The Vaccine-Autism Debate Revisited

by John C. Pittman, MD

Back in February of this year, the Associated Press released an article titled “Officials say 'bad science' links vaccines, autism.”  The article, which was picked up by newspapers across the country, proclaimed that the U.S. Court of Claims had found little if any evidence to support a connection between vaccine use and autism risk, and that overall the evidence was evidence "weak, contradictory and unpersuasive."  The ruling was in response to some 5,500 claims filed by families who were seeking compensation through the government’s Vaccine Injury Compensation Program.

In 1998, considerable media attention in the United States and Europe followed the publication of a controversial report on autism in the esteemed medical journal, The Lancet.  In that report, British researchers documented the emergence of autistic behaviors and intestinal problems, which in several cases closely followed vaccination for measles, mumps and rubella (MMR). The study found measles virus antigens in the intestinal linings of many autistic children—antigens presumably linked with MMR vaccination.  The Lancet’s publication of this issue sparked a torrent of media attention because of the fact that Thimerosal, an antiseptic containing ethyl mercury, was being used as a preservative of vaccines distributed and administered worldwide. 

As documented in the 12 March 2009 issue of the American Journal of Perinatology, “There are studies that point to a significant link between exposure to TCVs [Thimerosal-containing vaccines] and neurodevelopmental delays.” Direct intramuscular injection of Thimerosal results in the rapid release of mercury into the blood stream, and this mercury can eventually accumulate in the tissues of the brain. In animal experiments, vaccination was shown to result in autistic symptoms.

Some evidence has begun to link Thimerosal-containing vaccines to the onset of autistic behaviors.  In 2001, researchers at the Institute of Medicine published an analysis of autism rates and mercury exposure and found an association between rising autism rates in California and mercury exposure in childhood vaccines.  This preliminary report, though heavily criticized at the time, was followed by a more rigorous report published in the August 2006 issue of Neuro Endocrinology Letters—a meta-analysis of autism and other neurodevelopmental disorders following vaccines administered in the United States from 1994 through 2000.  Pooling together data from many studies at once, the researchers found a statistically significant association between the development of autism and early exposure to Thimerosal-containing vaccines. 

Prior to the hubbub over vaccines and autism, there was a history of toxic effects associated with the use of Thimerosal in topical medicines, such as contact lens solution, eye drops, and other products. Indeed, it was due to this history of documented toxic effects that the Food and Drug Administration (FDA) eventually instituted restrictions on the use of Thimerosal in these medical products in the late 1990s.  And in 1999, the United States and the European Union countries took major steps to reduce and even eliminate Thimerosal from most vaccines.  Nevertheless, all U.S. pregnant women, infants, and children (until 18 years old) are still advised to receive an annual influenza vaccination, of which more than 90% still contain Thimerosal.  In addition, Thimerosal is still found in trace amounts in many vaccines on the market today, according to the FDA.

What worries many integrative physicians and environmental medicine experts is that any mercury at all—whether from vaccines, the diet, or from the silver fillings used in dental work—can be a threat to young brains, which undergo many changes in the early years. Mercury exposure begins in utero, being passed easily from the mother to fetus due to consumption of tuna and other fish, presence of amalgam dental fillings, and sometimes the use of mercury-containing vaccines like Rhogam.  Mercury exposure may then continue after birth through fish consumption, dental amalgams (especially with increasing age), and flu vaccines.  Both the fetal brain and infant brain are uniquely vulnerable to the effects of even small amounts of mercury, lead, and other neurotoxic factors.

Researchers reported in the October 2007 Journal of Toxicology and Environmental Health that individuals with severe Autistic Spectrum Disorders (ASDs) had significantly increased levels of various indicators of mercury exposure in their urine.  These indicators, called “porphyrins”, were much higher in people with severe ASDs compared to those with mild ASDs, whereas other urinary porphyrins—those not linked with mercury exposure—were similar in both groups. At the same time, the individuals with severe ASDs had much lower levels of glutathione, a core antioxidant in healthy cells that is inextricably linked to the body’s detoxifying capacity.

This last point offers us a vital piece to the autism puzzle:  Along with the unique developmental vulnerability of the young brain, autistic kids are far less able to process and eliminate mercury from their bodies, often due to having extremely low glutathione levels.  Many of these children have a genetic predisposition to low glutathione levels.  This means that, even with low-level exposure to mercury and other toxic metals, they may be far more vulnerable than other kids with normal glutathione levels.

At the Raleigh-based Carolina Center for Integrative Medicine, we see the best outcomes when glutathione, intestinal infections and other factors are addressed in a systematic way. The mother’s mercury burden from her diet and from dental amalgams may also contribute substantially to the higher mercury levels that are often seen in autistic children.  Ridding the body of mercury and other toxins is most likely to be therapeutically successful in the context of this more comprehensive approach.

Shifting the Focus to the Immune System

If there is an adverse impact of vaccinations, it probably has more to do with disrupting the functioning of the immune system and with "developmental immunotoxicity", as reviewed by Cornell immunologist Rodney Dietert in the October 2008 Journal of Toxicology and Environmental Health. Part B. These days, vaccination programs often entail more than 30 immunizations administered to the child between the ages of 12 and 24 months. This practice introduces a vast number of foreign proteins into the body—sometimes as three different attenuated viruses in one vaccine, as in the case of the MMR.  This raises the possibility that there may be insufficient time between vaccinations for the child’s immune system to return to a normal healthy baseline.  Side effects of these vaccinations have included allergic reactions, autoimmunity, and on some rare occasions, the full development of viral diseases (ostensibly from infections by the attenuated viral particles of the vaccine). 

It is possible that such inflammatory immune reactions to a multi-vaccine program could result in neurobehavioral changes that have been linked with autism and ASDs.  This is something we have heard repeatedly from parents who brought their autistic children into our Raleigh-based clinic, the Carolina Center for Integrative Medicine.  In some cases, we have been able to document the effects ourselves.  Even with contemporary vaccine programs (containing little or no Thimerosal), we still see children who are fine one day and then quit talking or behaving normally the day after they get vaccinated.  Some of these children will regress dramatically, so much so that the parents fear they are losing their children before their eyes.

So, the question remains: Are we overvaccinating our children?  According to an April 2009 article by Bernadine Healy, M.D.  in U.S. News & World Report, the United States “gives more vaccines to all its children, and earlier in life, than the rest of the developed world: some 36 doses before our little ones hit kindergarten, with most crammed into the first 18 months of life. If you look at the best-performing countries in terms of infant and early-childhood mortality, the average number of doses is 18, with most of the Scandinavian countries, Japan, and Israel mandating just 11 to 12.”

Does the simultaneous administration of multiple vaccines overwhelm the immune system and predispose some individuals to autism?  Epidemiological studies (which focus on populations, not individuals) have thus far been unable to show a significant link between autism and vaccinations.  However, epidemiology is a crude science in some respects, often leading to general conclusions that overlook individual differences or variations.  Large population studies may look impressive, but they may totally miss the small and specific subsets of the general population (such as those with glutathione deficiency) that may be at elevated risk of neurodevelopmental problems, possibly including developing autism subsequent to live virus vaccination.

Autism most likely arises from a complex interplay of genes, nutrients, and toxic factors, all affecting the individual during unique windows of developmental vulnerability.  Studies are now underway to examine the possible role of environmental risk factors and their interplay with genetic susceptibility during the prenatal, neonatal and early postnatal periods.  Let’s hope that some studies will compare groups of vaccinated and unvaccinated children by measuring individual effects on their immune systems while also taking into account their genetics, detoxification capacity (again, many autistic children lack the essential means to detoxify due to low glutathione levels), and exposure to toxic factors such as mercury and intestinal infections.

Until such studies are done, the jury is still out on whether we are overvaccinating our children and fueling the autism epidemic.  Multiple vaccinations could certainly play a role, especially given the many immune problems that have been found in autistic children.  On a precautionary basis, then, pediatricians should consider spacing out shots that are normally given in one visit—particularly those that contain live viruses like measles, mumps, and chicken pox and tend to deliver strong immune reactions.  Some Docs now advocate delaying hepatitis B vaccination until school age.  Helping our kids develop strong, healthy bodies and immune systems, and giving parents the tools to support such development, could prove extremely valuable.

To reach Dr. Pittman, or to obtain more information on his integrative pediatrics program, contact the Carolina Center for Integrative Medicine in Raleigh, NC at 919-571-4391, or visit the website at carolinacenter.com.

Comments

[Jean Belford, 6998 Prospect-Dublin Rd. Prospect, OH 43342]

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[Korean Ginseng]

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[Anthony Russell, MD MPH]

There are a few errors in this essay.
#1 Thimerosol is not present in the MMR vaccine.
#2 The initial Lancet Article stating that there was a link between autism and the MMR vaccine was retracted by most of the authors and then the Lancet retracted the entire article. The primary author was paid by lawyers representing children with autism.
#3 There are different forms of Mercury, just like there are different forms of Hydrogen. In one form it is safe, and in another it can kill you. The form of mercury in Thimerosol is safe. But even if it were not, many states and countries have removed it from vaccines over the past 15 years, but we are still seeing an increase in the rates of Autism. Look at Denmark, for they removed Thimerosol from their vaccines more then 15 years ago, and they are still seeing increased levels of Autism.
Cheers,
Anthony Russell, MD MPH

[Anthony Russell, MD MPH]

Delaying the Hep B vaccine is reckless.
Even if you as a pregnant mother get tested and you are negative. Their is a small percentage of false negative results and some women get infected with this virus late in pregnancy as well.

Children who receive this vaccine early in life, get the best immunity; for the later you get the vaccine the lower the effectiveness of prevening infection and developing liver failure.

We know that if a child is exposed to Hep B virus at 1 week of age, the likelihood of liver failure is 95% and it slowly decreases from there.

Early Vaccination gives the Best Protection for your child. Don't take a chance with your child's life - give the Hep B Vaccine at birth.

Anthony Russell, MD MPH

[Mark N. Mead]

Dr. Russell apparently did not read Dr. Pittman's article. There is no mention of mercury being present in the current MMR vaccines (those were removed as of 1999). As the article states, the concern with MMR and other vaccines is disruption of immune system functioning in these children.

Additionally, the "reckless" claim regarding Hep B vaccination at birth is questionable. What risk of Hep B does an infant have in the first few months of life, and why couldn't it therefore wait a few months, when the liver and immune system are more stable?

Mark N. Mead, MSc