Vaccines

This is a post that will be updated from time to time (as I have a chance to type). I get a lot of questions about vaccinations, and have written several emails addressing the question. Since I keep repeating the same information, I thought I would just do a post that my friends can look up any time.
Just so everyone is aware: I am a board certified pediatrician. I am very much PRO immunizations. Both my children have been immunized. I followed the AAP recommended schedule. I have also been immunized (including typhoid and yellow fever) and so has my husband. I get my yearly influenza vaccine. My children get a yearly influenza vaccine. 

I've posted common questions with associated articles. Any article that is colored red and starred is a "must read" as it summarizes more than one issue very nicely.

Question: Does vaccinating my child with a thimerisol-containing vaccine increase the risk of autism?

Answer: No.

1. Thimerosal-containing vaccines and autistic spectrum disorder: a critical review of published original data. Pediatrics. 2004 Sep;114(3):793-804. (full text: http://pediatrics.aappublications.org/content/114/3/793.long)
2. Prenatal and infant exposure to thimerosal from vaccines and immunoglobulins and risk of autism. Pediatrics. 2010 Oct;126(4):656-64. Epub 2010 Sep 13. (full text: http://pediatrics.aappublications.org/content/126/4/656.long)
3. Thimerosal exposure in early life and neuropsychological outcomes 7-10 years later. J Pediatr Psychol. 2012 Jan-Feb;37(1):106-18. Epub 2011 Jul 23. (abstract only: http://www.ncbi.nlm.nih.gov/pubmed/21785120)



Question: What is "herd immunity?"
Answer: Herd immunity (or community immunity) describes a form of immunity that occurs when the vaccination of a significant portion of a population (or herd) provides a measure of protection for individuals who have not developed immunity. Some vaccines may provide better protection than others; for instance, meningococcal conjugate vaccines are superior to polysaccharide vaccines, as is true of pneumococcal and Haemophilus influenzae type b vaccines.
1. http://en.wikipedia.org/wiki/Herd_immunity (nice Wikipedia article with good additional references)
2. Vaccination and herd immunity: what more do we know? Curr Opin Infect Dis. 2012 Jun;25(3):243-9. (abstract only: http://www.ncbi.nlm.nih.gov/pubmed/22561998).

Is the MMR vaccine associated with autism?
Answer: No 
1. The combined measles, mumps, and rubella vaccines and the total number of vaccines are not associated with development of autism spectrum disorder: The first case-control study in Asia. Vaccine. 2012 Apr 20. (abstract only: http://www.ncbi.nlm.nih.gov/pubmed/22521285).
2. Lack of association between measles-mumps-rubella vaccination and autism in children: a case-control study. Pediatr Infect Dis J. 2010 May;29(5):397-400. (abstract only: http://www.ncbi.nlm.nih.gov/pubmed/19952979).

3. Immunization Safety Review: Vaccines and Autism. Institute of Medicine (US) Immunization Safety Review Committee. (full text: http://www.ncbi.nlm.nih.gov/books/NBK25344/)

4. What Every Behavior Analyst Should Know About the "MMR Causes Autism" Hypothesis. Behav Anal Pract. 2010 Spring;3(1):46-50. (full text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3004684/?tool=pubmed).

Do children get exposed to too many antigens with the current recommended schedule?

Answer: No. The recommended schedule should be followed as it provides maximum protection against early childhood killers.

*1. The problem with Dr Bob's alternative vaccine schedule. Pediatrics. 2009 Jan;123(1):e164-9. (full text http://pediatrics.aappublications.org/content/123/1/e164.long)

2. Do Children Get Too Many Immunizations? The Answer is No.  (full text: http://www.quackwatch.com/03HealthPromotion/immu/too_many.html)

Other good websites:

http://www.cdc.gov/vaccinesafety/Activities/vaers.html

http://www.immunize.org/aap/

http://kidshealth.org/teen/school_jobs/college/immunizations.html

http://thecaffeinecoquette.com/2011/why-am-i-pro-immunization/