US Pharm. 2017;42(5):2.

The potential harm arising from a belief that childhood vaccines play any role in a rise in rates of autism spectrum disorders (ASDs) is hard to underestimate. Parents concerned about a possible causal effect are more likely to deviate from the CDC’s recommended vaccination schedule, potentially imperiling their children.

Their concern is perhaps understandable. In an article published in U.S. Pharmacist in January 2013, authors Robyn Pisacane, PharmD and Marissa Salvo, PharmD wrote in “Pharmacist Update on Autism and Its Management” that the CDC estimated 1 in 88 children had an ASD. Surveillance data from 2000, they wrote, indicated that ASDs were found in 1 in 150 children.

Although there are no cures for ASDs, the authors point out that there are both nonpharmacologic and pharmacologic therapies available to aid in the management of these conditions. Research continues to explore environmental risks such as parental age, family medical conditions, complications during birth and pregnancy, and the potential for ASD development. “Vaccines containing thimerosal are also at the center of the debate regarding ASD risk,” they add. “However, no evidence supports this theory, and the American Academy of Pediatrics (AAP) supports childhood immunizations.”

In this issue’s Patient Teaching Aid (PTA), we stress that adhering to the recommended childhood vaccination schedule is still the best method for guarding against infectious childhood illnesses, controversies surrounding vaccines and autism notwithstanding. Vaccinating children ranging in age from newborn to 18 years reduces most problematic and even potentially fatal contagious illnesses. Furthermore, the PTA states, “Serious side effects from vaccines remain extremely rare, varying from about one in 100,000 to one in 1 million immunizations, depending on the specific vaccine.”

That is not to say that vaccines are completely safe. In rare cases, as stated in the PTA, some children are allergic to some ingredients in vaccines, such as the egg ingredients used in many influenza vaccines. To remedy this situation, children may receive vaccines made with other ingredients. As a routine matter, physicians and pharmacists should ask patients about allergies in their children before administering immunizations. Still, it is not unusual for a child to develop a mild local reaction to a vaccine or a brief, low-grade fever and mild diarrhea. As this month’s PTA advises, children with side effects lasting more than a day, or that become severe, should seek medical attention.

The findings of a major Institute of Medicine (IOM) study undertaken in 2013 examining the safety of childhood immunization schedules should also put parents at ease. The authors concluded “Over the previous 40 years the IOM has conducted over 60 vaccine safety studies, including this comprehensive review of the immunization schedule. The IOM committee did not find any evidence of major safety concerns related to receiving on-time vaccinations according to the Recommended Immunization Schedule for children.” They concluded, “While receiving on-time vaccines was not harmful, it was strongly associated with reducing vaccine-preventable diseases.”

As the most trusted healthcare professionals, pharmacists should do their part to convey the lack of hard evidence concerning a purported link between autism and vaccines, and focus on protecting children against tangible health threats.

To comment on this article, contact rdavidson@uspharmacist.com.