Guest: Dr. Jane M. Charles – Pediatrician
Host: Dr. Linda Austin – Psychiatrist
Announcer: Welcome to an MUSC Health Podcast.
Dr. Linda Austin: I am Dr. Linda Austin. I am talking with Dr. Jane Charles, who is a Developmental Behavioral Pediatrician and an expert on autism. Dr. Charles, surely one of the great controversies in this area; in fact, one of the great controversies in all medicine in this era is the question of the relationship between childhood vaccinations and autism. What are the two sides of that controversy?
Dr. Jane Charles: This is a very hot topic at the moment. Actually, it has been for a number of years. The concern is that the preservatives that had been in vaccines until the year 2000, these preservatives are a form of mercury that were used to keep the vaccine that was in the vial, the liquid in the vial from being contaminated. This particular substance called thiomerosal, which contains mercury may cause autism in children. Especially the children that appear to have normal development and then when they receive good many immunizations between 15 and 18 months, then they were receiving a big chunk of thiomerosal or a big chunk of mercury and that this mercury may have caused them to regress and lose speech and social interaction. There have been a large number of studies done looking at whether this type of mercury causes autism or not and they have found no relation between exposure to thiomerosal in the development of autism.
Dr. Linda Austin: Now, what is a scientific method for examining that since most kids do get those vaccinations?
Dr. Jane Charles: What they have done is looked at large population studies and a very good one was done in Denmark a few years ago where they looked at all of the children born within a certain time period and they have put these children in the entire country. They split them into two groups, the groups that got vaccines and the group of children that did not get vaccines, and they found that the rate of autism or the number of children with autism in each group was about the same. In fact, there were actually more children with autism in the group that did not receive vaccines than in the group that did get vaccines; however, the issue has continued to be a big concern and it’s a question that many pediatricians ask me and many of my patients ask me. My lot of parents have fears about giving their children vaccines. Especially parents who already have a child with autism and should they give their second child who does not appear to have any signs of autism yet or hopefully will never, should they give their children vaccines and it’s a very difficult question to answer knowing that there is no scientific evidence that thiomerosal causes autism, but and yet being concerned and understanding the parents? fears about exposing their child. Now, thiomerosal was removed from vaccines in the year 2000, but does exist in the flu vaccine that children do receive. I am not sure why they don’t take that or just take it out. There is another vaccine that raised a lot concern as well and that was the measles, mumps, and rubella vaccine. Now, this vaccine actually has never had thiomerosal or mercury in it, but there are some early studies in England that showed that children with autism had a lot of measles antibodies floating around in their blood and so they felt that perhaps the measles shot also was a reason for people to get autism and this again through large population studies have shown that there is no connection between the measles, mumps, rubella or MMR, and autistic disorder.
Dr. Linda Austin: You described in another Podcast that often in that 25% group of kids who seem to develop normally and then regress, that regression occurs around age 18 months, would it be possible to postpone a child getting MMR because after all schools and camps require kids to have these vaccinations, so they are not really optional if you want to send your kid to school, would it be possible, let’s say, to let the child even if only for the sake of the parent’s peace of mind. Wait until 2-1/2 or 3 to get those shots?
Dr. Jane Charles: Yes. I have specially families that have an older child with autism when they have come to me and expressed concern about their second child receiving immunizations. I have felt comfortable saying why don’t you just wait or another option is to spread the immunizations out and instead of getting all of the immunization say at your 18-month visit or your 15-month visit to spread it out, spread the immunizations out over a number of months and many parents feel comfortable with that as well.
Dr. Linda Austin: So, it’s nice to know that there really are 05:07 options...
Dr. Jane Charles: Yes.
Dr. Linda Austin: and that it’s not a rigid system.
Dr. Jane Charles: No, I mean, I think I am sure the health department would like you to get them all in time, but I can -- myself and other pediatricians certainly understand parents? fears and concerns and even though the studies show that there isn’t a connection, the fear is there and I think all of us who are moms do the same thing, would spread the vaccine 05:31 or else delay them.
Dr. Linda Austin: Do you ever hear of cases where that regression seems to happen much later, say at 3 years of age?
Dr. Jane Charles: If it does, it happens late, then it’s generally not autistic disorder and it may instead be either what we call a metabolic disorder or some kind of neurodegenerative disorder where your neurological system is degenerating. Also, there is another disorder called childhood disintegrative disorder, which is very rare sometimes it lumped in with autism spectrum disorders, but it’s a separate disorder and it’s very rare where you have regression after age 3 and you continue to regress.
Dr. Linda Austin: So, it sounds then as if a parent has one child with autism, if their second child makes it to say age 3 and seems like a normal happy outgoing child, they can more or less draw a psi of relief and say, things are looking pretty good.
Dr. Jane Charles: Yes.
Dr. Linda Austin: Don’t need to worry.
Dr. Jane Charles: Right, and also children who have autism, who have regressed and then start to make gains and start to develop with intervention, there is no concern that they will regress again, it does not happen again. It happens the one time. I don’t think people are really sure why this happens, but it does not happen again.
Dr. Linda Austin: In that subtype of autism that 25% who show regression as opposed to the ones who have autism from early infancy on, does that particular form the regressive form tend to run in families too or to see all patterns of the autistic presentation?
Dr. Jane Charles: You see all patterns. I will say and I don’t know if there are any studies to back this up. With the families with a lot of family members who have unusual corky behaviors and may not quite meet criteria for autism. I generally have not seen the regressive autism in those families where you think of those children generally from the get-go, have language delayed, and may be kind of socially -- have social deficits and may not be -- even as infants may be quiet and were not very interested in being around other people and watching other children.
Dr. Linda Austin: Dr. Charles, thank you so much.
Dr. Jane Charles: You’re welcome.
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