Autism Spectrum Disorder - Immunizations

It is my opinion that the problem with immunizations is not solely Mercury. I am concerned with the number of immunizations given the first two years of life starting with Hepatitis B at birth. Hepatitis B is very low risk for a newborn since transmission of this virus is primarily from sexual contact and needle use with addictive drugs. Hepatitis B given to a newborn with follow-up shots at two and four months should be given, in my opinion after age five. I also have concerns with the combination of Measles/Mumps/Rubella. I believe these vaccines should be given separately. A good case could be made for giving Rubella at age five to six or even to a preteen. I would personally prefer not giving Varicella vaccine. Chickenpox certainly causes acute illness for seven to 10 days for many children but the long term risk is generally not significant enough to warrant a vaccine. Children who are vaccinated may run the risk of losing immunity at a later age. Chickenpox in teens to adults can be a severe infectious illness.

I remain an advocate of the immunization program but do feel that giving fewer vaccines such as Hepatitis B, Varicella, separating Measles/Mumps/Rubella, as well as not giving more then two vaccines at one time and never giving a vaccine to sick children makes sense. The immune system the first two years is fragile. Although it has not been scientifically proven, the fact that the rate of Autism has risen to frightening levels over the past 20 years mandates that safety needs to be a part of the immunization program in the United States. The following is a letter that I sent to the American Academy of Pediatrics on 03/27/2008 that details what I believe needs to be implemented for a safe and effective program:

Letter I sent March 2008 –
American Academy of Pediatrics Committee on Immunizations

I am a pediatrician who has been in pediatric practice for over 42 years.

I have practiced during a Measles epidemic and have actually treated 2 children with Diphtheria in 1969. Recognizing that Pertussis has increased and that Meningitis has always been a major concern, there is no question that an appropriate immunization program is absolutely a necessity.

For the past 10 years, I have been specializing in evaluating children with Autism Spectrum Disorder and other developmental delays and do have concerns, not with the need for immunizations, but a more rational immunization schedule.

I believe that the primary issue, which actually everybody agrees on, is that the rate of Autism has increased from 1 in 2,000 (1990) to 1 in 150 currently.

It is my opinion that even though the autism diagnosis is being made more frequently, pediatricians are better at diagnosing Autism, and more children are going on the spectrum to receive services, this still does not nearly account for the alarming increase in Autism over the past 17 years.

Regarding research – I agree with the A.A.P. that studies to date do not prove Thimerosal as the primary cause of Autism. Unfortunately, the amount of money spent on research is meager. Pediatricians, parents of autistic children, and individuals who disagree with the academy on immunizations should really unite to demand more extensive research.

With the recent ruling in Vaccine Court that this child was entitled to a settlement because of the vaccines, those who believe in Thimerosal jumped on that issue; those who believe that the MMR is the problem jumped on that one.

I was bothered by the fact that the child was acutely ill and received 9 vaccines in one day. This one patient should be a learning tool for pediatricians, parents, and anyone involved with autistic children. This is another example of our need to recognize that a common sense approach is in order while we wait for better studies.

While we await conclusive studies, we have another generation of children who are potentially at risk of having Autism and the rate going even higher.

My own personal opinion is that we need to take a step back and critique the immunization program as it currently stands and make changes over the next 2-3 years.

My opinion is as follows:

  1. Children should receive, in their first 2-3 years of life, the critical immunizations where we know the benefits outweigh the risks this would include:
    • HIB
    • Pneumococcal
    • DPaT (without Thimerosal)
    • Measles vaccine
    • Polio
  2. I would also recommend that no more than 2 immunizations be given in 1 day and never to a sick child.
  3. I am concerned that children immunized in their first 2 days of life with Hepatitis B in a nursery when the risks of that Neonate using needles or having sex is nil. Certainly, children born to parents with Heroin addiction should receive Hepatitis B coverage, but this should not be a universal program the first 2-3 years of life.
  4. The Flu vaccine should be given but without Thimerosal until we know, without question, that Mercury is not a problem.

With other vaccines, I personally believe that Varicella, Rubella, Mumps, Hepatitis A, and Hepatitis B should wait at least 2-3 years before being given to children on a routine basis.

As mentioned above, I do not believe that Thimerosal is the sole reason for the increase in Autism, but I do worry that this heavy metal is cause for alarm – that it is in our air, and affecting air quality, and if Mercury drops in a house from a light bulb there is concern; yet it is okay to give it in injectable form. Research or no research, I remain concerned.

This letter is written not to chastise the American Academy of Pediatrics; I just think that we really need to step back because of the lack of research, rethink our current immunization policy, and implement a program that provides a very good chance of lowering the rate of Autism.

One more point ... if we were to adapt a policy more in line with my own, the problem that we are now facing with parents who refuse categorically to immunize their children would improve dramatically. I believe that many parents would accept the rationale of: immunize my child for what my child is at risk for the first 2 years, rather than immunize for everything to fully achieve full compliance.

If you have any questions about the contents of this letter, please contact me.

Richard E. Layton, M.D.