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AUTISM FIRST STEPS
AUTISM DAILY NEWSLETTER
Wednesday January 9, 2002
INDEX:
* Opposition to vaccine
ups children's tetanus risk
* Families seek compensation for alleged vaccine harm
* Docs: Babies Need Hepatitis Vaccine
* U.S. study says multiple infant vaccines safe
* Study: Vitamin A Helpful vs. Disease
* Drug Middlemen Are Facing Pressure Over Rising Prices
* Children's Vaccine in Short Supply
* Pneumococcus vaccine urged for US day-care tots
* Laura's little miracles
update
******************************
Opposition to vaccine ups children's tetanus
risk
NEW
YORK, Jan 07 (Reuters Health) -
Children whose parents decide not to vaccinate them against tetanus are at risk
of contracting the potentially serious disease, according to
researchers.Tetanus is an infection that occurs when a toxin found in soil and
animal and human intestines enters the body through a wound. The disease, which
is not contagious, leads to muscle spasms and may be fatal.The study of 15
cases of tetanus in children younger than 15 years found that 80% had not been
vaccinated due to their parents' religious or philosophic objections. Vaccinated
children had milder illness compare with unvaccinated children. Although none
of the children died, all were hospitalized and about two-thirds were put on a
respirator.Two cases of tetanus occurred in infants younger than 10 days old
and 13 were diagnosed in children aged 3 to 14 years, the report
indicates.Typically, US children are inoculated against tetanus at 2, 4 and 6
months, and 15 to 18 months of age. The vaccine, known as DTP, is given along
with an inoculation against diphtheria, a potentially fatal infection that
damages the heart and central nervous system, and pertussis (whooping cough), a
highly contagious respiratory infection.In recent years, an increasing number
of parents have decided not to vaccinate their children against a handful of
diseases, some potentially fatal, due to concerns about the safety of vaccines,
the belief that these diseases are rare, and the belief that parents can
protect their children.But according to the report in the January online
edition of the journal Pediatrics, these decisions can put children at risk of
contracting tetanus."Parents who choose not to vaccinate their children
should be advised of the seriousness of the disease and be informed that
tetanus is not preventable by means other than vaccination," conclude
Elizabeth Fair from Stanford University School of Medicine in Stanford,
California, and colleagues.According to their report, all US states require
children entering school to be vaccinated against tetanus. However, the
majority of states also recognize religious and medical exemptions, while 15
states recognize philosophic objections."Tetanus in individuals who are
not protected can result from mild injury and can cause life-threatening
disease even with the availability of intensive medical care," Fair's team
concludes.SOURCE: Pediatrics online 2002;109:e2.
http://www.reutershealth.com/archive/2002/01/07/eline/links/20020107el
in003.html
******************************
Families seek compensation for alleged vaccine
harm
By Richard WoodmanLONDON, Jan 07
(Reuters Health) -
More than 1,000 British families have joined a legal battle for millions of
pounds compensation for harm they claim was caused to their children by
measles, mumps and rubella (MMR) vaccines, their solicitors said on Monday.The
case--which is scheduled to come to trial in February 2003--follows
controversial research findings suggesting that use of the vaccines could be
linked to inflammatory bowel disease and autism.Two firms of solicitors,
Alexander Harris and Freethcartwright, have been appointed as the joint leading
firms in the generic litigation against Aventis Pasteur MSD, GlaxoSmithKline
and Merck.A spokeswoman at Alexander Harris said that the firm represented
about 1,000 families while the total number involved was probably around 1,500.
She said likely levels of compensation varied but could be worth several
million pounds for children with serious brain damage.The firm's Web site says
that the case is being brought under the Consumer Protection Act--part of the
European Union's Product Liability Directive that imposes liability on
manufacturers of products for any injury caused by an unsafe product. The
families had been granted public funds to pay for the legal action.The firm
said that the UK Department of Health stopped using SmithKline Beecham's
Pluserix and Aventis Pasteur MSD's Immaravax in 1992, two years after a similar
vaccine containing the Urabe strain of mumps vaccine virus was withdrawn in
Canada after reports of meningitis."After we had been contacted by several
hundred families a clear pattern began to emerge," the solicitors said.
"Children who were developing well, both physically and intellectually,
before the vaccine, regressed after vaccination, often accompanied by other
symptoms and a gradual decline into autism."They added: "It is
important to stress
that we appear to be dealing with cases where the children, who were fit and
well before being vaccinated and were developing normally in every way, are now
chronically ill and as a result many are seriously mentally or physically
disabled."A spokesman for GlaxoSmithKline said that all the manufacturers
were still trying to clarify exactly what was being alleged by the families. He
added that numerous studies had failed to show a link between MMR vaccination
and autism, and that the legal action would be defended.The Department of
Health and the Medical Research Council have also dismissed reports by
researchers at London's Royal Free Hospital suggesting that the triple vaccine
may trigger autism.
http://www.reutershealth.com/archive/2002/01/07/eline/links/20020107el
in021.html
More than 1,000 British families have joined a legal battle
for
millions of pounds compensation for harm they claim was caused to
their children by measles, mumps and rubella (MMR) vaccines, their
solicitors saidon Monday.
The case--which is scheduled to come to trial in
February
2003--follows controversial research findings suggesting that use of
thevaccines could be linked to inflammatory bowel disease and autism.
Two firms of solicitors, Alexander Harris and
Freethcartwright,
have been appointed as the joint leading firms in the generic litigation
against Aventis Pasteur MSD, GlaxoSmithKline and Merck.
A spokeswoman at Alexander Harris said that the
firm
represented about 1,000 families while the total number involved was probably
around 1,500.
She said likely levels of compensation varied but could be worth
several million pounds for children with serious brain damage.
The firm's Web site says that the case is being
brought under
the Consumer Protection Act--part of the European Union's Product
Liability Directive that imposes liability on manufacturers of products for any
injury caused by an unsafe product. The families had been granted public
funds to pay for the legal action.
The firm said that the UK Department of Health
stopped using
SmithKline Beecham's Pluserix and Aventis Pasteur MSD's Immaravax in
1992, two years after a similar vaccine containing the Urabe strain of mumps
vaccine virus was withdrawn in Canada after reports of meningitis.
"After we had been contacted by several
hundred families a clear
pattern began to emerge," the solicitors said. "Children who were
developing well, both physically and intellectually, before the vaccine,
regressed after vaccination, often accompanied by other symptoms and a gradual
decline into autism."
They added: "It is important to stress that we appear to
be
dealing with cases where the children, who were fit and well before being
vaccinated and were developing normally in every way, are now chronically ill
and as a result many are seriously mentally or physically disabled."
A spokesman for GlaxoSmithKline said that all the
manufacturers
were still trying to clarify exactly what was being alleged by the
families.
He added that numerous studies had failed to show a link between MMR
vaccination and autism, and that the legal action would be defended.
The Department of Health and the Medical Research
Council have
also dismissed reports by researchers at London's Royal Free Hospital
suggesting that the triple vaccine may trigger autism.
Copyright © 2002 Reuters Limited
******************************
Docs: Babies Need Hepatitis Vaccine
By
LINDSEY TANNER
.c
The Associated Press
CHICAGO (AP) - All U.S. newborns should be vaccinated against hepatitis B
before leaving the hospital to protect against possible disease from infected
mothers, doctors recommend.
Previously, giving the shots in the hospital was recommended only for newborns
whose mothers were known to be infected or whose disease status was unknown.
The new recommendation is listed in the childhood immunization schedule for
2002, prepared by the American Academy of Pediatrics, the Centers for Disease
Control and Prevention's Advisory Committee on Immunization Practices, and the
American Academy of Family Physicians.
It is a minor change from the group's list last year. For one of the first
times in recent years, no new shots are recommended; both lists recommend a
series of seven vaccine shots starting in infancy for all U.S. children.
The list is published in January's Pediatrics.
The recommendation for hepatitis B shots was made out of concern that some
infants of mothers mistakenly thought to be disease-free might be falling
through the cracks, said Dr. Julia McMillan, a member of the AAP committee that
helped create this year's list.
Doctors also worried that some infants were not being vaccinated early because
of concerns that some shots had a mercury-containing preservative called
thimerosal, which has since been removed from most vaccines, said Dr. Louis
Cooper, AAP president.
While there's been no known increase in infants infected with hepatitis B,
vaccinating them before they leave the hospital ``just makes good sense,''
Cooper said.
Newborns can contract the virus from infected mothers' blood during childbirth,
but vaccinating them soon afterward can prevent the disease from taking hold,
said McMillan, a pediatrics professor at Johns Hopkins University.
The seven recommended vaccines are: hepatitis B; diphtheria, tetanus and
pertussis combined; haemophilus influenza type b; inactivated polio; measles,
mumps, rubella combined; chickenpox; and pneumococcal vaccine. Hepatitis A and
flu vaccines are recommended for certain at-risk children.
McMillan noted that because of a current shortage of pneumococcal vaccine -
which protects against childhood pneumonia, meningitis and ear infections -
doctors are urged to reserve the full four-shot series for at-risk children
with weakened immune systems until supplies rebound.
Vaccine maker Wyeth-Ayerst Laboratories has said it expects the shortage,
blamed on unforeseen demand, to ease by the end of March.
On the Net:
Academy of Pediatrics: http://www.pediatrics.org/cgi/content/full/109/1/162/F1
CDC: http://www.cdc.gov
AP-NY-01-07-02 0001EST
******************************
U.S. study says multiple infant vaccines safe
By
Michael Conlon
CHICAGO, Jan 7 (Reuters) - Today's children, who receive as many as 11
vaccinations routinely, are not in danger of having their immune system
overwhelmed, according to a study published on Monday.
"Current studies do not support the hypothesis that multiple vaccines
overwhelm, weaken, or 'use up' the immune system," said the report from
Children's Hospital of Philadelphia and several other institutions.
"On the contrary, young infants have an enormous capacity to respond to
multiple vaccines, as well as to the many other challenges present in the
environment," it added.
"By providing protection against a number of bacterial and viral
pathogens, vaccines prevent the 'weakening' of the immune system and consequent
secondary bacterial infections occasionally caused by natural infection,"
it added.
The report was published in this month's issue of "Pediatrics," the
journal of the American Academy of Pediatrics. The authors said they
investigated the subject because recent surveys in the United States indicated
that about a quarter of all parents were concerned about the possible negative
impacts of multiple vaccinations.
A century ago, the study said, children received only one vaccination, for
smallpox. Forty years ago four others came into common use -- for polio,
diphtheria, whooping cough and tetanus. Today children in developed countries
receive 11 vaccines routinely and will have had as many as 20 completion shots
by age two, the report added.
CAPACITY TO COPE WITH 10,000 VACCINES
By a conservative estimate infants have the theoretical capacity to respond to
as many as 10,000 vaccines, it said.
"Parents who are worried about the increasing number of recommended
vaccines may take comfort in knowing that children are exposed to fewer
antigens (proteins and polysaccharides) in vaccines today than in the
past," the report said.
"Although we now give children more vaccines, the actual number of antigens
they receive has declined. Whereas previously one vaccine, smallpox, contained
about 200 proteins, now the 11 routinely recommended vaccines contain fewer
than 130 proteins in total," it added.
"Two factors account for this decline: First, the worldwide eradication of
smallpox obviated the need for that vaccine, and second, advances in protein
chemistry have resulted in vaccines containing fewer antigens ..."
In a related development, the academy in the same issue published its annual
recommendation for immunizations, saying there were no major changes to
suggested timetables except one involving pneumococcal vaccine. Because there
is a shortage of that vaccine, it said, healthy children should receive only
the first three doses and doctors should defer the fourth or booster shot until
the shortage eases.
The vaccine wards off pneumonia, meningitis and bloodstream infections. The
U.S. manufacturer of the vaccine has reported it has been unable to keep up
with demand.
01/06: AOL Health News:
U.S. study says multiple infant vaccines safe
******************************
Study: Vitamin A Helpful vs. Disease
.c
The Associated Press
CHICAGO (AP) - Vitamin A supplements could help improve growth in children in
developing countries with HIV, malaria and persistent diarrhea, a study in
Tanzania found.
Delayed growth and vitamin A deficiency in infants and young children are major
public health problems in developing countries, where infectious diseases like
AIDS and malaria also are common.
The results show that vitamin A supplements ``could constitute a low-cost,
effective intervention to decrease the burden of growth retardation in settings
where infectious disease are highly prevalent,'' says the report in January's
Pediatrics.
Dr. Eduardo Villamor of Harvard University and researchers at Muhimbili
University College of Health Sciences in Dar es Salaam followed 554 Tanzanian
children for up to 12 months.
Participants were 6 months to 5 years old at the outset; 24 percent had malaria
and 9 percent were HIV-infected. All were initially hospitalized with pneumonia
and received two doses of vitamin A. Most also got two more doses four months
apart after they were released.
The doses - 200,000 international units or 100,000 for infants - were much
higher than recommended daily childhood doses but were within the supplement
ranges recommended by international aid agencies, Villamor said. While high
doses of vitamin A can cause severe side effects including liver damage, he
said none were found in the study.
Four months after the first dose, height increases were particularly large
among HIV-infected infants, who grew an average of an inch more than
HIV-infected infants who got placebo supplements. This difference remained
constant throughout the study, the researchers said.
Thin children who got the supplements gained an average of about one pound more
than those taking placebos, with a slightly greater difference among infants with
malaria.
In addition, the risk of stunted growth associated with episodes of persistent
diarrhea lasting 14 or more days during follow-up was virtually eliminated by
vitamin A supplements, the researchers said.
On the Net:
Pediatrics: www.aap.org
AP-NY-01-07-02 0001EST
01/07: AOL Health News:
Study: Vitamin A Helpful vs. Disease
******************************
Drug Middlemen Are Facing Pressure Over Rising
Prices
By MILT FREUDENHEIM
Paul O. Boisvert for The New York Times
Peter E. Shumlin, chairman of the Northeast Legislative Association on
Prescription Drug Prices.
s employers, consumers and government
officials grow increasingly frustrated by upwardly spiraling drug costs,
pressure is building against a handful of powerful companies that have
prospered for years as middlemen between drug manufacturers and those who pay
for medicines.
The companies, called pharmacy benefit managers, administer drug plans for some
200 million Americans and play a critical role in determining which drugs
people take for different ailments.
But increasingly, large corporations and major public employers say pharmacy
benefit managers have not done enough to stem the rapid growth in national
spending on prescription drugs, which nearly tripled in the last eight years
from $50 billion in 1993 to $150 billion last year.
Consumers and employers have filed lawsuits against several pharmacy benefit
managers, claiming that they inflate drug costs for some customers and violate
their duty to act in the best interest of customers. And pharmacists in a dozen
states are pressing for laws that would tighten regulatory oversight of
pharmacy benefit managers.
Officials at Merck-Medco Managed Care, a unit of Merck (news/quote) Inc. and
the largest pharmacy benefit manager, said drug costs increased at a slower
rate for its clients than the national average. Executives of several other big
drug plan managers said that they had to provide savings for their customers or
they would lose the business to rivals. "We don't switch to a
higher-priced product," said Barrett Toan, chairman of Express Scripts.
David D. Halbert, chairman of AdvancePCS (news/quote), said, "We are held
accountable through the competitive bidding process."
But critics say the pharmacy benefit management companies negotiate deals with
drug makers that benefit themselves and the drug companies more than anyone
else.
Some say the drug plan managers actually contribute to rising medical costs
because they strike deals that then lead them to induce patients to use more
expensive medications.
For example, after Merck-Medco Care was sued by several employers and consumers
who said the company was not serving customer interests, lawyers and
consultants for the company said in court documents and interviews last year
that Merck- Medco and other pharmacy benefit managers sometimes ended up
promoting the most expensive drug in a class because Merck and other drug
makers paid them the most to do that.
Pharmacy benefit managers often receive payments or rebates from drug makers to
include their drugs on lists of preferred medicines. The benefit managers then
structure the lists so that consumers pay less for those drugs than for other
brand name drugs in the same class. Consumers are often happy to request those
drugs from doctors because their own payments are smaller. But the employers
covering the rest of the cost of the drug may have to pay more to treat a given
ailment.
Drug plan managers say they allow clients to audit the rebates they receive,
and they say they pass on at least some of the payments. But they rarely
disclose the full terms and amounts of the payments they receive, and some
critics have questioned whether the companies are cooperating with drug
manufacturers to maximize their own profits rather than serving the cost-saving
interests of their customers — corporations, government employers, union welfare
plans, health maintenance organizations and other purchasers of health care.
Some of the drug plan managers' biggest customers are now demanding a more
complete accounting. General Motors (news/quote), which spends more than $1
billion each year on drug benefits, is second-guessing its pharmacy benefit
manager, Merck- Medco, and closely monitoring drug purchases. The company's
direct spending for drugs rose $143 million in 2000 and the increase will
probably exceed $180 million this year, a G.M. spokesman said. "I monitor
every drug in the top 100," said Cynthia Kirman, director of pharmacy at
G.M.
Verizon Communications (news/quote) is encouraging Merck-Medco, its pharmacy
benefit manager, to pay less attention to making deals with drug manufacturers
and to focus more on getting the right drug to the right patient.
Prodded by customers like Verizon and General Motors, Merck- Medco contacted
physicians and patients to urge them to switch to fluoxetine, the generic
version of Prozac, after it became available last year.
Jim Astuto, a regional manager in charge of employee health care at Verizon,
said he did not count on rebates passed on by a pharmacy benefit manager to
lower his company's $500 million in annual drug costs. "We declared the
rebate strategy dead a couple of years ago," he said.
Officials of at least 20 states are going further, working on plans to stop
using drug plan managers altogether or manage central elements of their own
drug plans themselves for state employees and Medicaid members.
In a study last summer for a group of legislators from eight Northeastern
states — New York, Connecticut, Pennsylvania, Maine, Rhode Island,
Massachusetts, Hampshire and Vermont — Health Management Associates
(news/quote), a consulting firm, projected potential savings of $1.8 billion a
year on drugs for Medicaid patients if the states created their own joint
pharmacy benefit manager, or P.B.M.
"The P.B.M. model has failed," said Peter E. Shumlin, president of
the Vermont Senate and chairman of the Northeast Legislative Association on
Prescription Drug Prices. "The P.B.M.'s often negotiate secret kickbacks
that don't benefit the purchaser."
Drug Middlemen Are Facing
Pressure Over Rising Prices
******************************
Children's Vaccine in Short Supply
.c
The Associated Press
ATLANTA (AP) - The national shortage of the vaccine that protects children
against tetanus, diphtheria and whooping cough will continue through at least
the middle of the year, the Centers for Disease Control and Prevention said
Thursday.
The CDC did not estimate when the shortage of DTP might end. It has been in
short supply since 2000, when two manufacturers quit making it, leaving Aventis
Pasteur and GlaxoSmithKline as the only U.S. suppliers.
The shot is typically given to children in a series of five doses - beginning
during the child's first six months and ending at age 4 to 6.
During the shortage, the CDC said, doctors can defer the fourth and, if
necessary, fifth doses. The first three doses are more critical because the
diseases can strike harder against infants.
On the Net:
CDC: http://www.cdc.gov
Aventis Pasteur: http://www.aventispasteur.com
GlaxoSmithKline: http://www.gsk.com
AP-NY-01-03-02 1619EST
01/03: AOL Health News:
Children's Vaccine in Short Supply
******************************
Pneumococcus vaccine urged for US day-care tots
By
Paul Simao
ATLANTA, Jan 3 (Reuters) - U.S. health experts said on Thursday that parents of
young children attending day-care centers should consider having their kids
vaccinated against pneumococcus, a bacterium that is the leading cause of
childhood pneumonia, meningitis and ear infections.
The Centers for Disease Control and Prevention said the recently licensed
vaccine Prevnar, which protects young kids against the seven most common forms
of pneumococcus, should be considered for day-care toddlers under age 2.
Pneumococcal infections kill about 200 infants and cause millions of painful
ear infections in children every year in the United States. Drug-resistant
strains of the bacteria have become a bigger problem in recent years,
especially in day-care centers where children share close quarters.
"Children who attend day care centers are twice as likely as those who do
not attend child care centers to develop serious infections with
antibiotic-resistant pneumococci and are a group for which the vaccine should
be considered," the CDC said in weekly health report.
The CDC had previously recommended that parents vaccinate all children under 2
with Prevnar and issued Thursday's advice to emphasize the vaccine's benefits
for children who attend day care after the agency investigated a recent
outbreak.
The agency issued its advisory in conjunction with its findings of an
investigation into drug-resistant pneumococcus that surfaced in late 2000 among
children at a day-care center in southwest Georgia.
Ninety percent of the children tested at the center were carrying the bacteria.
The CDC noted that frequent use of antibiotics to treat illnesses in the
children likely helped make them vulnerable to the bacteria.
The CDC added that a survey of parents whose children attended the day care
center showed that two-thirds were unaware of Prevnar, which is manufactured by
Wyeth-Ayerst, a division of U.S. drug maker American Home Products Corp.
AHP's vaccine has proven so popular that a temporary shortage has occurred, prompting
some doctors to direct supplies to children at the highest risk of infection,
such as those with sickle cell anemia, the AIDS virus or other diseases that
weaken the immune system.
The shortage is expected to ease in the coming months.
A different pneumococcal vaccine has been available for older children and
adults, but it can not be administered to young kids.
Shares of AHP fell 21 cents to close at $61.46 on Thursday on the New York
Stock Exchange.
18:50 01-03-02
01/03: AOL Health News:
Pneumococcus vaccine urged for US day-care tots
******************************
Laura's little miracles update
If the
Palm Beach Post's brilliant article in Sunday's edition--Laura's little
miracles--wasn't good enough about life with autism and the care issues
surrounding those lives, then staff photographer Paul J. Milette's stunningly
25 picture series in today's online edition surely must be.
Click on Laura's little miracles below the top right picture at:
The
Palm Beach Post: Sunday Photo of the Day
'Andy, you're going to drive me crazy,' Laura Miller jokes with Andrew on his
8th birthday in August. Andrew does not speak,...
Photo
Gallery
While Anthony (center) can't wait to get in there, Andrew can't quite get the
last candle from his birthday cake blown out. ...
Photo
Gallery
Laura (right, facing camera) sometimes attends a support group with relatives
of other autistic children on the Treasure Coast.
Photo
Gallery
Andrew puts up a fuss for Laura at bedtime.Andy is often the hardest of the
three kids to get to sleep at nihgt. Copyright...
Photo
Gallery
Besides being one of Laura Miller's best helpers with the kids, Melissa
Collison is also one of Laura's best friends. ...
Photo
Gallery
After being scolded for throwing toys around the house, Andrew pouts in the
corner of the 'classroom' Laura has set up in the...
Photo
Gallery
Laura likes to keep the kid's senses stimulated, so in the boys' bedroom,
everywhere you look, there are Sesame Street figures,
Photo
Gallery
Laura tries to get answers about her broken down computer from a technician.
Laura sometimes is able to get online late at...
Photo
Gallery
Andrew gets a big lift up and a hug from his grandmother (Laura's mother),
Evelyn Saliba, while waiting for a bus at Walt...
Photo
Gallery
Laura cherishes moments like this one with Anthony at MGM Studios in Orlando.
Copyright © 2002, The Palm Beach Post. By...
http://www.gopbi.com/shared/mod_perl/search/unified_search
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