This is part one of the two-part series on children and autism. Next month, we’ll look at how Orange County schools deal with autism in the classroom.
It was just another typical day for mom Becky Estepp. It was the year 1999 and she had just brought her 15-month-old son, Eric, into his pediatrician’s office for his last round of recommended routine vaccines. Her son, at that time, had received the full normal schedule of vaccines since he was born, and thankfully, this was his last dosage.
But this time, something went wrong, says Estepp. As little as two hours later after receiving his final shot, Eric began having violent reactions. He was up all night crying hysterically, and then throwing violent tantrums during the day. Then, Eric became sick all the time. He had mysteriously contracted every disease imaginable from the regular cold and flu-like symptoms to rotavirus and hand, foot and mouth disease‚ all one right after the other.
Estepp, who now works as a policy manager for the nationally recognized nonprofit Talk About Curing Autism (TACA) in Costa Mesa, is convinced that the vaccines were the culprit of her son’s autism, a belief she shares with celebrity-turned-autism advocate Jenny McCarthy. Due to Estepp’s pending legal investigation for a vaccine injury case with the federal government, she could not reveal specifics of the vaccines given to her son.
McCarthy, whose son was diagnosed in 2007 with autism at the age of 2, has campaigned aggressively since her son’s diagnosis that certain ingredients in vaccines “trigger” autism. McCarthy, author of the 2009 book “Healing and Preventing Autism” and the 2007 “Louder Than Words: A Mother’s Journey in Healing Autism,” has raised concerns on the subject among young moms.
South Orange County, in particular, is getting a taste of the consequences from parents who stop or delay childhood vaccinations due to autism fears. Why? One reason offered is that South Orange County has more of a concentration of women who fall into the Jenny McCarthy demographic: Young, white and pop culture-centered.
“Certainly, south Orange County, I think, is more influenced by the media or celebrities in the media,” Dr. Mary Ann Wilkinson, M.D., a pediatrician at Sea View Pediatrics with offices throughout South County says. “They’re more willing to follow people even though they don’t have any facts to follow it.”
Wilkinson says she has seen more and more parents stopping, delaying or picking and choosing what vaccines their child will receive. Because of this, schools in South Orange County are seeing a rise in once-dormant diseases such as measles and chicken pox than any other Orange County area. Diseases like pertussis, also known as bronchitis, have spiked over the past two years from parents delaying or refusing to get their child the DPT (diphtheria, pertussis and tetanus) vaccine, says Wilkinson. This is worrisome for doctors like Wilkinson who explain that choosing not to vaccinate for certain diseases like pertussis can be life threatening in young children, as well as increase the risk of other children contracting these infectious diseases.
She says that from what she’s seen, parents won’t risk it, citing autism as their number one concern. According a Center for Disease Control and Prevention (CDC) report released in October 2009, there’s a 57 percent increase in prevalence of autism since 2002, when health officials first began a nationwide effort to quantify its risk during childhood. Autism spectrum disorders (ASDs) is a group of related developmental disabilities, caused by a problem with the brain, that affect a child’s behavior, social and communication skills. Recent data from the CDC suggests that about 1 in 110 U.S. children have an ASD.
Although many of the causes of autism are unknown, researchers say there may be different reasons that make a child more likely to have an ASD, including environmental, biologic and genetic factors. The idea that adverse reactions to vaccines cause autism is a controversial topic, and some parents fearlessly debate between what science says and what they experience. ”Basically, he went from a healthy child to literally sick every couple of days,” Estepp says, now 39. Following her son’s odd reactions, Estepp did what any normal mother would do. She brought her son back to his pediatrician’s office where Estepp explained to the doctor everything from the late-night cries to the pounding of fists. The doctor, however, concluded that it was a parenting issue and not a medical one. He then gave to her some unique advice that not every mom expects to hear from her doctor: “The pediatrician told me to spank him severely,” Estepp says.
Confused, Estepp pondered the doctor’s advice the following day when Eric awoke in the middle of the night throwing another tantrum. “I’m processing that I’m supposed to spank him,” Estepp says. “Here he is crying hysterically and I’m supposed to have an open palm to him.” Tossing the doctor’s parenting prescription out the door, Estepp turned to her maternal instincts to what may be really wrong. She looked up autism online and found one website that explained its symptoms. Estepp discovered that she could put a mark in every box for the common signs. She says she knew her son’s vaccine reaction ultimately led to his autism.
Estepp brought Eric back to his pediatrician’s office where he was diagnosed with autism at the age of 2 years and 10 months. Although Estepp clearly has strong viewpoints about what may lead to autism, she says she’s not anti-vaccine. Estepp believes that the vaccines administered to her son did not directly cause his autism, but because of her son’s genetic makeup, he was more susceptible to the condition. Estepp says her son was born with an autoimmune disorder, which she says she did not find out he was diagnosed with until she took him to see an immunologist at the University of California at Irvine after his autism diagnosis. After a series of tests, the doctor explained to Estepp that her son had only built immunity for the mumps disease; he had no immunity against any of the other routine childhood vaccines he had received.
Estepp believes vaccines need to made safer and the recommended childhood vaccination schedule should be tailored for each child’s unique situation. She says that because it’s mandatory for children to get the same vaccines at the same time, some children may have reactions to different things. ”What in the world is a one-size-fits-all vaccine?” Estepp quips. She says that children, like her son who have a compromising immune system, shouldn’t receive three different vaccines in one shot, for the chance that they’ll have a vaccine-induced autism.
J.B. Handley, founder of Generation Rescue, a nonprofit in Sherman Oaks, Calif., says children with autism often have nonstop colds and flu’s or pre-existing conditions. He also believes that because of adverse reactions to vaccines, children will often have a slow physical decline that turns into autism.
“We think that without question, vaccines are the most likely cause of autism,” says Handley, who founded the organization in 2005. Generation Rescue’s most notable board member is Jenny McCarthy.
Unlike medical professionals and scientists who point to data that suggests genetic factors are one cause of autism, Handley says there’s much more to it. “Autism is not as simple as a genetic variant,” he says. “Children who have immune-compromising disorders are more susceptible to toxins.” Handley believes these toxic overloads‚ “the recommended immunization schedule‚” can lead to autism in children with compromising immune systems.
He also says exposure to mercury from coal plants or toxins in the home from paint and cleaning products are just a few other factors that may contribute to autism in low-immunity children. And Handley strong believes that America’s pediatricians are at fault for the rise in autism cases over the last decade because of their adherence to the recommended immunization schedule.
In Handley’s opinion, pediatricians who follow the recommended immunization schedule for children aren’t taking into account the pre-existing conditions of certain children that may affect how their bodies handle the vaccines. Like Handley, Estepp also can’t fathom why children need Hepatitis B and MMR (measles-mumps-rubella) vaccines right away.
“What are the chances that they’ll get all three at once?” she says. Handley suggests that pediatricians need to wait to administer any kind of vaccine until at least 2 years of age, when he says a child’s immune system has had an opportunity to develop. After Estepp’s second son was born in 2000, she didn’t want to take any chances with vaccines. She says her son received about half of the recommended vaccines and then she stopped and “never looked back.”
Parents who stop vaccinating their children, however, are putting their children, other children and people at serious risk for outbreaks of diseases that were eradicated or will be, Dr. Harry Pellman, M.D., who is a pediatrician at the Edinger Medical Group and Research Center, as well as a pediatric resident for the Orange County American Academy of Pediatrics (AAP) says.
This is because of a concept called “herd immunity”. This means that vaccines people receive also protect others who aren’t immune from these infections, either because they don’t get vaccinated, their vaccine wasn’t effective or they’re immunity systems are compromised. Even if a few people are unable to be immunized, the entire community will be indirectly protected because the disease has little opportunity for an outbreak. With a low percentage of population immunity, however, there is a greater chance of an outbreak. Vaccines for diseases like Hepatitis B, for instance, are given soon after birth because if the child contracts that disease later in life, it’s much more serious.
Pellman understands that autistic children can be a difficult situation for many parents, but his belief, grounded on research and science, is that vaccines are not the cause of autism. Parents of autistic children, he says, sometimes make a temporal relationship between autism and routine childhood vaccinations. The symptoms of autism are so subtle during the first year of life that the more noticeable developmental signs often coincide when many routine vaccines are given, usually around 1 to 2 years old, Pellman says. He realizes that many parents are fearful of vaccines because of the alleged autism link, but he asserts that no scientific data supports this connection. On the other hand, he says there are more than 20 studies that show no link.
”Not one study has shown a relationship,” Pellman says. “It’s time to bury this.” Just in February, a 12-year-old study published in the medical journal The Lancet purporting that the MMR vaccine causes autism, was formally retracted by the journal. A medical council in the United Kingdom concluded the author of the paper, Dr. Andrew Wakefield, provided false information and disregard to the 12 children who participated in the study. The report by Wakefield led to a sharp drop in vaccination rates in both Britain and the United States, according to a Feb. 2, 2010, article on LAtimes.com.
Pellman says parents need make a decision about whether they are going to trust what science has shown or celebrities such as Jenny McCarthy. “What parents really need to do is look at their sources of information,” Pellman says. There is not one study that has shown a link between MMR and autism, he explains.
Like McCarthy, Estepp isn’t necessarily anti-vaccine, just demanding of “safer vaccines.” Estepp contends that pediatricians are “over-loading the immune system” with shots. Handley points out that the United States has 36 mandatory vaccines for children less than 5 years old compared with the United Kingdom, which has 20. Pellman disagrees saying science proves that it’s just not true. He says vaccines have always been safe, but now they’re even safer. About 25 years ago, vaccines like DPT had about 3,000 antigens in it alone. Antigens are substances such as bacteria or viruses that cause the immune system to produce antibodies against it. Today, vaccines have 20 times less the amount of antigens.
Pellman adds that vaccines are highly regulated and extensively tested for immunity reduction. Although years ago that amount was still safe, scientists are now under-loading — or rather accurately loading — the immune system with antigens by targeting certain diseases more effectively with fewer side effects, Pellman says. Children are exposed to thousands of bacterial, viral and other types of antigens on a daily basis such as a runny nose, that comparatively, the ones in vaccines are tiny, he adds.
Laurie Bouck, co-author of the 2009 book “The Complete Idiot’s Guide to Vaccinations” also believes that autism is not linked to vaccines. “I think that [McCarthy’s platform] does affect parents,” she says. “You see Jenny McCarthy on TV and it makes you stop and question vaccinations.” Bouck, an award-winning health and medical writer, says that from the studies she’s seen, there’s signs of autism before the vaccinations were given. “When your child is sick, you want to find some reason,” Bouck says. “There is a reason, but vaccines aren’t the reason.”
Pellman and Handley both agree that there are genetic links to autism, but what they disagree on is the role vaccines play. Researchers are also looking into environmental influences that may turn on or off a gene of a fetus in utero for autism. Advocates like McCarthy and other concerned parents are blaming the ingredients in vaccines such as mercury-containing thimerosal that has been said to cause autism and other birth defects during pregnancy.
A 2008 study, however, published in the Archives of General Psychiatry, is the latest in a series that has investigated the connection between thimerosal and autism. It found that from 2004 to 2007, when exposure to thimerosal dropped significantly for 3 to 5 year olds in California, the autism rate continued to increase in that group from 3.0 to 4.1 per 1,000 children. Thimerosal is a preservative used in a number of biological and drug products, including many vaccines, to help prevent contamination. Mercury, however, has not been in thimerosal since 2001 in California for vaccines given to children under the age of 3 because of raised concerns. And today, with the exception of some influenza vaccine, none of the vaccines used to protect preschool-age children against 14 infectious diseases contain thimerosal as a preservative.
In early 2009, the three judges at the U.S. Court of Federal Claims ruled that the MMR vaccine, given in combination with thimerosal-containing vaccines, does not cause autism. The ruling was consistent with 18 major scientific studies, which have failed to prove a link between vaccines and the neurodevelopmental disorder.
Pellman also says that the idea that mercury in thimerosal causes autism is unlikely. He points out that although mercury is a neurotoxin, it affects completely different places in the brain than where autism is known to affect. Pellman says the average pregnant woman consumes twice the amount by eating mercury-containing foods like fish than vaccines with thimerosal. And although autism rates have seemingly skyrocketed over the years, since mercury was removed, rates have still gone up, Pellman adds. Between the years 2003 to 2004, the CDC reported an average 5.6 per 1,000 school-age children were diagnosed with autism. In 2006, the average ASD prevalence was nine per 1,000 children.
Although there is still not a definite answer to why rates are climbing, Pellman offers a few reasons. First, he says that the label for autism has changed over the years to encompass a broader diagnostic code, or definitions, for the condition than before. The increasing sensitivity of parents looking for it, Pellman believes, may also be a contributing factor along with studies that have linked increasing maternal and paternal age to higher autism rates. Additionally, the two national surveys conducted by the CDC between the years 2003 and 2004, found that boys were nearly four times more likely than girls to have been diagnosed with autism. This finding, Bouck points out, does not coincide with the idea that vaccines are linked the autism. Boys aren’t more likely to vaccinated, she says. While autism remains somewhat mysterious to what exactly causes it, Pellman says people need to start focusing on what is likely the reason and develop treatments geared toward it. People like Jenny McCarthy, he says, aren’t doing anything bad‚ they’re just misled and don’t fully understand the science behind everything. “People who aren’t scientists are making accusations,” he says.
Pellman suggests that parents should start doing their research if they’re apprehensive of vaccines because of what they’ve seen on TV or read on the Internet. But he cautions against looking on Web sites that aren’t monitored for quality. And Bouck completely agrees. Parents need to ask, “Is what you heard based on research and science?” she says. “You have to stop and think how true it is.”
Estepp, although vying for the other side, agrees that parents should do their own research. She’s grateful that her son, now 12 years old, was able to be treated for his alleged vaccine injury and is now considered “highly functioning” and like any other kid his age. But it doesn’t seem as if she’ll ever set foot into a doctor’s office again to give her two sons any more shots. “I’d rather gamble with my son dying of the measles than getting autism‚ which is a chronic condition,” she says.
Whether you’re looking for local support groups, want to learn more about autism or aid the cause for a cure, we’ve compiled a list of resources to help you.
Cure Autism Now. 1-888-8-AUTISM.
National Alliance for Autism Research. 1-888-777-NAAR
Orange County Chapter Four American Academy of Pediatrics
Talk About Curing Autism Now. 949-640-4401.
Autism Speaks, Los Angeles branch. 323-549-0500.
Centers for Disease Control and Prevention (CDC) National Center on Birth Defects and Developmental Disabilities.
California Department of Developmental Services.
American Academy of Pediatrics. 1-847-434-4000.
California Childcare Health Program. 510-839-1195.
According to the Center for Disease Control and Prevention (CDC), Autism Spectrum Disorders (ASDs) occur in all racial, ethnic, and socioeconomic groups, but are four times more likely to occur in boys than in girls. CDC estimates that 1 in 110 children in the United States have an ASD. Researchers do not yet know all the causes of ASD, but here are a few facts from the CDC:
Genes are one of the risk factors that most scientists agree can make a person more likely to develop an ASD.
Children who have a sibling or parent with an ASD are at a higher risk of having an ASD.
ASDs tend to occur more often in people who have certain other medical conditions. About 10 percent of children with an ASD have an identifiable genetic disorder, such as Down syndrome and other chromosomal disorders.
Some harmful drugs taken during pregnancy have been linked with a higher risk of ASDs, for instance, the prescription drugs thalidomide and valproic acid.
There is evidence that the critical period for developing ASDs occurs before birth, however, concerns about vaccines and infections have led researchers to consider risk factors before and after birth.
Common belief that poor parenting practices cause ASDs is not true.