Analysis: U.S. vaccine payment no landmark

[Guest guest]

Analysis: U.S. vaccine payment no landmark

Updated Fri. Mar. 7 2008 10:44 AM ET

The Associated Press

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

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 acknowledged 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

autism-related 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.

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. They said she was a

bright child until she got five shots when she was about 18 months old.

Almost immediately after the vaccinations, 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 37-year-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 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 about what happened to Hannah. One is

that she was born with the mitochondria disorder and the vaccines caused a

stress to the body that worsened the condition. The other was that the

ingredient thimerosal caused the mitochondrial dysfunction, Jon Poling said.

CDC officials decline to talk about the Poling case, but they said Hannah's case

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, a pediatric

neurologist who heads the CDC's birth defects center.

Some research suggests they occur in one in 4,000 births, but because some

experts believe the rate is closer to one in 2,000, similar to childhood

leukemia, because of missed diagnoses. And it is often just as fatal, said

Mohan, who lost a daughter to the disease in 1995.

Other federal vaccine advisers sought to portray Hannah Poling as an isolated if

not unique case.

She is " not a typical autistic child, " said Dr. 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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