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An editorial discussing recent misleading information related to vaccines and autism.
Early last month, news media outlets proclaimed that a compensatory award made by the national Vaccine Injury Compensation Program (VICP) to the family of Hannah Poling, a 9-year-old child with mitochondrial dysfunction, constituted government concession that there is a link between vaccines and autism.
As described in a case report coauthored by her father,1 the child had been developing normally until she experienced developmental regression with symptoms consistent with autism, following catch-up immunization at 19 months of age with DTP, Hib, MMR, polio vaccine, and varicella vaccine. The VICP court agreed to a compensatory award to the family in November 2007, but details concerning the case will not be released by the government agency for several weeks. In the meantime, the family and the lawyers representing them have publicized the outcome.
The VICP is located in the Health Resources and Services Administration (HRSA) of the Department of Health and Human Services, and was created in 1988 as a no-fault alternative to the traditional tort system for resolving vaccine injury claims. The VICP helps children and families. It has been an effective mechanism to protect the public's health and stimulate vaccine research. In providing reasonable compensation to people found to be injured by certain vaccines, the program helps to ensure that vaccine injury claims do not threaten the supply of vaccines, while providing a forum for individuals seeking compensation for injury. Decisions are made by the US Court of Federal Claims.
How do we put all this together? Based on the limited information available, it appears that the VICP court concluded that Hannah Poling's underlying mitochondrial dysfunction put her at risk of neurological deterioration when confronted by the stress of multiple simultaneous immunizations. It happens that, in this child, the neurological deterioration apparently took the form of autism-like symptoms, but it was the underlying disease that was the primary reason for the deterioration; similar consequences could have resulted from sleep deprivation, exertion, or infection, including one of the infections she was protected from by immunization. Hannah's parents have stated that, if they had to do it over again, even if they had recognized her underlying disease, they would choose to have her immunized, though probably not with so many vaccines simultaneously.
It's not surprising that parents and members of the media are confused by what they think has happened. Without additional clarification from the VICP, it will be difficult to reassure them that the award to Hannah Poling's family does NOT constitute a concession about a relationship between vaccines and autism. We can say, however, that individuals and agencies that know the facts have continued to assure us all that there is nothing about this case that suggests a need for any change in vaccine recommendations. Specifically, there is nothing about this case that suggests a link between vaccines and autism, though it may provide a reason to pursue research to determine if there is a link between mitochondrial dysfunction and autism.
Our message to parents, acknowledging that they are continuing to be confronted with provocative and alarming but misleading allegations, must be straightforward and honest:
Vaccines save lives and reduce illness better than any other health care measure available.
The diseases vaccines prevent (meningitis, pneumonia, polio, measles, hepatitis, whooping cough, and more) have not disappeared, and continue to threaten unvaccinated children.
Vaccines do not cause autism.
Perhaps this message is just too good for some people to believe!