SCHAFER AUTISM REPORT "Healing Autism:

No Finer a Cause on the Planet"

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Monday, February 09, 2004 Vol. 8 No. 27

THE AUTISM CALENDAR: NOW WITH OVER 300 EVENTS LISTED

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PUBLIC HEALTH

* Debate Grows On Vaccine-Autism Link

* Probe Into Autism And Vaccine Links

* Prenatal Exposure to Mercury From a Maternal Diet High in Seafood Can

Irreversibly Impair Certain Brain Functions in Children

* Estimate of Fetuses Exposed to High Mercury Doubles

* Parents Reassured About Safety of Vaccines

* Autism Link To Vaccines Disputed

* Web links about Mercurialism* and autistic Mercurialism

RESEARCH

* Autistic spectrum disorders in Lothian, Scotland: A Study Of

Prevalence With Use Of The Capture-Recapture Technique

* 22q13 Deletion Syndrome: Update & Review for the Primary Pediatrician

COMMENTARY

* Beware of Vaccine Bullies

PUBLIC HEALTH

Debate Grows On Vaccine-Autism Link

Stakes are high as panel reviews risk from mercury

e_autism_link/

The new vaccines kept coming, each containing a tiny amount of mercury as a preservative. For nearly a decade, until regulators realized the problem in 1999, children who received all the recommended vaccinations could have absorbed an elevated amount of the toxin by the time they were 6 months old.

"I feel badly that I didn't pick it up," acknowledged an adviser to the National Immunization Program, Dr. Neal Halsey of Johns Hopkins University, at a hearing in Cambridge three years ago.

The preservative, called thimerosal, is used only in trace amounts or not at all in today's US vaccines, but the debate over the human cost of that public health miscalculation is growing. Tomorrow, a panel of the Institute of Medicine will hear new evidence on whether mercury-containing vaccines could explain the apparent increase in autism, a neurological disorder whose victims have difficulty interacting with others or even with talking, and often rely on ritual behavior to cope.

By some estimates, the number of US autism cases has risen tenfold in the past 30 years, although it is unclear how much of the increase reflects greater awareness of the disease rather than a true rise. Many public health officials say the amount of mercury was too small to do much harm, but parents of autistic children say their concerns are not getting a fair hearing because federal health agencies, along with vaccine manufacturers, manipulate studies to play down the role of vaccines in neurological problems.

"I just want to figure out what happened to my kid," said Mark Blaxill of Cambridge, whose 8-year-old daughter was diagnosed with autism shortly after she received childhood immunizations.

The anticipated hearing in Washington marks the second time that the institute, an independent science adviser to the government, has tackled the emotional and politically charged issue. In 2001, it concluded that it is "biologically plausible" that mercury, used since the 1930s to keep vaccines fresh, causes autism. The institute's Immunization Safety Review Committee found insufficient evidence to substantiate the claim but recommended that mercury be phased out of vaccines for children as a precaution.

Since then, advocacy groups have zeroed in on changes in the vaccine program beginning in the late 1980s as a possible cause of the apparent increase in autism cases. In that period, a broad effort to increase vaccination rates raised the number of children getting thimerosal-containing vaccines, and new vaccines for hepatitis B and a form of bacterial meningitis were added. The US Food and Drug Administration found that an infant would receive more mercury from the shots than the federal safety standard for mercury in the environment, although mercury in vaccines takes a different chemical form.

But studies in the past three years have reached conflicting conclusions about whether any harm was done. The federal Centers for Disease Control and Prevention has found no consistent link, but other specialists, such as Richard Deth of Northeastern University, have found in laboratory experiments that the form of mercury in vaccines can disrupt chemicals that are key to the developing brain.

The stakes in the vaccine review, expected to be made public by May, are enormous, both for the parents of autistic children and for the US childhood immunization program. Already, 3,500 families of autism patients have applied to the National Vaccine Injury Compensation Program, a federal fund that pays hundreds of thousands of dollars for proven vaccine injuries. Hundreds of other families of autism sufferers have sued the government and vaccine makers directly. But "no one has been compensated one penny yet alleging that mercury in vaccines causes autism," said Jack Hamilton, a lawyer in Melbourne, Fla., who represents more than 50 claims before the compensation program.

More broadly, researchers say the thimerosal controversy has contributed to growing anxieties about children's scheduled shots, and they fear a drop in immunization rates even though today's vaccines, collectively, contain 60 times less thimerosal than the 1990s vaccines. A new University of Michigan survey found that 93 percent of pediatricians had encountered at least one parent who refused vaccines for his or her child in the past year.

"We can do tremendously more harm if we in fact create an environment where children don't get vaccines and we begin to have outbreaks of vaccine-preventable illnesses," said Dr. Gary Freed, director of the Child Health Evaluation and Research Unit at the University of Michigan and author of the study.

Critics say the CDC itself may have undermined confidence in vaccine safety with a study published last November that found no consistent link between mercury in vaccines and autism. The study, based on a review of records from three health maintenance organizations, found only scattered evidence of an increased risk of tics and speech delays -- but not autism -- for children exposed to thimerosal. The study called for further investigation.

But SafeMinds, an advocacy group, obtained the transcript of a meeting in July 2000 in which study authors and advisers discussed preliminary findings that indicated the risk of autism was 2 1/2 times greater among children who received the highest levels of thimerosal compared with those who received none. "I do not want [my] grandson to get a thimerosal-containing vaccine until we know better what is going on," said Richard Johnston, a pediatrics professor at the University of Colorado, according to the transcript.

The version of the study published in the journal Pediatrics last year found no such link, in part because the researchers obtained new data on children from Harvard Pilgrim health plan that diluted the original findings.

US Representative Dave Weldon of Florida, one of the few doctors serving in Congress, is pressing the CDC to give outside researchers access to the study data and calling for an independent review. "There may have been a selective use of the data to make the associations in the earliest study disappear," he wrote to CDC director Julie Gerberding.

CDC spokesman Von Roebuck declined to respond publicly to Weldon's charge, although the researchers have said they collected the Harvard Pilgrim data to broaden their analysis. And Roebuck defended the CDC's objectivity in the vaccine debate: "We're really trying to take a look at the science and understand it."

© Copyright 2004 Globe Newspaper Company. © Copyright 2004 The New York Times Company

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Probe Into Autism And Vaccine Links

9&section=news

A panel of independent experts will take a fresh look today at the possibility that vaccines, especially those made with a mercury preservative, may cause autism.

A panel from the Institute of Medicine will examine a raft of new studies on the subject on Monday, including a Danish study of nearly 500,000 children that found no link between vaccines and autism and a U.S. study that found a possible mechanism for mercury, lead and other heavy metals to cause such disorders.

The panel issued its last report on the subject in 2001, saying there was no evidence that vaccines caused autism, but noting there was not a lot of research either.

"Since the Institute of Medicine released its report on autism back in 2001, there have been new studies done since, and there are still ongoing concerns among parents about this issue," said Christine Stencel, a spokeswoman for the institute, which advises the federal government on health matters.

Several advocacy groups claim vaccines cause autism, a mysterious disorder with symptoms ranging from a lack of social skills to a crippling inability to relate to others.

Autism appears to be on the rise, although there are no clear studies showing whether it is occurring more often, or simply being recognised more as a disorder separate from mental retardation or mental illness.

Because it is usually diagnosed during the toddler years, when children receive many of the 18 or so early childhood shots, many groups believe vaccines are to blame.

The mercury preservative thimerosal is no longer found in childhood vaccines in the United States, but remains in the influenza vaccine and in vaccines in other countries. The American Academy of Paediatrics and the U.S. Public health Service recommended removing thimerosal from childhood vaccines in 1999 as a precaution.

Brain Damage

Scientists say it is plausible that if thimerosal got into the brain, it could cause brain damage. In one study published last week, Richard Deth of Northeastern University in Massachusetts found that DNA damage done by thimerosal, lead and some other metals could damage nerve cell signalling.

Danish researchers will discuss what many scientists say is the most convincing study to date.

Anders Hviid and colleagues at the Statens Serum Institute in Copenhagen looked at 467,000 children born between 1990 and 1996, some of whom were vaccinated with a thimerosal-containing whooping cough vaccine and some who got one without the preservative.

They found no differences in autism rates between the groups.

Dr. Polly Sager of the National Institute of Allergy and Infectious Disease will also speak to the panel. She reviewed several studies that show babies eliminate the mercury found in thimerosal within days.

"The fact that it is excreted in stool really is pretty exciting," she said in a telephone interview. "It is a simple concept -- if a kid is pooping out mercury, it is not in their body, it is not getting to their brain, it can't do damage."

But Boyd Haley of the University of Kentucky will discuss a study that suggests autistic children have lower-than-expected levels of mercury in their hair, raising questions about whether mercury remains in their tissues and if they have an impaired ability to rid their bodies of the toxic metal.

Some experts note vaccines are not the biggest source of mercury in the body. Many fish contain high levels of mercury, as does the water supply in some parts of the country

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Prenatal Exposure to Mercury From a Maternal Diet High in Seafood Can

Irreversibly Impair Certain Brain Functions in Children

Boston, MA— With methylmercury a worldwide contaminant of seafood and freshwater fish and known to produce adverse nervous system effects, especially during brain development, researchers from the Harvard School of Public Health and institutions in Japan, Denmark and the Faroe Islands undertook an assessment of possible brain function impairment in adolescent children due to prenatal exposure to mercury when the mothers’diet was high in seafood. The authors found that high levels of mercury passed from mother to child in utero produced irreversible impairment to specific brain functions in the children. The study was carried out in the Faroe Islands and appears in the February issue of The Journal of Pediatrics.

Mercury exposures among the children in the study were assessed through analyses of cord blood samples at birth and hair samples taken at ages 7 and 14. Some 1,022 mothers and their children from the Faroe Islands participated in the research. The mothers’ hair mercury levels at childbirth in most cases exceeded 1 microgram per gram, the exposure limit recommended by the National Research Council and the U.S. Environmental Protection Agency (EPA). Follow-up testing of the children showed much lower exposure levels. At the most recent follow-up, more than 850 14 year-olds participated in the study.

The Faroe Islands are located in the North Atlantic Ocean between Norway and Iceland. The islands’ economy is centered on the fishing industry and fish processing. The diet of the inhabitants includes high intake of seafood and whale meat.

To assess the impact of the exposure to mercury, brainstem auditory evoked potentials (BAEP) were recorded using surface electrodes placed on the skull. At two different sound frequencies, the researchers measured the transmission of electrical signals in the brain from the acoustic nerve, via the pons (connecting the medulla oblongata to the thalamus) to the midbrain. The latency of the electrical transmission from the acoustic nerve to the pons was significantly increased at higher intrauterine exposure to mercury. This observation was found to be true both at 7 years and at 14 years, suggesting that this effect is lasting.

Prolonged latencies of the electrical signals to the midbrain among the 14 year-olds was linked to the current mercury exposure and therefore suggested that postnatal mercury exposure may damage brain functions that are different from those that are sensitive to mercury during fetal development. Although hearing loss has been observed in severe mercury poisoning cases in adults, the mercury levels among the children in the study was not associated with detectable hearing loss. The authors did not find a link between simultaneous prenatal exposure to PCBs and electrical signal latencies.

A second paper in The Journal of Pediatrics by the same authors reports that the neurological changes are also linked to decreased nervous system control of the heart function. At higher mercury exposures, the children were less capable of maintaining the normal variability of the heart rate necessary to secure proper oxygen supply to the body.

"We found that both prenatal and postnatal mercury exposure affects brain functions and that they seem to affect different targets in the brain. The fact that the current exposure has an additional effect, despite the low mercury concentrations is worrisome, especially for communities where seafood constitutes an important part of the diet," said Philippe Grandjean, senior author of the study and adjunct professor in the Department of Environmental Health at the Harvard School of Public Health. He added, "The current focus on protecting pregnant women against this neurotoxin should be expanded to cover children and adolescents as well. Seafood is an important part of a healthy diet, and consumers should choose species low in the food chain caught in waters without mercury pollution." He added, "In this country we need to set uniform mercury exposure levels. The children in the study had average exposure levels that are similar to the current limit used by the U.S. Environmental Protection Agency, and 95 percent of them were below the current limit used by the Food and Drug Administration."

The research was supported by grants from the National Institute of Environmental Health Sciences, the Danish Medical Research Council and the Nissan Science Foundation.

Listen to audio clips

The effect mercury has on brain function

Establishing mercury exposure limits MP3

Seafood advice MP3

Copyright, 2004, President and Fellows of Harvard College

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Estimate of Fetuses Exposed to High Mercury Doubles

.story?coll=la-headlines-nation <- - address ends here.

Washington — The Environmental Protection Agency believes that about 630,000 of the roughly 4 million babies born annually in the United States — twice as many as previously thought — may be exposed to dangerous levels of mercury in the womb, according to an analysis released Thursday.

The primary source of newborns' exposure to mercury is the fish and shellfish their mothers eat. Mercury in children can impair motor functions, learning capacity, vision and memory, and can cause a variety of other symptoms related to neurological damage.

The EPA's analysis reflects a new understanding among scientists in the U.S. and Japan that umbilical cord blood has higher mercury concentrations than a mother's blood, said Kate Kathryn Mahaffey, the author of the analysis and a division director in the EPA's toxics and pesticides office.

The new information comes as the Food and Drug Administration is redrafting its guidelines on how much and what kind of seafood women of childbearing years can eat without putting their babies at risk.

At the same time, the EPA is taking public comment on its proposal to limit power plant emissions of mercury into the air. The emissions are believed to work their way into ground water and then through the food chain, reaching the fish sold in supermarkets.

The EPA based its estimates on data from the Centers for Disease Control and Prevention (news - web sites), which last year found that 8% of women of childbearing age had mercury blood levels higher than 5.8 parts per billion, the level the EPA then considered safe.

Given the new finding that umbilical cord blood has higher concentrations of mercury, the EPA believes that the safe level for mercury in mothers' blood is 3.5 parts per billion. About 15% of women of childbearing age had blood levels that high, according to the CDC study.

The EPA formerly thought there was a 1-1 ratio between mercury concentrations in blood and the blood that reached the fetus. But it now believes that umbilical cord blood has 1.7 times more mercury, on average.

Mahaffey stressed that the science was evolving and that the estimates could change. But she urged expectant mothers and women who planned to become pregnant to choose fish that have lower mercury levels and higher levels of Omega-3 fatty acids, which are beneficial to developing fetuses.

Swordfish, shark, tilefish and king mackerel are all high in mercury but relatively low in Omega-3 fatty acids. Sockeye salmon and herring have low mercury levels but are high in Omega-3 fatty acids.

"It's important for the public to recognize the nutritional value of fish, and it's important that we work hard to keep the food supply as low in contaminants as we can," Mahaffey said.

Environmental and public health groups said the report should serve as a wake-up call to the Bush administration.

"This heightens the urgency for FDA to give women adequate advice on what fish are safe to eat, and it ups the burden on the administration to cut mercury pollution from coal-fired power plants," said Jane Houlihan, vice president of the Environmental Working Group, a research and advocacy organization.

"The problem is twice as serious as previously believed."

Houlihan said the FDA should particularly warn women not to eat albacore, or white meat tuna, which is high in mercury but is not on the FDA's list of fish to avoid.

Last week, the EPA announced its plan to reduce mercury emissions from power plants by 70% over 15 years.

The agency's own Children's Health Protection Advisory Committee called the proposal inadequate.

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Parents Reassured About Safety Of Vaccines

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Saskatchewan's chief medical health officer is reassuring parents that immunization and flu shots are safe for children, even if a new study shows some of them contain chemicals that may interfere with normal brain development.

"I wouldn't jump to any conclusions where the study is a cell biology study," said Dr. Ross Findlater, chief medical health officer with Saskatchewan Health.

"It's very easy to raise the question of a problem. You don't need really good evidence to raise the question."

An American study published on Thursday points to an apparent link between certain preservatives used in some vaccines and an increased risk of neurological disorders such as autism and attention-deficit hyperactivity disorder (ADHD).

In tests on human brain cells, researchers found two natural chemicals -- one compound that stimulates cell growth and another that transmits nerve signals -- are key to a process in the brain called methylation.

Methylation is crucial to the normal development of the brain.

Through laboratory studies, the team found the vaccine preservative thimerosal, ethanol and the metals lead and mercury all interfere with methylation. No children were involved in the tests.

What happens in a laboratory doesn't necessarily happen with people, according to Findlater.

"There's a lot of information that says thimerosal is safe and really there isn't any credible, epidemiologic evidence that says that it's not safe," he said.

One study tracked down all children born in Denmark between 1991 and 1998, more than 500,000 kids, and compared the rates of autism between those who were immunized with vaccines that contained thimerosal and those who did not receive immunizations. The rate of autism was no different between the two groups.

Still, Findlater says, because thimerosal does contain mercury, it is best to avoid it if at all possible. This is why many vaccine manufacturers have either reduced the concentration of thimerosal in their products or switched to other preservatives.

In Saskatchewan, the routine infant vaccines administered to those 12 months and younger are purchased in single dose vials and do not contain thimerosal. The preservative is phenoxyethanol. Even though the vaccines given to school age children are bought in multi-dose vials, they do not contain thimerosal either. The exception is the hepatitis B vaccine, which is manufactured with thimerosal. The chemical is then "washed out" resulting in such a small amount that it is unmeasureable, according to Findlater.

Also, this year's flu shot contained a trace amount of thimerosal.

He says vaccines are still one of the safest tools available in medicine.

Findlater has not seen many studies that have looked at the possible link between immunizations and ADHD. But just because some children who have received vaccines develop neurological problems doesn't mean the vaccine is the cause, he says, given that many more children receive vaccines and don't get sick. He points out that a small number of children will develop an allergic reaction to a vaccine.

© Copyright 2004 The StarPhoenix (Saskatoon)

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Autism Link To Vaccines Disputed

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[Robin Summerfield for the Calgary Herald; with files from Canwest News Service.]

The causes of autism should still be considered a mystery despite a new study that suggests a link between a vaccine preservative and the increasingly common disease, say medical experts.

"There's not a vaccine today I would hesitate to give to my own children," said Calgary-based microbiologist and infectious disease researcher Dr. Tony Schryvers.

Schryvers said we forget about the usefulness of vaccines because they work so well -- the diseases they prevent aren't seen much anymore.

"Let's not jump off the end of a cliff on this one. We don't want to make the mistake of throwing something out that is really good."

Lyndon Parkin, a father two children diagnosed with autism, cautioned other parents against jumping to conclusions.

"Nobody has the true answers out there," said Parkin, a father of four.

However, Parkin, who is a board member of the Autism Calgary Association, has decided to wait until his 15-month old reaches six before getting immunizations.

Colleen Eggertson, a family support worker the association, suggested parents do as much research and reading of their own about vaccinations.

"Science isn't determined by any one study," she said.

Health Canada defended the safety of its vaccines Thursday, after a study by the journal Molecular Psychiatry published online Thursday suggested a link between thimerosal, a mercury-based preservative commonly found in Hepatitis B and influenza vaccines, and autism and attention-deficit hyperactivity disorder in children.

"The vaccines used in Canada are safe and effective," said Health Canada spokesman Emmanuel Chabot in Ottawa. "The benefits of vaccines outweigh any perceived risk.

"This study was done in cell cultures. The implications for humans are not known."

Researchers found thimerosal, ethanol and the metals lead and mercury all interfere with methylation, a process that is crucial to development of the brain.

In Canada, thimerosal is not being used in routine childhood immunizations, according to both Health Canada and Alberta Health. However, it is still found in influenza and two Hepatitis B vaccines that are commonly used.

Dr. Nicholas Bayliss questioned the study's conclusions because the research was performed on cells and not on animal models, the standard for making the connection to the effect on humans.

"They leap to a conclusion. The science has to be tested,"said Bayliss, an Alberta Health officer. "Vaccines save lives," he added.

The Calgary Health Region takes its cues from Alberta Health in terms of using or not using vaccines. Alberta Health takes its lead on vaccines from the federal government, which has a licensing board that approves or reject vaccines for use in the population.

In July 1999, the World Health Organization, following the lead of the American Academy of Pediatrics and the United States Public Health Service, advocated the phasing out of thimerosal (also referred to as thiomersal) in childhood vaccines. In that same directive, the WHO underlined the importance of continuing to use available children's vaccines.

In March 2003, Health Canada put out its own directive saying vaccines used in routine infant immunization do not contain thimerosal.

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Here are some links about Mercurialism* and autistic Mercurialism (thanks to

Patakay.)

70970

&oe=UTF-8&start=10&sa=N

* Also known as hydrargyrism, or chronic mercury poisoning.

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RESEARCH

Autistic spectrum disorders in Lothian, Scotland: A Study Of Prevalence With Use Of The Capture-Recapture Technique

[Developmental Medicine and Child Neurology.]

Objective: There is a public perception that the rate of autism is escalating. Health Services have to anticipate the diverse medical needs of these children from their challenging behaviour to epilepsy. The objective of this study was to determine whether an estimated prevalence of autism based on a two-point 'capture- recapture' technique previously employed in animal populations, gives an accurate picture of the conditions in a geographical population of under 15-year-olds.

Method: Information on sex, age, and Carstairs Deprivation Index was determined from 11 different datasets maintained for children with autism and from these a point prevalence was estimated. Data from the diagnostic services and from the Community Child Health Special Needs System were entered into a two-point capture- recapture calculation to calculate a true estimated prevalence.

Results: Four hundred and forty-three out of the total population of 134 661 under 15-year-olds resident in Lothian were known to Autism Services, giving a point prevalence of 32.9 per 10000 (95% CI 29.8-36.0). Two-point capture-recapture estimated prevalence was 44.2 (95% CI,

40.7-47.8) which suggests that 74% of affected children are registered with services in some way. The age distribution was similar to the background population under the age of 12 years with no indication of a rising prevalence. The ratio males to females was 7:1 and there was no relationship to Deprivation Index. Conclusions: Prevalence of autism in a geographically-based population employing two-point capture- recapture analysis is comparable to that quoted for the best active ascertainment studies. This technique offers a tool for establishing the prevalence of autism in Health Service Populations to assist in planning clinical services.

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22q13 Deletion Syndrome: An Update and Review for the Primary Pediatrician

Recent advances in genetic testing can help to provide a specific diagnosis to children born with syndromes that result in congenital anomalies and developmental delay. One such emerging condition is the 22q13 deletion syndrome.

With the introduction of subtelomeric fluorescence-in-situ hybridization (FISH) analysis, the 22q13 deletion has become recognized as a relatively widespread and underdiagnosed cause of mental retardation. Primary-care physicians play an important role in the care of children with 22q13 deletion syndrome, from suspecting the diagnosis in a developmentally delayed child through the medical, developmental, and behavioral aspects of their care. Furthermore, they serve as a valuable source of support and advocacy for the family and a resource for other care providers.

See Also:

An Investigation Into Sub-Telomeric Deletions Of Chromosome 22 And Pervasive Developmental Disorders

ds=14755453&dopt=Abstract <- - address ends here.

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COMMENTARY

Beware of Vaccine Bullies

Why on earth should we vaccinate our newborn baby against Hepatitis B - a virus that is contracted mostly through intravenous drug use and sexual contact? That is the question my husband and I had for the doctors and nurses at the hospital where our son was born two and a half months ago.

We didn't get very good answers. It was "convenient," "recommended" and "routine," the medical staff assured us. We wanted more information. A nurse gave us a brochure, which explained that babies whose mothers had the Hep B virus were at high risk of developing acute Hep B infections. Well, I tested negative for Hep B. The Centers for Disease Control named unprotected sex, IV drug use and being stuck with a needle on the job as the likeliest routes of Hep B transmission. Well, my husband and I both work primarily from home, our two children stay at home, and neither we nor our 3-year-old daughter nor our baby (for heaven's sake!) live the Kid Rock-and-Pamela Anderson Lee lifestyle.

When we told the hospital staff that we simply wanted more time to think about giving the Hep B shot to our son - doesn't "informed consent" mean we should be truly informed? - we were badgered aggressively. Some lectured us about the need to "get on the proper vaccination schedule." Others warned that Maryland, like more than 40 other states, requires all schoolchildren to be vaccinated for Hep B. Teachers, however, are not subject to the mandate, which is driven not just by altruistic concern for children's health. Ohio legislator Dale Van Vyven snuck the Hep B mandate into a 1998 hazardous-waste bill at the behest of profit-maximizing vaccine manufacturers' lobbyists.

The "everybody does it" and "for the greater good" arguments worked when we were overcautious, over-trusting, first-time parents who submitted our daughter to every single vaccine without question. This time, we resolved not to be rushed or bullied. We declined to give our son the politically correct Hep B shot, decided to do more research, and then took up the issue with our pediatrician.

Boy, were we in for a rude awakening. Our doctor parroted the American Academy of Pediatrics line and mindlessly emphasized the efficacy of vaccines in eradicating childhood diseases. Well, we weren't questioning their collective efficacy. We questioned what the individual health benefits and health risks to our newborn were. Physicians have blindly plied vaccines before that have done more harm than good. A childhood rotavirus vaccine, for example, was approved for widespread use in 1998 and withdrawn from the market less than a year later after causing an increase in the incidence of painful bowel obstruction among infants.

Our doctor, however, pooh-poohed our inquiries about potential side ef fects. He seemed to have no idea what those risks were and no interest in finding out. He was also incredibly condescending: "95 percent of what you read on the Internet" is unreliable, he sermonized, as if we were too dumb to separate scientific fact from fraud.

In the end, we concluded that some of the vaccines were more worth the risks than others. At my son's two-month checkup, the pediatrician expected him to receive a triple-combination shot called "Pediarix" (consisting of Hep B, inactivated polio, and DTaP, which covers diphtheria, tetanus and acellular pertussis), as well as HiB (for certain bacterial infections) and Prevnar (for meningitis and blood infections). I reiterated my refusal of Hep B, accepted DTaP and HiB, and asked to put off polio and Prevnar. In response, I received a threat: Get all the vaccines or get out of our practice.

"Informed consent"? Ha. This was uninformed coercion.

We're leaving for another practice, a little bitter but wiser. The strong-arm tactics of the medical establishment mustn't intimidate parents from challenging the universal vaccine orthodoxy. When it comes to protecting our children's health, skepticism is the best medicine.

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