Autism linked to vaccines/ a case history

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Federal Officials Say Vaccines Worsened Condition That Led to Autism

Spectrum Disorder in Georgia Girl

 

By Kathleen Doheny

WebMD Medical News

 

 

 

Federal officials say a Georgia girl is entitled to compensation from

a federal vaccine injury fund because she developed autism†" like

symptoms after receiving childhood vaccines in 2000.

 

Hannah's father, Jon, tells WebMD he was not surprised by the

compensation decision.

 

" When you are talking about the courtroom versus science, the burden

of proof is different, " Poling says. " (But) we showed there was a

plausible mechanism. We showed that an injury occurred shortly after

her vaccination. Her growth curve went flat for months. "

 

The government has not said that childhood vaccines cause autism;

rather, officials conclude that the vaccines given to the girl in

2000 aggravated a pre†" existing condition †" †" a mitochondrial disorder †"

†" that then manifested as a regressive neurological disease with some

symptoms of autism spectrum disorder.

 

Those who believe there is a vaccine†" autism link call the decision a

victory, but those who see no link worry that parents will once again

shy away from childhood vaccines.

 

" Nothing of this situation should be generalized to the risk of

vaccines for normal children, " CDC Director Julie Gerberding, MD,

said at a news conference. " None of this is going to change any of

our recommendations stating the importance of vaccination for every

child. "

 

The Back Story

 

Autism and autism spectrum disorders begin before the age of 3,

according to the CDC, and include a group of developmental

disabilities marked by great difficulty in social interaction and

communication. Difficulties on the spectrum range from mild to

severe.

 

The disorder is on the rise, with one in 150 children now diagnosed

with autism spectrum disorders, according to the CDC.

 

Suspicion of a vaccine link with autism has been ongoing at numerous

advocacy groups, who believe that thimerosal, a mercury†" containing

preservative used in some vaccines, is to blame. There is increasing

concern and an increasing awareness of the theoretical potential for

neurotoxicity. The preservative, used in vaccines since the 1930s,

has been removed or reduced to trace amounts in all vaccines

recommended for children 6 years of age or younger, with the

exception of inactivated flu vaccine. A preservative†" free version of

the inactivated flu vaccine is available.

 

Advocacy groups against childhood vaccines take issue with other

vaccine components as well.

 

Autism Groups: Decision a Victory

 

Sallie Bernard, co†" founder of SafeMinds (Sensible Action for Ending

Mercury†" Induced Neurological Disorders), is ecstatic about the

decision. " We're finally seeing the truth come out, " she tells

WebMD. " We've gotten such incredible pushback, yet here is a case

showing this connection quite clearly.

 

" Here is a case that really looked into the science, and behind this

child's case of autism, they have found a link between the child's

autism and the vaccines that she was given, " she says.

 

Bernard says she hopes the decision will spur re†" investigation of the

issue. " I think this will push more scientists and hopefully the NIH

[National Institutes of Health] to really investigate the role of

vaccines, the role of mercury, in autism, because this case is so

compelling. "

 

Autism Expert: Case Is " Rare "

 

A pediatrician who serves on a childhood vaccine advisory committee

for the U.S. Department of Health and Human Services sees the case

differently. " To say mercury causes autism is a giant leap, " says

Jaime Deville, MD, a pediatrician at Mattel Children's Hospital at

the University of California Los Angeles.

 

" Epidemiological studies do not support the hypothesis that mercury

in vaccines causes autism in the general population,'' he tells

WebMD. " However, there might be individual sporadic, or rare cases in

which patients have an adverse reaction after a dose of a vaccine

that might exacerbate a pre†" existing condition. "

 

That was the contention in Hannah's case †" †" that Hannah developed a

disorder of the mitochondria, the cells' " power sources, " before

developing autism†" like symptoms.

 

In a statement, Chuck Mohan, executive director and CEO of the United

Mitochondrial Disease Foundation, says science has not linked

vaccines to mitochondrial disorders.

 

" There are no scientific studies documenting that childhood

vaccinations cause or worsen mitochondrial diseases, but there is

very little scientific research in this area, " the statement

reads. " Mitochondrial diseases are as prevalent as childhood

leukemia, however the National Institutes of Health devotes only $11

million a year to research into mitochondrial disorders and only

about one†" third of that is earmarked for primary mitochondrial

disease research. Many scientists believe unmasking the causes of

mitochondrial disease may lead to possible cures for Parkinson's,

Alzheimer's, heart disease and cancer. "

 

Deville worries that parents will again shy away from vaccines. " I

would expect parents to start calling pediatricians, " he tells WebMD.

But he adds that Hannah's situation " seems to be an isolated case. "

 

He also points out: " Once mercury was removed [from most childhood

vaccines] in 2001, autism cases did not decline. "

 

He doubts that the decision will spur further research into the

proposed vaccine†" autism link, partly because of a lack of research

funding.

 

Autism†" Vaccine Link: Hannah's Story

 

According to the government concession in the Poling case, Hannah had

met her " developmental milestones " such as crawling and walking on

schedule during her first 18 months. But two days after receiving

five childhood vaccinations in July 2000, she developed a 102.3†"

degree fever and became irritable and lethargic. The symptoms

continued and worsened over the next few months.

 

By the fall of 2000, the parents became worried about her language

development and had her assessed. The health care professional

examining her concluded there were deficits in communication and

social development.

 

Complicating the picture was a history of middle ear infections which

began at age 7 months, and the need to prescribe multiple rounds of

antibiotics and to insert pressure†" equalization tubes.

 

By February, 2001, doctors examining Hannah found that she had a

persistent loss of previously acquired language, lacked eye contact,

and did not relate well to others. She persistently screamed and

arched her back. Doctors concluded that she was developmentally

delayed and had features of autism spectrum disorder.

 

Later in 2001, doctors found a defect in " cellular energetics " and

diagnosed a disorder of the mitochrondria.

 

Her father, Jon, then a neurologist at Johns Hopkins Hospital in

Baltimore, co†" authored a paper describing how autistic spectrum

disorders can be associated with mitochondrial dysfunction. It was

published in 2006 in the Journal of Child Neurology.

 

Accepting his daughter's diagnosis was difficult, Poling tells WebMD.

He says the family was in denial initially that anything was

seriously wrong. " After six months of essentially our daughter being

a zombie and gone, we knew this wasn't going away, " he says. " This

was chronic. And we had to come to grips with that. "

 

Still, Poling says his daughter's experience has not turned him

against vaccines; he just wants any vaccination risks to be

acknowledged and addressed.

 

" I want to make it clear I am not anti†" vaccine, " he says. " Vaccines

are one of the most important, if not the most important advance, in

medicine in at least the past 100 years. But I don't think that

vaccines should enjoy a sacred cow status, where if you attack them

you are out of mainline medicine.

 

" Every treatment has a risk and a benefit, " he says. " To say there

are no risks to any treatment is not true.

 

" I don't think the case should scare people, " Poling adds. " Sometimes

people are injured by a vaccine, but they are safe for the majority

of people. I could say that with a clean conscience. But I couldn't

say that vaccines are absolutely safe, that they are not linked to

brain injury and they are not linked to autism. "

 

Poling hopes the fed's decision will trigger government action. " I

hope it will force government agencies to look further into what

susceptibility factors are out there for children to develop brain

injury after vaccination, to look into the susceptibility factors of

people at risk. "

 

His advice for parents? They should demand to know a vaccine's safety

record before agreeing to give it to their child, including any known

links with metabolic disorders and susceptibility to injury, he says.

 

Mitochondial Disease

 

Hannah Poling suffered from a form of mitochondrial disease caused by

a genetic defect in her mitochondrial DNA.

 

Mitochondria are organelles †" †" tiny bodies within our cells †" †" that

carry their own DNA, which we inherit from our mothers. Mitochondria

provide the energy cells need to function.

 

Edwin Trevathan, MD, MPH, director of the CDC's National Center on

Birth Defects and Developmental Disabilities, said at the news

conference that when children with mitochondrial disorders are placed

under severe stress, such as a high fever, their bodies don't make

enough energy. This often damages the brain, the body organ that

needs the most energy.

 

The type of problem such children develop depends on the part of the

brain that is affected. Some may become spastic and have trouble

walking. Others may have seizures, problems with language, and

sometimes problems with social behavior, Trevathan said.

 

Children who have mitochondrial disorders, even though they seem

normal, are predestined to have a problem when they have stress, " he

said at the CDC news conference. " This is distressing for parents who

watch their children suddenly deteriorate. Most are normal appearing

until they exhibit signs of disease when placed under severe stress.

Most do not have problems with autism. "

 

Some researchers have suggested that mitochondrial diseases or

disorders are more common in children with autism than in other

children.

 

" If anyone said mitochondrial disease prevalence is higher among

children with autism, that is a hypothesis and there is remarkably

little data to support it, " Trevathan said. " The truth is we don't

know the prevalence of mitochondrial disease in the general

population. "

 

Mohan of the United Mitochondrial Disease Foundation tells WebMD that

mitochondrial disease affects one in 4,000 children †" †" and maybe

more. But he rejects the link to autism.

 

" Persons with mitochondrial disease don't necessarily have autism,

and persons with autism don't necessarily have mitochondrial

disease, " Mohan says. " Just as with vaccines, there is no scientific

proof vaccinations cause mitochondrial deficiencies or autism. "

 

Trevathan notes that though doctors are urged to consider each

child's individual risk, vaccinations are generally recommended for

children with mitochondrial disorders.

 

" We do recommend immunizations, because many of the diseases we

immunize against are associated with regression in children with

mitochondrial disorders, " he said.

 

 

Vaccine†" Autism Link: More Info

 

The court has not yet decided on the amount of damages. That

decision, those close to the case say, could take a few months or

more.

 

The federal Division of Vaccine Injury Compensation was set up to

ensure an adequate supply of vaccines, stabilize costs, and to

provide an avenue for individuals injured by certain vaccines.

 

The American Academy of Pediatrics in a statement, says the

case " raised many questions. "

 

" The AAP leadership is seeking access to official documents in the

case so medical experts can examine the science and consider whether

it raises implications for other children. The AAP wants to ensure

the public is provided accurate information about the safety and

importance of vaccines. Our members are dedicated to the health of

all children and urge parents to fully immunize their children, " the

statement says.

 

SOURCES:

 

U.S. Court of Federal Claims response to Poling petition for

compensation.

 

Sallie Bernard, co†" founder, SafeMinds.

 

John Gilmore, executive director, Autism United.

 

Jaime Deville, MD, pediatrician, Mattel Children's Hospital,

University of California Los Angeles and member, Advisory Commission

on Childhood Vaccines, U.S. Department of Health and Human Services.

CDC.

 

United Mitochondrial Disease Foundation.

 

Statement from Chuck Mohan, executive director and CEO, United

Mitochondrial Disease Foundation.

 

Chuck Mohan, executive director and CEO, United Mitochondrial Disease

Foundation.

 

Jon Poling, MD, PhD, neurologist.

 

Statement, American Academy of Pediatrics.