By Mark Blaxill
John McCain's surprise decision for his Vice Presidential running mate, Alaska Governor Sarah Palin, has shaken up the 2008 presidential election race. Since Palin, who has served only two years as Alaska's governor, is not well known, her selection as the Republican candidate for Vice President has raised a number of questions. The most obvious and important question is being asked widely: is she ready to be President should something happen to John McCain? In the meantime, this telegenic, 44 year old mother of five has made history as only the second woman in American history to be selected as Vice President for a major party ticket.
But for some of us, the selection of Sarah Palin has a special resonance. Palin's younger son, Trig, born on April 19, 2008, is barely 4 months old now. Trig has Down's syndrome, a disorder that began at conception when he received two copies of his 21st chromosome from either his mother or father (close to 90% of the time, the extra copy is maternal), leaving him with three copies of this chromosome instead of the usual two. This genetic condition, formally known as trisomy 21, affects roughly 1 in 800 American children today, but as many as 1 in 27 children born to mothers who, like Palin, give birth at age 44.
For readers of the Age of Autism, this 4 month child is worth watching. Because trisomy 21 is not just the cause of Down's syndrome, it is also a genetic susceptibility factor for autism.
Rates of autism in children with Down's syndrome have not been determined with any great precision. They are quite likely increasing as the background rate of autism has also increased in the last 15-20 years. But there is little dispute that autism rates are high in the Down's syndrome population. One 1999 study in the UK estimated the minimum rate of autism in a population of children with Down's syndrome in South Birmingham at 7%. That places the risk of autism in children with Down's syndrome at least 10 times higher than the regular population. For Sarah Palin, that means her 4 month old son Trig may have at least a 1 in 15 chance of developing autism in addition to his Down's syndrome if one applies a ten year old estimate. If one makes the reasonable assumption that autism risk has risen over the last decade Trig's autism risk may well be greater than 1 in 10. Those aren't very good odds, especially for a family already facing the hardship of managing the difficulties of a special needs child.
These concerns would be important for any mother of a child with Down's syndrome, but they will take on an even greater urgency for Sarah Palin now that she is a Vice Presidential candidate. Quite literally overnight, Sarah Palin has become America's most visible mother of an infant child. And in her position, a stark and important personal health care decision now becomes a matter of public interest.
How will Sarah Palin vaccinate her infant son Trig?
Trig will be over six months old when flu season rolls around. Will Governor Palin consent to give him the recommended mercury-containing flu shot when his next well baby visit arises? As Governor, when she signed a statement in October 2007, as part of Influenza Vaccination Awareness Season in Alaska, to "encourage all Alaskans to get a flu vaccination to protect themselves, their families, and their communities," did she follow her own guidance? Indeed, did she receive a mercury-containing flu shot herself during last year's flu season when she was in the late stages of her pregnancy? Will Governor Palin follow the CDC's recommended immunization schedule for Trig and receive over 40 separate vaccine doses over the first 5 years of his life. Indeed, at 4 months of age, at a time when Trig should already have received 16 different vaccine doses, is he on schedule or not?
Make no mistake, as the mother of a Down's syndrome child, Sarah Palin is playing with fire if she chooses not to deviate from the recommended schedule. With so many children with no identifiable risk factors showing up with autism that their parents connected to a vaccine reaction, if I were the mother of a child in an identified high risk group, I'd be scared to death to follow the rules. And I'd be doing everything I could to select only the most important vaccines and slow the entire process down. Most of all, I'd do my best to stay under the radar and not call attention to anything I was doing. The easiest way to delay the process is to feign ignorance and let the task of scheduling appointments carry the necessary delay.
Unfortunately for Sarah Palin, her newly visible public role doesn't allow her to fly under the radar. Every personal choice she has ever made, from playing point guard on her high school basketball team, to entering the Miss Alaska beauty pageant, to running for Mayor of Wassilla, is about to come under relentless scrutiny. Her decision not to abort Trig even after she learned he was a Down's syndrome child has won her the admiration of the pro-life crowd. But knowing that she has delivered her special needs child and has started to manage this 4 month old baby's health and development, she has a new set of choices to make that will become a matter of intense public interest. Will she follow the recommended childhood immunization schedule for Trig, or will she not?
What are you going to do Governor? What are you going to do?
Mark Blaxill is Editor at Large of Age of Autism.