Do vaccines cause autism?
The Department of Health and Human Services has ruled that a Georgia girl who developed autism after receiving routine vaccinations is entitled to compensation from the federal vaccine injury fund. The case is reigniting debate about whether vaccines cause autism, and whether thimerosal is the culprit. However, there is another less sinister explanation --at the bottom of this blog post.First, from the Atlanta Journal-Constitution story about the case (Ga. girl helps link autism to childhood vaccines)
While government officials continue to maintain that vaccines don't cause autism, advocates say the recent settlement of the girl's injury case in a secretive federal vaccine court shows otherwise.The U.S. Department of Health and Human Services has concluded the family of Hannah Poling of Athens is entitled to compensation from a federal vaccine injury fund, according to the text of a court document in the case. The amount of the family's award is still being determined.
The language in the document does not establish a clear-cut vaccine-autism link. But it does say the government concluded that vaccines aggravated a rare underlying metabolic condition that resulted in a brain disorder "with features of autism spectrum disorder."Some medical experts say it's difficult to fully assess the case because the federal vaccine-court documents are sealed from public view."It raised a lot of questions for us," said Dr. David Tayloe Jr., president-elect of the American Academy of Pediatrics. The national medical group's leadership has been seeking more information about Hannah's vaccine-court case since last week when a sealed vaccine-court document detailing the government's settlement was posted on the Internet by an autism book author, then circulated widely among autism groups.According to the leaked document posted online, the government's Division of Vaccine Injury Compensation concluded that five shots Hannah received in July 2000, when she was 19 months old, "significantly aggravated an underlying mitochondrial disorder" and resulted in a brain disorder "with features of autism spectrum disorder."The Polings described how Hannah was a normal, verbal toddler until she received several vaccines during a well-baby visit. Within 48 hours of the shots, she developed a high fever and inconsolable crying and refused to walk. She stopped sleeping through the night. Within three months after receiving the vaccine, she began showing signs of autism, including spinning and staring at lights and fans. For a while, she lost her ability to speak.Hannah's father co-authored an article about her case, which was published in the Journal of Child Neurology in 2006.
I asked pediatric neurologist and SimulConsult CEO Michael Segal MD PhD for his take. Here's what he wrote:
The paper is Developmental Regression and Mitochondrial Dysfunction in a Child With Autism, which documents some metabolic abnormalities of mitochondria in Hannah and others with autism.Even though this case is from the thimerosal era, it is unlikely that thimerosal was involved in the worsening; the rate of diagnosis of autism has remained unchanged since thimerosal was removed from vaccines. But vaccines often trigger some fever, and fever can trigger episodes of many inherited metabolic diseases, so the link between vaccines and autism may be more than just coincidence. But such a coincidence does not make vaccines "responsible" for autism. Since fevers are an unavoidable part of childhood it is likely that the vaccine just served to trigger a metabolic illness that would have arisen with the child's next febrile illness. Studies have shown an increase in such deteriorations in the days after vaccinations and a corresponding decrease in subsequent weeks, suggesting that the fever from vaccination triggered a deterioration that would have happened anyway with the next febrile illness.
WebMD interviewed the father --an MD PhD neurologist-- who said,
"I don't think the case should scare people," says Poling, 37, who emphasizes that vaccines, like all of medicine, carry risks and benefits.
The New York Times covers the story today: Deal in Autism Case Fuels Debate on Vaccine.