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Now that the courts have recognized a link between vaccinations and autism, we need to revisit public policy. Individual vaccines can't get much safer, but vaccine protocols can. The 2008 Centers for Disease Control protocol for pediatric vaccines is not the safest way to accomplish the goal of immunity to multiple infectious diseases in an individual.

A vast majority of children will not be affected by the administration of vaccinations. But if epidemiological purposes can be met with a more directed approach, there is no reason to endanger a genetically vulnerable child with unneeded boosters. Titer checking protocols are inherently safer for individuals, especially in the at-risk families for autism.

A simple lab test to check titers can tell you whether an additional "booster" is needed. The vast majority of kids, 95 percent, are immune for life to measles-mumps and rubella after one dose. Multi-shot vaccine protocols are a boon to vaccine companies, not North Dakota families. Pediatricians using titer checks would shift resources from multinational vaccine corporations to North Dakota hospitals via laboratory services utilization.

The argument against this approach has always been, "It's too troublesome," and "What if we lose the patient to follow-up?" These are legitimate concerns, but is it fair to make the social assumptions that no one in this state sees their pediatrician after the first few months of a baby's life?

As the art moves forward in vaccinomics, the future will show how easily we can do this better. We now have simple finger-stick titer checking technology for HIV antibodies. This could be ported into titer checking systems for vaccine efficacy, and the University of North Dakota School of Medicine could be the institution that leads the charge on this innovative research. It will take some time to calibrate such systems, but we can do it here better than anywhere because of our high compliance with vaccination in this state and our close-knit medical and governmental communities.

Even current policy needs some modification in light of the growing public concerns in vaccine safety due to the Hanna Poling case. She is the child of parents who hold M.D., Ph.D., R.N. and J.D. degrees. They would probably advocate as I, after their experience, that parents need to be made aware of better ways to vaccinate. The first modification of law and policy that should occur is a disclosure on consent forms for vaccine boosters. A child may already be immune for life in certain series after one dose of vaccine (live virus vaccines have incredible long-lived titers and high first response rates). A titer check can obviate the need for an unneeded booster; shouldn't the public be made away of this? This is particularly important in families with high rates of autoimmune disease.

In my own experience, I lost my vaccine records, and in order to get into medical school, I had a whole series titer (antibody) check to prove that I was immune to the diseases we all need protection from in this incredibly helpful arm of medicine.

To ensure that this is done appropriately for your child is to be a loving parent, and to push your colleagues in medicine and government is to be a certain kind of patriot. To fail to educate parents on this option is engendering the socialistic mentality of a cradle-to-grave caretaker federalist system. Governments and school districts would be better served to require titer levels, not written records of vaccine shots. Titer levels are scientific evidence of immunity. A vaccine record actually isn't, as it can be forged.

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All U.S. physicians and state legislators should thoroughly read the Simpsonwood Transcripts (www .nationalautismassociation.org /library.php). This is the most honest assessment of the relationship of vaccines to autism and shows a clear signal of "uncertain" strength.

The CDC conveniently "forgets" to publish the transcript as part of the timeline of understanding the relationship of vaccines to autism. This is clearly a lack of transparency at the federal level of health policy, a timely discussion in light of John Irby's front-page piece in the March 16 Tribune.

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Federal mandates turn a blind eye to the at-risk child harmed by vaccines. We are abusing the molecular machinery of some of our more fragile children to protect vaccine companies, it's a deal with the devil that all of us in medicine hate having to make; I make it every day as a member of the medical specialty, radiology, that deals the most heavy metals and known teratogens to U.S. citizens.

The integrity and smarts of our state level public health officers is getting usurped by the federal government whose agencies are drunk on the influence of multinational corporations, especially in medicine and pharmaceuticals.

As a father of an autistic child, I will fight the federal government's continuing to abuse certain vulnerable children in this nation's war against disease. We don't send everyone to the front line of other wars, why aren't we more discriminating in this one?

North Dakota physicians know how to better vaccinate the children of this state than the CDC. We all need to get behind the pediatrics and public health community of North Dakota to improve this art in scientific ways. It may be a decade before that happens, but we can do it.

(Dr. Edward "Ted" Fogarty is a Bismarck radiologist. - Editor)

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