Behind the Vaccine Scare, Parental Fear

Our children's health, our children's future, and the need to keep these safe and secure: This desire fuels worries about vaccines as somehow being linked to autism, and suggests how this issue is very much a matter of the heart. This is further reason why, when it comes to the subject of vaccines and autism, it's going to be an unending story: That last phrase is the title of a Newsweek blog post by Sharon Begley, who wrote last week's article about how childhood vaccines became villains. Begley cites a case concerning vaccines and Pervasive Developmental Disorder that was decided in 2007 but only released now:

In the case, the parents of Bailey Banks, now 10, argued that their son had a seizure 16 days after his first MMR, in 2000. That, they said, led to Acute Disseminated Encephalomyelitis (ADEM), a rare neurological disease, which in turn led to PDD.

Autism is one type of PDD, "Pervasive Developmental Disorder; Asperger's Syndrome, Childhood Disintegrative Disorder, and Rett's Syndrome are others. Bailey's delays are connected to the MMR vaccine, but the court is careful to distinguish PDD from autism in saying that Bailey "'more likely than not suffers from PDD, and not from autism.” As PalMD on Science Blogs writes:

[This case] examined a young patient who received an MMR vaccine, and then 16 days later suffered a seizure. He was evaluated and at least one doctor felt he had ADEM, a severe neurological disease. The best statistics estimate a rate of ADEM after measles vaccination of about 1-2 per 1 million, although the vaccine has never actually been proved to cause ADEM. The rate of ADEM associated with measles infection is about 1 in 1000, a proven causation.

Some time after his seizure, he was diagnosed as having pervasive developmental delay, a diagnosis that falls on the "autism spectrum". Because of the temporal relationship of these disorders, and because there was at least some scientific plausibility to connect the vaccine to his later neurologic illness, the court found in favor of the plaintiff. Notice, this is not a "vaccines cause autism" finding---it is a "in this particular case, a vaccine may have caused ADEM, which may have lead to an autism-like disorder."

Robert Kennedy, Jr., and David Kirby have presented the Banks case in the February 24th Huffington Post as nothing less than proof that the recent Omnibus rullings are irrelevant, as the "vaccine court" had already found a connection---the case of Bailey Banks---to be true. Kirby even writes that "PDD" is interchangeable with "ASD" in the language of public health"----an interesting statement from him, as PDD refers to the broader spectrum of autism diagnoses. (See Left Brain/Right Brain for more on this.) In his various writings seeking to link autism to mercury, vaccines, etc. over the years, Kirby has often made it clear that "autism" in the (supposedly "vaccine-injured") children he is representing is something different the more "high-functioning" types of autism (i.e., Asperger's Syndrome). Curious then to see Kirby referring to the autism spectrum and to the different conditions that are grouped under the umbrella of "autism spectrum disorders" and of "pervasive developmental disorders": Is he moving away from only writing about children with "full-blown" autism?

So what is it with the continued desire, certainly in Kennedy and Kirby and in many others, to find a link between autism and vaccines?

One answer lies in a more general concern about the well-being of our children. This worry that vaccines might be "harming" a child rather than helping them hangs over parents' heads --- it's part of a more widespread concern among parents today about keeping children safe, or so writer Peggy Orenstein writes in the February 22nd New York Times Magazine in The Toxic Paradox.

Orenstein lives in the city I have an underriding affinity for, "smugly green hamlet" of granola-ness, Berkeley.

On learning that the air quality around Berkeley schools "fell in the lowest 10 percent," if not in the "bottom 1 percent," in the whole country:

Since December, when the report came out, the mayor, neighborhood activists and various parent-teacher associations have engaged in a sometimes-acrimonious, acronym-laced battle over its validity: over the culpability of the steel-casting factory on the western edge of town, over union jobs versus children’s health and over what, if anything, ought to be done. With all sides presenting their own experts throwing down the gauntlets of conflicting scientific studies, whom should parents believe? Is there truly a threat here, we asked one another as we dropped off our kids, and if so, how great is it? .................. this latest drama, repeated in various permutations in so many communities, is a crucible for how today’s parents perceive risk, how we try to keep our kids safe — whether it’s possible to keep them safe — in what feels like an increasingly threatening world. It raises the question of what, in our time, “safe” could even mean.

How "safe" can we make the world for our children; for ourselves?

Orenstein notes that she applies "all-natural sun block" to her daughter's skin to protect her against skin cancer; fearful of mercury levels, she limits tuna. She writes: "Better safe than sorry, I say. But safe from what? And, more to the point, safe from which?" It's not so much the "concrete hazards" of fire, car accidents, drowning that "go bump in the night," but those dangers that a parent can never fully "quantify"; can never fully even, perhaps, identify and point a finger at.

This "intuitive toxicology" is what University of Oregon psychology professor Paul Slovic calls such a "skewed response." Orenstein continues:

Yet, I wonder sometimes if avoiding the vinyl lunch box — I don’t care if it has “Hello Kitty” on the front — is just another blade in a helicopter parent’s propeller, another version of the overzealous monitoring that has produced kids who leave for college without ever having crossed the street by themselves. In this era when children symbolize emotional fulfillment rather than free household labor, we cling to the belief that if we just do everything right — starting with what a woman eats before she’s even pregnant — we can protect them from pain or failure or sadness. We can make them perfect and, in the process, prove ourselves beyond reproach. But of course, that control is illusory: even if it were possible to do everything “right,” it could still come out wrong. What if it wasn’t the creosote or the pesticide that gave me cancer but something even more frightening — plain old bad luck? What is a parent supposed to do about that?

In our determination to make this world 100"-plus safe for our children, we may be overlooking something in our loving rush to "protect them from pain or failure or sadness." With all those products out there----the vitamins, the anti-bacterial skin creams, the sweet organic cotton outfits, the non-toxic toys, so much "good food"---surely (we think) we are making things better for our children. Surely we can "can make them perfect and, in the process, prove ourselves beyond reproach"-----but then what do we do when "plain old bad luck" steps in and we find ourselves the parent of a child who, however much we know they're perfect, get the evil eye from the world because she or he is..........different? In a world where people talk about "designer embryos," woe all the more to the parent whose child is not even "normal." If we "know," or claim for sure, that we "did everything right," how can we account for a child who has a "problem" (i.e., autism)----surely something must have happened because, we parents swear, we know we did everything right.

Consider the last sentence of Kirby's latest Huffington Post piece: "Robert Kennedy, Jr. and I would love nothing more than to reassure parents that the nation's current vaccine program is 100% safe for all kids.....". The wish to protect "all kids" and keep them safe is herein invoked. And it's this wish to keep our kids safe, not only from diseases and pollution and whatever evil we fear is out there, that is one reason vaccines and autism indeed seem to be an unending story.

Even as we try to make the world a green paradise for our children, why are we still haunted by that toxic paradox?

Photo from the Berkeley Daily Planet.