Experts Weigh in On US
Government's Vaccine Injury Ruling
March 14, 2008 — The US government's recent decision
to compensate the family of a 9-year-old girl
because it ruled her underlying mitochondrial
disorder was exacerbated by vaccines and resulted in
autismlike symptoms has raised concerns the judgment
will send an unintended message that
population-based immunization is harmful.
On the other hand, some believe the decision may
open the door to more research into potentially
vulnerable subpopulations that could be at increased
risk of sequelae from vaccines.
On March 6, the parents of Hannah Poling
announced that federal health officials ruled a
series of 9 simultaneous vaccines administered to
their daughter when she was 19 months old worsened
an underlying mitochondrial condition that
ultimately led to a diagnosis that included
"features of autism spectrum disorder." As a result,
the family is being compensated from the National
Vaccine Injury Compensation Program.
A news release from the US Health Resources and
Services Administration (HRSA) states that while the
government cannot publicly disclose details of a
specific case without the consent of the individuals
involved, it "has reviewed the scientific
information concerning the allegation that vaccines
cause autism and has found no credible evidence to
support the claim.
"HRSA has maintained and continues to maintain
the position that vaccines do not cause autism and
has never concluded in any case that autism was
caused by vaccination."
Decline in Immunization Rates
Wendy Roberts, MD, codirector of the autism
research unit at Toronto's Hospital for Sick
Children, in Ontario, agreed.
"The confusion here is there may be an occasional
child who has a very bad reaction to immunization —
statistically it is about 1 in a population of
100,000. But as soon as parents hear of 1 case, not
understanding the 1-in-100,000 statistic, they
immediately think all immunization is bad," Dr.
Roberts said in an interview.
The consequence of this is a potential decline in
immunization rates, which poses a serious public
health threat. According to Dr. Roberts, prospective
research undertaken by her team indicates this is
"We know that our vaccination uptake has gone
down at least 3% to 4%. But in some sectors where
individuals have a family history of autism, it has
dropped by 30% to 40%," she said.
Dr. Roberts added that she is concerned the US
government ruling will contribute to a further
decline in immunization rates.
The McCain Factor
She noted in particular that she was very
concerned by media reports quoting US Republican
presidential candidate Sen. John McCain that
thimerosal, the mercury-based preservative used in
vaccines, was strongly linked to autism.
"When someone in his [McCain's] position makes
those kinds of strong statements, it is such a
misuse of power. Canada has led the way in removing
preservatives from vaccines, and our rates of autism
are just as high as anywhere else," she said.
Both Drs. Bregman and Roberts made the point that
there are a whole generation of people who have no
experience with outbreaks of infectious diseases
such as measles and their potentially devastating
"We're not just talking about a rash or a fever.
Many of these diseases are associated with
significant mortality and adverse consequences,
including brain damage," said Dr. Bregman.
More Research Warranted?
Robert Hendren, president of the American Academy
of Child and Adolescent Psychiatry (AACAP), said his
organization is also concerned that the public may
interpret the decision as a blanket attack on or
condemnation of population-based immunization.
"This is a complex issue, and we are expecting
the lay public to sort it all out, and so there is a
possibility that it will be simplified and seen as a
message that vaccines are associated with autism."
For its part, the American Academy of Pediatrics
released a position statement about the Poling case
stating that the academy 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."
In its statement, the HRSA says it will present
its views "on the allegation that vaccines cause
autism in an omnibus autism proceeding in May."