autism and vaccines - long

[Dr. R. Swift]

Thought Leah and others may find this interesting. I think it is quite
amazing that the author mentions individual genetic susceptibility and
"constitution". Now where have we heard those concepts before when talking
about disease...could it be those HOMEOPATHS?
November 10, 2002 NEW YORK TIMES
The Not-So-Crackpot Autism Theory
By ARTHUR ALLEN
Neal Halsey's life was dedicated to promoting vaccination. In June
1999, the Johns Hopkins pediatrician and scholar had completed a decade of
service on the influential committees that decide which inoculations will be
jabbed into the arms and thighs and buttocks of eight million American
children each year. At the urging of Halsey and others, the number of
vaccines mandated for children under 2 in the 90's soared to 20, from 8.
Kids were healthier for it, according to him. These simple, safe injections
against hepatitis B and germs like haemophilus bacteria would help thousands
grow up free of diseases like meningitis and liver cancer.

Halsey's view, however, was not shared by a small but vocal faction of
parents who questioned whether all these shots did more harm than good.
While many of the childhood infections that vaccines were designed to
prevent -- among them diphtheria, mumps, chickenpox and polio -- seemed to
be either antique or innocuous, serious chronic diseases like asthma,
juvenile diabetes and autism were on the rise. And on the Internet,
especially, a growing number of self-styled health activists blamed vaccines
for these increases.

Like all medical interventions, vaccines sometimes cause adverse
reactions. But unlike pills, vaccines come packaged with high expectations,
which make them particularly vulnerable to public criticism. Vaccines don't
cure people, and they are administered to healthy children, which gives them
few opportunities for good press. When they work, nothing happens. When
vaccinated children become ill, their parents are grief-stricken and often
enraged, even if vaccines aren't proved to be at fault. All of this puts
public-health advocates like Halsey on the defensive. Most attacks on
vaccines, they say, are based on hysteria, bad science and dubious politics.

Halsey, 57, has green eyes, a white beard that makes him look like a
ship's captain and an air of careful authority. As chairman of the American
Academy of Pediatrics committee on infectious diseases from 1995 through
June 1999, he often appeared in the media administering calm reassurance.
''Many of the allegations against vaccines,'' Halsey said in one interview,
''are based on unproven hypotheses and causal associations with little
evidence.''

And then suddenly in June 1999, during a visit to the Food and Drug
Administration, a squall appeared on the horizon of Halsey's confidence.
Halsey attended a meeting to discuss thimerosal, a mercury-containing
preservative that at the time was being used in several vaccines --
including the hepatitis B shot that Halsey had fought so hard to have
administered to American babies. By the time the dust kicked up in that
meeting had settled, Halsey would be forced to reckon with the hypothesis
that thimerosal had damaged the brains of immunized infants and may have
contributed to the unexplained explosion in the number of cases of autism
being diagnosed in children.

That Halsey was willing even to entertain this possibility enraged
some of his fellow vaccinologists, who couldn't fathom how a doctor who had
spent so much energy dismantling the arguments of people who attacked
vaccines could now be changing sides. But to Halsey's mind, his actions were
perfectly consistent: he was simply working from the data. And the numbers
deeply troubled him. ''From the beginning, I saw thimerosal as something
different,'' he says. ''It was the first strong evidence of a causal
association with neurological impairment. I was very concerned.''
The investigation into mercury vaccines was instigated in 1997 by
Representative Frank Pallone Jr., a New Jersey Democrat whose district
includes a string of shore towns where mercury in fish is one of many
environmental concerns. Pallone, who had been pressing the government to
re-evaluate its overall guidelines on mercury toxicity, attached an
amendment to an F.D.A. bill requiring the agency to inventory all mercury
contained in licensed drugs and vaccines.

The job of adding up the amount of mercury in vaccines and assessing
its risk fell to Robert Ball, an F.D.A. scientist, and two F.D.A.
pediatricians, Leslie Ball, Robert's wife, and R. Douglas Pratt. Thimerosal,
which is 50 percent ethyl mercury by weight, had been used as a vaccine
preservative since the 1930's in the diphtheria-tetanus-pertussis shot,
known as D.T.P., and it was later added to some vaccines for hepatitis B and
haemophilus bacteria, which by the early 1990's had become routine
immunizations for infants.

The F.D.A. team's conclusions were frightening. Vaccines added under
Halsey's watch had tripled the dose of mercury that infants got in their
first few months of life. As many as 30 million American children may have
been exposed to mercury in excess of Environmental Protection Agency
guidelines -- levels of mercury that, in theory, could have killed enough
brain cells to scramble thinking or hex behavior.

''My first reaction was simply disbelief, which was the reaction of
almost everybody involved in vaccines,'' Halsey says. ''In most vaccine
containers, thimerosal is listed as a mercury derivative, a hundredth of a
percent. And what I believed, and what everybody else believed, was that it
was truly a trace, a biologically insignificant amount. My honest belief is
that if the labels had had the mercury content in micrograms, this would
have been uncovered years ago. But the fact is, no one did the
calculation.''

Making matters worse, the latest science on mercury damage suggested
that even small amounts of organic mercury could do harm to the fetal brain.
Some of the federal safety guidelines on mercury were relaxed in the 90's,
even as the amount of mercury that children received in vaccines increased.
The more Halsey learned about these mercury studies, the more he worried.

''My first concern was that it would harm the credibility of the
immunization program,'' he says. ''But gradually it came home to me that
maybe there was some real risk to the children.'' Mercury was turning out to
be like lead, which had been studied extensively in the homes of the
Baltimore poor during Halsey's tenure at Hopkins. ''As they got more
sophisticated at testing for lead, the safe level marched down and down, and
they continued to find subtle neurological impairment,'' Halsey says. ''And
that's almost exactly what happened with mercury.''

Halsey was beginning to think that it would be prudent to limit
thimerosal-containing vaccines and urge pediatricians to use thimerosal-free
shots when possible. But his decision inflamed some of his peers. After all,
although the thimerosal data was worrisome to Halsey, the available science
offered no clear proof that the preservative posed a genuine danger to
children when given in parts per million. Moreover, it wasn't clear that
there were enough thimerosal-free vaccines available for diseases like
pertussis and hepatitis B. Should an unproven fear justify the cessation of
a procedure that protected children from proven dangers?

Halsey looked into the matter further and found only complexity. In
the medical literature, most cases of acute mercury poisoning result from
doses hundreds or thousands of times higher than what infants received with
thimerosal-laden vaccines. And although the thimerosal levels in vaccines
exceeded the E.P.A.'s guidelines for methyl mercury, thimerosal contained
ethyl mercury, a compound that behaves somewhat differently in the body. The
E.P.A. based its guidelines on a series of studies of 917 children born in
1987 in the Faeroe Islands, a windswept North Atlantic archipelago, to women
who ate methyl-mercury-tainted whale meat. The Faeroes children, whose
umbilical cord blood averaged four times the E.P.A.'s daily ''safe'' dose --
which was 0.1 micrograms per kilo -- exhibited small but measurable
neurological deficits seven years later. They had slower reaction times and
diminished attention spans and their word choice and memorization were less
keen than those of their classmates who had been exposed to less mercury,
according to Philippe Grandjean, a Danish researcher who leads the
continuing Faeroes study and teaches at Boston University.

During most of the 90's, many American 6-month-olds received a total
of 187.5 micrograms of ethyl mercury through vaccination. While the Faeroes
children were exposed to mercury as developing fetuses, and therefore were
more vulnerable than the vaccinated American infants, the American babies
included about 60,000 each year who had already been exposed to high mercury
levels because their mothers had eaten a lot of contaminated fish. What's
more, hundreds of thousands of Rh-negative pregnant women and their unborn
Rh-positive babies received additional thimerosal each year through
injections designed to keep the mothers' immune systems from attacking the
fetuses.

The Faeroes studies, though they dealt with methyl mercury, unnerved
Halsey. Other researchers were troubled, too. George Lucier, a toxicologist
who led a 1998 White House review of mercury's dangers, went so far as to
say it was ''very likely'' that thimerosal had damaged some children. There
was precious little data to back up that precise suspicion -- and little to
dismiss it -- because of the lack of toxicology research on ethyl mercury.

On July 7, 1999, at Halsey's urging, the American Academy of
Pediatrics and the Public Health Service released a statement urging vaccine
manufacturers to remove thimerosal as quickly as possible and advising
pediatricians to postpone giving most newborns the birth dose of the
hepatitis B vaccine. The decision, which helped to create vaccine shortages
and led some babies to become infected with hepatitis B, outraged some
senior vaccine experts. Walter Orenstein, director of the National
Immunization Program at the Centers for Disease Control and Prevention,
would charge that the rush to remove thimerosal-containing vaccines was
''precipitous.'' Stanley Plotkin, a renowned vaccine developer, said that it
was fruitless to try to soothe vaccination critics. ''If antivaccinationists
did not have mercury, they would have another issue,'' he said at one
meeting. ''One cannot prevent them from making hay regardless of whether the
sun is shining or not.''

In Halsey's view, however, thimerosal wasn't simply a bone for rabid
vaccine opponents to gnaw on. In the middle of that hectic summer he took a
vacation in Maine. Canoeing on a lake, he came across posters that advised
fishermen to ''protect your children -- release your catch.'' Halsey took
that message to heart. If the government was warning people against eating
fish with mercury, he asked his colleagues, ''does it make sense to allow it
to be injected into infants?''

Although other vaccinologists criticized Halsey, many of his
colleagues rallied around him. ''Neal put kids ahead of the vaccination
program, which was gutsy,'' says Lynn Goldman, a former E.P.A. official who
has been on the Hopkins faculty since 1999 and worked with Halsey on
thimerosal. ''It would have been easier for him to line up on the other
side.''

Few scientists believe that the spike in autism could have been caused
solely by the thimerosal in vaccines, but in October 2001, a vaccine-safety
committee at the starchy Institute of Medicine confirmed that it was
''biologically plausible'' -- though by no means proved -- that thimerosal
could be related to neurodevelopmental delays in some children. The
committee recommended that thimerosal be removed from vaccines and called
for extensive research to determine any damage it had caused.

alsey's fellow researchers were right about one thing. Antivaccine
advocates immediately seized upon the thimerosal theory, and Halsey became
something of an unwilling hero to the vaccine-safety advocates with whom he
had so often sparred. In fact, thousands of parents with autistic children
have responded to the Institute of Medicine report by filing lawsuits.
Michael Williams, who has won millions in toxic tort settlements from
pharmaceutical companies, was among the first lawyers to sue vaccine
manufacturers, on behalf of William Mead, a 4-year-old Portland, Ore., boy
with autism. Williams also filed a separate class-action lawsuit with
William's healthy older sister, Eleanor, as lead plaintiff, demanding that
vaccine makers also pay for studies to determine thimerosal's effects on
millions of children who might have lower I.Q.'s or other less obvious signs
of mercury poisoning. Past studies have shown that mercury's effects vary
tremendously from person to person, presumably because of genetic
differences in the body's capacity to protect delicate organs from it.

''In order to win the Eleanor lawsuit you need to establish liability,
but I don't think that is going to be that hard,'' Williams said in a recent
chat in his Portland office. ''Organic mercury is a very serious
neurotoxin.''

Williams embodies the vaccine establishment's worst fear about
Halsey's course of action -- which is that taking the precautionary step of
eliminating thimerosal would be read as an admission of fault. ''The agenda
was set by the lawyers and the antivaccine activists,'' a source close to a
number of manufacturers complained to me. ''The scientists responded to it
scientifically, and that put them behind the eight ball right away. You had
Neal Halsey running around saying: 'We've got to do something! We've got to
show we're concerned!'''

Paul Offit, a vaccinologist at the Children's Hospital of
Philadelphia, takes it a step further. ''In some instances I think full
disclosure can be harmful,'' he says. ''Is it safe to say there is zero risk
with thimerosal, when it is remotely possible that one child would get sick?
Well, since we say that mercury is a neurotoxin, we have to do everything we
can to get rid of it. But I would argue that removing thimerosal didn't make
vaccines safer -- it only made them perceptibly safer.''

For Halsey, thimerosal injury is a possibility that must be
addressed -- but by science, not by the courts. The scientific agenda,
however, is already deeply politicized. From the start, the C.D.C.'s efforts
to examine the possibility of thimerosal damage became snarled in acrimony.
Critics of the vaccination system don't trust the C.D.C., which monitors
evidence of adverse reactions to vaccines through the Vaccine Safety
Datalink, a computerized set of 7.5 million medical records. Safe Minds, an
advocacy group of parents who believe that their autistic children were
damaged by thimerosal, has used the Freedom of Information Act to obtain
documents showing that as early as December 1999 the C.D.C. had reason to
believe that thimerosal caused developmental delays in some children. It was
far from conclusive evidence, but vaccine critics charged that the C.D.C.
tried to play it down. One of those critics was Dan Burton, a Republican
congressman from Indiana, who says he firmly believes that his grandson's
autism is a result of vaccines. ''I'm so ticked off about my grandson, and
to think that the public-health people have been circling the wagons to
cover up the facts!'' Burton fumed at a June hearing. ''Why, it just makes
me want to vomit!''

What comes through in an examination of the documents uncovered by
Safe Minds is less a coverup than an impression of scientists anxiously
watching over their shoulders as they work. One document, for example,
records comments made by Robert Brent, a Philadelphia pediatrician who
served as a consultant for the thimerosal study. ''The medical-legal
findings in this study, causal or not, are horrendous,'' Brent said. ''If an
allegation was made that a child's neurobehavioral findings were caused by
thimerosal-containing vaccines, you could readily find a junk scientist who
would support the claim with a reasonable degree of certainty. But you will
not find a scientist with any integrity who would say the reverse with the
data that is available. . . . So we are in a bad position from the
standpoint of defending any lawsuits if they were initiated.''

More research is in the works. The C.D.C. is setting up a study of
neurodevelopmental effects based in part on the Faeroe Islands model. The
N.I.H. is financing studies of thimerosal metabolism in animals and
children. (An early University of Rochester study was reassuring: it
indicated that children eliminate thimerosal much more quickly than
expected.)

Clearly, a lot is riding on this research, and pressure is being
brought to bear on both sides. Can the vaccine authorities accept a positive
answer? Can the vaccine opponents accept a negative one? ''No one wants to
think that harm might have been done,'' Halsey says. ''I don't want to think
harm might have been done.''
American children still receive up to 20 vaccines in the first two
years of life. The first symptoms of autism often appear between the ages of
12 and 24 months. Most autism experts say that the two facts are
coincidental, but as a major California study recently confirmed, autism is
being diagnosed in numbers far higher than ever before, suggesting that a
nongenetic cause may be partly to blame. In some children, the behavioral
traits of autism present themselves along with physical problems like
sensory dysfunction and motor disorders that have rough correlates in the
mercury-poisoning literature. For some parents, thimerosal provides a grand
unifying theory that squarely points the finger at the government and
vaccine makers.

During much of the 20th-century, children suffered from an ailment
called pink disease, which caused peeling skin on the extremities as well as
regressive behavior. In 1948, a keen-eyed Cincinnati pediatrician named
Josef Warkany noticed a common risk factor in these children: they had all
been given teething powders containing calomel, a mercury derivative. Only
about 1 in 500 children whose parents gave them calomel got pink disease --
suggesting that a constitutional vulnerability to mercury was part of the
clinical picture. Soon after the powders were taken off the market, pink
disease disappeared.

Autism is a global phenomenon that was first reported in America in
1943, long before the potential dangers of thimerosal vaccines were raised.
Removing the preservative won't -- even in the best case -- eliminate the
illness. But scientists estimate that the current rate of autism in its
various forms might be as high as 1 in 500. If the autism trend begins to
recede now that thimerosal has been removed, it could certainly suggest a
cause. If it does decline, we might have Neal Halsey to thank. If it
doesn't, his colleagues in the vaccine establishment may blame him for
stoking an irrational protest from the public.

Halsey, who still heads the Hopkins Institute for Vaccine Safety,
which he was a founder of in 1997, is on the fence. ''I don't believe the
evidence is convincing now that there has definitely been harm done by
thimerosal,'' he says, absently stroking his balding head. But to keep the
vaccine program on a steady keel, Halsey says, the public-health authorities
simply must follow through with the studies and face the consequences
without flinching. If there is damage, he says, ''there should be some kind
of compensation, though I don't know how.'' He pauses, and sighs. ''I
empathize with families of children with these disorders. How are you going
to put dollar values on that?''
Arthur Allen lives in Washington and is working on a history of
vaccination.
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Russell Swift, DVM
Classical Homeopath
phone 561-391-5615
email drswift@therightremedy.com
www.therightremedy.com

"Allopaths have protocols, Homeopaths have principles."