How much do I love thee?

Last week, my friend Natasha whatsapped me her concerns about the MMR (Measles, Mumps, Rubella) vaccination because it is said to be linked to autism. A friend told her that the baby of a friend was diagnosed with autism after the shot, even though the child was developing well and normal prior to it. The friend also quoted the 1998 Wakefield research that linked autism to the MMR vaccination. To be honest, I got a little concerned and it prompted me to find out more.

The Wakefield paper, published in the journal, The Lancet, was considered by the medical community to be flawed. The reason being it was not properly conducted because the sample size was only 12 children, and they were recruited at a children’s party and paid to participate. The researchers involved, later retracted the paper and so did the journal. Since then there were numerous studies done to investigate this so-called link, and to-date there was no evidence that the shot causes autism. Nonetheless many parents insist that it was what caused their babies, who were developing normally before the shot, to become autistic. Doctors think that parents make the causation link because the shot is given to babies at 12th month, and that is when the autistic signs become more obvious. Even today, the Wakefield study is still causing a great deal of controversy.

I have to admit that I didn’t know much about autism before this, other than the patients having impaired social skill, and some of them are savants, possessing an amazing ability like memorization for instance. The character, Raymond, in Rainman, played by Dustin Hoffman is one. From my research I pick up a little more info on the illness, the symptoms, risk factors and possible causes.

In summary, autism is a disorder of the neurological development, affecting the areas of the brain that governs communications and social functions. So an autistic child doesn’t speak much (without proper treatment), using only a few words. In the case of those children who suffer from regressive autism, they may initially have a vocabulary of 20 words for instance and then suddenly reduced to 3 words. Other obvious signs are avoiding eye contacts, not socializing with other children, and lining up objects like toy cars in a straight line etc. The illness becomes apparent at a very young age, before 3 years old. Genetics are the main cause though autism is a very complex disorder that scientists are still not sure how that works. A main risk factor is the advanced age of both parents.

Scientists can’t find any evidence that the MMR vaccination causes autism. None of the viruses of these diseases cause the illness, and vaccination is basically a small dosage of these viruses injected into the body to trigger production of anti-bodies to fight them. It is not just the shot that causes parental concern, but also the ‘overloading’ of vaccination, like the MMR is a 3-in one, and there are many such shots with some being 4-in one or 6-in one. Some parents believe that the baby’s body can’t take so much vaccinations, and may have triggered autism. So they arrange for the shots only when the kids are older, like 10 years old, or take separate shots.

Another possible cause brought up was heavy metal in the vaccines, such as mercury, found in the preservative. Natasha was told of another baby who was also diagnosed with autism, though the cause was not the shot. The pediatrician thought it might be due to mercury from taking too much fish when the baby was weaning off milk. Natasha is concerned that the preservative in the flu shot, Thimerosal, which is mercury-based, is a risk. Scientists have also looked into this and couldn’t find the link between this risk and vaccine overloading to autism. Still CDC (Center for Disease Control) and the American Academy of Pediatrics advised makers of vaccines to remove the preservative as a precautionary measure, and they have done so. Though the action convinced some parents there was really a link.

A day or two after I was alerted by Natasha, I saw a program on BBC Knowledge (cable) presented by Louis Theroux called Extreme Love: Autism. Louis visited an innovative autistic school in New Jersey, met up with the students and their families, and learn how they cope with the illness. This is a very real portrayal of autism; one severely autistic child was seen to get very agitated at one point when he started to knock his head against the wall. His parents had to hold him down on the floor to calm him. I have a lot of respect for the families particularly the mothers. It is really tough taking care of the kids, particularly those who are severely autistic because they can become violent. The mothers try their best, and it is very moving to see their unconditional love for their children. Yet despite their best effort, some have to seek help from the state when they can’t handle the child. One of the autistic children is a 20-year old young man who had attacked his mother and even set fire to the house. His mother had no choice but to put him in residential care. Now that I am a mother, I realize how much we love our children no matter what happened to them.

When I was pregnant with Alex, I decided that I would not go for the amniocentesis because I would accept Alex for who he was. I knew there would be risks, like Down Syndrome, because both my husband and I are not young. But Alex turns out well and healthy, and we believe this is a blessing from God. It is devastating to the parents when the child suddenly stops developing or regresses in his or her development from the previous normal self. What worse is that children who suffer from such regression will develop severe autism. So I can understand the worries of those parents who decline vaccination for their kids.

In Singapore, vaccinations against 10 infectious diseases such as Hepatitis B, Measles, Tetanus and TB etc, are compulsory for babies and children, unless there is a special medical reason. In which case, the pediatrician has to write to the Ministry of Health, on behalf of the parents, to request to opt out or defer. Regardless whether there is an option or not, I will still go ahead with the shots. I don’t think they cause autism and neither does vaccine overloading, and I think the diseases, that these vaccines protect against, are far more dangerous. Besides it is really impractical to have separate shots for each disease because there are just too many. There are two MMR shots alone.

I checked with Dr OK (aka Anita Menon) a few days ago, when Alex had his 4th month vaccinations (6-in one shot plus an oral vaccine), if there was heavy metal present in them and she asked if I was referring to mercury. She assured me there was none and the vaccines are from GSK and they have gone through rigorous testing. Alex tends to be cranky for a couple of days after each shot, even though he doesn’t have fever. We had to give him some paracetamol to take the edge off. But I have been observing him to see if there was anything out of the ordinary. Maybe I was being paranoid since it is expected the poor boy would be out of sort. Luckily it only lasted for a few days.

Alex is our precious and we do whatever it takes to protect him, and vaccination is one way. Even if he develops signs of autism later, it is something we have to accept and we will put all our resources into helping him to cope with the illness.



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