Autism-vac­cine link not cer­tain

Set­tle­ment fu­els fur­ther de­bate

The Covington News - - Health & Wellness - By Mike Stobbe

AT­LANTA — 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.

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 autis­tic chil­dren say the case is a land­mark le­gal prece­dent that sig­nals the gov­ern­ment is fi­nally con­ced­ing po­ten­tial autism­re­lated 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, Ga., 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.

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 37year- old neu­rol­o­gist.

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.

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.

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.

“ 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.”

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