Saturday, March 8, 2008

Vaccine settlement complex, may not be first

On April 2, CNN will report on the global impact, latest science and controversies related to autism for the first "World Autism Day." Watch for coverage on CNN.com and CNN TV.

ATLANTA, Georgia (AP) -- For those convinced that vaccines can cause autism, the sad case of a Georgia girl, daughter of a doctor and lawyer, seems like clear-cut evidence. The government has agreed to pay the girl's family for injury caused by vaccines.


Hannah Poling's parents, Terry and Jon, allege that vaccines played a role in Hannah's autism.

But it turns out it's not that simple -- and maybe not even a first.

The 9-year-old girl, Hannah Poling, had an underlying condition that may have been worsened, triggering her autism-like symptoms.

Her parents believe it was the five simultaneous vaccines she got as a toddler in one day eight years ago that did it. Government scientists say something like a fever or infection could have set off the problem -- but they didn't rule out the vaccines either.

This week, government officials said they have agreed to pay the Polings from a federal fund that compensates people injured by vaccines. The amount is not yet determined.

While parents and advocates for children with autism say the case is a landmark legal precedent that signals the government is finally conceding potential autism-related risks from childhood vaccines, government officials are saying it's nothing of the kind.

"This does not represent anything other than a very special situation," said Dr. Julie Gerberding, head of the U.S. Centers for Disease Control and Prevention.

Her comments came after the Polings, from Athens, Georgia, held a news conference Thursday to talk about their daughter, who accompanied them. At the briefing, Hannah seemed socially engaged with her caregiver, but later in an appearance on CNN's "Larry King Live," she was quiet and seemed to be in her own world. Larry King Live goes behind the scenes with the Polings »

As a toddler, they said she was a bright, normal-behaving child until she got five shots when she was about 18 months old. She was a little behind on her vaccinations, so the decision was made to give her five shots.

Almost immediately after, she was screaming, feverish and irritable. Then, her behavior gradually changed so she would stare at fans and lights and run in circles.

"It wasn't like a switch being turned off. It was more like a dimmer switch being turned down," said Hannah's father, Jon, a 37-year-old neurologist. Paging Dr. Gupta blog: Parents still see good in vaccines

It was heartbreaking, said her 47-year-old mother, Terry, who is trained as both a lawyer and a nurse.

"Suddenly my daughter was no longer there," she said.

The family filed a claim with the federal vaccine compensation program in 2002, which the government ultimately decided to concede before any evidentiary hearing.

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The case may not be a first, said Gary Golkiewicz, chief special master for the U.S. Court of Federal Claims. He oversees the special "vaccine court" which rules on requests for payments from the vaccine injury fund.

"Years ago, actually, I had a case, before we understood or knew the implications of autism, that the vaccine injured the child's brain caused an encephalopathy," he said. And the symptoms that come with that "fall within the broad rubric of autism."

And there are other somewhat similar cases, Golkiewicz says, that were decided before autism and its symptoms were more clearly defined.

Hannah has a disorder involving her mitochondria, the energy factories of cells. The disorder -- which can be present at birth or acquired later in life -- impairs cells' ability to use nutrients. It often causes problems in brain functioning and can lead to delays in walking and talking. I-Report: Are you living with autism? Tell us your story

The Polings were exploring two theories to explain what happened to Hannah. One is that she was born with the mitochondria disorder and the vaccines caused a stress to her body that worsened the condition. The other is that the vaccine ingredient thimerosal caused the mitochondrial dysfunction, Jon Poling said.

CDC officials decline to talk about the Poling case, but they say it should not be used to draw conclusions about risks for other children.

Scientists believe that in cases in which a mitochondrial disorder causes a child's brain function to deteriorate, the disorder exists and then is worsened by a fever, infection or other stress on the body.

Scientists don't know if a vaccination -- independent of fever or infection -- can cause such a stress, said Dr. Edwin Trevathan, a pediatric neurologist who heads the CDC's birth defects center.

Others echoed his assessment.

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"There are no scientific studies documenting that childhood vaccinations cause or worsen mitochondrial diseases, but there is very little scientific research in this area," said Chuck Mohan, executive director the United Mitochondrial Disease Foundation, a Pittsburgh-based group that raises money for research.

Mohan said there are more than 100 types of mitochondrial disease, and genetic tests can find only a couple dozen.

"Most children with autism do not seem to have a mitochondrial problem, so this association ... is probably relatively rare," said Trevathan.

Some research suggests the disorder occurs in one in 4,000 births, but some experts believe the rate is closer to one in 2,000, similar to childhood leukemia. And it is often just as fatal, said Mohan, who lost a daughter to the disease in 1995.



Other federal vaccine advisers seek to portray Hannah Poling as an isolated if not unique case.

She is "not a typical autistic child," said Dr. Paul Offit, chief of infectious diseases at Children's Hospital of Philadelphia and a longtime government vaccine adviser. "It's not a precedent-setting case." E-mail to a friend

2 comments:

baby trevor's mommy said...

I wish my brain could absorb all the details...and help me make sense of what to think! But alas...I can hardly remember what day of the week it is!
Thought Bristel had the c-pox today...so took her to the pedi (VERY pro-vax kinda guy) and of course the topic of Trev's vax plan came up. I suprized myself by how calmly I was able to discuss my concerns...the Italian in my usually gets the better of my blood-temp. But I left knowing that he thinks I'm a complete fruit-loop to even contemplate waiting or moving forward slowly with Trev's vax! Ugh! Soooo...like I said I wish it could stick in this pea-brain & make sense when I spit it back out!

Anyway...

...danielle

Shanna Grimes said...

I think I have changed my mind about the whole vax thing. I have decided to do one at a time from here on out and delay the MMR until she is older, since that seems to be the one causing most of the problems. No harm in getting it when her immune system and brain are more mature.