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Duke Medicine: Multiple vaccines and autism

Posted June 28, 2010

Do multiple vaccines somehow overwhelm a child's immune system? Could they be a cause of autism?

Dr. Jeffrey P. Baker, director of Duke's History of Medicine Program and an associate clinical professor of pediatrics, takes a look.

This was the question at the heart of the Federal Vaccine Court’s decision to award damages to Hannah Poling, a girl with a mitochondrial disease (a very uncommon disorder disrupting her ability to process nutrients) who regressed developmentally and developed signs of autism after receiving several vaccines at age 19 months.

Cases such as Hannah’s are tragic, but raise more questions than they answer. There are in fact rare children with silent metabolic disorders who may develop normally until suddenly regressing after the stress of a childhood infection. Whether vaccines are a risk has not been proven. Certainly, the infections that vaccines prevent do constitute a danger for these children. Even if we could identify at-risk children, it is far from clear that holding or splitting vaccines would do them a service.

Before accepting the “multiple vaccine” hypothesis, it is worth remembering that more vaccines does not mean more stress on the immune system. The 14 vaccines given to young children expose them to a total of about 150 immunological units, or antigens. The MMR, for all the ballyhoo, contains only 24. In contrast, the old smallpox vaccine included 200 proteins, and the whole cell pertussis vaccine used before the 1990s contained 3,000.

In a nutshell, while more vaccines are being given to infants, these vaccines are far more targeted and purified than was the case twenty years ago. This is why giving vaccines separately makes so little sense to the scientific community. Splitting vaccines certainly makes the schedule even more complicated, and will likely lead to lower immunization rates. When these rates fall below a certain threshold in a community, outbreaks become possible. This has already happened with respect to whooping cough and measles in various locations in the United States.

It will always be possible to think of new mechanisms linking vaccines and autism as others are disproven. But after 10 years of extensive research on vaccines, it is time to entertain other ideas regarding environmental exposures. Vaccine opponents consistently disparage the positive benefits of vaccines, which the vast majority of physicians and public health leaders regard as one of our most powerful tools to protect the health of our children. Deferring or declining vaccines has consequences for our neighbors’ children as well as our own. It is important to learn about the diseases they prevent prior to questioning their benefits.

To read more about Dr. Baker's thoughts on whether vaccines explain the surge in autism, go to his full piece in the Your Child's Health section on


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  • ucdburnjd Jul 2, 2010

    Remember, when using the rhetoric "far fewer antigens than in the days" and therefore, one can have several varities of antigens (diseases)...there are problems with this argument.
    1. To get fewer antigen, one must give more adjuvanct. This is because the immune system must go into overdrive to do something with less antigen. It is robbing Peter to pay Paul and the outcome can be the same or worse, depending on the adjuvant (aluminum) and/or antigen. It could be worse.
    2. Pitting a
    Ito patients immune system into hyperdrive with adjuvanct is bad enough. Add 9 different diseases, (antigen), 4 of them serious live viruses...all to a toddler who may succumb to a common cold...there is nothing left to say...

  • kittiboo Jul 1, 2010

    That picture that goes with this story is priceless!!

  • jajs123 Jun 30, 2010

    When writing about the Hannah Poling case most researchers fail to note that Hannah's mother has the same mitochondrial disease as her daughter. Hannah's mother does not have autism.