Dr. Harley Rotbart’s GERMBlog™

Responding to the urgings of pediatricians, family medicine doctors, and the FDA’s own outside advisors, the agency acted this week to officially recommend against the use of over-the-counter cough and cold medicines for kids younger than 2 years. In some ways this is a ceremonial, but still important, move – manufacturers of these medicines withdrew their advertisements and labeling for kids under 2 last fall in anticipation of the FDA advisory panel’s recommendation in October, 2007 (see Dr. Rotbart’s GERMBlog posting 10/19/07). Pediatricians have been recommending against these medicines in young kids even longer (see Chapter 8, Germ Proof Your Kids – The Complete Guide to Protecting (without Overprotecting) Your Family from Infections (ASM Press, Washington, D.C., 2008).

The rationale behind this official recommedation is straightforward – the medicines have never been shown to benefit kids in this age group, there are undesirable side effects of the medicines, and accidental overdoses are far too common – the medicines are tasty and easy for kids to snatch off the countertop if parents turn their backs for just a minute.

What’s coming next? I anticipate the FDA will follow advisory panel recommendations and extend the admonition against cough and cold medicines for kids between the ages of 2 and 6 years old. More controversial is the possibility of banning the medicines for all kids under age 11 – the FDA’s outside advisors couldn’t come to consensus on that age group (i.e. kids between 6 and 11 years old).

For more about all over-the-counter medicines for kids’ infections, see Chapter 8 in Germ Proof Your Kids – The Complete Guide to Protecting (without Overprotecting) Your Family from Infections (ASM Press, Washington, D.C., 2008).

Nothing stirs the passions of doctors and parents more than a discussion of vaccines. As mothers took to the streets beginning in 1950 for the March of Dimes campaign to eliminate poliomyelitis, emerging vaccines targeted some of civilization’s greatest scourges. One by one, diphtheria, tetanus, whooping cough, measles, German measles, and mumps were dealt lethal or near-lethal blows. A generation has grown up not knowing the fear of these once prevalent infectious diseases (see chapter 3 in Germ Proof Your Kids – The Complete Guide to Protecting (without Overprotecting) Your Family from Infections).

But along with blessed ignorance came a national nonchalance. Why risk giving our kids vaccines when the diseases are gone from the headlines? The side effects, real and imagined, of vaccines took center stage as the diseases they prevented exited the theatre – and some mothers again took to the streets, this time to advocate against vaccines. Vaccines have been blamed for sudden infant death syndrome, mental retardation, paralytic syndromes, and, most recently, autism. If not the active ingredients of the vaccines, the preservatives have been faulted. Anti-vaccine advocacy groups have realized some successes in decreasing immunization rates – and the effects have already been seen, with increasing incidences of once vanishing illnesses.

A complete review of the safety issues surrounding vaccines can be found in chapter 7 of Germ Proof Your Kids – The Complete Guide to Protecting (without Overprotecting) Your Family from Infections), and is beyond the scope of this GERMBlog forum. Even all the nuances of the alleged association between autism and vaccines are far too complex for a brief review, but can be found in the same chapter 7 of Germ Proof Your Kids. The purpose of this posting is to supplement the evidence against a role for vaccines in causing autism with the newest study, just released in the news this week. In a large, 12 year study (1995-2007), the rate of autism in this country, unfornately, has continued to rise. However, that rise has occurred in the context of the complete removal, in 2001, of thimerosal from childhood vaccines. Thimerosal is the ingredient (a preservative) that has received the most attention and the most concern regarding its possible role in causing or contributing to autism. Had thimerosal in vaccines been responsible for causing or contributing to autism, the occurence rate of autism should have dropped when vaccines were purged of the thimerosal preservative in 2001, not continued to rise.

This is not the first “vindication” of vaccines from a role in autism. Many other lines of evidence are reviewed in chapter 7 of Germ Proof Your Kids. But as more and more evidence accumulates, it is becoming clear that we need to continue our search for the true cause of the rising epidemic of autism in U.S. kids.