Does my child need all those vaccines?

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Parents question vaccines Some believe shots increase risk of autism By LISA LIDDANE The Orange County Register It's a question Dr. Bob Sears increasingly hears from new parents, a question for which the California pediatrician wishes he had a simple answer. "Does my child need all those vaccines?" Infants and toddlers have been getting as many as four shots in one visit. And with the addition this year of RotaTeq -- a new rotavirus vaccine -- to the kids' immunization schedule, the maximum shot load has risen to five. But to accommodate parental concern about the safety of vaccines, Sears' young patients typically receive no more than two shots per visit. Sears' flexible approach is unorthodox and uncommon, but it's one of several ways a handful of doctors and a growing number of

parents are dealing with vaccine worries. "Reports of staggered vaccinations are true," said Dr. Jasjit Singh, associate director of pediatric infectious disease at Children's Hospital of Orange County in Orange. Debate intensifies| Some parents are choosing not to vaccinate at all, Singh said. Others are picking and choosing vaccines that their children are going to get. Singh said that although she has no specific statistics, she has noticed that more educated, middle-to-high income families are opting to forgo vaccinations. Parents worry that some vaccines can increase risk of asthma, autism and learning disabilities. Last month, the vaccine debate intensified. An outbreak of mumps in nine states has tripled the number of mumps cases usually reported in the United States over a full year. Mumps is one

of several diseases close to being eliminated in the United States. Though no deaths have been attributed to mumps, the disease can cause deafness in children and sterility in men later in life. But the vaccine for mumps, measles and rubella, MMR, is the one parents are most likely to worry about. The MMR vaccine is at the core of the immunization debate because some researchers and parents believe thimerosal used as a preservative in the vaccine can cause autism. Thimerosal, a compound containing mercury, has been removed from children's vaccines, except for trace amounts, according to the Centers for Disease Control and Prevention. Autism controversy| A review of studies does not show a link between vaccines with thimerosal and autism, according to Immunization Safety Review Committee of the Institute of

Medicine of the National Academies. But some parents and doctors are not convinced that enough research has been done. A study in the Journal of American Physicians and Surgeons in March showed that autism and other neurological disorders decreased after mercury was removed from children's vaccines. The controversy is heating up all the way from pediatricians' clinics to the halls of Congress and the CDC offices. On April 6, autism activist groups accused the CDC in a full-page ad in a national newspaper of covering up knowledge that mercury in vaccines caused the rise of autism. The CDC, which issues the immunization schedule, denied the accusation. A panel from the National Institute of Environmental Health Sciences will meet later this month to address a study about whether the incidence of autism decreased after thimerosal was removed from or substantially reduced in most vaccines. Parents need to remember that vaccines have been largely responsible for preventing many deaths and health problems from numerous childhood diseases, Singh said. Vaccines are more than a family health issue -- they are a public-health matter, she added. "If you don't have your children vaccinated, you're counting on the herd immunity of the population and putting not only your children but others around them at risk for preventable diseases," Singh said. "Vaccines are excellent, but they're not 100 percent protective." Parents also need to better scrutinize their sources of vaccine information, she said. Parents may be getting biased and inaccurate information, she added. Vaccines are relevant, but the busy nature of managed care practice makes it difficult for doctors who see children to spend a lot of time discussing the risks and benefits of each vaccine, Salmon said.

Giving parents some flexibility with the immunization schedule is a much preferable option to children not getting vaccinated at all, said Sears, who is finishing "The Vaccine Book." The vaccination schedule has some room for spreading out the vaccines, especially when a child reaches 6 months old. "You decrease the exposure to a variety of chemicals if you spread out the vaccines," he said. "The only downside for parents is the extra driving and extra co-pays." ------ © 2006, The Orange County Register (Santa Ana, Calif.). Visit the Register on the World Wide Web at http://www.ocregister.com/ Distributed by Knight Ridder/Tribune Information Services. ----------

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