By ALISON YOUNG
The Atlanta Journal-Constitution
Published on: 03/06/08
In a move autism family advocates call unprecedented,
federal health officials have concluded that childhood
vaccines contributed to symptoms of the disorder in a
9-year-old Georgia girl.
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."
In an interview Wednesday with The Atlanta
Journal-Constitution, Hannah's parents, Jon and Terry
Poling, said the government's concession in the case
will help pay for the numerous therapists and other
medical experts their autistic child needs — now and
for the rest of her life.
"At least we have some commitment from the government
to take care of Hannah when we're gone," said Dr. Jon
Poling, a neurologist.
But the case also thrusts the family into a national
spotlight in the controversial public debate over
whether vaccines have played some role in the growing
number of U.S. children diagnosed with autism. Of
particular concern to some families is the
mercury-based preservative thimerosal, not used in
child vaccines (except for some flu shots) since 2001.
Hannah's case was one of three vaccine-court test
cases alleging that thimerosal caused the children's
autism. The other cases go to trial in May.
Suspicion of vaccines is fueled in part by vocal
advocates — including radio shock jock Don Imus and
actress Jenny McCarthy — speaking out on radio and TV
shows such as "Oprah" and "Larry King Live."
Even Republican presidential candidate Sen. John
McCain said on the campaign trail that "there's strong
evidence" that a preservative in vaccines is fueling
the dramatic rise in autism cases across the country.
As many as 1 in 150 children in some communities have
autism disorders, says the Centers for Disease Control
and Prevention.
"We need to recognize this is a national crisis," Jon
Poling said.
Autism is a lifelong neurological disorder that causes
problems with communication and the ability to have
normal social interactions. Autism and related autism
spectrum disorders cover a range of symptoms that can
vary from mild to severe. The cause is unknown, but
scientists believe genes may play a role.
Pediatricians and public health officials worry that
this case may cause fear among some parents and prompt
them to refuse to vaccinate their children, and put
them in real danger from measles, whooping cough and
other diseases.
The risks of diseases are real risks," said Dr.
Melinda Wharton, deputy director of CDC's National
Center for Immunization and Respiratory Diseases.
Numerous large studies don't support a relationship
between vaccines and autism, according to the CDC and
the Institutes of Medicine.
The Georgia girl's case – and its implications in the
vaccine-autism debate – raise more questions than it
answers, experts say.
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.
The pediatrics association has been trying to get
access to official documents in the case so medical
experts can delve into the science, assess whether
there are implications for other children and answer
questions from doctors and families.
"Our responsibility is to make sure the public is
given good information and make sure the hype doesn't
distract from public health," Tayloe said. "I still
would not think that we're going to have evidence
showing a role of vaccines actually causing autism."
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."
Sallie Bernard, executive director of the national
autism advocacy group SafeMinds, called the case
"unprecedented" in that a link between vaccines and
autism is being made public. Federal health officials
"have insisted there is no link at all between
vaccines and vaccine components and autism. And
apparently that is not true," she said.
The case also is significant because other autistic
children have mitochondrial disorders, Bernard said.
"The question is: What is the proportion?"
Robert Krakow, a New York attorney representing other
autistic children in vaccine court, said the
significance of the case is "potentially explosive."
He said he has several clients with similar histories.
Hannah requires one-on-one care at all times, said her
mother, Terry Poling, a nurse and lawyer. 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.
Then, within six months after the shots, as the family
came to grips with the likelihood that she was
autistic, they turned to leading experts in neurology.
"I had to know. My daughter didn't just suddenly
develop autism for no reason," Terry Poling said.
Hannah's father co-authored an article about her case,
which was published in the Journal of Child Neurology
in 2006.
Hannah, who has two older brothers, continues to have
mild to moderate symptoms of autism. The family says
early and ongoing intensive therapy has been critical
for her.
"The biggest question right now for the public is: How
unique is Hannah's case?" said Jon Poling. Poling said
he suspects there are other children like Hannah.
Cliff Shoemaker, the Polings' attorney, said the
family has filed a petition with the vaccine court to
unseal all of Hannah's records and allow both the
family and the government to fully discuss the case.
Despite this, a spokesman for the U.S. Department of
Justice, which reprersents the government in court
cases, would not grant interviews or explain to the
AJC why it isn't releasing the records. HHS officials,
who administer the vaccine compensation fund, also
declined to be interviewed, citing the court's
confidentiality requirements.
Shoemaker said the government's November concession in
the case is public, but the government's reasons
aren't. "I'm not aware of any other conceded autism
cases," he said.
Congress created the National Vaccine Injury
Compensation Program in 1988 after widespread lawsuits
against manufacturers and health-care providers
stemming from reports of side-effects of a version of
the diphtheria-tetanus-pertussis vaccine used in the
1980s.
With companies getting out of the vaccine business for
liability reasons, Congress established the program
and a trust fund to serve as a no-fault alternative
for resolving certain vaccine injury claims.
The average injury compensation to an individual in
vaccine court has been about $1 million. In fiscal
year 2007, more than $91 million was awarded to people
harmed by vaccines.
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