Dr. Shruti K. Gohil, associate medical director for epidemiology and infection prevention at UCI Medical Center, holds a dose of MMR, the vaccine against measles, mumps and rubella. ANA VENEGAS TNS
Dr. Shruti K. Gohil, associate medical director for epidemiology and infection prevention at UCI Medical Center, holds a dose of MMR, the vaccine against measles, mumps and rubella. ANA VENEGAS TNS

Health & Family

THE FACTS ABOUT VACCINATION

By Karen Garloch

kgarloch@charlotteobserver.com

February 28, 2015 04:54 PM

UPDATED February 28, 2015 11:57 PM

The vaccine-autism link

Ask any public health expert if vaccines cause autism, and they’re quick to say that theory has been debunked.

Dr. Andrew Wakefield, whose research had linked autism to vaccine injuries, was discredited in 2011. The British Medical Journal published evidence that Wakefield had falsified data. He was stripped of his British medical license, and the Lancet, which had published the original paper in 1998, retracted his work.

Instead of focusing on autism, Barbara Loe Fisher, president of the National Vaccine Information Center, said her group has always focused on encephalopathy, or brain damage, which “has been associated with vaccines since the first vaccine.” Brain inflammation can lead to dysfunction with a range of symptoms, including learning disabilities, seizure disorders, mental retardation and symptoms of autism, she said.

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Some children who received compensation from the federal vaccine court for brain damage caused by vaccines have had symptoms of autism. But the compensation was for encephalopathy.

Other theories

Some parents and doctors think underlying genetic conditions or medical problems could make certain children more susceptible to adverse vaccine reactions. One suspect is disorders of the mitochondria, the “powerhouse” responsible for generating energy needed to perform a cell’s many tasks.

This was discussed in the wake of the 2008 federal vaccine court decision that vaccines injured Hannah Poling of Georgia, who got nine vaccines at once when she was 18 months old. The court, established by Congress to compensate victims of vaccine injuries, awarded millions of dollars over her lifetime and concluded the vaccinations she received “significantly aggravated an underlying mitochondrial disorder … and manifested as a regressive encephalopathy with features of autism spectrum disorder.”

The United Mitochondrial Disease Foundation says: “In the absence of scientific evidence, the UMDF cannot confirm any association between mitochondrial diseases and vaccines.”

Douglas Wallace, director of the Center for Mitochondrial and Epigenomic Medicine at Children’s Hospital of Philadelphia and a past member of the foundation’s advisory board, has said the lack of data on mitochondria and vaccines makes it difficult to know what to recommend. “We do not know what is safe. We do not know what is not safe,” he testified before a national vaccine committee in 2008.

“We have always advocated spreading the immunizations out as much as possible because every time you vaccinate you are creating a challenge for the system, and if a child has an impaired system, that could, in fact, trigger further clinical problems.” (The Centers for Disease Control and Prevention recommends a schedule that includes multiple vaccines at various times.)

What’s the law?

In North Carolina, children must be immunized before attending public and private schools. Exemptions are allowed for medical or religious reasons. In North Carolina, 179 children received medical exemptions and 1,204 received religious exemptions for the 2013-14 school year, according to the state’s Department of Health and Human Services.

What’s the immunization rate?

In 2013, 72 percent of North Carolina children, ages 19-35 months, received recommended immunizations, compared to 70 percent nationally. Nearly 99 percent of North Carolina children received the measles, mumps, rubella (MMR) vaccine before kindergarten in the 2013-14 school year.

The impact of the measles cases?

Since the outbreak at California’s Disneyland in early January, a total of 154 cases have been reported in 17 states and Washington, D.C., according to the Centers for Disease Control and Prevention. North Carolina has had no measles cases this year and only one in 2014. That case was in Charlotte in December (unrelated to the Disneyland outbreak) and was the first Mecklenburg County case since 1989, according to county health officials.

For more information

▪ N.C. Department of Health and Human Services: www.immunize.nc.gov

▪ U.S. Centers for Disease Control and Prevention: www.cdc.gov

▪ United Mitochondrial Disease Foundation: www.umdf.org

▪ National Vaccine Information Center: www.nvic.org