Please Note: Lamaze does not endorse any particular practice in terms of childhood or prenatal vaccination nor does the organization specifically teach childbirth educators how they should guide expectant/new parents in this topic. Lamaze does, however, encourage parents and expectant moms to research and investigate the most current, evidence-based information on vaccines, as well as to have open discussions with care providers in order to make the best decision for you and your family.
______________________________________________________________________________
By Alfred Romeo, RN, PhD
Here at the Pregnancy Risk Line in Utah, we hear from callers who are concerned about vaccine use during pregnancy. Some moms are so concerned that they do not want to be vaccinated.
Much of the concern by parents has come from one poorly-done research study. The study, published back in 1998 in Lancet, made false claims about the measles, mumps, and rubella (MMR) vaccine and the preservative thimerosal. The preservative thimerosal contains a very small amount of mercury, causing some concerns. Since that time, the medical journal that published the study has publicly stated the research did not show any link between the vaccine and its preservative thimerosal and autism.
Vaccines are one of the most important medical advances in modern times. We have seen worldwide control of devastating diseases like polio and smallpox and are making progress in reducing other diseases, like chicken pox, hepatitis, pertussis, and other illnesses. Vaccines keep our children healthy and reduce disabilities that have lifelong consequences.
Even with all the evidence supporting the safety and effectiveness of vaccines, some parents are still concerned. In response to those concerns, vaccine manufacturers have reduced or eliminated the preservative thimerosal from vaccines. Most children’s vaccines do not have the preservative. Some of the current influenza, or flu, vaccines contain thimerosal at low levels that are safe for pregnancy and breastfeeding (see the Vaccines and Pregnancy fact sheet link below). Preservative-free flu vaccines are available for anyone who still may have concerns. Even with the reduction and elimination of the preservative, the rates of autism continue to increase, further showing that neither vaccines nor preservatives were the cause.
What is autism and what causes it? Autism spectrum disorders (ASD) are a range of conditions that include developmental delays, autism, and Asperger syndrome. Children typically have problems with communication, behaviors, and social skills. Currently, researchers think parents may pass on genes that may lead to ASD or that may become active after being exposed to something in the environment. Some researchers also believe the drugs thalidomide and valproic acid may increase the risk for ASD. Some of the symptoms of ASD, including communication and behavior problems, begin to be noticed as developmental delays when a child is about 18 months to 2 years old.
There is no cure for ASD, but early detection and treatment can help improve language, behavior, and social skills. Parents can learn about developmental milestones and ask their primary care provider (medical home) if they have any concerns.
Autism is still a puzzle, but parents can track their children’s growth, take them for regular check-ups, and read to them to give them the best start possible.
Alfred Romeo, RN, PhD, works at the Pregnancy Risk Line, a partnership between the Utah Department of Health and the University of Utah. His experiences include working as a nurse in newborn intensive care units, training medical homes in improving services, and training young adults with disabilities in leadership and advocacy.
The Pregnancy Risk Line is an affiliate of the Organization of Teratology Information Specialists (OTIS), a non-profit with affiliates across North America. Utah women with questions or concerns about pregnancy or breastfeeding exposures can call 1-800-822-2229. Outside Utah, please call OTIS at 1-866-626-6847. OTIS is conducting several studies, including vaccine studies for influenza, meningitis, and the human papillomavirus (HPV). Women who have received these vaccines during their current pregnancy can call OTIS to volunteer to participate in the studies or learn more by visiting OTISPregnancy.org.
References:
http://www.otispregnancy.org/files/vaccines.pdf
http://www.bmj.com/content/340/bmj.c655.full
http://www.cmaj.ca/cgi/reprint/182/4/E199
http://www.cdc.gov/vaccinesafety/concerns/thimerosal/index.html
http://www.pregnancyriskline.org
About admin
Ask our resident obstetrical expert, Henci Goer, any question you have about conception, pregnancy, birth, and newborns. 
Thank you, Lamaze! It’s so important for people to be aware of the science, not the emotions, and to keep themselves and their children safe, and vaccines do an excellent job at protecting people.
I also feel it should be mentioned that many adults with autism are both for vaccines and offended by the way so many people talk about autism as a nasty thing. They view it as who they are.
I find it really too bad that Lamaze has chosen to publish an article like this. Since when is it your job to inform parents about the risks or potential benefits of vaccination. You say you are not picking sides, but by posting this article you have indeed chosen to do so. Up to date, evidence based information is important. Why would Lamaze choose to post one article? Why wouldn’t you choose to post many links to different articles FOR and AGAINST vaccinations and really let it be up to the parents to make a choice. The fact is that many parents regard Lamaze as a good place to find information regarding wise choices … but choosing to post this article makes it known that Lamaze leans towards vaccination as a standard.
Although it is true that most vaccinations now contain no thimerosal, they DO contain human DNA. http://www.cbsnews.com/8301-31727_162-20049118-10391695.html
I’m not saying people should or shouldn’t vaccinate… I’m saying people should be informed on the issue on both sides with up to date information. Let the parents decide. For some the choice may not be at all an autism issue. Maybe some people don’t want to give vaccines because they contain human DNA.
I don’t have both sides of the story. I’m not trying to make a point for or against vaccines. I’m disappointed Lamaze would post an article so much in agreement with vaccines without posting the other side to allow parents to make their own informed choice.
@ Stephanie
I have to disagree with your stance that this one post “makes it known that Lamaze leans towards vaccination as a standard.” If that were the case, the disclaimer that opens up this post would not have been included.
As a Lamaze Certified Childbirth Educator, I can tell you that Lamaze DOES NOT maintain any official stance regarding vaccines–for or against. Likewise, a brief post discussing ONE aspect of the vaccination debate does not equate to dogmatic support of one side of a very large issue.
If you read carefully, this post is mainly about one aspect of one vaccine–concerns over a link between the MMR and autism. It is not about ALL vaccines. It is not a blanket statement of ANYTHING. Also, I think it is important to note that the author of the post is not even a representative of Lamaze, nor a Lamaze educator. I think we need to congratulate efforts to open this forum to other voices–providing a long-term, well-rounded dialog. No, this post does not represent the voice of those who are skeptical of vaccination, but that doesn’t mean that portion of the discussion won’t be covered in a subsequent post. (In fact, per the GBWC Facebook page, there will be another piece in the future, representing “the other side” of this debate.)
More generally, we must resist the temptation to always say, “we don’t belong in this debate.” As childbirth educators, when covering postpartum/early parenting topics, we are likely to be asked by our students about vaccination. This does not mean we must be experts in this topic, but we must at least be prepared to discuss the issue intelligibly. To respond to a class with a sentiment like, “Lamaze didn’t teach me about vaccination, therefore I don’t discuss it” would feel inadequate to the parents genuinely seeking information on the topic.
So quick to jump down each others’ throats when a topic we don’t like surfaces, we risk squelching the very dialogue which can inform us for future personal and professional discussions.
As a pediatrician, a mom, a patient safety advocate, and a blogger on the sister Lamaze Science and Sensibility site, here’s my two cents on this issue:
Was the Wakefield study ultimately a fraud? Yes.
Is thimerosal still used as a preservative in routine childhood vaccines (other than some influenza vaccines)? No, not since 2001.
Are vaccines 100% effective? No.
Are vaccines 100% safe? No.
Do vaccines save lives? Yes.
Does vaccination ever cause harm or death? Yes.
Does lack of vaccination ever cause harm or death? Yes.
Could a vaccine cause autism? Maybe.
Do I vaccinate my own children? Yes.
In my experience, most parents who are initially skeptical about vaccines are usually fine with it if you give them a chance to air their concerns and fears, provide them with information, and then let them make the final decision in a nonjudgmental way. Many parents are fine if you meet them halfway, like agreeing to space out the vaccines or giving some and not others. I used to work for a practice where the policy was basically “No vaccine, no service.” I thought that was pretty heavy-handed, even though I knew it was because the senior pediatrician absolutely had his heart in the right place and was saying it because he had practiced in the era before the polio vaccine and had seen kids die from polio (for any medical history buffs, Pittsburgh is the home of the Salk vaccine). Before the varicella (chickenpox) vaccine was widely used, I routinely hospitalized children for horribly painful complications like cellulitis who couldn’t drink, urinate, or even cry because of superinfected pox lesions. Now it’s been years since I’ve seen a case of chickenpox, let alone one that led to hospitalization, and the last case of measles I saw was in medical school.
But I also have parents and friends who have children with autism and are absolutely convinced that a particular vaccine/food/environmental toxin caused it. Nothing anyone can say will ever change their minds about that. Plus, we also don’t know everything about vaccines and drugs, and who is to say that your next patient won’t be the one-in-a-million child that has some rare undiscovered metabolic pathway for processing a vaccine that leads to a bad neurological outcome? That’s why the ultimate decision has to lay with the parent. If a parent refuses a vaccine, I do ask them to sign a waiver stating that we discussed risks/benefits and they chose not to vaccinate.
I was disappointed to see this on this site. It is biased. I am sick of seeing Autism as the only reason someone would choose not to vaccinate. Please, give those of us who have spent hours and hours researching all sides of the issue, prayed endlessly, and finally made the counter culture choice not to vaccinate, just a wee bit of credit. Most parents who do not vaccinate are much more informed on the history of vaccines, other possible cause for a down turn in disease, why we should hesitate to vaccinate etc, than parents who do choose to vaccinate. Obviously some pro vaxers research, but I dare say not as much as the non vaxers. It is easy choice, so it just may be that those who choose the hard road have a pretty darn good reason.
I agree that this post does imply that Lamaze endorses vaccination, despite the disclaimer given at the beginning. Why post such a one-sided piece it doesn’t express your viewpoint? I am also tired of seeing articles that treat parents who’ve decided not to vaccinate or to skip some vaccines as though they’re being emotional about the single issue of autism. There are so many other causes for concern when it comes to vaccines. Autism is but one and, in my experience, it’s not a common one when it comes to reasons parents question vaccines or ultimately choose not to vaccinate their children. If you’re going to bring this subject up, you need to do a much better job of covering the multi-sided, multi-faceted discourse on it. This piece is just way too narrow, imo.
As a health practitioner and doctor, I feel the title as well as the article are completely irresponsible and misleading. To boldly (or ignorantly) state that “Vaccines are Not a Piece of the Autism Puzzle” implies that we have done NUMEROUS peer reviewed studies on ALL questionable ingredients in vaccines and have definitively found NO connections between the ingredients and autism or any of the other chronic conditions plaguing our children today. Obviously, we know that this is NOT the case. In fact, in the case of autism, we have only studied thimerosal and not that well. In consideration that the article is written only about the mmr and autism connection and not including other vaccines, it makes the title seem even more misleading. To keep bringing up ONE study as a fraud and not being progressive in studying all the chemicals added to the mmr and their possible side effects is unforgiving. It is premature to rule things out just yet. Also, I agree wholeheartedly that autism is not the main reason parents decide not to vaccinate. I find it interesting that autism is often portrayed as the ONE and ONLY reason parents decide to forgo vaccination and the Wakefield study is always used to defend pro-vaccine position.