Flu shot for kids makes some parents anxious

Debate continues over whether mercury plays role in development of autism

Lauri Githens Hatch
Rochester Democrat and Chronicle

(November 10, 2005) — Twice Terri Kerr felt a twinge of uncertainty when it came time to vaccinate her babies, once in 1992 and again in 1994.

Twice she ignored that twinge — largely because of broad suggestions that declining the shots made her appear an unfit mother.

And twice Kerr and her husband wound up with autistic sons: one mildly and the other so acute he has required continual watching since babyhood, when periodically he might dash into the snow in just a diaper, or leap from furniture and land on his knees, feeling no pain.

The boys' vaccines contained thimerosal — a mercury-containing preservative removed from U.S. vaccines, except flu, in 1999 — which the Kerrs, along with a cadre of other parents and some researchers believe can accumulate to trigger autism, typically diagnosed by age 3.

As flu season begins, Kerr hopes parents will press for a mercury-free vaccine — particularly because the flu shot may be added to the already long list of those required for school.

"I would say to pregnant women and new mothers, 'Read, read, read,'" before vaccinating a child, says Kerr of Irondequoit. While she cherishes the gifts her sons have brought to her life — "It's made me a better person, a better advocate" — she often thinks about those doctor visits.

"I should have grabbed my baby and run like hell. And I didn't. And I don't think anything has changed at all."

Yet many pediatricians disagree, saying science has never been clearer about this.

"Since 2001 there have been 10 studies, and they've all found no link, no causal association between thimerosal as a preservative and autism, nor the measles, mumps and rubella vaccines," says Dr. Michael Pichichero, the University of Rochester professor whose 2002 pharmacokinetic study on mercury's rapid elimination from the body appeared in the British medical journal The Lancet.

"I'd give this flu shot to my own grandchildren. You don't get a higher endorsement than that."

What's available

Thimerosal-free flu vaccines are out there. But to get one, you may have to shell out as much as $1,000.

Why?

The single-dose nasal spray (FluMist) isn't recommended for kids younger than 5, kids with underlying medical problems or adults older than 50.

That leaves mercury-free shots, but single doses aren't widely available. What is, is a roughly 10-dose vial, the cost of which isn't covered by insurance. With each shot costing about $100, "that's a lot of money to shell out for one shot," says Pichichero, who in December will unveil a larger version of his 2002 study, this one indicating mercury leaves a child's body faster than previously thought.

For people who rely on the county health department or community clinics for their flu vaccines, the mercury-free option doesn't exist.

Nancy Hackett, clinical supervisor for the Monroe County Immunization Clinics, says the county's position is that the minute amount of thimerosal in the flu vaccines renders them safe. Providing an alternate "would make it appear that we're lying," says Hackett, who is also a registered nurse. "And we're not. We believe these are safe."

When the county does get its supply, she says, it will be in multidose vials that do contain the preservative.

Debate continues

The fierce dispute over thimerosal shows no signs of ceasing, nor does the loop of study-debate-study-debate.

For example, a May 2004 comprehensive report from the Institute of Medicine firmly rejected a link between autism and vaccines; barely a month later, Columbia University released a study showing there was an autismlike response in mice exposed to the substance.

Parents must sift through the ever-growing pile of evidence, or what claims to be evidence, and make a choice.

"They still talk about it, but there's less refusal (of shots) in general," observes Dr. Robert Tuite, a pediatrician with Panorama Pediatric Group in Penfield, which has approximately 16,000 patients.

"Most pediatricians feel (the risk) it's pretty minimal. We try to be the patient's advocate, and if we don't recommend the thimerosal-free one, it's because it's so much more expensive."

Neither he nor Pichichero can recall ever having a family use the 10-dose vial, just for the one shot.

And some parents make up their minds long before a vial is needed.

Julie Kuss, a registered nurse, had her first two children inoculated. While the eldest, a girl now 15, did not become autistic, her brother, now 13, did develop a mild form.

So when she delivered her third child, a girl now 10, Kuss looked her doctor in the eye and asked him to guarantee that autism wasn't brought on by the shots.

"He said no, I can't say that. So I said, OK, no shots," recalls Kuss, of Gates. "He let me hold off and I feel fortunate, because this was before it became such an issue. Now, to this day, do I believe it caused (my son's) autism? I can honestly say you never know. Let's see what science says 10 or 20 years from now, when it's gone from vaccines. Will autism be leaping and growing? There's your answer."

LGITHENS@DemocratandChronicle.com

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