vaccines.
num improve the body’s immune response to some vaccines. That’s why
it is in there.
The goal is to protect your child as quickly as possible from diseases that
are very dangerous to young children.
Why is formaldehyde in vaccines? Well, small amounts sterilize the vac-
cine fluid so your child doesn’t get something like the flesh-eating Strep
And even though the number of shots has gone up, the actual load on the im-
bacteria when he gets his shots.
mune system has gone down. That’s because today’s vaccines are “smarter”
and better engineered than the shots from a few decades ago.
If you use paper towels or mascara, or have carpeting in your home,
you’ve been exposed to formaldehyde. Obviously, exposure to large
Case in point: whooping cough. Before 1991, the whooping cough vac-
amounts of formaldehyde is not a good thing for anyone’s health. But,
cine had 3000 different germ particles (antigens). Today’s whooping
again the amount in vaccines is extremely small.20
cough shot has just three to five particles—just as effective, but much
better designed to be easy on your immune system.
BOTTOM LINE: Vaccine additives are there for a reason—to make
them safer and more effective.
Before 1996, the polio vaccine was “live”—this carried a small risk of
actually getting polio. Today’s polio vaccine is dead (inactivated) . . .
Clear Answers & Smart Advice About Your Baby’s Shots
page 6 of 6
There’s so much anti-vaccine stuff online—it’s hard
I know, I know, who are you going to believe? Don’t I trust parents
to know whom to believe. Can doctors be trusted
and their instincts? Absolutely—you know your kids better than anyone
else. But having a child diagnosed with autism is a highly emotional
on this issue?
experience. And the diagnosis is usually made around the same time a
Most pediatricians are ALSO parents—and docs dedicate their life to
child is going through his vaccination series. It’s true . . . but unrelated.
protecting kids. If I ever thought vaccines were harming kids, I’d change
It’s true that vaccinations are happening, and it’s true that developmental
what I do. I vaccinated my own kids and would do it again in a heartbeat.
differences become apparent. That doesn’t mean they are related. Tod-
If you have any doubt about vaccinations, just ask your pediatrician if
dlers are also wearing diapers, drinking whole milk, and hanging out
she vaccinated her kids.
with parents who use cell phones. Do diapers cause autism? How about
How do you explain the parents who claim their
cell phones or milk? Obviously, no.
child was perfectly normal and then “something
And let me be clear, parents aren’t the only ones who miss the early
signs of autism. Pediatricians do, too. Full developmental assessments
It seems like just about everyone’s heard one of these heart-wrenching
are often three to four hours in a specialty referral center. We rely heav-
stories—whether it be a child with autism that you know personally, or
ily on parents to point out their concerns. Parents and doctors can both
a celebrity’s kid you hear about on TV. The parent reports that the child
miss early signs of autism spectrum disorders in the first year of life.
was developing just fine, until one day the lights just went out. Often,
This is one of the key reasons why the American Academy of Pediat-
that phrase is accompanied by “after he got his shots.”
rics created an Autism Toolkit in 2007 for its doctors to learn the signs,
screen specifically for autism at every well child visit, and provide re-
And understandably, it’s enough to make any other parent freak out and
sources and educational materials for affected children.
think twice when it’s time to vaccinate his or her own child.
BOTTOM LINE: Stoking parents fears about vaccines with false ru-
About 50% of parents with a child affected with autism spectrum disor-
mors about safety is irresponsible and creates a lose-lose situation for
der believe it was triggered by vaccination. However, the other 50% do
society—and the casualties are children.
not think vaccines had anything to do with it.
Vaccines work. And they are safe. Rather than demonize vaccines,
Here is what I think, based on what I see in my own practice. Autistic
we (doctors, parents, researchers, the government) should put our time,
kids were never “typical” to begin with. Not one patient of mine who has
effort, and money into researching the CAUSES of autism and the best
ASD was perfectly normal, got a vaccination, and returned the next week
with autism. In fact, all the parents in my practice whose children have
ASD tell me that they either a) did not recognize the early differences
in their child’s development or that b) they always knew something was
2. Grinker R. Unstrange Minds. Basic Books; New York: 2007.
different about their child. The signs just became more apparent over
3. Grinker R. Unstrange Minds. Basic Books; New York: 2007.
time, the milestones stagnated, or the child seemed to lose skills. About
4. The autism epidemic: fact or artifact? J Am Acad Child Adol Psychiatry; 2007;46:721-30.
one in five parents will report a loss of milestones. That’s what brings it
5. The autism epidemic: fact or artifact? J Am Acad Child Adol Psychiatry; 2007;46:721-30.
to the parent’s attention.
6. DSM-IV-TR 2000.
7. Jamain S et al. Mutations of the x-linked genes encoding neuroligins NLGN3 and
An important fact: above, we noted that one in five parents report a loss
NLGN4 are associated with autism. Nature Genetics 2003;34:27-29.
in milestones. That means that a vast majority (80%) of kids diagnosed
8. Arking DE, et al. A common genetic variant in the neurexin superfamily member CNT-
with autism spectrum disorder have no loss of milestones. They start
NAP2 increases familial risk of autism. American Journal of Human Genetics; Jan
out on a different developmental path and the symptoms become more
9. Johnson CP, et al. Identification and evaluation of children with autism spectrum disor-
apparent over time.
ders. Pediatrics 2007;120 (5):1183-1215..
One of my ASD patient’s moms, who is a medical professional, told me
10. Reichenberg A, et al. Advaincing paternal age and autism. Arch Gen Psychiatry.
that she realized how clearly different her son’s early development was
11. Mills J et al. Elevated levels of growth-related hormones in autism and autism spectrum
after she watched her second child, without ASD, breeze through her
disorder. Clinical Endocrinology; 2007;67 (2):230-37.
developmental milestones. She had no frame of reference with her first
child. And since just about every parent has a camcorder these days, the
13. Schechter R, Grether JK. Continuing increases in autism reported to California’s develop-
mental services system: mercury in retrograde. Arch Gen Psychiatry. 2008 Jan;65(1):19-
developmental differences early in a child’s life are easily chronicled on
videotape for developmental specialists to review. They say the same
14. Thompson WW, et al. Early Thimerosal exposure and neuropsychological outcomes at 7
thing I do. The child was never perfectly normal and these, sometimes,
to 10 years. N Engl J Med 2007;357:1281-1292.
subtle differences are seen before a year of age.
15. Wakefield AJ et al. Ileal-lymphoid-nodular hyperplasia non-specific colitis, and perva-
sive developmental disorder in children. Lancet, 1998; 351(9103):637-41.
Heck, even the most vocal autism mom of all, Jenny McCarthy, who
16. Horton R. The lessons of MMR and A statement by the editors of The Lancet. Lancet,
claimed on Oprah that her son was normal until receiving his combina-
17. Uchiyama T, et al. MMR vaccine and regression in autism spectrum disorders: negative
tion measles-mumps-rubella vaccine, admits in her book that she missed
results presented from Japan. J Autism Dev Disorder. 2007;37:210-217; and Honda H, et
the early signs of her child’s ASD. Specifically, she said that it took her
al. No effect of MMR withdrawal on the incidence of autism: a total population study. J
child until he was five months old to smile at her, when her friend’s
Child Psychol Psychiatry 2005;46:572-9.
babies all smiled by two months.
18. Offit P, Jew RK. Addressing parents’concerns: do vaccines contain harmful preserva-
tives, adjuvants, additives, or residuals? Pediatrics 2003;112 (6):1394-7.
One of the leading autism experts in the country has told me that there
19. Dept of Health and Human Services, Agency for Toxic Substances and Disease Registry,
are, indeed, an extremely small number of ASD children who have com-
ToxFAQ’s for Aluminum, Sept 2006.
20. Dept of Health and Human Services, Agency for Toxic Substances and Disease Registry,
pletely normal milestones and then regress, which is known as “late on-
ToxFAQ’s for Formaldehyde, June 1999.
set autism.” This type of autism likely represents a subset of children
who have a distinct genetic abnormality that turns off spontaneously
without any trigger at all. And this distinct group deserves genetic test-
ing and more research.