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« Obama: "I am not for selective vaccination." | Main | Alaska Autism Mom to Barack Obama: Will You Listen »

Is Obama Pro-Choice? And What if Autism Were Contagious?

JabberwockyBy Kim Stagliano

We reported at Age of Autism that Senator Obama told Claudine Liss, "I am not in favor of selective vaccination. I believe that it will bring back deadly diseases, like Polio." (HERE) 

When I write or talk about vaccines and autism, I often get the same response from people: "Do you want Polio back?" My instinct is to slap them. Such a stupid question. Even from a Presidential candidate. No one wants Polio back. Nor should we have to trade one crippler for another.

But that question leads me to wonder, "What if autism were contagious?"

Would the response to the 1 in 150 (or lower!) rate of diagnosis change from, "Oh my, what a shame. We'd better learn how to diagnose it earlier and take care of these poor souls." to "We'd better figure out the cause and come up with treatments immediately!" Would we go into attack mode as we did for AIDS, which in 30 years has seen great improvement in prevention and treatment? And would our political leaders turn the microscope onto our vaccination program, instead of frightening us with the prospect of forced vaccination and offering pat answers like, "I don't want deadly diseases like Polio back"?

Senator Obama, if you think the photos of the old Polio wards are frightening, take a day off and go visit a classroom for children on the severe end of the autism spectrum. You'll see children who are ambulatory and yet cannot care for their most basic needs. They will require a lifetime of care. Can you tell me that these children are not as disabled as those who contracted Polio?  Come meet my girls; Mia, Gianna and Bella. They are every bit as beautiful as your Malia and Sasha - and yet they are part of an at risk population that you have yet to acknowledge. You need to read up on Miss Hannah Poling and Dr. Bernadine Healy and even the CDC, which has stated that the vaccination schedule is flexible. Flexible means selective, sir.

How about it, Senator Obama. What if autism were contagious? Would you have a greater depth of understanding of the vaccine issue then? You claim to be a Pro-Choice candidate. Does Pro-Choice end at birth? You know, voters have a choice too.

Kim Stagliano is Managing Editor for Age of Autism.

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Was it just me or did the older Obama girl displays an odd quirky behavior when she walked out on stage in Chicago? Reminded me of the way my friends son skips as he walks and he holds his arms funny. He's autistic by the way.

Actually, the autism being contagious is not far off the mark. I know of several moms who had older kids who were vaccinated, shedding their vaccines on their unvaccinated siblings...which would then result in autism. But far more than that, I believe it is contagious in a very insidious manner. Moms or Dads may have lyme disease, and this can be transferred across the placenta to the baby. This sets up a funky immune system response TO vaccines, such as increased ROS (oxidative stress). ROS causes glutathione to lower, and so on and so forth, causing what you call, also, LEAKY GUT/LEAKY BRAIN. Toxins would have a hey day on such a child...so yes, autism IS contagious, and I have seen it first hand when we had our first conference on this connection (see my URL page). The mothers were ill with many autoimmune things, but most of all LYME, and their children have it it too. They all reacted BADLY to vaccines. This is also seen when LYMERIX vaccine came out...those with a particulary funky immune system didn't handle the vaccine well, and even got neurological sequale from it, if not lyme disease (sound familiar?)

The bottom line? No vaccine is safe...and polio was a man made up man made illness by pesticides and sugar. Get the facts straight people...Don't vaccinate your babies any more, and see what a true unvaccinated child is. Keep them away from day cares and vaccinated children and you should be fine. Learn homeopathy, learn nutrition, learn to detox and identify if you are infected mom, and you won't have a child with autism. My grandchildren are FREE of it because of these practices...this mind you from a family with two autistic children (their siblings). So, if autism is so genetic, it should been expressed in an X linked disorder way right? WRONG...their mothers also had lyme, so we treated them....so they didn't give lyme to their babies...it is all so real to me...parents, get tested, and you will be shocked. Do a NEurospect mom...our/your brain has already been infected.. Your brain will look like your child's with hypoperfusion, lesions, bright spots..white matter, T2, yadah yadah... It is abundantly clear, autism is catching, and most of all set up congenitally, and vaccines finish the job...

Kim has spoken so well, but once again this underscores the need for us to get the public to understand what autism really means. Not long ago there was a documentary on autism on tv and it focused on the therapy being given to autistic kids and there was only one single, very brief - few seconds devoted to a severely autistic boy.And as usual, the message most people take away from such documentaries is "Autism, no problem- They just need therapy and they get alright. We do not only have to educate Sen. Obama, but all Americans to the facts that new vaccines are not properly studied before approval and no new vaccine should be made compulsory for a very very long time ,if ever. We need to point out to all the new vaccines and the rise of autism which occured after pharma companies were endemnified against lawsuits.
I notice also that no one here seems to have noticed that Bill Frist was one of the big players at the Republican convention. So dont expect that party to help you out on autism issues. The candidates may say whatever nice thing pleases you today, and when the bills come up for voting- their considerations have very little to do with your situations. The only remedy for this is to educate people to the horror of autism and it is very interesting that we have not been able to do this so far.
A suggestion: Off and on in these comments we read of some parents tactics for educating the public about autism and vaccines. Could someone perhaps make a list of those great ideas and we could assist each other in carrying them out?

As far as Obama's comments go, I have read and recieved emails from his camp. I didin't get from any of the emails that he was against a schedule but against people not getting vaccinated. I totally agree that we need to continue to vaccinate our children, maybe not on the present day schedule but a different one. I have been following this election real close and have read just about everything. Half the time people are misinformed or just don't have the facts. I was driving myself nuts everytime I read something regarding Autism and the polictical system. Now I find out where the info came from and research whether its truth or half truths or just down right wrong. I went to both canidates website and read the issues, Sen Obama had two pages regarding his position and what he would do. John McCain's website had half a paragraph at best and said absolutly nothing about what he would do. I also sent emails to both camps and only one responded back and that was Sen. Obama's camp. Although I am a resistered Republican, I am leaning toward Sen. Obama right now. He at least seems receptibe to learning and helping the Autism and other Special needs area. Thanks for listening.

Senator Obama, please get up to speed on this issue. Your comment exposes that you are not yet well versed on the science.

There has not been a case of wild polio in the US for almost 30 years.

In addition, for the past 8 years, we have been using a vaccine (IPV) that DOES NOT PREVENT TRANSMISSION.

My father had polio as a child. (As did his brother, both make full recoveries and went on to be naval aviators)
That made him 1 in 3,000.

His father had polio and did not recover. That made him 1 in 60,000.

My son was vaccinated for diseases like polio and developed autism.
That has made him 1 in 150.

If someone asked me if I had to choose between the height of the polio epidemic and the height of the autism epidemic, do you see why I might be leaning toward the 1940's?

kat23 mentions the report regarding this years flu vaccine recommendations, from msnbc.com.
Here is one of the reported reasons why all children 6mo-18years should be vaccinated...

"But the kid connection is getting increasing attention. Helping to drive the new inoculate-all-children advice is "a belief that if you could do that, you would limit transmission" to the elderly, says University of Rochester flu vaccine specialist Dr. John Treanor.There's no proof yet, he cautions. But there's mounting suggestive evidence"
What is suggestive evidence?? Is that the same as the anecdotal evidence they keep throwing back at people?

Kim

Well said. Your elegance and our pain are a force to be reckoned.

You asked of Obama: "Does Pro-Choice end at birth?" I didn't want to get into this debate, but apparently for some there isn't a choice even after they've exited their mother's womb. For someone who claims to want universal healthcare for all Obama sure doesn't include everyone in his plan.

From the article entitled, Obama More Pro-Choice Than NARAL, by Amanda Carpenter

"In 2002, as an Illinois legislator, Obama voted against the Induced Infant Liability Act, which would have protected babies that survived late-term abortions. That same year a similar federal law, the Born Alive Infant Protection Act, was signed by President Bush. Only 15 members of the U.S. House opposed it, and it passed the Senate unanimously on a voice vote.

Both the Illinois and the federal bill sought equal treatment for babies who survived premature inducement for the purpose of abortion and wanted babies who were born prematurely and given live-saving medical attention.

When the federal bill was being debated, NARAL Pro-Choice America released a statement that said, "Consistent with our position last year, NARAL does not oppose passage of the Born Alive Infants Protection Act ... floor debate served to clarify the bill's intent and assure us that it is not targeted at Roe v. Wade or a woman's right to choose."

But Obama voted against this bill in the Illinois senate and killed it in committee. Twice, the Induced Infant Liability Act came up in the Judiciary Committee on which he served. At its first reading he voted "present." At the second he voted "no.""

Source:
http://findarticles.com/p/articles/mi_qa3827/is_200612/ai_n17190692


Okay, and adding about taht "flu vaccines" study.

HOW IN THE WORLD is a study based on zip codes and ER visit really have ANY bearing on SCIENCE??? I know at the hospital I work at we do see a lot of things that would normally be taken care of at a doctor's office. I work at an indignet hospital and so we are trated like a clinic. But isn't this the same as trying to count only hospital based diagnosis for autism? Yes there is a lot of flu that makes it to the ER. But, I would think, that for teh majority of inssurance carrying people, it would be far more cost effective to go to their doctor.
jmo

Jeanne, thanks for the up-lifting words! You know, I was feeling a lot better until I finshed reading the new news article about how ALL children will be given the flu vaccine. WHY? Because they are the little culprits spreading the virus. How does this new enlightened way of thinking equate to giving all children a vaccine that is lacklauster at best?
Just another lovely reading moment (rolling eyes).

http://www.msnbc.msn.com/id/26611205

Got to love the greed...

Thanks again Jeanne, and have a good night:)

Kim,

I love the image of Obama going to visit a classroom of severe kids, accompanied by lots of press of course. Then maybe he and the world would start to get how serious this is. What he said was very scary! Is he just ignorant and not reading any of the letters parents send him or is he trying to be Big Pharma's main prostitute?

Kim,

I think you've spawned an idea for a "Come To My House" (before you forge vaccine policy) letter writing campaign. In all seriousness, it would be interesting for candidates to see how parents of vaccine injured children really live, to see what happens if the children go off their diet, to see how families even of upper stratas still have to work like they're on a poor farm to tend to sick children, what it takes to get a measley few services paid for, the humiliation many experience dealing with the schools-- and to see the lab reports where signs of something environmental having happened are displayed as unambiguous fact.

There's even a theme song:
http://tinyurl.com/5gwfzb

Jenny and Jim where are you? Make people aware of Barack Obama's beliefs. I thought democrats where for the people's rights to be free?? Pro-choice doesn't just stand for abortion, pro-choice stands for having a choice with our bodies, a choice for our children, a choice for our families. If that choice goes away we are dombed......

This is such a great point, and one of the most frustrating aspects of the whole "autism debate". 1 in 150 is way too many children. Either the CDC, NIH, AAP are stupid and did not see the growing epidemic or they are ignorant and did not recognize that so many children were impacted (that is for the flat earthers that say there is not an increase in autism, just better diagnosis. As an aside, the book "What to Expect the First Year" -copyright 1989 - quotes autism as a rare disorder impacting only 2 to 7 per 10,000.). Stupid or ignorant -- take your pick, either way they haved failed our children. Early intervention is NOT prevention. Those in the mainstream a/o not impacted by autism do not want to hear that "Green our Vaccines" is to autism, what "Use a condom" is to HIV/AIDS. As for the politics, I can not support a candidate who is opposed to parental choice regarding vaccines. Forced vaccination combined with protecting vaccine manufacturers from civil (a/o class action) lawsuits, and insurance companies that "do not cover autism services" does not sound like a free America. My hope would be that Palin would at least bring visibility to "special needs" families and how the entire family is impacted.

Mom to Tom:
Downs and Autism dxs are apples and oranges.
They get better services. They are usually dxed immediately upon birth. They are not cast as a psyche disorder or ruined by terrible parents.
I have several Mom friends who have children dxed with Down's. While they have surgery issues they have different stress than us.
It is off base to question Sarah Palin's parenting. She had baby gear in both offices and nursed.
I find it so ironic that I am defending McCain/Palin. I was sitting on the fence for the first time in my whole Republican life.
Obama's comments are unacceptable.
His Pharma contributions explain the unsuitable answer.
I was saddened today that he would give such a trite answer to an exploding epidemic that the former head of NIH is outspoken on.
I find Age of Autism to be very balanced.
They have featured questions and challenges from both sides.
When you get right down to it Autism is not respective to party alignment.
A friend recently slammed Ted Kennedy over his liberal views and I fired back "Yeah but Ted Kennedy saved the VICP language in the Senate pandemic bill." I might not like his platform but the man stood up for our kids and for that reason I don't draw partisan lines. We are all in this together.

I was at the rally the other day Louise held.

Obama's response to Claudine, and effectively to all of us - that he doesn't support vaccine choice out of fear is appalling.

He is afraid of an epidemic that will kill us off like Polio. Well, he needs to wake up and realize that the epidemic is here and now. While it may not be contagious it is spreading and populating at a rate that should be alarming enough to garner attention. And he is worried about polio returning? The USA will be the United States of Autism sooner than later.

If the Mccain/Palin ticket wins then at the White House gatherings over the holidays: there will be a child with downs syndrome, a child with autism(Sara's sisters son)and a former special needs teacher(Cindy McCain) to remind everyone that our families need help.

Oh, Mom to Tom, the week is young, dear, the week is young. Don't lose heart.

I'll take Obama to task and I'll take McCain to task. Don't you worry. Have you been to my Kim blog recently?

Thanks for commenting.

KIM

I used to think Kim had some good points, but this article has totally made me lose all respect! I'm very sad and upset. I truly thought Kim would be above partisan politics. But obviously I'm wrong. If Kim really wanted help for the children in America with Autism she would actually contact both camps and give them an opportunity to provide input rather than just attacking one over the other.

McCain has totally backpedaled on his questioning vaccines comments and that's just the beginning. And if you think Palin is going to help you - your crazy. Do you think Palin intends to spend any time with that child she bore - it sure doesn't look like it. I figure that's where my husband and I miscalculated. We actually reduced our work schedules when we realized we had a special needs child - we obviously should have upped them and left the child raising to someone else! McCain Palin only care about making certain the child is born. Once that child is here that's your problem. Mark my words - you can't give the top 1% of the US population a tax cut and help the families with special needs children - it just can't be done! But good luck on that one!

WRITE CALL WRITE AND CALL SOMEMORE!
CHANGE HIS MIND! NOW!

Of course no one wants polio back. My MIL is a polio survivor herself. She cannot use both her legs and suffers from post-polio syndrome.

However, she also got married, went to college, raised three boys, and traveled to different parts of the world and generally had a very fulfilling life.

Now, my daughter could still end up doing all of the above, but it isn't looking likely that she will at this point, with her being five years old and nonverbal and not potty trained and all. And when *I* travel with her I have to pray to God that she can handle it, that she will not have a meltdown (fortunately she doesn't seem freaked out by air travel like so many kiddos with autism do), that we won't be in the next "autistic kid kicked off plane" headline with a bunch of comments under the article from hateful people telling us to keep our children out of public places.

Some days I would be thrilled if the only problem my daughter had was that she couldn't use her legs.

Not saying I want polio back, but hey, if you want me to honestly compare which one seems way worse to me based on real-life experience, at this point in my life autism seems worse.

Even though autism is not contagious people are going to wake up in about 20 years when these people are filling group homes and institutions will be overcrowded with them because their parents can no longer care for them. Once their tax dollars start being hit, you can bet that they will care. Until then, don't count on anyone to care.

Does Obama realize that 1 in 68 families have a child with autism? Does he know that at least 54% of these parents think vaccines are the reason??
I am a lifelong democrat but Obama may have just lost my vote.
Obama, please tell me/ us you made a mistake. And while you're at it can you promise to ban thimerosal/mercury from vaccines as soon as you take office, if elected? It is unconscionable to me that pregnant women and infants are still being injected with 25 mcgs. of mercury when they get the flu shot. Even the Tripedia DTaP which only (a relative term!) has .3 mcgs. of mercury lists autism as a possible adverse reaction on its package insert!

Obama has mentioned several times he has a senior staffer who has a child with autism. I wonder what their beliefs or feelings are about vaccines and autism?

I would wager they don't "buy into it" for if they did- he would show he knows a little bit more about our communities concerns.

Excellent as always Kim! And I'd like to remind everyone who brings up polio that at the height of the epidemic in the 1950s, polio affected one in 3,000 Americans. And while some victims of polio died, most recovered and went on to lead productive lives. The same won't be said about the victims of the autism epidemic. They will need support and care for life. That's something that every politician should care about.
Anne Dachel
Media editor

Well Said Kim! I could not have said it better myself!!!!!

I think for as many people out there who think that autism is merely a parental discipline issue, there are probably twice that who think it's contagious. Friends and family who "love" us fade away into distant memories. Can't get more contagious than that!

kat23,

Do not get tired. Do not lose momentum. We are all here to support you... each and every one of us support each other, give strength to each other... we're family.

We must stay focused and strong... together.

Never lose hope. Never give up. Keep fighting.

Kim, great article. Unless autism directly touches Obama or any other politician, they will shrug it aside as a terrible thing that "we don't know the causes for, yet" (I am so tired of hearing THAT one.) Politics is all about doing what is best for the masses so you can get the most votes. Right now, we are not the masses. This is only getting worse before it gets better. As all our kids get older this terrible thing called autism will be a bigger concern. Mostly, because our society will not know what to do with a whole generation of children whose parents are aging and can no longer take care of them (that is a sad thing to even think about). I was thinking about the AIDS comparison the other day. That used to be such a death sentence. Now, AIDS is such a different disease because our society took that disease by the throat. Why oh why can't we do the same here?
Nicole

Living in Atlanta I often bump in to CDC epidemiologists in the oddest of places, like my kid's camp.

In those casual settings it's always great to volley questions for a robust game of "Stump the CDC". Last time it was 2:1 the epi and the contract IT guy from the CDC.
It's a Christian camp so everyone played fair.
The epidemiologist was volunteering as the camp nurse and the IT guy was a counselor.
His last and final trump card was the "Polio" scare tactic.
Little did he know that I had been to Haiti twice for a humanitarian mission trip and researched the snot out of Polio.
Because Haiti has suffered outbreaks of wild Polio viruses. Back then, preAutism in my life, I opted for a booster after carefully reading the CDC and State Dept webpages.
They mentioned Polio outbreaks brought on by
the oral Polio vaccine. Polio mutating fast.
Polio is a baseless argument for vaccine choice when the cause of Polio world wide is the dang oral vaccine! I'm not anti-polio vaccine I'm anti polio vax with 67 others and boatload of toxic metals before age 5. Cheez give a kid a chance.

Here are my Polio talking points:
*What polio?
*Gee why doesn't the CDC speak out against the global use of the oral polio vaccine that literally kills the immune suppressed in undeveloped countries.
*Why aren't people more concerned with Chronic disease which the WHO touts as the leading cause of death. 3 of every 5 global deaths.
*What about anti-biotic resistant MRSA or Clostridia that those over prescribing physicians brought on. It's working it's way into schools and killing people.
*and Finally...
"Close your eyes and think about this for a second...how many kids were there with Autism in your school????"

From the CDC Mr Obama....

"A small proportion of immunodeficient persons exposed to OPV have excreted iVDPV over prolonged periods (>6 months)."
(Hummm let's see how many people in Africa have AIDS?????)

Update on Vaccine-Derived Polioviruses

In 1988, the World Health Assembly resolved to eradicate polio worldwide. The Global Polio Eradication Initiative (PEI) of the World Health Organization (WHO) has led to a decline in global polio incidence, from an estimated 350,000 cases in 1988 to fewer than 2,000 reported cases in 2005, and polio remains endemic to only four countries (Afghanistan, India, Nigeria, and Pakistan) (1). However, two additional obstacles to global eradication involve vaccine-derived polioviruses (VDPVs). Polio outbreaks continue to be associated with circulating vaccine-derived polioviruses (cVDPVs) in areas with low oral poliovirus vaccine (OPV) coverage. In addition, long-term excretion of neurovirulent immunodeficiency-associated vaccine-derived polioviruses (iVDPVs) can lead to poliovirus spread to contacts. Overcoming these obstacles is challenging. High rates of OPV coverage will prevent all poliovirus spread, including spread of VDPVs, but will not prevent establishment of prolonged VDPV infections in certain persons with B-cell immunodeficiencies (i.e., having defects in antibody production). Inevitable gaps in vaccination coverage will give rise to cVDPVs as long as OPV use continues. This report updates a previous report on VDPVs and describes the potential implications of VDPVs in the final stages of global polio eradication (2). The findings underscore the critical need to strengthen strategies to prevent emergence of VDPVs and to stop all OPV use once wild polioviruses (WPVs) are eradicated (2--5).
Biologic Properties of VDPVs

The critical biologic properties of VDPVs are their capacity to cause paralytic polio in humans and their potential or demonstrated capacity for sustained circulation. VDPVs have lost key attenuating mutations and resemble WPVs biologically (2). All known cVDPVs (except those from China) (Table 1), but no iVDPVs, are recombinants with nonstructural protein sequences derived from species C enteroviruses, a property associated with poliovirus circulation (2). Most VDPVs are antigenic variants of the Sabin strains, but antigenic evolution appears to be faster in iVDPVs than in cVDPVs. Unlike cVDPV isolates, iVDPV isolates commonly contain mixed VDPV populations. These biologic distinctions (and the differing conditions favoring iVDPV and cVDPV emergence) have helped in recognition of the likely origins of many ambiguous VDPVs (aVDPVs) (2).
Categories of VDPVs

VDPVs differ from the majority of vaccine-related isolates by having genetic properties consistent with prolonged replication or transmission. Because poliovirus genomes evolve at a rate of approximately 1% per year, vaccine-related isolates that differ from the corresponding OPV strain by more than 1% of nucleotide positions (usually determined by sequencing the genomic region encoding the major viral surface protein, VP1) are estimated to have replicated for at least 1 year after administration of an OPV dose, substantially longer than the normal period of vaccine virus replication of 4--6 weeks. Poliovirus isolates are divided into three categories, identified by the extent of VP1 nucleotide sequence divergence from the corresponding Sabin OPV strain: 1) OPV-like viruses (15% divergent) (2). VDPVs are further divided into 1) iVDPVs isolated from persons with primary immunodeficiencies who have prolonged VDPV infections after exposure to OPV, 2) cVDPVs that emerge in communities with inadequate OPV coverage, and 3) aVDPVs, which are clinical isolates from persons with no known immunodeficiency and environmental isolates whose ultimate source has not been identified (2).
iVDPVs

A small proportion of immunodeficient persons exposed to OPV have excreted iVDPV over prolonged periods (>6 months). WHO maintains an iVDPV registry; since the introduction of OPV in 1961--1962, only 30 persons excreting iVDPVs have been identified. Persons with primary B-cell immunodeficiencies, but not persons with T-cell immunodeficiencies (e.g., from human immunodeficiency virus infection), are at risk for iVDPV infections (6). Approximately 70% of iVDPV infections have spontaneously ceased within 3 years of exposure to OPV, or the patients have died from complications of their immunodeficiency. Five persons excreted virus for 3--8 years, and in three persons, the duration of excretion exceeded 9 years (Table 2). Eighteen (60%) documented iVDPV infections were associated with type 2 poliovirus infection, eight (27%) with type 1, one (3%) with type 3, and three (9%) with mixed infections (Table 2, Figure). The first reports of iVDPVs came from high-income countries (e.g., the United States, countries of Western Europe, and Japan) but recent reports of iVDPVs include middle-income countries (Table 2). No iVDPVs have been reported from low-income countries, where survival rates for persons with B-cell immunodeficiencies are low (7). Exposure usually is from receipt of OPV, but three of the known iVDPV infections occurred in unimmunized persons (Table 2). Strategies for resolving iVDPV infections are needed, both because of the risk for paralytic disease to infected persons and the risk for transmission to the wider community. No antiviral drug that has been shown to resolve iVDPV infections is currently available. However, new antiviral drugs broadly effective against VDPVs are under development (8).
cVDPVs

VDPVs do not circulate when high vaccination coverage leads to high population immunity. However, low vaccination coverage increases the proportion of nonimmune persons in a population; this increases the potential for VDPVs to circulate. Under circumstances of low vaccination coverage, cVDPVs have produced several localized polio outbreaks. Eight independent outbreaks (i.e., two or more polio cases) in eight countries have been associated with cVDPVs (Table 1, Figure). The largest documented outbreak (46 polio cases) occurred on the Indonesian island of Madura. Genetic studies on stored isolates suggest that a type 2 cVDPV circulated endemically in Egypt for 10 years (approximately from 1983 to 1993) and probably caused more polio cases than were reported (2). Outbreaks of cVDPVs have been associated with all three poliovirus serotypes. Two independent type 2 cVDPV outbreaks occurred in Madagascar in 2002 and 2005 (2), possibly signaling a higher potential for the emergence of type 2 cVDPVs.
aVDPVs

aVDPVs are VDPV isolates that cannot be clearly assigned to either of the other two well-defined categories. They have been isolated from paralyzed persons with no evidence of additional paralyzed VDPV-infected persons among household or community contacts. Highly divergent (>12% VP1 nucleotide divergence) aVDPVs also have been isolated from sewage in Estonia, Israel, and Slovakia. The sewage isolates have similar genetic and antigenic properties as iVDPVs, but measures to identify the infected persons have been unsuccessful. In 1966, aVDPVs were found in Belarus after local suspension of OPV use; in 1999, they were found in Russia among children in orphanages (2). A growing number of aVDPVs having VP1 sequence divergence slightly above 1% have been found by the Global Polio Laboratory Network.

Limited person-to-person transmission for certain aVDPVs has occurred. In 2005, a type 3 aVDPV was isolated from one polio patient and seven nonparalyzed contacts in Madagascar. Similarly, a type 1 VDPV was isolated from one patient and seven contacts in Romania in 2002, a type 2 VDPV was isolated from one patient and two contacts in Laos in 2004 (2), a type 1 VDPV was isolated from an unimmunized severe combined immunodeficiency (SCID) patient and four community members in rural Minnesota in 2005 (9), and a type 1 VDPV was isolated from one patient and six contacts in Myanmar in 2006. Other aVDPVs with genetic properties resembling those of cVDPVs were found in Peru in 1983, in Pakistan in 2000, and in Nigeria in 2002 and 2006 (2).
Risk Factors for VDPV Emergence

The key factors favoring cVDPV emergence and spread are the same as for WPV circulation: low OPV coverage, poor sanitation, high population densities, and (usually) tropical conditions. In all but the remaining polio-endemic areas, immunity to polio is no longer acquired from natural infection; immunization is the only current means to prevent the spread of emerging VDPVs or imported WPVs (3).

Although OPV is not recommended for immunodeficient patients, it is often inadvertently administered because certain primary immunodeficiencies (e.g., common variable immunodeficiency [CVID]) develop later in life. Certain persons with CVID who excrete iVDPVs had onset of polio several years after the implicated OPV dose was administered, and three have demonstrated no signs of paralysis. Survival of patients with primary immunodeficiencies can be extended in upper- and middle-income countries by intravenous immunoglobulin therapy; however, for patients in low-income countries, such therapy often is too expensive and difficult to obtain (7).
Global VDPV Surveillance

Since the cVDPV outbreak in Haiti and the Dominican Republic in 2000--2001 (Figure, Table 1), all polioviruses isolated in the WHO Global Poliovirus Laboratory Network from patients with acute flaccid paralysis have been characterized by one molecular method, to identify polioviruses by their genetic properties (usually using the polymerase chain reaction), and one antigenic method, to detect antigenic differences from the OPV strains (using either an enzyme-linked immunosorbent assay [ELISA] or panels of specific neutralizing monoclonal antibodies) (10). Isolates found to be genetically related to an OPV strain but with antigenic differences are possible VDPVs. VP1 sequencing is routinely performed on all possible VDPV and WPV isolates. Approximately 12,000 isolates from all WHO regions have been routinely screened for VDPVs since 2001 (10). Temporal or geographic clustering of vaccine-related isolates of the same serotype has prompted the detection and investigation of cVDPV outbreaks in eight countries (Table 1).

Reported by: WHO Global Poliovirus Laboratory Network. Immunization, Vaccines and Biologicals Dept, WHO, Geneva, Switzerland. Div of Viral Diseases and Global Immunization Div, National Center for Immunization and Respiratory Diseases (proposed), CDC.
Editorial Note:

VDPVs will continue to emerge as long as OPV is used. Intensified surveillance has indicated that cVDPVs can emerge repeatedly under conditions of low OPV coverage (e.g., Madagascar). VDPVs also can be found in developed countries with no paralytic cases (e.g., Estonia, Israel, and Slovakia) and can circulate in isolated pockets of unimmunized persons in countries with overall high rates of vaccination coverage (e.g., China and the United States). Although iVDPVs can emerge in middle-income developing countries, cVDPVs have not been found in some areas of high biologic risk, such as in northern India, presumably because of the current high rates of OPV coverage.

Occurrences of VDPVs, including cVDPV-related outbreaks, are rare events, and all recent outbreaks of cVDPVs have been rapidly interrupted using OPV campaigns. The recent increase in the detection of VDPVs is probably primarily attributable to intensified surveillance and improved laboratory methods. Enhanced surveillance for VDPVs has allowed for better understanding of the risks associated with the different types of VDPVs. Areas with continued use of OPV but lacking optimal coverage (e.g., Indonesia in 2005) are at increased risk for cVDPV emergence. The importance of detecting aVDPVs with limited VP1 divergence is not clear; the presence of aVDPVs in certain settings might not have any public health consequences, whereas aVDPVs found elsewhere might signal conditions favoring the emergence of a cVDPV.

Under certain circumstances, OPV viruses regain both neurovirulence and the capacity to circulate and cause outbreaks and therefore are of concern to the PEI. After global eradication of WPVs, the continued use of OPV would continually generate cVDPVs and could eventually pose a challenge to the goal of stopping all poliovirus infections in the human population. The increasing risk of cVDPV emergence in countries with widening immunity gaps and the ongoing risks for vaccine-associated paralytic polio and iVDPVs have prompted an evaluation of the feasibility of orderly cessation of OPV use as soon as possible in the posteradication era (4) while population immunity and surveillance sensitivity are still high (6). Continued development and implementation of a comprehensive strategy to minimize the risks for VDPV emergence in the posteradication era presents a challenge to the PEI and to the public health and scientific communities.
References

1. CDC. Progress toward interruption of wild poliovirus transmission---worldwide, January 2005--March 2006. MMWR 2006;55:458--62.
2. Kew OM, Sutter RW, de Gourville EM, Dowdle WR, Pallansch MA. Vaccine-derived polioviruses and the endgame strategy for global polio eradication. Annu Rev Microbiol 2005;59:587--635.
3. Duintjer Tebbens RJ, Pallansch MA, Kew OM, et al. Risks of paralytic disease due to wild or vaccine-derived poliovirus after eradication. Risk Analysis. In press 2006.
4. World Health Organization. Progress towards global poliomyelitis eradication: preparation for the oral poliovirus vaccine cessation era. Wkly Epidemiol Rec 2004;79:349--55.
5. World Health Organization. Conclusions and recommendations of the Advisory Committee on Poliomyelitis Eradication, Geneva, 11--12 October 2005. Wkly Epidemiol Rec 2005;80:410--6.
6. Hennessey KA, Lago H, Diomande F, et al. Poliovirus vaccine shedding among persons with HIV in Abidjan, Cote d'Ivoire. J Infect Dis 2005;192:2124--8.
7. Halsey NA, Pinto J, Espinosa-Rosales F, et al. Search for poliovirus carriers in persons with primary immune deficiency diseases in the United States, Mexico, Brazil, and the United Kingdom. Bull WHO 2004;82:3--8.
8. National Research Council. Workshop report: exploring the role of antiviral drugs in the eradication of polio. Washington, DC: National Academies Press; 2006.
9. CDC. Imported vaccine-associated paralytic poliomyelitis---United States, 2005. MMWR 2006;55:97--9.
10. CDC. Laboratory surveillance for wild and vaccine-derived polioviruses, January 2004--June 2005. MMWR 2005;54:958--61.


I wish I knew the honest answer. We are just a political football. The candidates are promising something (Even though I am not exactly sure what it is)... Will they deliver? Everyday I have hope... Everyday I pray... Everyday I look for Tanner's smile. Most days I float along thinking the bad dream will end and my son will return. As A life long conservative, I am having a tough time with this election. I have a gut feeling that Obama has over-promised and will under-deliver. It sure is nice to have a "dream". I hope AOA can help me work through the decision before Nov.

What if Autism was contagious? Fabulous statement! How would they market vaccines then?
It feels like many people already do think Autism is contagious. Friends and family fall away. I believe they think they will catch it. A family member recently stated to me that I chose to call our son Autistic. WHAT????
We need a catch phrase as strong as Pro Choice.
I want a do over so I can choose between the contagious childhood illness and lifelong damage and difficulty for my child.
Kim, Thank you for you great writing.

Great post, Kim!
I am disheartened to believe that Barack Obama may not believe in parents having a choice when in comes to vaccines. HOW can we be asked to choose between country and child? That is not a choice.
HOW can it be so hard to find a person, in a position of power, that is willing to help these children? HOW,as a parent, can I be expected to choose a political leader best suited to run our country, and then have to check if he will keep my son safe?
This sucks, and I am so tired of this fight.
SCREAM!
I feel like a Jamie Lee Curtiss book, "...today I feel disheartened, I have lost my way, tomorrow will be better, it's a different day..."
(my words, her rhythm)

Well said Kim, well said.

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