Reluctance toward vaccinations puts health officials on alert
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Measles back on the rise as parents' fears of autism keep kids from getting shots
8/29/2008 - 8/30/08
CHICAGO — Angela O'Connell will not allow her 15-month-old son to be vaccinated against measles, mumps and rubella because she is certain the vaccination caused autism in her older boy, Aidan."The little boy that would stare into your eyes and laugh when you played with him turned into a boy that wouldn't even respond when you called his name," the Minooka mother said.
Over and over, careful scientific research has found no link between vaccinations and autism. Experts note that autism tends to emerge at the same age kids receive their shots, leading to a false sense of cause and effect.
But stories like O'Connell's are so powerful, and so easily spread online, that pediatricians say they are spending unprecedented time answering questions about vaccinations, from mercury fears to concerns over the increasingly intense schedule of shots.
Parental suspicion is now so high that public health officials fear it could undermine one of the most important advances in medical history. Although vaccination rates have remained fairly steady, pockets of vaccine rejection can lead to outbreaks of childhood diseases that were once thought conquered.
Last week federal officials reported that measles cases in the U.S. have reached their highest level in more than a decade, with nearly half of the cases involving children of parents who opted against vaccination.
Doctors say worried parents tend to find scientific data less persuasive than the horror stories they hear about vaccine side-effects online or from friends. One expert said attitudes are likely to change eventually, but only after children start dying again of diseases parents have come to think of as obsolete.
"I think people have a hard time separating out what's reliable information and what's not reliable," Dr. Ruben J. Rucoba, a Wheaton, Ill., pediatrician. "What gets attention is not the statistics, but the story. All it takes is one friend of a cousin of a neighbor who they can point to who says, 'My child got an immunization and now he has a problem.' "
Rucoba and other pediatricians say they are frustrated and worried about how to reassure parents.
"The number of people who are trying to make changes in the vaccination schedule based on what they have heard or seen or read on the Internet is climbing every year," Rucoba said. "Even those who ultimately decide not to alter the schedule have questions about it, and every year we spend more time talking about immunizations with parents."
In the next few weeks, the Illinois chapter of the American Academy of Pediatrics will launch a survey to ask pediatricians how much time they spend answering parents' questions, how it affects their medical practice and whether they are asking parents who refuse shots to leave their practices.
One of doctors' biggest concerns is loss of "herd immunity." Because no vaccine is 100 percent effective, successfully fighting disease requires that most children be vaccinated. Some communities may already have reached a tipping point, said Dr. Paul Offit, chief of infectious diseases at the Children's Hospital of Philadelphia.
Immunization rates overall remain high, but experts said clusters of unvaccinated children are cause for alarm. Dr. Jane Seward, deputy director of the CDC's viral diseases division, said the measles outbreaks this year had hit areas with "pockets of susceptible people."
No one has died in the seven outbreaks seen in the U.S. as of July 30, but more than a dozen patients have been hospitalized, according to the CDC. Measles is one of the first diseases to reappear when vaccination coverage rates fall, the agency said.
Doctors say the most common questions from parents concern the idea that autism may be linked to a mercury-based preservative called thimerosal that used to be a frequent ingredient in vaccines. The preservative has been removed from most childhood shots, and recent research has found no link between thimerosal and autism.
"My heart aches for the parents of an autistic child," said Dr. Kenneth Alexander, chief of pediatric infectious disease at the University of Chicago. "Nonetheless, to accuse vaccines of causing autism is a misplacement of blame; people who claim that vaccines cause autism are executing the wrong suspect for the crime. I don't know what causes autism, but study after study show that it is not immunization."
Erin Micklo, of Glen Ellyn, Ill., is one parent who believes the measles, mumps and rubella shot had a negative effect on her son, Emmitt. Within a couple of days of being vaccinated, the 18-month-old boy developed a high fever and a rash and became extremely lethargic, she said. He was later diagnosed with autism.
"The childhood vaccination schedule shouldn't be a one-size-fits-all because every child is different," said Micklo, who has decided against having him vaccinated again.
