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The EditorsNovember 02, 2009

Autism spectrum disorder is a medical catch-all classification that includes a range of neurological syndromes. It covers people with pervasive development disorder, Asperger’s syndrome and mild-to-severe “classic” autism. In children, symptoms of autism spectrum extend broadly from minor challenges with social interaction and sensory integration all the way to the kind of complete withdrawal and accompanying physical disabilities most often associated in the public imagination with autism. Autism’s telltale signs include lack of eye contact, sporadic or prolonged lack of awareness of others and repetitive motions and vocalizations. A diagnosis of autism can be the predictor of a lifetime of difficulty for the children and families affected, but it also represents significant costs to local school districts at the front line in the age of autism.

Not too long ago estimates of the number of children with autism were as low as two to five in 10,000. Just two years ago that number was revised to a startling one in 150 by the Centers for Disease Control and Prevention. A new survey published in the monthly Journal of Pediatrics suggests the number of children “on the spectrum” in the United States is as high as one in 91 among all children and one in 58 among boys, a revision corroborated by a parallel study by the C.D.C. That means that 673,000 U.S. children—1.1 percent of children ages 3 to 17—and a comparable number of U.S. families are grappling with autism and the impact that diagnosis has on family life and, not least of all, family budgets.

A C.D.C. statement noted: “These data affirm that a concerted and substantial national response is warranted.” This is the kind of rhetoric we have already heard as the autism spectrum numbers leapt higher. When will that concerted response begin? It is true that new federal money—$100 million—has recently been directed to autism research as part of the economic stimulus package, but even that lofty figure pales in comparison to the commitments made to other, similarly large-scale public health crises. Though it now clearly affects a much higher number of children, autism has historically received only a fraction of the monies devoted to other childhood afflictions. Over the long term, this apparent epidemic will represent an as yet undetermined cost to U.S. society as it attempts to respond to the special needs of children, teens and adults with autism.

One fundamental question needs to be answered immediately: Are these numbers “real” or just a statistical anomaly generated by greater awareness of autism? After years now of rising anxiety because of reports of autism’s increasing prevalence, how is it possible that a public figure as prominent as Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services, still cannot say for sure if the higher numbers recorded by her own researchers merely reflect better reporting and a broadening diagnosis?

If an alarming increase in autism is indeed occurring in our homes, and not just on statistical spreadsheets, then we need to confront this problem as the major health care crisis that it is. Discovering more about what provokes this puzzling neurological syndrome and how it can be treated effectively should be a major C.D.C. priority. Much of the institutional debate surrounding autism spectrum disorder has revolved around its suspected connection to the increasing vaccine load required of U.S. children. More research needs to be done to confirm or deny this hypothesis about the origins of autism before faith in the entire vaccination enterprise collapses. Clearly genetics plays a primary role, but as the numbers pile up the possible effect of so-called environmental triggers like vaccines cannot be ignored.

While a more determined effort to address the causes of autism and develop strategies to prevent it is absolutely necessary, another serious lapse also needs attention: the lack of support for families of autism-spectrum children. Parents of children on the spectrum are growing more confused about how to help their children even as they grow more vulnerable to medical quackery of all sorts. Many have waded through oceans of bureaucratic ridicule or indifference to find treatments they say are working. Such parents find themselves falling into a void between what they believe they can do to help their children and what insurance plans will cover or school districts provide. Many proven therapies are extremely costly but must be paid for out of pocket by parents. With evidence building that early intervention is crucial in the response to autism, families frequently find themselves balancing bankruptcy against the obvious needs of their children. It is a choice they should not be forced to make.

When Jesus said, “Let the children come to me,” it was a gesture of benevolence. It was also an acceptance of responsibility. Autism is not something that happens only to “other” families. These are our children. Let them come to us and be helped or healed, or at the very least be comforted.

Comments are automatically closed two weeks after an article's initial publication. See our comments policy for more.
Elise F Thomas
14 years 5 months ago
As a pediatrician, I fully agree that autistic children and their families need more support from the community, schools, and health insurance industry.  However, I must disagree and point out that the hypothesis that vaccines are linked to autism has been disproved conclusively.  After reviewing the many studies and available data from around the world, the Special Masters that met in February to judge test cases brought against the Dept of Health and Human Services unequivocably ruled that vaccines are not linked to autism.  Even "Autism Speaks", a main autism advocacy organization, states that there is not evidence for a link between autism and vaccines, and is directing current funding towards research into other causes for autism.  It is time to accept that the vaccine link does not exist, and focus future funding, research, services and support to evidence-based therapies and treatments.
Vic O'Callaghan
14 years 5 months ago
I am pleased to find this article and also the comment from EFT. As I carry the
information offered in the article, I load my consideration with a hope that
what EFT has stated is accurate. [Of course I will check as far as possible to
locate the research that outlines the absence of a link between autism and
vaccines.] Being a grandparent and quietly working away to influence some of my
'young parents', I have encountered the 'new scepticism around the use of
vaccines regime. It has been a slow and difficult task. I will now gently allow
this information to appear within our family circle. Many thanks.
Victor Pace
14 years 5 months ago

While welcoming the prominence given to an important public health problem, I am surprised that this article gives credence  to the vaccine hypothesis. The evidence for a link has always been vague, of poor quality, inferential and tenuous; the evidence against a link is now devastatingly strong.  For a recent , readable, medical summary of the evidence, see for example, Gerber & Offitt in the journal Clinical Infectious Diseases, available online at [url=http://www.journals.uchicago.edu/doi/full/10.1086/596476?cookieSet=1]http://www.journals.uchicago.edu/doi/full/10.1086/596476?cookieSet=1[/url]. 

In the UK, we have seen a measles outbreak  as a result of reduced vaccinations from the scare, which has led to at least one death, a number of cases of  permanent disability in children, many hospitalisations for a preventable illness, much unnecessary distress – and no drop in autism rates.  Parents have thankfully now wised up, and MMR vaccination rates are  rising again; but the trend has moved to the US.  Reducing vaccination rates does not just put that child at risk; it reduces the number of individuals in a community who are immune, raising the risk for everyone.  There is no public health benefit to peddling a discredited hypothesis which also increases parental guilt – if their  children get autism parents blame themselves, and if they don’t vaccinate their children and they become ill they also blame themselves.   Please do not join the “something must be done” brigade, and give space to misinformed opinion hyped up by celebrity endorsements.  Something must indeed be done, but you start that by building up and examining the evidence meticulously and dispassionately.  The evidence is there, in spades; one just hopes journalists are prepared to do the hard work needed to understand it.  But without that, with the best intentions, one can do serious damage to the health of children and families.  

Please do not give this discredited hypothesis the light of day.

Christopher Kuczynski
14 years 4 months ago

Thank you to America Magazine for highlighting this important issue.  I would fault the editorial for only two things, one of which it said and one of which it failed to say.  It is troubling that the editorial gave credence to the now discredited theory that there is a link between the apparent increase in the number of persons diagnosed with some sort of autism spectrum disorder.

More important to me as a civil rights lawyer, however, was the editorial's failure to make even a passing reference to critical legal protections that should, but too often do not, enable children and adults with autism to live with dignity as persons with disabilities.  The Federal government has never fully honored its financial commitment under the Individuals with Disabilities Education Act, originally enacted as the Education for All Handicapped Children Act in the 1970s, to provide this nation's children with disabilities a free, appropriate public education.  Ten years after the Supreme Court said that Federal law requires that individuals with disabilities receive services in the most integrated setting possible, the Federal and state governments have been slow to implement a plan to move our brothers and sisters in nursing home facilities (some of whom have autism) into community settings with appropriate supports. 

This is true, by the way, even though research has shown that providing services to persons with disabilities in the community costs less than providing services in nursing homes.  Until recent changes in the law, the Supreme Court and other Federal courts construed the Americans with Disabilities Act so narrowly as to exclude persons with autism spectrum disorders and other disabilities from the most basic civil rights protections, most important among which is the right to work free of discrimination.

I do not discount the importance of finding ways to alleviate or eliminate suffering that is a consequence of the physical or mental limitations that disabilities cause.  But we must realize that, despite our best efforts, there may be generations of persons with autism and their families who will not benefit from a "cure," and we must offer them dignity today, not just hope for tomorrow.  And, bearing in mind that we now talk in terms of a "spectrum" of disorders, it is wrong to assume that a cure will necessarily be the right choice for everyone.  Without oversentimentalizing the special gifts that people with autism spectrum disorders have, it is apparent to me that removing what society regards as a disability will sometimes come with important trade-offs.  

Cognizant of the need to do scientific research into the causes of autism and other disabilities that will result in new or improved methods of treatment, I would urge that we invest just as much energy to ensure that we continue to benefit as a society from what our citizens with disabilities have to offer just as they are.  Jesus didn't just tell us about what awaited us after this life of suffering.  He exhorted us to act right now, reminding us that the "Kingdom of God is at hand."  Strengthening and enforcing the laws and structures already in place for persons with autism and other disabilities is something we can do today. 

Teresa Conrick
14 years 4 months ago
Thank you very much for this on target opinion piece.  As a Catholic, a special education teacher but more importantly, as a parent of a teen with severe autism, I applaud your viewpoint as well as a much needed call for help and acceptance.
My daughter was a healthy and happy baby who began to regress after a series of vaccinations before her 2nd birthday.  Many of those were with thimerosal, the mercury preservative that has been around since the start of autism in the 1930's. After a triple live virus vaccine, the Measles, Mumps, and Rubella (MMR) vaccine, my daghter broke out in a rash, lost all language, began to have chronic gastrointestinal pain, cried all the time, lost eye contact, and was ill with fevers then was subsequently diagnosed with "Idiopathic" (of unknown origin) autism.  Not one medical professional who dealt with her then (pediatrician, neurologist,psychiatrist) told us that these were signs of vaccine injury. 
Research on the actual children is showing that they are ill with dysfunctional immune systems, mitochondria disorders, and inflammation (brain and GI).  This is a new paradigm with a medical focus rather than the psychiatric one originally written about by child psychiatrist, Dr. Leo Kanner.  There is mounting research showing that this historically misunderstood disorder has its roots in neuroinflammation, not produced by genes, but by an outside (environmental source).  There is no such thing as a genetic epidemic and thousands of other families share my story of regression, an autism diagnosis, and then labs, tests now showing vaccine injury - mitochondria dysfunction, demyelinating disorders, transverse myelitis, toxic encephalopathy, hypotonia, seizures, and chronic arthritis. It is refreshing and encouraging to read your thoughts that the Catholic Church should see that this is an epidemic and not ignore all of the evidence.  Our religion is based on faith, love and trust but our Public Health system and its vaccine program can not be relied upon by faith only.  Science and common sense are integral for trust and faith in medical procedures and there has been limited transparency and much conflict of interest in the vaccine program. Our children are disabled by an illness that is treatable and recovery can happen -  so there is much to hope for but we need all the help, faith, accepatance and love that our religion and its members can offer.
For more information on the science/medical aspects:
[url=http://www.cbsnews.com/stories/2008/05/12/cbsnews_investigates/main4086809.shtml]http://www.cbsnews.com/stories/2008/05/12/cbsnews_investigates/main4086809.shtml[/url]
[url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1280369/]http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1280369/[/url]
[url=http://www.rescuepost.com/files/hepb_asd_abstract1.pdf]http://www.rescuepost.com/files/hepb_asd_abstract1.pdf[/url]
[url=http://www.time.com/time/health/article/0,8599,1721109,00.html]http://www.time.com/time/health/article/0,8599,1721109,00.html[/url]
[color=#0000ff][url=http://www.safeminds.org/]http://www.safeminds.org/[/url][/color]
[url=http://www.ageofautism.com/2009/10/advocacy-groups-ask-president-obama-to-order-suspension-of-hepatitis-b-vaccine-birth-dose/comments/page/3/#comments]http://www.ageofautism.com/2009/10/advocacy-groups-ask-president-obama-to-order-suspension-of-hepatitis-b-vaccine-birth-dose/comments/page/3/#comments[/url]
[url=http://www.ageofautism.com/2009/10/autism-at-1-in-58-boys-safeminds-calls-for-thimersol-from-seasonal-h1n1-flu-vaccine.html][/url]
ANN ODONOGHUE
14 years 4 months ago
Q3 - "Please do not give this discredited hypothesis the light of day".

I still have an open mind on the subject and feel we need a lot more independent and comparative studies before we can be sure one way or the other.

What disturbed me about your post is that you are so absolute, so sure there is no link, you leave no room for doubt. And you link us to a paper co-authored by Paul Offit, a man who makes millions on the sale of vaccines.

I think that any doctors posting on this subject should use their full names and make no-conflict disclosures; I'd feel a lot more open to your opinion if I knew you had never sat on the board of a drug company or never received payment from one.

Victor Pace
14 years 4 months ago

No, I have no links with any vaccine (or other) drug companies, do not sit on any company boards and have received no payment from drug companies.
My point is simple. Science is about fact, cause and effect, and over hundreds of years we have evolved sophisiticated methods for sorting out fact from mistaken impression.  It does not depend on who says something but on their basis for saying it, so all the evidence is laid out for all to examine in great detail  - but you need to do the work, by understanding what over many years we have learned constitutes reliable and unsound evidence, and then scrutinising all the evidence available. 

There is no grand conspiracy out there; anyone looking at medical journals soon learns how bogus claims eventually come to light, and the perpetrators are dealt with severely, because the evidence is open for all to see.

It is very natural for people facing a problem which has devastated their lives to want to find an explanation; as doctors we cannot butunderstand and fully sympathise.  But follow the evidence, and you will avoid a  lot of false hopes which lead you down false trails which can cause harm to the people you love.  Evidence takes time to build up, but there is an awful lot of it pointing the same way now out there.

ANN ODONOGHUE
14 years 4 months ago
If science is about fact, and if it's a fact that mercury is poisonous, why are we allowing it to be injected into pregnant women and babies when there is an alternative?  

I have no problem with you stance, you have been trained to think that way. I, however, have an open mind and am willing to hear and try to understand both sides. 

But do you not at least think we need to do more research - comparative studies of children who have not received mercury laced vaccines and those who did?  Why would more research be a bad thing?  If we didn't have opposition and ongoing research on nicotine, we would never be as educated to the dangers of smoking as we are now.
 
My own disclosure is that I am just an interested observer. I am not involved in the autism debate at any level and I have no bone to pick with the medical profession in general. I am,  however, increasingly concerned with the amount of vaccines being forced on our children. 
 
Thank you for your disclosures. And yes, I did Google you. :)
Teresa Conrick
14 years 4 months ago
Dr. Pace,

As a physician, it may be difficult to shift your thoughts about vaccines and what you have been told about them.  I think it is reasonable to say that your profession is educated by those who sell vaccines and those who mandate them.  Neither of those two entities can be objective and unbiased.

There is much to still be learned and a comparative study on vaccinated and unvaccinated individuals would be helpful.  Meanwhile, to examine the studies that have exonerated vaccines as a source of injury, ie - autism, is imperative.  Here is a good place to read about that information.

http://www.fourteenstudies.org/
Elise F Thomas
14 years 4 months ago

In answer to Ms. O'Donaghue -

I have been a general pediatrician for almost 20 years.  My education and training was not funded by any drug company but by the United States Navy, in exchange for which I served 7 years active duty, 3 overseas.  I then practiced for 9 years in a small rural town in Western NY.  There I discussed the issue of vaccines and autism in my bi-weekly column for the local county newspaper, accompanied by my photograph, for which I received no compensation.  I now practice in York, PA.  Along with several other community pediatricians, I recently appeared on the local WITF TV public service segment about childrens' health, discussing the same information in my post. 

Also in reference to secondary gain:  it is a great burden for pediatricians, especially those in private practice, to buy and maintain the inventory of vaccines.  They must be refrigerated at a constant temperature, and back-up systems are mandatory, for a power-outage has meant the loss of tens of thousands of dollars.  It takes time and effort to give the vaccines, for which there is little compensation, if not negative cash-flow.  Not to mention it is not fun to give shots to cute babies (the docs give the shots in my practice).  However, we believe vaccination is a core part of preventive pediatric care, and the older docs among us remember long nights of treating gasping babies with whooping cough (Pertussis) and trying to save toddlers from the ravages of Hemophilus meningitis.  Sadly, these infections have reappeared in US children whose parents declined vaccines. 

At a very personal level, I am uncomfortable when parents refuse vaccines, because if the parents don't trust my medical advice on this most basic level, how will they trust my advice if their child is very ill and there are crucial decisions to be made? I try very hard to address their concerns, but it can become very difficult to develop trust and work as a team in their child's best interest, now and in the future. 

As per Dr Offitt:  his work was instrumental in developing the Rotavirus vaccine.  This is a virus that causes severe diarrhea, and in the past was responsible for hospitalization and even deaths in children, especially small infants.  Since this vaccine has been implemented, the number of hospitalizations of infants with dehydration due to this infection has decreased substantially.  I have seen this in my own practice.  I strongly encourage you to read his book, Autism's False Prophets.  (I believe that he is donating all royalties.) There is a multitude of factual information that you can verify.   

Not many people know that the author of the original paper claiming evidence that MMR caused autism has been discredited and is not allowed to practice in Britain.  Additionally, his co-authors and the editors of Science, the respected journal who published the research, have retracted the article. 
As per research into thimerisol:  Kaiser Permanente in California, which has a very large data base, has been tracking the incidence of autism over the years after mercury was removed from children's vaccines, and the incidence has not decreased.

I do not know what causes autism in every case, nor do I think that all autism is the same. Many autistic children exhibited signs of problems with interaction and communication before they received the MMR vaccine, as demonstrated by research involving family videos of these children as infants.  The pediatric community is trying to screen specifically for such abnormalities at the 18 month well-child visit, but we assess for interaction as early as 2 months, when we look for the responsive smile.  As the ability to detect chromosomal and genetic abnormalities increases, medical research is finding specific genetic mutations for more conditions.  Rett Syndrome is an example of a condition where a specific genetic mutation affecting brain development  causes a normal child to regress in developmental abilities.
Finally, even if the available research and statistical analyses are not convincing to some,  I encourage observers of the issue to "follow the money".  See where the mainstream autism organizations are focusing the majority of research dollars.  Now that the Special Masters has rejected the test cases, see at whom, and where, lawsuits are focused. I predict that vaccines will decline as a target.

Lucie Johnson
14 years 4 months ago

The rise in number of children associated with the autism label has mushroomed in part because of the introduction of the notion of "autism spectrum" and the awareness of milder levels of autism. Children who were not labeled in the past are now labeled. Our awareness of an autism continuum has grown.

There is however a second reason for the increase: children with "autism" characteristics need a stable, predictible and nurturing environment. Families are less stable now than they were in the past. Societal change of all kinds has greatly accelerated. Life is way more frantic. Constant stimulation, increased screen time, mutitasking, constant change are the order of the day. This is difficult to handle for all of us, but it is pathogenic for anyone with autistic tendencies, anyone who needs more stability and peace and calm to thrive.

In addition to improving access to the medical system, we also need to think about the way we live, the way we craft our culture. We are too frantic, way out of sync... and it will make our children -particularly those who may be more fragile, or more sensitive- less able to cope.

Teresa Conrick
14 years 4 months ago
Elise Thomas, MD-

Your post is disappoining. Comments like:

"it is a great burden for pediatricians, especially those in private practice, to buy and maintain the inventory of vaccines."

- does little to prove vaccine safety.  How about the truth here-
http://www.cbsnews.com/stories/2008/07/25/cbsnews_investigates/main4296175.shtml

"They're some of the most trusted voices in the defense of vaccine safety: the American Academy of Pediatrics, Every Child By Two, and pediatrician Dr. Paul Offit.
But CBS Newshas found these three have something more in common - strong financial ties to the industry whose products they promote and defend.
The vaccine industry gives millions to the Academy of Pediatrics for
conferences, grants, medical education classes and even helped build
their headquarters. The totals are kept secret, but public documents
reveal bits and pieces."
And this comment you made:

"As per Dr Offitt:  his work was instrumental in developing the Rotavirus vaccine."
-does little to instill trust in vaccines but again shows the conflict of interest to the people and facts you present because Dr. Offit is part of the vaccine industry and can not be a reliable, honest, or unbiased source about vaccines. 

http://www.ageofautism.com/2009/02/voting-himself-rich-cdc-vaccine-adviser-made-29-million-or-more-after-using-role-to-create-market.html

"Dr. Paul Offit of the Children’s Hospital of Philadelphia (CHOP) took
home a fortune of at least $29 million as part of a $182 million sale
by CHOP of its worldwide royalty interest in the Merck Rotateq vaccine
to Royalty Pharma in April of last year, according to an investigation
by Age of Autism. Based on an analysis of current CHOP administrative
policies, the amount of income distributed to Offit could be as high as
$46 million."

Or this mistake of information:

"mercury was removed from children's vaccines, and the incidence has not decreased."

but here is a recent study showing the damage from 1 thimerosal vaccine (mercury)
http://www.ageofautism.com/2009/09/blockbuster-primate-study-shows-significant-harm-from-one-birth-dose-of-a-mercurycontaining-vaccine.html?cid=6a00d8357f3f2969e20120a5ad8820970b

yet 1 flu vaccine is being given to pregnant women and then babies are to receive 2. This is in addition to the H1N1 (Swine) flu vaccine which also has thimerosal. which 2 doses are also the number being quoted for babies 6 months and children up to age 10.

http://www.phillyburbs.com/information/guides/parenting/parenting_details/article/249/2009/october/14/2-swine-flu-vaccine-doses-for-kids-under-10-likely.html
http://tinyurl.com/yk829cg

Then you continue this parroting of Dr. Offit's confabulations with:
"Not many people know that the author of the original paper claiming
evidence that MMR caused autism has been discredited and is not allowed
to practice in Britain.  Additionally, his co-authors and the editors
of Science, the respected journal who published the research, have retracted the article."

Instead, why not listen to Dr. Wakefield discuss this openly in an interview- (and  the journal was The Lancet not Science, a very basic fact)  He has nothing to hide.

http://www.cbsnews.com/video/watch/?id=5369973n&tag=mg;health

Lastly, your blatant insinuation that all of these children (1:91) have a genetic disorder is ridiculous.  It is completely impossible to have a genetic epidemic ( to borrow the title of this article) and to use Rett disorder with it's "1 in 10,000" ratio is just bad math as this Autism Speaks post shows your following comment to be inappropriate:


http://www.autismspeaks.org/navigating/rett_syndrome.php

"As the ability to detect chromosomal and genetic abnormalities
increases, medical research is finding specific genetic mutations for
more conditions.  Rett Syndrome is an example of a condition where a
specific genetic mutation affecting brain development  causes a normal
child to regress in developmental abilities."

For more on how the genetic search is showing little and how it has become a good excuse to avoiding much needed research on vaccine injuries and the children who have an "autism" diagnosis:

http://www.ageofautism.com/2008/03/the-fragile-b-1.html

http://www.ageofautism.com/2009/10/autism-and-genetics-what-weve-got-here-is-a-failure-to-replicate-.html

It is sad and obvious that your desire to protect the vaccine program outweighs your motivation to look at autism as a medical diagnosis with roots in the immune system via vaccines received.  These children can be helped but searching for elusive genes will keep them ill and the numbers inreasing.
Elise F Thomas
14 years 4 months ago
Thank you to  Ms Conrick for correcting my error in naming the prestigious journal that published the original Wakefield article about MMR and autism.  (I tried to include information in my post that could be easily verified)  The point remains that the journal and his co-authors have retracted their support.
My comment about the burden of providing vaccine is not designed to prove vaccine safety, for that has been already accomplished, but to show that community pediatricians are willing to bear the burden, if not net financial cost, because we believe that vaccines are safe, effective, and crucial to children's health. 
Teresa Conrick
14 years 4 months ago
Dr. Thomas,
 
Your comment about "providing vaccine" vs "proving vaccine safety" is quite an announcement but maybe not a surprise that the financial burden of vaccines seems sadly,  more important than the issue of safety to a pediatrician. Your statement that vaccine safety "has already been accomplished" is your quick attempt to disprove the thousands of injuries now associated with vaccines and an "autism" diagnosis.  I found this information to be alarming and pertinent to what you are defending- that vaccination is a business in which pediatricians must recoup money paid out:

http://www.cispimmunize.org/pro/pdf/The%20Business%20Case%20for%20Pricing%20New%20Vaccines.pdf

"As new vaccines are introduced into the AAP, AAFP and ACIP schedule, how should the practicing pediatrician price them to ensure recovery of direct and indirect costs and what payments are appropriate from the insurers? To answer this question, we must first accept the fact that a pediatric practice is really a business entity and must run on sound, generally accepted business principals to remain viable. These new vaccines have become increasingly expensive, necessitating a more business-like approach.

 
"So what should be the final price for a vaccine that ensures recovery of direct and indirect costs? If you are receiving adequate immunization administration fees, then the vaccine charge should stand on its own. Payments need to cover the purchase price, the office expenses as noted above and a return on the investment for the dollars invested in vaccine inventory. When you add this up, we estimate that the total costs of providing the vaccine is approximately  17-28%  above the direct vaccine purchase price. If the immunization administration fee is less than appropriate, then thiseither needs to be renegotiated or additional costs moved into the vaccine charge.Insurers understand business principles including the concept of return on investment and expect it in their business. There is no reason we should accept their refusal to recognize it in our business by paying only the vaccine purchase price. They pass on their increased costs to their purchasers to maintain profitability. We have a legitimate businesscase to make for adequate payment for vaccines and immunization administration and we must all make it."

Somewhere along the way, children became secondary to this "business" called vaccination.

Marie Rehbein
14 years 4 months ago

A number of replies here have disputed the implication of vaccinations in the increase in autism cases.  In our family, there was no autism in any generation until this newest one that received the abundance of immunizations at such an early age.  The statistic in our family is one case of serious autism out of eight of my parents' grandchildren. 

Just because there is no fault in any one of the vaccines does not get vaccinations off the hook.  It is still possible that the response of some individuals' immune systems to the measels vaccine, for example, causes them to develop autism.  

I noticed a setback in each of my four children after they received the measels vaccine and pointed this out to our pediatricians who dismissed it.  Then one of their cousins developed autism shortly after being immunized for measels.  The cousins born after that were not vaccinated and did not have any developmental problems. 

Considering how unlikely it is that a small child will catch measels, it is wise, in my opinion, to wait to administer this vaccine until the child starts elementary school. 

14 years 4 months ago
In 1978 my sister came to visit me with her two sons, 4-years and 11-months old. In the week they visited the baby didn't look around once nor did he make eye contact with me. That first year is when a baby's brain is doubling in volume and developing the complex systems of neurological connections that support perception and social relatedness. Think of all that he missed in that first year of basic development! He wasn't diagnosed with autism until years later. And wasn't this before the multitude of vaccines for infants were developed?
Whether or not autism always existed, it certainly is increasing. Probably there are various causes. But, like heart attacks and strokes, the earliest intervention is crucial for preventing complications. And yet even today there are years-long delays in diagnosis by experts. Parents aren't recognized as the ones who best know their children, caring lay experts who are interacting with the child and observing them throughout every day. (The first breakthroughs for treating polio came from the parents and that's true with autism also).
Three basic things need addressing: establishing cause(s)- prevention-and early intervention. But Lucie Johnson has pointed out another crucial factor-of how recent societal change, which is negatively impacting all children, is disastrous for children with autism. The bond between mother and child is being weakened from generation to generation and our pace of life isn't consistent with mental and social health.
I'm dismayed that most of the others who have commented on this article are obsessively focusing on the debate over vaccines.
Teresa Conrick
14 years 4 months ago

Autism is not a way of living or a learned behavior.  I'm sorry but this following comment is offensive as it may as well say that mothers, again, are to blame for autism as they were back in the 1950's, when Bruno Bettelheim did much damage and had zero evidence or credibility with his Refrigerator Mother theory:

"The bond between mother and child is being weakened from generation to generation and our pace of life isn't consistent with mental and social health. I'm dismayed that most of the others who have commented on this article are obsessively focusing on the debate over vaccines."

Autism is a medical illness not a psychiatric illness or a retreated response to bonding, from anyone or society.  It is 2009 and there is a wealth of information about the medical pieces that are seen in autism - oxidative stress, immune dysregulation, chronic bacterial infections, neuroinflammation, gastrointestinal reflux, colitis, and inflammation, as well as mitochondria dysfunction. 

Thank you again to the Editors for these meaningful and much appreciated words: "When Jesus said, “Let the children come to me,” it was a gesture of benevolence. It was also an acceptance of responsibility. Autism is not something that happens only to “other” families. These are our children. Let them come to us and be helped or healed, or at the very least be comforted."

ANN ODONOGHUE
14 years 4 months ago
"As per research into thimerisol: Kaiser Permanente in California, which has a very large data base, has been tracking the incidence of autism over the years after mercury was removed from children's vaccines, and the incidence has not decreased."

My understanding is that while mercury has been phased out of most child vaccines, it is still present in flu vaccines, and women and infants are first in line for those. So really, infants were, and still are, being exposed to it. (I do understand that there is a small percentage of thimerosol free flu vaccines available.)

Again, I will be happier when I see comparative studies, not numbers culled from a pharmaceutical companies database. I certainly don't think you should be relying on them as a data source as they have not exactly proven themselves above deception when it comes to clinical date.

As for Dr Offit, I won't even go into the conflict of interest issues which you must be aware of. And while he may have donated the profits from his book he certainly made tens of millions on his rotavirus vaccine. He also holds a $1.5 million research chair funded by Merck. How can someone so in bed with the pharmaceutical industry be unbiased?

If I might ask, what is your position on Gardisil?
14 years 4 months ago
Great Article
14 years 4 months ago

My research has led me away from blaming vaccines to studying the effects of two more crucial factors: was the mother of this generation of autistic children herself breastfed during the 1960s though 80s? And if not, did she and has her children received a disproportionate number of anti-biotic medications during her life compared with HER mother?


It would seem that vaccines are not a cause of autism... and neither is wheat and milk products.... the cause is somewhere in the health of the GI tract and what disrupts the normal flora of bacteria that helps all humans breakdown food.


A child who was put on formula in the 1970s and not breastfed would not pick up her mothers' bacteria....instead she'd be sick(er) and then given more anti-biotics than her mother would have received as a child. This weakens her system.


When HER child is born in the 1990s or 2000s' the baby is at an immediate disadvantage for not having proper bacteria in the GI tract to begin with, and in such as state, is more susceptible to bad bacteria, more susceptible to pathogens, not being able to digest 'normal' foods, etc. leading to all the harm.


That at least is one newer theory. It would make sense if only because we know that many people are vaccinated without developing autism and others can eat wheat and milk without problems. So it may not be the vaccines or food that's the problem at all....


But this is not dogma, we're all searching and we all need to keep an open mind.


 


 


 

Elise F Thomas
14 years 4 months ago
For a wide selection on specific studies on vaccine safety, go to:  [url=http://www.cdc.gov/vaccinesafety/vsd/]http://www.cdc.gov/vaccinesafety/vsd/[/url]
Kaiser Permanente is not a drug company, but a health care organization with a large data base of its own patients and their diagnoses.
Returning to the main focus of the column, perhaps the editors could do a follow-up article commenting on insurance coverage of autism in the various proposals for health care reform?
Teresa Conrick
14 years 4 months ago
Dr. Thomas,
I think the main focus of this column was to look at these topics that the Editors presented and as a parent in the trenches of this autism epidemic, I really am grateful for their understanding of what is going on.   :
- "how is it possible that a public figure as prominent as Kathleen
Sebelius, secretary of the U.S. Department of Health and Human
Services, still cannot say for sure if the higher numbers recorded by
her own researchers merely reflect better reporting and a broadening
diagnosis?"
- "A C.D.C. statement noted: “These data affirm that a concerted and
substantial national response is warranted.” This is the kind of
rhetoric we have already heard as the autism spectrum numbers leapt
higher. When will that concerted response begin?"
- "Clearly genetics plays a primary role, but as the numbers pile up the
possible effect of so-called environmental triggers like vaccines
cannot be ignored."
- "While a more determined effort to address the causes of autism and
develop strategies to prevent it is absolutely necessary, another
serious lapse also needs attention: the lack of support for families of
autism-spectrum children."
And since you mentioned the VSD in your link - here is more information on the original Vaccine Safety Data, the one that is now missing.
excerpts:
http://tinyurl.com/yksy42c
the full transcript:
http://www.nationalautismassociation.org/pdf/simpsonwood.pdf
Elaine Tannesen
14 years 4 months ago
For fifteen years, ending in 2006 I taught students with the most severe disabilites in our school district. At first we had one or two students on the autism spectrum per class but now, half or more of our classes are composed of these students. The behaviors of these children have not just become more recognizable. There simply are more of them.
I have had the privilege of working with some of the most amazing families on the face of this earth. Parents of children with autism face enormous challenges from the moment they wake up and sometimes all through the night, day after day. Their support groups and efforts to provide the best for their children are remarkable. New strategies and teaching techniques provide hope and improvement for some but not all. It was not unusual to hear the tragic story of a normal little child, walking, talking, then regressing into autism after a vaccination. I could not help but wonder about this connection.
Your call for additional research is so very timely. I wonder about what has changed in our environment.  Is it true that the Amish have a 1 to 10,000 ratio of incidence?  Even if it were one tenth of this I would wonder why.  I also wonder about the validity of studies when the powerful drug corporations are in bed with our regulators. I also wonder about the sheer number of vaccinations that children in the US receive-two to three times the number of other industrialized nations. Its important to follow the money.
Children with autism are here. They are down the block, in our stores and schools, in our families. We, as Catholics, need to provide support not judgment. That means saying "hi", inviting these folks into our homes and classrooms, refraining from negative comments about "melt downs", offering to babysit or bring a meal over from time to time, but most of all having the courage to move past our comfort zone and get to know the fascinating and delightful side of a person with autism. If you think about it, we are all on the spectrum, the magnificent spectrum of human beings.
14 years 4 months ago
Thank you for bringing attention to the enormous, complex issues related to autism. For a future follow-up article I'd recommend that you do an examination of how the Catholic Church is responding to this epidemic.  My own experience with my autistic son and autistic daughter was very negative.  They (and I) received no support, acceptance or anything remotely loving from the local churches we belonged to.  My daughter, age 38, has never received Confirmation and refuses to attend church.  My son, age 43, found more comfort in the local evangelical church . He celebrates Mass with me and calls himself an evangelical Catholic.  Our church had nothing to offer them  in instruction in the Faith and I had to work full-time to support my family and had little time and energy to give much other than example. I still feel very sad about this.  Now, the issue is what will happen to them when I die?  I'm depending completely on the state to provide services, and a few relatives who are also old and ailing.  In my city, the only Catholic sponsored services for developmentally disabled adults are a training school and a residence.  Both are run by two different orders of nuns and both are wonderful facilities.  But, my children are too high functioning for either resource.  We can't look to our parish priests as they are overwhelmed.  Where does that leave us?
Perhaps, younger Catholic families with disabled members are finding  comfort  and help in the church.  I sincerely hope so. It seems to me, a betrayal of Christ for Catholics  as individuals and as church to neglect such vulnerable families.  Your last paragraph really struck home with me. Jesus cannot be pleased.
I wonder what the social justice and the culture of life people are doing to help, heal or at the very least comfort.  Surely our families are deserving of the attention of these groups!   
Anne Dachel
14 years 4 months ago
"It is time to accept that the vaccine link does not exist."

We always hear about the studies that supposedly prove no link between vaccines and autism but no one actually looks that those studies. Autism advocate Julie Obradovic examined the fourteen studies that are used to prove safety.
http://www.ageofautism.com/julie-obradovic/

Julie wrote, "Having read all of the studies several times, I can assure you they have not [disproved a link.] And regardless of what side of the debate you fall, that fact is indisputable. Studying 1 ingredient of dozens and 1 injection (given sometimes twice) out of a possible 35 before age 5 is certainly inadequate."



These studies are riddled with flaws and hopelessly tied to the industry that produces the products in question or they’re done by the agency with everything at stake in showing vaccines are safe. They will never settle the controversy. In Julie's words,

"Each and every study was conducted and/or funded by someone who patents, manufacturers, promotes, endorses, profits from and/or defends in a court of law vaccines."



Regarding thimerosal, the mercury-based vaccine preservative, there is no justification for its use.


The mercury-based vaccine preservative thimerosal goes back 75 years. It was invented and tested Eli Lilly Pharmaceutical Company in 1930. The one study done on thimerosal was done by Eli Lilly on 22 adult patients suffering from meningitis. There was no chance for follow-up to observe long-term effects, as all of the patients died. Even if follow-up had been possible, damage to the developing brains of very young children would have remained an unknown. Eli Lilly said it was safe and the medical community just accepted it. After the creation of the FDA, its use was simply continued. This unconscionable oversight failure should call any safety claim into question.

We continually hear from doctors with no background in toxins who tell us that it's safe to inject the second deadliest element on Earth into children and pregnant women. I have yet see a toxicologist willing to put his/her reputation on the line supporting the safety of thimerosal.

Ninety percent of the regular flu shot has toxic mercury. The H1N1 vaccine will only add to the mercury load. With the annual flu vaccine A child from 6 months to age three receiving a flu vaccine gets 12.5 mcg of mercury. This amount of mercury can be processed only by someone weighing 275 pounds according to the EPA. One month later, another 12.5 booster is recommended. Older children receive the adult vaccine with 25 mcg of mercury. That much mercury is meant for someone weighing 550 pounds according to the EPA.


This vaccine is also recommended for pregnant women at all stages of pregnancy. The huge mercury assault easily passes the placental barrier and enters the developing fetus whose tiny brain is just forming.

Incredibly, the manufacturers of the flu vaccine state in their published information that accompanies the vaccine that it's never been tested on pregnant women.
http://www.safeminds.org/about/documents/SM%20Flu%20Brochure%202009-2010.pdf



Anne Dachel

Age of Autism http://www.ageofautism.com/
Maurine Meleck
14 years 4 months ago
Thank you for this important article. It is so refreshing to read an article that is not biased in favor of the typical "all vaccines are safe for everyone."
Again, I want to state that the autism community has been waiting for years to see an independent study of vaxed vs unvaxed children in this country. Why hasn't this been done.?? What are some people afraid of that they won't do this? I have two vaccine injured grandchildren. I've been studying this for 10 years. There is no question in my mind.
Thanks again. Your article is important.
Nancy Alspaugh
14 years 4 months ago
Thank you for presenting one of the most unbiased, comprehensive articles about the autism epidemic that I have ever read. As the executive director of a non-profit that funds grants for families that cannot access or afford treatment (autism care and treatment today or ACT Today!), I can tell you that we must do something to help the vast numbers of families in this country who simply cannot cope with the financial and emotional toll that autism takes on their lives. It is time to say we have had enough to the special interests that protect their own well-being over the well being of our future generations. It is time to say we have had enough to those who stand in the way of truth. It is time to take care of the legions of individuals suffering with the disorder today, and to turn the tide before it is too late.
Meredith DiLiberto
14 years 4 months ago

THANK YOU for this excellent article!  As a Cathlic and a mom it does my heart good to see Catholic voices looking out for individuals and families struggling with autism - and for generations of kids to come.


I am not a doctor, but I am a lawyer and I would like to point out that the only comments made have been about the "test cases" in which the courts have not found a link.  The Vaccine Court has, however, found the exact oppposite as well: the Bailey case was decided only 10 days after the "test cases" referred to above and the court held that the MMR vaccine was the "cause in fact" of Bailey's autism spectrum disorder.  The case received no media attention - likey because the media has already made up its mind.  The opinion is public though for anyone who wants to read it.


If the same court can find two completely different outcomes, does that not, at the very least, demonstrate the need to find more answers?

Anjali Truitt
14 years 4 months ago

   I applaud this editorial for providing space to highlight the importance of ASD and its public health implications.  Furthermore, I think that it calls us to reflect on the social factors that contribute to disabling persons. 


    In a society where accessibility remains a barrier for individuals with disabilities and their families, we must ask ourselves what more can be done in our communities to promote inclusion.  Consider as a general rule that religious organizations are exempt from any Title III accommodations under the Americans with Disabilities Act.  Resulting from a simple lack of accessibility, a family adjusting to the disability of their child may have to relocate to a new place of worship.


    Furthermore, we must challenge the prevailing negative attitudes about autism and other disabilities.  While my intention is not to devalue the importance of medical research and interventions, the notion of “cure” itself can be stigmatizing.  The language we use to describe people is important and should reflect individuals’ inherent worth, rather than simply their limitations.      


    The commentary cites, “Let the children come to me.”  While the authors highlight this gesture as one of benevolence and responsibility, the gesture underscores the importance of respect for persons.  The tacit message is come as you are.  Too often, however, oppressive social structures keep this from happening, but hopefully, more articles like this will create avenues to make positive changes.    

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