Tag: tics

Do Vaccines Cause PANDAS?

PANDAS, first described in 1998, is an acronym for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections.

Kids with PANDAS can have tics and/or OCD that come on suddenly or get worse after they get a strep infection. Specifically, a group A streptococcal infection, like strep throat.

These kids might also be moody and irritable, develop problems at school, have trouble sleeping, and have anxiety, including separation anxiety.

What Causes PANDAS?

Like other post-strep complications, PANDAS is thought to be an auto-immune disorder that occurs when a child’s immune system targets the strep bacteria, but also cross-reacts with molecules that strep uses to hide in our body.

“However, the molecules on the strep bacteria are eventually recognized as foreign to the body and the child’s immune system reacts to them by producing antibodies. Because of the molecular mimicry by the bacteria, the immune system reacts not only to the strep molecules, but also to the human host molecules that were mimicked; antibodies system “attack” the mimicked molecules in the child’s own tissues.”

PANDAS—Questions and Answers

If antibodies to mimicked molecules target a child’s brain tissue, then you can get the neuropsychiatric symptoms of PANDAS, including tics and OCD.

Does it sound a little unbelievable?

Do you know what causes rheumatic fever, besides an untreated group A streptococcal infection? It is an auto-immune disorder that occurs when the antibodies that are produced after a strep infection attack your joints and heart, including the valves of your heart.

Similarly, if the antibodies attack your kidney, you can develop post-streptococcal glomerulonephritis.

Do Vaccines Cause PANDAS?

PANDAS is caused by a strep infection.

Vaccines do not cause strep infections and vaccines do not cause PANDAS.

The Advisory Commission on Childhood Vaccines recently voted against adding PANDAS as a vaccine table injury.
The Advisory Commission on Childhood Vaccines recently voted against adding PANDAS as a vaccine table injury.

Responding to a petition to add PANDAS and similar conditions as a vaccine table injury, the Advisory Commission on Childhood Vaccines voted 5 to 1 against, stating that:

  • No published study that examines anti‐neuronal antibodies including anti‐dopamine receptor 1 (DR1), anti‐dopamine receptor 2 (DR2), anti‐tubulin, anti‐lysoganglioside – GM1 or antibody‐mediated activation of calcium calmodulin dependent protein kinase II (CaMKII) in children suspected of PANS and/or PITAND following pertussis infection or following pertussis immunization was found.
  • No published case report of conjugate pneumococcal vaccines or pneumococcal infections and Hib vaccines or Hib infections causing or enabling the development of acute neuropsychiatric symptoms via a mechanism of blood‐brain barrier disruption with GAS antibody‐mediated CNS cross‐reaction in a susceptible child were found.
  • No published case report of PANS, PITAND and/or PANDAS following pertussis vaccination or during or following pertussis infection were found.
  • No published case report of PANS, PITAND and/or PANDAS following either pneumococcal conjugate or Haemophilus influenzae type b (Hib) vaccination or pneumococcal or Haemophilus influenzae type b infection were found.

There is no evidence that vaccines cause PANDAS.

“Children with PANS and PANDAS should receive standard childhood vaccines, following recommendations from the Centers for Disease Control and Prevention, the American Academy of Pediatrics, and the American Academy of Family Physicians (Centers for Disease Control and Prevention 2016a). The patient and all family members should receive annual influenza immunization as described under Influenza (described earlier).”

Clinical Management of Pediatric Acute-Onset Neuropsychiatric Syndrome: Part III—Treatment and Prevention of Infections

What about PANS and PITANDS?

These are similar, although much more controversial than PANDAS.

What’s the difference?

With PANDAS, the trigger is a strep infection. What about if you have symptoms of PANDAS, but no evidence of a strep infection?

Then some folks stick with the diagnosis and simply label you as having PANS or PITANDS, blaming some other infection, even though there is little evidence that these are a real thing.

More on PANDAS

Do Vaccines Cause Tics or Tourette Syndrome?

One thing to understand when talking about tics and Tourette Syndrome is that tics are not Tourette Syndrome.

Instead, Tourette Syndrome is a type of tic disorder.

What Causes Tics and Tourette Syndrome?

You should also understand that tics are common.

In fact, about 20% of school age kids get tics, although few have them for more than a year. These motor or vocal tics (involuntary eye blinking, head jerking, shoulder shrugging, humming, sniffing, grunting, throat clearing, or yelling out a word or phrase) are most common when kids are between the ages of 10 to 12 years old, but may start as early as age 6 to 7 years.

Not only are these tics common, but they are thought to be normal and very often go away without treatment. About 97% of kids have complete resolution of their tics within a year or so.

The rest might go on to have a persistent motor or vocal tic disorder though.

And some kids with persistent motor and vocal tics might have Tourette Syndrome.

Why?

“While environmental factors and illness may influence ticcing, the weight of evidence argues that tic disorders and their comorbidities are inherited/genetic. The inheritance pattern can be subtle and unexpected. In clinic, we often see a parent, while either indicating that they experienced childhood tics that remitted or that no one in the immediate family ever had tics, demonstrating frequent subtle tics.”

Kids and Tics: What’s “Normal” and When to see a Specialist

That’s right. Genetics.

Tics and Tourette Syndrome often run in families.

Do Vaccines Cause Tics or Tourette Syndrome?

As you might suspect, vaccines do not cause tics or Tourette Syndrome.

Neither does thimerosal, which used to be a common preservative in vaccines.

That’s not surprising, as neither tics nor Tourette Syndrome are new conditions.

Why can you find studies that try to link thimerosal and vaccines to tics and Tourette Syndrome? Because they are poorly done studies by folks who routinely do studies that try to make it look like vaccines cause everything from autism and tics to ADHD.

Other studies have found no link between thimerosal and tics, including the study Neuropsychological Performance 10 Years After Immunization in Infancy With Thimerosal-Containing Vaccines.

Even the studies that found some association weren’t very convincing.

“With the possible exception of tics, there was no evidence that thimerosal exposure via DTP/DT vaccines causes neurodevelopmental disorders.”

Andrews et al on Thimerosal exposure in infants and developmental disorders: a retrospective cohort study in the United kingdom does not support a causal association.

One study, for example, did actually find some association between thimerosal and tics.

Maybe.

Infants who received one dose of DTP with thimerosal had a higher rate of tics than infants who didn’t. The strange thing about the study though is that infants who had two or three doses also had a higher rate than getting just one dose and a similar rate as kids who didn’t get any vaccines with thimerosal.

“We did find one statistically significant association between exposure to thimerosal-containing vaccines and the presence of tics among boys, however, this association was not replicated in girls. Previous associations between thimerosal containing vaccines and tics were found by Verstraeten et al. (2003) and Andrews et al. (2004) but the findings were not sex specific. Our tic finding was also consistent with the tic finding reported in the original study (Thompson et al., 2007).”

John Barile et al on Thimerosal Exposure in Early Life and Neuropsychological Outcomes 7–10 Years Later

None of this sounds like evidence that vaccines cause tics, does it?

No.

None of these studies found clinically significant evidence that vaccines cause tics or Tourette Syndrome.

What about other thimerosal-free vaccines? There have been no reports of increased rates of tics or Tourette Syndrome with any thimerosal-free vaccines either.

“There were 17 reports of Tourette’s disorder. Two patients developed movement disorders following 4vHPV with symptoms similar to Tourette’s, but did not have a definitive clinical diagnosis of Tourette’s disorder from a specialist (i.e., a neurologist or psychiatrist). In three additional reports, patients had a Tourette’s diagnosis or displayed symptoms of Tourette’s prior to vaccination. The remaining 12 reports were submitted by one physician who read on internet websites about possible Tourette disorder occurring after vaccines, but he had no firsthand information on any patient. None of these 12 reports could be verified.”

Arana et al on Post-licensure safety monitoring of quadrivalent human papillomavirus vaccine in the Vaccine Adverse Event Reporting System (VAERS), 2009-2015.

There is no evidence that vaccines cause tics or Tourette Syndrome.

In fact, at the December 2017 meeting of the Advisory Committee on Childhood Vaccines, there was a petition to add tics as a vaccine table injury. After reviewing all available evidence, including the work of William Thompson, the so-called CDC Whistleblower, the committee voted 5-1 for the option to not add tics as an injury to the Table. They also didn’t add asthma or PANDAS to the vaccine injury table, despite some folks petitioning them to do so.

Tics have not been added as a table injury.
Tics have not been added as a table injury.

That’s likely not a surprise to folks who know that vaccines are safe.

What to Know About Tics and Tourette Syndrome