DrJeremy's Journal

Two very interesting events occurred in the past couple of weeks. Both of which produced a good deal of interest, probably one more so than the other…and although not directly related (as I will explain below) both deeply intertwined by a theme that has become a major undertone in the pediatric population today…vaccines and autism.

Over the course of my career, I have seen the primary concern of parents evolve into the issue surrounding vaccines. I have some parents who have searched the internet for hours upon hours to those who heard something from a friend of a friend about vaccines. I have spent many a well-child care visit discussing vaccines and been sent email after email of questions, comments, and websites regarding any related information…usually not so good.

…And now everything has just been turned up a notch with the recent events. I first want to address the most recent event which involved a concession by the U.S Court of Federal Claims that the vaccines received at 19 months of age of a now 9 year old girl with a mitochondrial disorder exacerbated her underlying diagnosis as well as lead to her diagnosis of autism. At this 19 month old visit, 5 injections were given (which included a total of nine vaccines with thimerosal [the mercury additive] being the preservative used in the vaccines) and within 48 hours, a high fever developed with extreme inconsolability. Shortly thereafter, this young toddler soon stopped walking and her speech digressed. Now it should be noted, it is not clear as to the extent of the underlying medical condition’s impact on her development of autism but what we do know is she will now be eligible for compensation through the National Vaccine Injury Compensation Program…and, therefore, be the first child to do so with autism as the core of the reason.

So what about this other story I hinted at above. Well, in February this year, a measles outbreak was confirmed in San Diego County. It appears a 7 year old unvaccinated child acquired the virus when on vacation in Europe the previous month. And last I heard, 11 additional cases of measles in unvaccinated children in San Diego have been associated with this first case. Other than one infant being hospitalized for two days, I am unaware of any further complications for any of these children but I would like to take this opportunity to remind us all of some of the more severe complications with measles: 1. Acute encephalitis, which often leads to permanent brain damage, occurs in proximally 1 of every 1,000 cases. 2. Death occurs in 1 to 3 of every 1,000 cases in the U.S. (often from respiratory and neurological complications). One might think these numbers not being too significant, but when there exists something to prevent these even remote outcomes, I would claim that these numbers are unacceptable.

So where does this leave us? Probably in a greater state of debate and confusion than before…as there is more fuel for both sides to justify their beliefs. To not see this would be a disservice to our children and our children‘s children. This measles outbreak in San Diego County serves as a reminder to us all that in an unvaccinated community, a single case may evolve into an outbreak with minimal effort. And this court case provides some just cause that maybe something about the vaccines (possibly that some children cannot handle multiple immunizations at a single visit) needs to be reevaluated.

But I do hope all realize that, ultimately, we all have the same goal to do our best for our children…so when we speak with each other, we do it with respect. We all have something to learn.

Dr. Jeremy