We read your report, Mercury linked to
autism (June 19), with some dismay that yet again a single unpublished study
that has not been subjected to critical scientific scrutiny has generated such
an alarmist headline. Such articles, adorned with quotes from the usual band of
crusading commentators who use any study, however flawed, to justify their
beliefs, are misleading and irresponsible. Many suppositions are made in your
report that fly in the face of common sense, logic, established facts, and other
scientific evidence. Much publicity has been given to those who advocate that
the MMR vaccine is the cause of the rising numbers of children being diagnosed
as having an autistic spectrum disorder. This MMR scare began in 1998 with a
study by Dr Wakefield et al published in the Lancet. The study has since been
widely discredited and no valid scientific evidence has ever been produced to
support such a hypothesis. On the contrary, a large number of rigorous
scientific studies have testified to the vaccines safety and absence of linkage
with autism. The MMR vaccine does not contain thimerosal.
Having failed to demonstrate the
culpability of the MMR vaccine, we are now being told that it is thimerosal, a
preservative present in a certain brand of the Diphtheria/Pertussis/ Tetanus
vaccine (DTP), that is the cause of the perceived rise in autism in recent
years. Better diagnosis and changes in diagnostic classification are often
ignored as at least part of the explanation for the rise. This assertion is
strange in the context that DTP vaccine has been in use for over 60 years and
yet this claimed epidemic of autism is a relatively new phenomenon. In
addition it is also the case that the amounts of thimerosal received by children
from the infant immunisation programme in the UK have decreased in recent times.
These facts clearly contradict a causal relationship between thimerosal and
recent rises in autism.
Almost all previous studies on the
toxicological effects of heavy metals such as mercury and lead have
substantiated a positive correlation between very high levels of these
substances found in hair and an increasing adverse effect on neurological
development. Whereas in this quoted study the amount of mercury found in the
hair of autistic children is less than in the non-autistic children. Yet somehow
it is hypothesised, without any evidence, that mercury build-up somewhere else
in the body is responsible for their autistic symptoms.
Finally, it is the view of this department
that such unsubstantiated and ill-founded claims are detrimental to public
confidence in the childhood vaccination programme. This programme has been an
outstanding success in eradicating serious and life-threatening infections in
recent times. Irresponsible scaremongering could eventually result in death and
serious disability in many children if these diseases are allowed to return due
to low vaccine- uptake.
It is also a cruel blow to all those
parents of autistic children who are now being erroneously informed that they
have permanently damaged their own children because of their responsible actions
in attempting to protect their loved ones against the consequences of
contracting such diseases.
- Vincent McKeown, public health nurse;
Dr Syed Ahmed, immunisation
co-ordinator, Public Health, Greater
Glasgow NHS Board, 350 St Vincent
Street, Glasgow.
Aberdeen, S.D. - The rate of autism cases
has shot up in South Dakota, a trend that is also being seen around the nation.
There were 321 cases of autism among
people ages 3 to 21 in South Dakota public schools during the 2002-2003 school
year, according to the South Dakota Office of Special Education. That is a 700
percent increase from the 46 people with autism in public schools during the
1992-1993 school year.
According to data from the U.S. Office of
Special Education Programs, the number of people ages 6 to 21 with autism served
by the Individuals with Disabilities Education Act has increased 594 percent in
South Dakota during the past decade.
The Autism Society says that based on
various government statistics, the number of people with autism is growing by 10
to 17 percent every year nationwide. The organization estimates there could be 4
million Americans with autism within a decade. At present, 1.5 million Americans
are believed to have some form of the condition.
The increase in the number of autism cases
could be a result of improvements made identifying the condition and properly
diagnosing it, the Centers for Disease Control and Prevention said.
Aberdeen resident Annette Allen, whose
8-year-old son, Thomas, is autistic, agrees. Parents now want to find out the
real reasons for their childrens behavioral problems and not just think of them
as odd, Allen said.
Brittany Schmidt, director of the autism
program at the Center for Disabilities in Sioux Falls, said none of the top
autism experts nationally or internationally know for sure why autism cases are
increasing so dramatically.
Schmidt said she believes autism numbers
are on the rise because medical professionals are better able to identify it.
But she also said environmental or genetic factors could be causing the
condition to occur more frequently.
In Thomas case, Annette Allen said his
autism probably has a lot to do with genetics.
Theres a lot of mental illness and
(Attention Deficit Disorder) on both sides of the family. And theres a lot of
high IQs also, Allen said.
Amanda Lautenschlager is the coordinator
of the Autism Spectrum Coalition to Increase Opportunities Now, an
Aberdeen-based autism support and resource group. She said those involved in the
medical and school communities have joined to learn more about how they can help
those with autism.
The coalition also acts as a support group
for autistic people and their families. And it works to collect autism news and
developments to keep its members up to date on the latest treatments.
The problem in South Dakota and other
states is that people think those with autism cannot contribute to society,
Lautenschlager said.
Theres a preconceived notion out there
about what autism is. People have seen movies like Rain Man and kind of think
thats how people with autism are, she said. They dont think people with
autism can contribute to the community. Our biggest challenge is getting across
the whole concept that autistic people can live healthy and productive lives.
* * *
TREATMENT
A New Series of Autism Mini-Conferences
Starts In Los Angeles Saturday July 19th and
Sunday July 20th
[From a DAN! Conference announcement.]
A new series of mini-conferences on the
theories, causes and treatments of autism for both medical practitioners and
parents is scheduled to kick-off Saturday July 19th and Sunday July 20th in Los
Angeles. The mini-conferences, called Mini DAN!, are a downsized version of the
renowned major DAN! Conferences which take place twice a year.
The Mini DAN! is designed for those
parents and professionals who have difficulty traveling, and for those who have
requested smaller, more informal programs. Dr. Jaquelyn McCandless (author of
Children with Starving Brains and a well known autism expert) and the DAN!
Conference organizers have established the Mini DAN! These programs will occur
in various locations and will consist of a full day program for parents,
followed by a day-long intensive training for a limited number of local
practitioners.
On Saturday July 19th Dr. McCandless will
present evaluation information on the most relevant tests that will help
pinpoint a childs health issues. Parents will be given general guidelines on
how to work with their pediatrician and or DAN! trained practitioner to
interpret these test results as well as how to prioritize specific treatment
interventions.
The major DAN! conferences have become a
well-recognized forum where leading experts report to parents and professionals
on the latest research and theories regarding the causes of, and treatment
options for, children on the autism spectrum. These conferences draw well over a
thousand attendees, and typically alternate their location between the east and
west coast.
The kick-off Mini DAN! conference is
scheduled to take place at the Airport Marriott Hotel in Los Angeles, California
Saturday July 19th and Sunday July 20th.
Dr. McCandless will be joined on both days
by Teresa Binstock an autism researcher. Ms. Binstock will help dispel the myth
that there are no scientific studies supporting the biomedical approach to
treating autism by sharing published research pointing to the credibility and
effectiveness of many DAN! based interventions.
Maureen McDonnell, the national
coordinator of the DAN! conferences and a registered nurse for over 25 years,
will discuss effective methods for correcting many of the biomedical disorders
frequently found in children on the spectrum: including healing intestinal
permeability, balancing bowel flora, practical ways to help children transition
to a healthier diet and effective ways to administer nutrients.
The program on Sunday is specifically
designed for practitioners and is limited to 25 participants. It will emphasize
testing procedures, interpretation of tests, office procedures specific to this
population, treating heavy metal toxicity, nutrient deficiencies and immune
dysfunction. Guidelines for safely administering chelation therapy, as well as
reviewing recent new treatments will be given with specifics such as nutrient
and medication dosages and sources.
On both days at the Los Angeles program,
the presenters will be joined by the lab directors from Doctors Data (David
Quig, PhD), Metametrix (Richard Lord, PhD) and Immunosciences (Ari Vojdani,
PhD).
Dr. McCandless and the DAN! Conference
committee encourage those parents and practitioners who are not able to attend
the larger DAN! conferences, or who wish to participate in this smaller more
intimate forum to join them for this unique learning experience.
California CADDRE Spring/Summer Update on Autism
Research
California CADDRE is a research
center
funded by the federal Centers for Disease
Control and Prevention that brings
together
families, scientists, doctors, and other
experts in order to identify children with
autism spectrum disorders in California
and conduct studies.
[From a California CADDRE communiqué,
oui?]
This update provides the latest
information on California CADDREs activities and our collaborative activities
with the national CADDRE Centers of Excellence in autism epidemiology. This
update includes information on:
1) New Grants
2) Research Update
3) New Hires and Job Openings
4) Education and Outreach Efforts
5) Upcoming Conferences and Events
Spring/Summer 2003 Update
Together with our research partners we:
¨ Identify children with autism spectrum
disorders (ASD) in California
¨ Study causes and risk factors for ASD
¨ Look for early identification methods
for ASD
¨ Provide information on ASD to families
including resources in multiple languages
Grants Received: California CADDRE
received a $5,000 award from the Autism Coalition to produce an autism
conference in spring 2004 titled, Services, Treatments, Advocacy and Research
(STAR) Conference on Autism. Collaborators in this grant include the Family
Resource Network and Childrens Hospital Oakland. If you would like more
information or would like to be involved in the planning of this event, please
contact Nila Rogosin, CADDRE Health Educator and Community Liaison at
510-622-4759.
Grants Under Review: California CADDRE
investigators, Lisa Croen and Judith Grether have submitted a grant proposal to
the National Institute of Health (NIH) to study Maternal Serum Alphafetoprotein
(MSAFP) samples that were collected from pregnant women during the year 2000 in
Orange County, California. Investigators will conduct a case-control study to
examine early biologic markers that may impact the neurodevelopment of the
fetus, and may increase susceptibility and exposure for autism.
The study will also examine thyroid
hormones in newborn bloodspots of these children to look at neonatal hormonal
levels as a risk factor for autism. If funded, the project will start in early
2004 and will carry on for three years. Results from this study will provide us
with a better understanding of the underlying biology of autism, and may suggest
appropriate strategies for early intervention and contribute to eventual
prevention.
Progress in our Research
Out in the Field: We are actively
collecting data on children with autism spectrum disorders at Regional Centers
throughout California and Kaiser clinics in the Bay Area. We hope to start
collecting data at additional Bay Area clinics by the end of this year. The
collected data will provide us with more information about the prevalence of
autism spectrum disorders in California. We greatly thank all Regional Center,
Department of Developmental Services, and clinic staff who are helping to make
this effort possible.
The National CADDRE Study: Investigators
and staff at all six CADDRE sites (California, Colorado, Georgia, North
Carolina, Maryland/Delaware, and
Pennsylvania) have been working very hard to
design and finalize a CADDRE national case-control study protocol to investigate
the possible causes and risk factors for autism. The final protocol will be
submitted to the CDC Institutional Review Board (IRB) in September 2003 and then
to each states local IRB. If funds are sufficiently in place, all six national
CADDRE centers will begin recruiting families who have children with autism
spectrum disorders, children with other developmental delays, and
typically-developing children in the spring of 2004. We hope to recruit over
2000 families, making this the largest study of autism spectrum disorders to
date.
New Study: Investigation of Maternal
Antibodies in Association with Childhood Autism: California CADDRE center
director, Judy Grether has received IRB approval from the state of California to
conduct a case-control study of selected maternal IgG antibodies in newborn
blood spots of children with autism and a comparison group of controls.
This study is a collaborative effort with
the Genetic Disease Branch, Neurovirology Laboratory at Johns Hopkins
University, Kaiser Permanente Division of Research, and the National Institute
of Neurological Disorders and Stroke.
Update on The California Autism Study of
Twins and Multiples: California CADDRE will be recruiting families who have a
twin or other multiple born in California between 1987- 1998 with an autism
spectrum disorder to be a part of this study. Families will receive enrollment
materials from Regional Centers this fall. We hope to enroll over 400 families
from California in the study over the next two years.
Clinic and School Observations: California
CADDRE staff are currently observing the clinical evaluation process at child
development clinics and visiting autism school programs in the Bay Area. We
sincerely thank all who are cooperating in this effort including:
o The Autism Clinic at UCSF
o The Child Development Center at
Childrens Hospital Oakland
o The California Autism Foundation
o A Better Chance School
o Spectrum Center
Community Outreach: California CADDRE was
pleased to be a part of the following community events in these last few months.
If you are interested in having California CADDRE speak with your organization,
parent group or provide information at a community event, please contact Nila
Rogosin, Health Educator and Community Liaison at 510-622-4759.
o Asian American Press Conference on
Autism Awareness Month - April 11, 2003
o Support for Families Information and
Resource Conference - March 29, 2003
o Golden Gate Regional Center Information
Fair- May 8, 2003
o Harambee Community Event -June 7, 2003
Upcoming Conferences and Events
Autism Genes and Environment Conference
(AGE II) September 13-15, 2004 in Sacramento: This year the AGE II conference
will take place in Sacramento, California. The conference, sponsored by the
National Institutes of Environmental Health Sciences (NIEHS) and the M.I.N.D.
Institute will bring together clinicians, scientists, and parents to share and
present information on current autism research efforts. The conference will also
include a parent forum in which parents are able to ask scientists about the
status and future of autism research and raise specific questions or concerns
about their children with autism.
Interagency Autism Coordinating Committee:
Judith Grether is pleased to join the Interagency Autism Coordinating Committee
this July to speak about current barriers to autism research. This committee,
lead by the National Institutes of Health, is comprised of many federal
agencies, scientists, and parent advocates. If you have concerns or comments
that you would like to share on this subject, please email them to
autism@dhs.ca.gov.
California CADDRE
California Department of Health Services
1515 Clay Street, Suite 1700 Oakland, CA 94612
Phone: 510-622-4600 Fax: 510-622-4505 ...Working Together to Find Answers for
Autism...
The extraordinary thing about Molly Nash
is that she seems like a typical second grader in Englewood, Colorado. She can
be as stubborn as an ox, says Lisa Nash, her mother, and she smarts off now
and then. But like most 8-year-olds, she has redeeming qualitiesa round,
cheeky face, a toothy smile, brown bangs. She also takes dance lessons and plays
soccer, and shes a whiz in reading and math. Shes a bit small for her age,
says Nash. But not extremely small. There are kids in her class who are
smaller.
Smallness is a vestige of Mollys
tentative start in life. For a while Molly grew far too slowly, and the odds
were good that she wouldnt live much beyond the age of 6. She had been born
with a rare disorder called Fanconis anemia, which was causing cells in her
bone marrowthe ones that produce white blood cells and other defenses against
infectionto fail. Molly needed new ones from a donor who was an almost exact
genetic match. That meant that her parents needed to have another child, and
fast. The trouble was, the odds of having one with the right genes and who
didnt himself have the disease were only one in four.
Fortunately for Molly, there was a way of
loading the genetic dice. Mark Hughes, a molecular biologist, has worked for the
past 10 years building and perfecting the genetic equivalent of a one-hour
photo-developing shop. If parents want a child with certain genes, doctors first
use techniques of in vitro fertilization to make dozens of embryoshowever many
it takes to ensure that one of them has the desired genes. Hughess technique,
called preimplantation genetic diagnosis, then tells you which embryo to pick.
Whats more, Hughes can perform the test in 24 hours, with time to spare for
implanting the embryo into the womb. The Nashes used PGD to conceive Adam, now
2i, who successfully donated umbilical-cord blood to save Mollys life.
Molly wasnt the first child to benefit
indirectly from PGD, and she wont be the last. While the world panics over
false claims of human cloning, PGD is quietly transforming reproductive medicine
by giving parents unprecedented control over what genes their offspring will
have. So far the technique has been used largely, as in Mollys case, in
laudable efforts to avoid passing along single-gene inherited diseases. But PGD
makes some people nervous, because it also gives doctors a rudimentary ability
to manipulate traits the morally reprehensible practice of eugenics. At
present, manipulating complex traits like intelligence or athletic ability is
impossible, but it may not always be. The fear is that as other aspects of
reproductive technology improve, PGD may be misused. There are 900 genetic
tests available or in development, says Kathy Hudson, director of the Genetics
and Public Policy Center at Johns Hopkins University in Baltimore, and a fellow
of the World Economic Forum. Determining which of these tests to offer to whom
and at what point is really complex.
Are the benefits worth the risk? Hughes,
Mollys parents and many others think so. PGD has in recent years moved into the
mainstream of reproductive science. Clinics in London, Chicago, Tel Aviv and
Brussels have recently begun to offer the procedure. Although Hughes doesnt
keep count, his personal computer lists dozens of obstetricians whove sent
patients to his lab.
The process starts with the arrival of
tiny plastic tubes packed in ice, each containing a single human stem cell
plucked a few hours before from a three-day-old embryo. The cells come from
fertility clinics, where would-be parents have their eggs harvested, fertilized
and grown in petri dishes. By day three a human egg cell has managed to divide,
on average, into only six stem cells. To find out if it carries the genes for
Tay-Sachs or cystic fibrosis or sickle-cell anemia, the labs 60 researchers and
technicians copy the sample cells DNA and analyze it with a Willy Wonka
assortment of specialized machines. The trick is in coming up with clever ways
of finding specific genes quickly, starting with only a single sample of DNA.
Behind panes of glass, robotic hands shuffle trays of a hundred tiny test tubes.
The technique has attracted controversy in
the United States simply because it involves embryos. In 1997 Hughes was accused
of using federal funds for embryo work. He lost his funding from the National
Institutes of Health and resigned from Georgetown University in Washington, D.C.
(Hughes had initially taken up Molly Nashs case, but was forced to abandon it.
The Nashes eventually found a doctor in Chicago who performed the procedure.)
Hughes moved to Detroit and set up the Center for Molecular Medicine and
Genetics at Wayne State University.
The more substantial issue, though, is the
specter of eugenics. At least one clinic in the United States is currently
offering PGD services that allow parents to select the gender of their child,
and more will surely follow. Hughes doesnt condone the practice. We wont do
gender selection, he says. Gender is not a disease. What about fixing traits
that make a good sibling donor? Are Hughes and other PGD specialists unwittingly
turning children like Adam, selected to provide a transplant for his sister,
into commodities? Hughes has struggled with this question and, he admits, has
never managed to answer it unequivocally. He first confronted it when a case
came up, before Molly Nash, while he was still working for the NIH in
Washington.
I was very worried about it, he says.
We had meetings. We published in a serious bioethics journal. Hughes is not
the kind of person who finds it easy to say no, and its not hard to imagine him
taking pains to avoid the impatient parents. One day the husband tracked him
down at his lab unannounced. Ill never forget what he told me, says Hughes.
He says, While youre running around the world sitting at mahogany tables
debating the bioethics of this, our daughter is dying.
People have children for all kinds of
reasons, Hughes says, still paraphrasing. They have them for money, they
have them for power, they have them to work on the farm. Mostly they have them
by accident. Whats wrong with our having a child were going to love very much,
but who also has the miraculous power to save our other childs life? Its not
an easy question to answer.
* * *
Abstract
Treatment of Autism Spectrum Children With
Thiamine Tetrahydrofurfuryl
Derrick Lonsdale1, Raymond J. Shamberger2 &
Tapan Audhyaa
1. Preventive Medicine Group, Westlake OH, USA.
2. Director, King James Medical Laboratory
Inc., 24700 Center Ridge Rd. Westlake, OH 44145, USA. 3. Vitamin Diagnostics,
mc, Rt 35 & Industrial Drive, Cliffwood Bch, NJ 07735, USA. Correspondence to:
Derrick Lonsdale MB, BS. FAAP 24700 Center Ridge Road, Westlake, Ohio 44145, USA
TEL: +1 (440) 835-0104; FAX: +1(440)
871-1404
E-MAIL: dlonsdale@pol.net
Submitted: February 17, 2002
OBJECTIVES: In a Pilot Study, the clinical
and biochemical effects of thiamine tetrahydrofurfuryl disulfide (TTFD) on
autistic spectrum children were investigated.
SUBJECTS AND METHODS: Ten children were
studied. Diagnosis was confirmed through the use of form E2, a computer assessed
symptom score. For practical reasons, TTFD was administered twice daily for two
months in the form of rectal suppositories, each containing 50 mg of TTFD.
Symptomatic responses were determined through the use of the computer assessed
Autism Treatment Evaluation Checklist (ATEC) forms. The erythrocyte
transketolase
(TKA) and thiamine pyrophosphate effect (TPPE),
were measured at outset and on completion of the study to document
intracellular thiamine deficiency Urines from patients were examined at outset,
after 30 days and after 60 days of treatment and the concentrations of
SM-reactive metals, total protein, sulfate, sulfite, thiosulfate and thiocyanate
were determined. The concentrations of metals in hair were also determined.
RESULTS: At the beginning of the study
thiamine deficiency was observed in 3 out of the 10 patients. Out of 10
patients, 6 had initial urine samples containing arsenic in greater
concentration than healthy controls. Traces of mercury were seen in urines from
all of these autistic children. Following administration of TTFD an increase in
cadmium was seen in 2 children and in lead in one child. Nickel was increased in
the urine of one patient during treatment. Sulfur metabolites in urine did not
differ from those measured in healthy children.
CONCLUSIONS: Thiamine tetrahydrofurfuryl
disulfide appears to have a beneficial clinical effect on some autistic
children, since 5 of the 10 children improved clinically. We obtained evidence
of an association of this increasingly occurring disease with presence of
urinary SH-reactive metals, arsenic in particular.
* * *
AWARENESS
Autism Blocks Citizenship Bid
Cases across country on hold until rules for
waivers are set
It was the day Peter and Beverly
Chai-Seong of Cary and their three sons had waited eight years for.
The family from Canada went to the
Charlotte immigration office to become U.S. citizens on June 6, but their plans
soured when workers delivered bad news: 17-year-old Jeffrey couldnt be sworn in
because he is autistic and cant speak the oath.
Now, Jeffreys misfortune has prompted an
inquiry by U.S. Sen. John Edwards, and officials at the Bureau of Citizenship
and Immigration Services say theyre taking action and that Jeffrey could be
made a citizen within days.
What was supposed to be a day of
jubilation and excitement was pretty sad, because the youngest member (of the
family) didnt become a U.S. citizen, said Peter Chai-Seong in a telephone
interview from his Cary home.
It just seems very unfair that he was
excluded.
Cases like Jeffreys exist across the
country, immigration officials said.
In April, a mentally disabled Haitian
woman in Miami who cannot speak sued federal immigration officials, saying they
should waive the requirement that she speak the oath of allegiance.
Congress passed a law in 2000 permitting
people who cannot speak to receive a waiver that would enable them to become
citizens.
But three years have passed and
immigration officials havent come up with any regulations to apply the 2000
law, said John Schewairy, a spokesman with the Bureau of Citizenship and
Immigration Services.
So cases like Jeffreys are processed
until the point when most applicants would take an oath and become a citizen.
Then, theyre put on hold. A spokesman at the Charlotte Bureau of Citizenship
and Immigration Services said Jeffreys case is one of seven in the Charlotte
office alone.
Rulings about when guardians can speak for
minors differ from case to case, Schewairy said.
Theres no telling when immigration
officials will come up with a plan to implement the 2000 law.
But allowances can be made in individual
cases, as will likely be the case with Jeffrey, Schewairy said.
In a letter sent Friday, Edwards urged
Homeland Security Acting Director Edward Aguirre to implement the 2000 law.
I understand that Jeffreys is not an
isolated case and that there are many individuals and families nationwide who
have been waiting for over two years for these regulations to be issued so that
they, too, may enjoy the rights and privileges of being United States citizens,
Edwards wrote.
Peter Chai-Seong says although his son
cant express himself in words, he was visibly sad that he couldnt became a
U.S. citizen alongside his parents and two older brothers.
Whatever the family does, Chai-Seong
said, he wants to be part of it.
* * *
LETTER
Spotting Autism at Six Weeks?
I would disagree with Dr. Danczak about
babies not smiling by six weeks of age [Letters, June 23,] as a sign of autism.
In the USA infants are given the hepB vaccine at or before 24 hours of age. In
addition, often times premature infants are given their two month vaccines two
months after their birth, not when they WOULD HAVE been two months old.
In addition, a child that does not display
a genuine smile by six weeks does not signify a developmental delay. After all,
how many physicians have told us frantic parents that not talking, not walking,
not making eye contact, not eating, and not playing is nothing about which to be
concerned? If a baby not smiling at the six week deadline is a symptom of
autism, why are there not seven week autism evaluations as part of every childs
well-visit?
++ To Unsubscribe, Send an email to
unsubscribe@doitnow.com ++
To Unsubscribe, Send an email to
unsubscribe@doitnow.com
mailto:unsubscribe@doitnow.com Please do not use the address below We use
two listservers and it will only unsubscribe you from one of them.
DISCLAIMER:
All information, data, and material contained, presented, or provided here
is for general information purposes only and is not to be construed as
reflecting the knowledge or opinions of the publisher, and is not to be
construed or intended as providing medical or legal advice. The decision
whether or not to vaccinate is an important and complex issue and should
be made by you, and you alone, in consultation with your health care
provider.
"A foolish faith in authority is the worst enemy of truth."
-- Albert Einstein, letter to a friend, 1901
"I know of no safe depository of the ultimate powers of the society but the people themselves, and if we think them not enlightened enough to exercise control with a wholesome discretion, the remedy is not to take it from them, but to inform their discretion by education."
-- Thomas Jefferson, letter to William C. Jarvis, September 28, 1820
"What's the point of vaccination if it doesn't protect you from the unvaccinated?"
-- Sandy Gottstein
"Who gets to decide what the greater good is and how many will be sacrificed to it?"