Hi PMA, thanks for the thoughtful commentary. I believe the problem is that many folks consider autism & vaccines to be a binary, either-or discussion -- when discussions of vaccines should always be about risk, and understanding that, desp...ite extensive efforts, no credible study has found an association between vaccines and autism. My understanding is that is what Mr. Mnookin would like pediatricians to address. The risks are real, but extremely minimal -- especially compared to the risks of contracting the diseases themselves, including the "mild" ones like chickenpox/varicella. And the risks do not, based on current available research, include autism.

The main sense I had in coming off of IMFAR is that the more research we do, the more factors we find,See More

‎...the more we realize that autism is likely not only a multifactorial condition, but that it is an as-yet unpredictable one, with current idiopathic diagnoses having possibly unique genetic manifestations from person to person -- resultin...g in different symptom and behavior sets. So yes indeed, we need a systems approach. And we are just beginning. Can't wait to see what we know ten years from now.

As for autism and immune response, readers can see for themselves how many IMFAR sessions & papers addressed this issue via the abstract db: http://imfar.confex.com/imfar/2011/webprogram/start.html.See More

Thanks for the information. You and I are willing to have discussions about these matters, with the understanding that there are subtle factors and exception and possibilities and more work to do. We've addressed the need for more investiga...tion before on TPGA, in Emily Willingham's Mitochodrial disease/autism post: http://thinkingautismguide.blogspot.com/2011/03/mitochondrial-disease-and-autism-linked.html

But, to get back to the original matter -- most expectant aren't looking for complex discussions about vaccines and autism. And, as pediatrician Pierrette Mimi Poinsette has pointed out, pediatricians don't always have time to discuss vaccine risks at all, let alone qualify them at length.

Folks aware of the matter's true complexity are often hesitant to discuss it at all, especially in autism forums, due to (I hate to write this but) non-critical thinkers who cherry-pick for the "AHA! YOU ADMITTED THAT VACCINES CAUSE AUTISM" factor. When, if we're going to look at this from a mitochondrial or immune perspective, then vaccines are only one in a possible set of environmental stressors, for small subsets of the population, and unpredictably so. Again, it's all about risks.

We need a short sharp takeaway for concerned expectant parents. And that needs to be that vaccine benefits outweigh any risks. -SRSee More

Speaking not as an expert but as a parent - my major concern is that herd immunity is slowly being reduced because of what I see as a MISPLACED fear about the risks of vaccination. Risk is the operative word here. Nothing is without risk ...but to compromise the hard work of health authorities over many years because of as yet unproven causality is just tragic. Anything that could put this topic in perspective for parents is important and necessary.See More

With respect, I do not believe autism is a "disease" so we disagree there. You are arguing the merits of various types of logic but what this post was originally about was helping medical professionals to help parents so that they can make... an informed decision. As I stated originally, it is about understanding risk. The risk of my child developing autism from a vaccine or the risk of my child contracting an infectious disease with potentially serious complications. Not to mention the even greater risk to the community at large from outbreaks of preventable disease.See More