Aug. 16, 1999

Vaccine-autism link feared

By Anita Manning, USA TODAY

A stunning increase in the number of children diagnosed with autism has schools straining to provide services and health officials urgently seeking answers.

And the increases are fueling a grass-roots movement of parents determined to expose what they believe is a connection between autism and vaccines.

Autism, a developmental disability that usually appears before a child's third birthday, profoundly affects communication and social skills, impairing the child's ability to play, speak and relate to the world.

The U.S. Department of Education reports a 173% increase in autistic children served under the Individuals With Disabilities Education Act between the 1992-93 school year, when 15,580 children were counted, and 1997-98, when the figure was 42,500.

In California, state senators are calling for research to find out why there was a 273% jump in children with autism in the past decade . And Rep. Dan Burton, R-Ind., who held a hearing on vaccine safety last week, is leading an effort in Congress to find answers.

"It's truly an epidemic," says Bernard Rimland, founder of the private Autism Research Institute in San Diego.

Some experts doubt that. Lou Danielson of the Education Department's office of special education programs says his office's statistics are suspect because until 1991, there was no category for reporting autism. "Children with autism were always there," he says, "but they just weren't being counted in this category."

Yet the demand for more resources for autistic children is real: Martin Babayco, head of the special education program in the Ojai (Calif.) Unified School District, says he has sent three teachers to the University of North Carolina for special training, and he has formed an autism task force.

"Within the last two years, our numbers have gone steadily up," reaching 25 in the upcoming school year, he says. "Is this a large number? Yes, 25 in a small school district like ours, it is an extreme number. We don't know why. I've talked to other educators, and they have a similar upswing."

Scientists are puzzled - and worried. "I think the increase is real. I don't think there's any question," says Marie Bristol-Power, coordinator of the Network on Neurobiology and Genetics of Autism at the National Institute of Child Health and Human Development. People have cited other possible explanations, such as pesticides and pollutants, she says. "Right now, we're trying desperately to find out the cause."

Rimland, a research psychologist and the father of a 43-year-old man with autism, says he knows. Autism rates are rising, he says, "because of the overuse of vaccines."

He and many other parents of children with autism are convinced that at least some cases are caused by the multiple vaccines given children - up to 21 before they start school - and the combination vaccines, such as the measles-mumps-rubella (MMR) shot.

Jeana and Darrell Smith of Baton Rouge feel sure their son Jacob's autism isn't caused by genetics. Their proof? Jacob's identical twin brother, Jesse, shows no signs of it.

The boys, age 4, have slightly different medical histories. Jacob got his first vaccine, for hepatitis B, at the age of 1 month. His brother didn't get any vaccines until 3 months of age. At 15 months, they both got MMR. "At that point (Jacob) did not progress with language and developed weird behaviors," Jeana says. "I feel the hepatitis B knocked out his system, so when the MMR came along . . ."

The Smiths have two younger children, a boy, 3, who has had the first few vaccines normally given to children, and a daughter, 7 months old, who Jeana says "is vaccine-free." Refusing to vaccinate a child is "not something taken lightly," she says, but given her experience, she's "not willing to take the chance vs. the risk of the disease. If one of them steps on a rusty nail, I'll take him down and just get the tetanus shot."

Walter Orenstein, director of the National Immunization Program at the Centers for Disease Control and Prevention, says there should be more research on autism in general and any connection with vaccines. But "keep in mind there is a serious cost to the lack of vaccination, and we know what that cost is."

Parents call for 'good science'

Autism appears within the first three years of life - just about the time when most children are seeing pediatricians routinely for vaccinations.

"I know what happened in my son's case, and I know from talking to countless other parents that there is a strong temporal relationship between the onset of autism and vaccination," says Rick Rollens of Granite Bay, Calif., whose 8-year-old son, Russell, began showing signs of autism at 7 months old after routine vaccinations.

Linked through Internet chat rooms and Web sites, parents of kids with autism are drawing the attention of state and national education officials and politicians to what they believe is a looming crisis. They're demanding research into origins and treatments for the neurological disorder. "We've been jumping up and down about wanting good science to look into this," Rollens says. "Show us the science that says this stuff can't cause the kind of brain disorders we're seeing."

Merck & Co., manufacturer of the MMR vaccine, says it monitors safety during all phases of development and beyond through post-marketing studies.

"There is absolutely nothing in medical or scientific literature that would suggest a causal link between vaccination and autism," Merck spokeswoman Isabel Claxton says.

No U.S. studies have been done on the effects of combined vaccines, but a recent article in the British journal Lancet reported that autism began increasing in the United Kingdom before the use of the MMR vaccine and that rates are similar among vaccinated and unvaccinated children. Most cases , the researchers say, are genetic and probably occur "early in embryonic development." But they note there are cases in which a child appears to be developing normally and suddenly regresses into autism.

Bristol-Power says researchers are "looking at possible immunological problems in the children, not a single gene but underlying genetic susceptibility. "

Skipping vaccinations poses a risk

For most children, Bristol-Power says, "the symptoms of autism are evident from birth. MMR is given at 12 to 15 months of age. For most children, the MMR vaccine can't be implicated because symptoms are there before they got the vaccine. But about 20% have normal development and then regress. Right now, we don't know what would cause that."

But, she says, "there is a sufficient number of credible people who have reported the appearance of a link between the vaccine and autism, and we have to find out why. Although we think vaccines are safe for most children, research is needed to identify potentially susceptible populations. We also have to investigate the timing of administration and grouping of vaccines."

Last week, at a congressional hearing led by Burton, Surgeon General David Satcher and pediatrician Samuel Katz of the American Academy of Pediatrics testified to the importance of a strong vaccine policy, acknowledging the possibility of rare bad reactions .

"Whenever vaccines are administered," Katz said, "there is always the risk that coincidental illnesses, those that are known to occur at various ages, will occur and may be falsely attributed to the vaccine."

But Burton, whose 2-year-old grandson developed autism after a diphtheria-tetanus-pertussis vaccination, isn't satisfied. "I think vaccines made this country safe for a long time, but I've talked to doctors and scientists, and there seems to be something happening that wasn't occurring before."

He's not anti-vaccine, he says, and he's aware of the possibility that by raising concerns about vaccine safety, he could be contributing to a drop in vaccination rates. "I'm not sure anybody in Congress is opposed to vaccines, but we want them safe. If there are risks, make sure the parents know about them so they can make informed decisions. I believe an informed public is not a danger to this country."

Burton says he's considering holding another hearing - this one on autism, "to take a hard look at possible causes," he says. "I am absolutely committed to digging into this as much as possible. This is not the end of it, and it will not be the end of it."