Expert Q+A: Is There a Link Between Vaccines and Autism?

What about parents who say their kid was normal and then "something happened"?

It seems like just about everyone's heard one of these heart-wrenching stories--whether it be a child with autism that you know personally, or a celebrity's kid you hear about on TV. The parent reports that the child was developing just fine, until one day the lights just went out. Often, that phrase is accompanied by "after he got his shots." And understandably, it's enough to make any other parent freak out and think twice when it's time to vaccinate his or her own child.

About 50 percent of parents with a child affected with autism spectrum disorder believe it was triggered by vaccination. However, the other 50 percent do not think vaccines had anything to do with it.

Here is what I think, based on what I see in my own practice. Autistic kids were never "typical" to begin with. Not one patient of mine who has ASD was perfectly normal, got a vaccination, and returned the next week with autism. In fact, all the parents in my practice whose children have ASD tell me that they either a) did not recognize the early differences in their child's development or that b) they always knew something was different about their child. The signs just became more apparent over time, the milestones stagnated, or the child seemed to lose skills. About one in five parents will report a loss of milestones. That's what brings it to the parent's attention.

An important fact: above, we noted that one in five parents report a loss in milestones. That means that a vast majority (80 percent) of kids diagnosed with autism spectrum disorder have no loss of milestones. They start out on a different developmental path and the symptoms become more apparent over time.

One of my ASD patient's moms, who is a medical professional, told me that she realized how clearly different her son's early development was after she watched her second child, without ASD, breeze through her developmental milestones. She had no frame of reference with her first child. And since just about every parent has a camcorder these days, the developmental differences early in a child's life are easily chronicled on videotape for developmental specialists to review. They say the same thing I do. The child was never perfectly normal and these, sometimes, subtle differences are seen before a year of age.

Heck, even the most vocal autism mom of all, Jenny McCarthy, who claimed on Oprah that her son was normal until receiving his combination Measles-Mumps-Rubella vaccine, admits in her book that she missed the early signs of her child's ASD. Specifically, she said that it took her child until he was five months old to smile at her, when her friend's babies all smiled by two months.

One of the leading autism experts in the country has told me that there are, indeed, an extremely small number of ASD children who have completely normal milestones and then regress, which is known as "late onset autism." This type of autism likely represents a subset of children who have a distinct genetic abnormality that turns off spontaneously without any trigger at all. And this distinct group deserves genetic testing and more research.

I know, I know, who are you going to believe? Don't I trust parents and their instincts? Absolutely--you know your kids better than anyone else. But having a child diagnosed with autism is a highly emotional experience. And the diagnosis is usually made around the same time a child is going through his vaccination series. It's true, but unrelated. It's true that vaccinations are happening, and it's true that developmental differences become apparent. That doesn't mean they are related. Toddlers are also wearing diapers, drinking whole milk, and hanging out with parents who use cell phones. Do diapers cause autism? How about cell phones or milk? Obviously, no.

And let me be clear, parents aren't the only ones who miss the early signs of autism. Pediatricians do, too. Full developmental assessments are often three to four hours in a specialty referral center. We rely heavily on parents to point out their concerns. Parents and doctors can both miss early signs of autism spectrum disorders in the first year of life. This is one of the key reasons why the American Academy of Pediatrics created an Autism Toolkit in 2007 for its doctors to learn the signs, screen specifically for autism at every well child visit, and provide resources and educational materials for affected children.

BOTTOM LINE

• Stoking parents fears about vaccines with false rumors about safety is irresponsible and creates a lose-lose situation for society-and the casualties are children.
• Vaccines work. And they are safe. Rather than demonize vaccines, we (doctors, parents, researchers, the government) should put our time, effort and money into researching the causes of autism and the best possible treatments.