A few weeks after Steven Demos turned 1, his mother noticed a difference. He stopped looking her in the eye. He started flapping his arms. Around 18 months, high-pitched screams replaced his words.

When Steven was 3, a neurologist diagnosed autism, a neurological disorder that severely affects a child's ability to communicate and learn.

Now Steven is the subject of a lawsuit against the nation's major vaccine manufacturers. His parents, Linda and Nick Demos of North Miami Beach, believe his autism is linked to vaccinations containing mercury.

The Demos family is hardly alone. A coalition of 35 law firms, headed by a Portland, Ore., attorney, is currently handling lawsuits for about 1,000 families nationwide.

Though the Demos' lawsuit isn't part of The Mercury Vaccine Alliance, as the national group is known, they're after similar things. They want more research done on how mercury in vaccines affects small children and, if a link is established, they want compensation for the kids.

The pressing question is: Do these mercury-containing vaccines cause autism and other brain damage?

Pfizer spokesman Bob Fauteux says the company has seen no evidence that Steven Demos was exposed to a mercury-containing vaccine manufactured by them.

"We believe the claim in this case is without merit, and we'll defend the case vigorously," he says.

(A spokeswoman for GlaxoSmithKline says she can't comment on pending litigation, and eight attorneys, representing pharmaceutical companies named in the suits, either didn't return calls or also declined comment because of the pending litigation.)

As these lawsuits work their way through court, they highlight a much larger concern: Vaccines, once the hero for taming such deadly diseases as smallpox and polio, are now viewed as the villain by some.

Critics note that as the number of childhood vaccinations has mushroomed, so have the numbers of children diagnosed with everything from autism to learning disabilities and attention deficit/hyperactivity. But other medical professionals attribute the rise to more awareness, better diagnosing and broadened definitions of the disorders.

Meanwhile, a flurry of research is reassuring about vaccines' safety, but it can't definitively state what parents want to hear: Vaccines won't hurt my child.

The mercury lawsuits, for instance, followed an Institute of Medicine report that said current evidence neither proves nor disproves a link between thimerosal, a mercury-containing preservative once widely used in some childhood vaccines, and neurodevelopmental disorders, such as autism.

`A real mama's boy'

The Demos' story sounds all too familiar to many families dealing with autistic children.

For the first year of his life, Steven appeared perfectly normal. He crawled and then walked. He said "Mama" and "Dada."

"He was a real mama's boy," says Linda Demos, of Steven, who'll turn 5 in April. "He never took his eyes off Mama."

Demos says she followed the usual recommendations for childhood vaccinations. In the early months of his life, doctors vaccinated Steven for polio, diphtheria, tetanus, pertussis and hepatitis B, all of which contained thimerosal because it prevents bacterial contamination.

"I did everything a mother is supposed to do to protect her child," Demos says. "I thought I was doing what was best for him."

Demos had never heard of autism before the doctor delivered the diagnosis. So she went online and started researching. Many of the Web sites talked about thimerosal and autism. To her, it sounded like a logical explanation to an inexplicable change in her son.

Meanwhile, all around the country, other parents were looking askance at thimerosal and starting legal battles.

In Oregon, Tory Mead believes her son, William, 31/2, became autistic after getting vaccinations containing thimerosal. She's now part of a class-action lawsuit.

So is Kelley O'Clair of New Hampshire, whose 3-year-old son started showing signs of autism after his first birthday, around the time he received a series of vaccinations.

"It has shattered us and devastated our family," Mead says. "We had a beautiful 2-year-old child and in eight weeks he was a vegetable."

Something to blame

It's easy to understand why parents desperately want something to blame. Autism is a devastating disorder with no known cause and no cure.

The neurological disorder typically appears during the first three years of a child's life and affects as many as one in 500 children. Typically, people with autism have problems talking as well as with nonverbal communication, social interaction and play activities. They may exhibit repeated body movements, such as hand flapping and rocking. They may resist changes in routine and in some cases exhibit aggressive or self-injurious behavior.

Thimerosal became suspect, in part, because autism and mercury poisoning share similar characteristics. Both result in movement disorders, such as arm flapping.

Both result in poor eye contact, borderline intelligence, delayed language or failure to develop speech and oversensitivity to sound and touch.

But the families involved in the lawsuits are hardly the first to question thimerosal's use.

During an investigation into mercury that started in 1997, the federal government discovered that children following the recommended immunization schedule were exposed to mercury levels beyond some federal safety guidelines.

So in 1999, the U.S. Public Health Service and the American Academy of Pediatrics called for thimerosal's removal. Today, recommended childhood vaccines being made or marketed in the United States don't contain thimerosal or only trace amounts.

But it's still used in flu shots and some over-the-counter products, such as nasal spray.

And critics are concerned about an unknown amount of thimerosal-containing vaccines remaining on the shelves.

Increase in vaccines

Beyond the thimerosal controversy lies a bigger issue: the mushrooming number of childhood vaccines and potential complications.

Twenty years ago, children routinely received seven vaccines and up to five shots by age 2. Today, they get 11 vaccines and as many as 20 shots by age 2. In addition, many more vaccines -- for everything from Alzheimer's to ulcers -- are either on the drawing board or in drug trials.

Now, even the medical community doesn't agree on when enough is enough.

Dr. Stephanie Cave, a Baton Rouge, La., family practitioner and author of What Your Doctor May Not Tell You About Children's Vaccinations (Warner Books, 2001), questions the necessity of so many vaccines to fight an endless parade of medical problems.

"We've lived in tandem for centuries with some of these organisms, and we can fight them," Cave says.

Nor does Cave think that every vaccine on the market gets adequately tested and is safe. In the fall of '99, for instance, the much-touted rotavirus vaccine was recalled after being linked to a painful and potentially deadly bowel obstruction. An estimated 1 million infants had been given the vaccine, meant to curb the leading cause of childhood diarrhea.

Cave also is concerned that injecting so many organisms over short time periods could overwhelm a child's system.

But a new report published in the January issue of Pediatrics says that infants, at birth, can safely handle multiple vaccines.

"Their immune systems are designed to stand up to these challenges from the start," says Dr. Paul Offit, who reviewed current research and is director of the Vaccine Education Center at The Children's Hospital of Philadelphia. "The benefits of vaccines far outweigh any risk."

Other respected medical groups agree. Last month, the American Academy of Pediatrics, in agreement with the Centers for Disease Control and Prevention, issued its 2002 immunization recommendation schedule.

As usual, it calls for children to be protected from a slew of diseases by age 2, including hepatitis B, diphtheria, measles, mumps, polio and more.

Cave says caution about trimming the vaccination schedule stems from fear that parents will abandon vaccines altogether.

"They don't want to send a message to parents that would upset them to the point that they won't get vaccines," she says.

There is some risk

Indeed, vaccine manufacturers, federal health officials and doctors acknowledge that all vaccines carry a risk of injury and death. But they argue that side effects are usually mild and serious reactions are rare. The risk of getting the disease is far greater than the chance of suffering a serious reaction, they argue.

(While most school-aged children are vaccinated, a Florida law allows a personal/religious exemption from vaccines. For more information, parents can contact their county health departments. Private physicians can provide exemptions for medical reasons: severe allergic reactions, for instance.)

Many on both sides of the debate agree that vaccines have changed the face of the globe for the better by curbing devastating diseases.

"We're not saying all vaccines should be eliminated," says Roberto Villasante, an attorney with the Robles Law Center, which represents the Demos family. "We are saying they need to be scheduled in a way they don't build up in the system."

To the Demos family, the on-going debates over vaccinations are irrelevant. Their focus is Steven, who attends a school with services for children with special needs.

With a speech therapist's help, he learned to say "Mama" and "Dada" again. But he still flaps his hands. And he's a long way from being a typical 5-year-old who runs and plays with his friends.

"My child was perfectly normal for the first year of his life and then something happened," Linda Demos says. "It's like they took your child away and gave you a shell back."

Liz Doup can be reached at ldoup@sun-sentinel.com or 954-356-4722.

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