What The Poling Autism Case Means

March 13, 2008 | For the past decade, advocacy groups have claimed that vaccines cause autism, a behavior and language disorder, in children. At the center of the debate is a compound called thimerosal,health club a mercury-based preservative that was used in most vaccines until around 2001. Many of the advocates, including Robert F. Kennedy Jr. in Salon, have accused doctors, drug companies and the federal government of hiding the truth about thimerosal and its connection to autism.

Despite the charges, multiple studies have demonstrated no connection between thimerosal (or anything else about vaccines) and autism. health club In the past nine months alone, at least three studies have shown that thimerosal has no relationship to autism or any other neurological disorders. One study, published in the January issue of Archives of General Psychiatry, looked at autism rates in California after the removal of thimerosal. Not only did the rates not go down, they continued to rise. For these reasons, the government and most doctors stand by the belief that vaccines are effective and safe.

However, last week, the U.S. government awarded compensation to a Georgia family, the Polings, who had sued the government (along with 5,000 other families whose children have autism), claiming vaccines had caused autism in their now 9-year-old daughter, Hannah. As the decision made headlines, health club antivaccine groups claimed victory and vindication, and parents fretted over whether to vaccinate their children.

This is the real danger of this case. As a pediatrician, I hate to see parents pass up the chance to give their kids vaccines, which have saved countless lives, prevented some of the deadliest diseases in human history and remain safe. health club So what should we make of the Poling decision? Let me take it one point at a time.

What did the government decide?

For many years now, the federal government has set aside funds for children who have been injured by vaccines. Doctors and other health professionals can report adverse outcomes to the government, and parents can file claims in federal "vaccine court." The court's judges, known as special masters, review claims. If they find a child was injured by a vaccine, they award compensation to that child.

In this case, "CHILD [Hannah Poling] v. Secretary of Health and Human Services," the court "concluded that the facts of this case meet the statutory criteria for demonstrating that the vaccinations CHILD received on July 19, 2000, significantly aggravated an underlying mitochondrial disorder, which predisposed her to deficits in cellular energy metabolism, and manifested as a regressive encephalopathy with features of autism spectrum disorder. Therefore, respondent recommends that compensation be awarded to petitioners."

Does that mean vaccines caused Hannah to become autistic?

No. Look again at the court statement: Hannah has "an underlying mitochondrial disorder, which predisposed her to deficits in cellular energy metabolism, and manifested as a regressive encephalopathy with features of autistic spectrum disorder." Throughout the document health club, both Hannah's doctors and lab results support the diagnosis of mitochondrial disorder.

Not a diagnosis of autism?

Right. Mitochondrial disorder does not equal autism. Generally speaking, mitochondria are the parts of our cells that help generate energy. When they fail, the body's cells go awry, which can lead to failures in any number of normal body functions. There are at least 40 known mitochondrial disorders, and probably many more we haven't yet found. But it's clear from the transcript of the court's decision that this was not a case of vaccines causing autism. Rather, this is a case where the court deemed it plausible that vaccines aggravated an underlying disease caused by bad mitochondria, health club and that some of the symptoms Hannah showed were similar to autism. As you'll see below, there are even questions about that conclusion.