On Monday I criticized Senator John McCain for giving credence to claims that vaccines are linked to the rise in autism diagnoses. Some believers in such a link point to the case of Hannah Polling, recently settled by the federal government, as evidence in support of their claims. Specifically, the government agreed that Polling's parents were entitled to compensation from the federcal vaccine injury compensation fund because vaccines "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." Today's NYT reports on the case:
Advocates say the settlement — reached last fall in a federal compensation court for people injured by vaccines, but disclosed only in recent days — is a long-overdue government recognition that vaccinations can cause autism. . . .
Government officials say they have made no such concession.
“Let me be very clear that the government has made absolutely no statement indicating that vaccines are a cause of autism,” Dr. Julie L. Gerberding, director of the Centers for Disease Control and Prevention, said Thursday. “That is a complete mischaracterization of the findings of the case and a complete mischaracterization of any of the science that we have at our disposal today.” . . .
There are two theories about what happened to Hannah, said her mother, Terry Poling. The first is that she had an underlying mitochondrial disorder that vaccinations aggravated. The second is that vaccinations caused this disorder.
“The government chose to believe the first theory,” Ms. Poling said, but added, “We don’t know that she had an underlying disorder.”
In a news conference on Thursday, Dr. Edwin Trevathan, director of the National Center for Birth Defects and Development Disabilities at the disease control agency, said, “I don’t think we have any science that would lead us to believe that mitochondrial disorders are caused by vaccines.”
UPDATE: Orac rounds up posts on the Polling case here.
Related Posts (on one page):
Of course, the proponents of the vaccine-autism theory are going to keep arguing about possibilities, nothing is impossible, etc. They will come up with all kinds of scenarios, possibilities, etc. It's like they never heard of Occam. Scientific/statistical illiteracy is astonishing.
For example : "Five major studies have found no link, and since thimerosal’s removal from all routinely administered childhood vaccines in 2001, there has been no apparent effect on autism rates."
This is completely not true. They just reprinted what they saw elsewhere and did not do ANY research on their own. FLU shots have thimerosal are those not "routinely administered"? Also nice of them to bump the removal of thimerosal back to 2001 when in fact they were on the shelves until AT LEAST 2004. Not to mention it is still in all vaccines in trace amounts. You know you people who are so convinced that vaccines are perfectly safe and have nothing to do with autism would make a better case if you got some of your facts straight. Every time you peddle the false info you actually hurt your case more by those who have actually looked into this stuff.
As for the mitochondrial disorder what exact proof is there that this child(or any other) had the disorder in advance of the shots? Any proof at all?
Even if they did does it matter? The shots would still be the trigger.
Also some people might be interested to know that the people treating autism via biomedical methods (and succeeding in many cases) use treatments that target mitochondrial problems.
What is the treatment for mitochondrial dysfunction or disorder?
The basic "mito cocktail" is CoQ10, Carnitine and high dose B vitamins.
MANY parents are treating their kids with these and SUCCEEDING. What do you say to that?
Last, for the mitchondrial research let me put the whole quote in and not the partial :
Statement from Chuck Mohan, executive director and CEO of the United Mitochondrial Disease Foundation on reports of possible links between childhood vaccinations and mitochondrial diseases:
"There are no scientific studies documenting that childhood vaccinations cause or worsen mitochondrial diseases, but there is very little scientific research in this area. Mitochondrial diseases are as prevalent as childhood leukemia, however the National Institutes of Health devotes only $11 million a year to research into mitochondrial disorders and only about one-third of that is earmarked for primary mitochondrial disease research. Many scientists believe unmasking the causes of mitochondrial disease may lead to possible cures for Parkinson's, Alzheimer's, heart disease and cancer."
Dad in Autism-Vaccine Case Speaks Out
Jon Poling, Father of Hannah, Explains He's Not 'Anti-Vaccine'
By Kathleen Doheny
WebMD Medical News
March 6, 2008 -- Neurologist Jon Poling, MD, PhD, is not surprised that the federal government decided to grant compensation from a federal vaccine injury fund because his daughter Hannah, now 9, had developed autism-like symptoms after receiving childhood vaccines.
He knew the case was a good one.
An experience like that might understandably turn any parent -- even a doctor -- against childhood vaccines at all costs. Surprisingly, it has not, Poling tells WebMD.
"I don't think the case should scare people," says Poling, 37, who emphasizes that vaccines, like all of medicine, carry risks and benefits.
In deciding the case, which has sparked anew the vaccine-autism debate, the federal government has not said that childhood vaccines cause autism. Rather, federal officials conclude the vaccines, given to Hannah in 2000, aggravated a pre-existing condition that then manifested as autism-like symptoms.
The pre-existing condition was a disorder of the mitochondria, the "power sources" of the cell, according to Poling.
Court vs. Science
Proving the link legally is quite different than proving it scientifically, Poling says. "When you are talking about the courtroom vs. science, the burden of proof is different," Poling tells WebMD.
"We showed there was a plausible mechanism, we showed that an injury occurred shortly after her vaccination. Her growth curve went flat for months."
To prove something scientifically, rather than legally, he points out, only a 5% possibility (or one in 20 chance) that something happens by chance is allowable.
Decision Made, Questions Remain
In the wake of the decision, Poling, like other experts, says many questions remain about autism, vaccines, and mitochondrial disorders. "This mitochondrial issue, is it rare? Is it inherited?" he asks.
Poling says that Hannah's doctor in Atlanta, John Shoffner, MD, who was also a co-author on a scientific paper Poling wrote about the disorder and its link with autism, "has a number of cases of children who have mitochondrial disorder and autism. But he is not sure that the one causes the other or vice versa."
Even so, Poling says, "I don't think Hannah's case is as unique as many experts believe."
Poling Not Anti-Vaccine
The experience with Hannah, Poling says, has not turned him against vaccines. "I want to make it clear I am not anti-vaccine," he says. "Vaccines are one of the most important, if not the most important advance, in medicine in at least the past 100 years. But I don't think that vaccines should enjoy a sacred cow status, where if you attack them you are out of mainline medicine."
"Every treatment has a risk and a benefit. To say there are no risks to any treatment is not true.''
"Sometimes people are injured by a vaccine, but they are safe for the majority of people. I could say that with a clean conscience. But I couldn't say that vaccines are absolutely safe, that they are not linked to brain injury and they are not linked to autism."
Poling is hopeful that the decision will trigger government action. "I hope it will force government agencies to look further into what susceptibility factors are out there for children to develop brain injury after vaccination, to look into the susceptibility factors of people at risk."
Vaccine Safety: What Can Parents Do?
His advice for parents?
Poling says they should demand to know a vaccine's safety record before agreeing to give it to their child, including any known links with metabolic disorders and susceptibility to injury from the vaccine.
Coming to Terms With Autism
Although Poling has an MD and a PhD and is trained as a neurologist, he admits it was very difficult to come to terms with his daughter's diagnosis. In his neurology practice in Georgia, some of his patients are children with autism, so he is very familiar with the condition. His wife, Terry, is both a nurse and an attorney.
Even so, he says, they had some trouble initially getting doctors to take their concerns seriously. When Hannah exhibited symptoms after a series of five immunizations including nine vaccines, doctors initially passed them off as nothing serious. But as the symptoms didn't abate and in fact got worse, as parents, the Polings knew something was wrong.
"After six months of essentially our daughter being a zombie and gone, we knew this wasn't going away," he says. "This was chronic. And we had to come to grips with that."
In the beginning, it wasn't easy, he says. "We had denial," he admits. She had previously been treated for middle ear infections. "When Hannah got sick, we thought, 'Her ears are clogged. That is why she is not responding.'"
As he heard from other parents dealing with the same diagnosis, the initial denial, followed by difficulty in accepting the reality, was a common thread, Poling found.
The problem comes when people like you claim that scientists are "ignoring the evidence". It comes when people try to use anecdotal stories to prove things.
I can tell you that to a scientist, any attempt to prove anything using anecdotal evidence is a huge turn-off. It is a signal that this advocacy is led by scientific illiterates. It tells a scientist to immediately stop reading more, because it is likely to be a just a waste of time. A scientist has only a limited amount of time, like everyone else, and will allocate time/funds to what she thinks will pay off.
"Manufacturers, moreover, did successfully mobilize to remove thimerosal from their routine infant vaccines in a remarkably short time; the effort was largely complete by the summer of 2001." Baker, Jeffrey P.
Mercury, Vaccines, and Autism: One Controversy, Three Histories
Am J Public Health 2008 98: 244-253
Not to mention it is still in all vaccines in trace amounts.
Where it metabolizes to less mercury than is present in a liter of human milk.
Whether it's "the vaccines did it" or "allergies did it" or "genetics did/didn't do it" or "womb chemistry did it" and whether "behavior modification fixes it" or "guided writing fixes it [BEWARE!!!]" or "hugs fix it" or "there's nothing to fix and it's wrong to say there is"--the one thing very firmly agreed upon with regard to autism is the stunning multiplicity of suggested causes and cures.
From what I've read, the best bet seems to be that there is some cluster of underlying causal factors, prominently including the mitochondrial problem mentioned above, which in some cases never eventuate in autism, and in others do, very likely activated by one or more of the above.
The human brain/mind is a complex. It doesn't make sense to believe in single-causation theories too fervently.
Not true, this is claimed all the time and even here on this board we heard Neurodoc go on about how they were the safest most tested thing in science.
"It is a signal that this advocacy is led by scientific illiterates"
That was the whole point of posting that article by the father. He isn't a "scientific illiterate" by any means. Also I have two science degrees and though I don't work in the field as a career I don't think you can call me a scientific illiterate. Of course anecdotes are not proof but they do help generate refutable theories. There simply is no authoritarian source of knowledge, all knowledge is valid to some extent.
As for funding if I had the money I certainly would. Instead my wife had to stop working (though we still have to service 65k of loan debt for her masters) to care for our son. Add the extra costs for his treatments and having to plan for how he is going to be cared for when we die means money is not something we have to give away, even for research funding. The "good" news is that autism hits cross culture and cross economic standings so as more rich people have the diagnosis in their families I hope more money is spent on finding a cure/prevention.
pgepps, I don't have a problem with what you have said except that just because parents are under stress it does not automatically follow that they ignore reason and latch on to any confirmation as certainly.
Raghav, that is interesting and I am going to look up that article. It goes against multiple sources I have read including nurses that report still seeing vaccines on their shelves to this day with thimerosal on the bottles. Also what about the FLU vaccine?
Where it metabolizes to less mercury than is present in a liter of human milk.
Human milk? In any case metabolism of it hinges on the idea that ethyl mercury doesn't accumulate like methylmercury but in truth the studies on ethyl mercury toxicity are lacking. The fact that mercury binds to sites in the brain until chelation and the inflamed brain tissue of autistics may indicate something. Maybe not but lets see the transparent studies on chelation/mercury excretion and the reasons why it occurs.
I want to stress that I am not convinced that thimerosal or something else in vaccines causes autism (or autistic like symptoms). It's more that it is the most likely scenario so far (my son regressed just like Polling's after being perfect in every way up till then). When the cause is proven we can move on to cures. Until then everything is suspect. It's not the activists that are the fools it's the people who are adamant to the nth degree that there is no way the vaccines have anything to do with autism.
You are left with saying some portion of set X are ignorant and believe Y which is not proof that Y is untrue. They need new attacks if they are going to continue to persue this.
Dr. Kary Mullis, developer of the PCR technique, doesn't believe HIV causes AIDS. I guess that settles that issue too.
With all due compassion for your difficult situation and with the sincere hope that you will find resources outside of a court settlement to help with the many burdens, let me state a few thoughts. Note that I'm not a scientist or lawyer, just an interested citizen.
Over many decades, vaccinations have proven hugely effective and safe. Are they 100% safe? Given the differences in human physiology and other variables, of course not. I doubt any scientist will ever claim that they are. That includes neurodoc if he says that they are the safest most tested thing. That phrase does not appear to imply 100% safe.
Over many years multiple studies are made on many subjects. If they all come up with a preponderance of the evidence saying something is so and not different, at what point does it become not only inefficient but downright irresponsible to continue throwing resources at it which are then not available to answer other pressing questions? Does that leave some people affected by a bad outcome contrary to scientific evidence in limbo? Yes it does, but hardly because of indifference or malicious intent.
As regards the question of compensation, imposed and enforced by a court: There are consequences beyond the immediate case , the setting of binding precedent for example or the effects the ruling has on the economic realities behind the research and introduction of medicines and procedures. These rulings affect everybody, not just the plaintiff and the defendant. Understandably you are in favour of a very broad interpretation of what causes a bad outcome, such as a trigger effect or a rare constellation of events. Do you believe that everybody should be denied undoubted positive results in deference to a miniscule minority of bad ones? Do you think an approach like that would benefit society on the whole?
DB and Adler don't think that activists are fools, rather they believe that a series of consistent, peer-reviewed scientific study results are more convincing than the activist's emotionally clouded doubts which are also driven by economic necessity. In your last post you make the clear case why the courts are reluctant to grant relief: The case is immediately interpreted as having wide-ranging implications far beyond the facts.
The repeated raising of yet another doubt is at some point not only counterproductive but harmful. The serious doubs are not taken seriously any more.
Not exactly. It wasn't cancer (it was immune-system conditions) and it wasn't the courts (Dow Corning settled). The courts don't necessarily do a terrific job, but what's really scary is that even when the courts get it right eventually, as they did with Bendectin, the litigation costs can be so high that even products known to be safer than any alternative can be driven from the market.
Why does this mean it is the most likely scenario?
An effort to stamp out Autism by any means necessary. If a vaccine is to blame, then it's not Eugenics.
SenatorX, AutismSpeaks and all the others who want to eliminate people like me can go to hell.
"Thimerosal functions as an anti-microbial after it is cleaved into ethylmercury and thiosalicylate, which is inactive. It is the ethylmercury which is bacterial at acidic PH and fungistatic at neutral and alkaline PH. It has no activity against spore forming organisms.”
“There is a very limited pharmacokinetic data concerning ethylmercury. There is very limited data on its blood levels. There is no data on its excretion. It is recognized to both cross placenta and the blood-brain barrier.”
“The data on its toxicity, ethylmercury, is sparse. It is primarily recognized as a cause of hypersensitivity. Acutely, it can cause neurologic and renal toxicity, including death, from overdose…”
Dr. Verstraeten, pg. 31: “It is sort of interesting that when I first came to the CDC as a NIS officer a year ago only, I didn’t really know what I wanted to do, but one of the things I knew I didn’t want to do was studies that had to do with toxicology or environmental health. Because I thought it was too much confounding and it’s very hard to prove anything in those studies. Not it turns out that other people also thought that this study was not the right thing to do, so what I will present to you is the study that nobody thought we should do.”
"My mandate as I sit here in this group is to make sure at the end of the day the 100,000,000 are immunized with DTP, Hepatitis B and if possible Hib, this year, next year and for many years to come, and that will have to be with Thimerosal containing vaccines unless a miracle occurs and an alternative is found quickly and is tried and found to be safe." John Clements, World Health Organization (WHO)
"I don’t think we can set a rule here because some people have gotten these documents. For example, some of the manufacturers were privileged to receive this information. It has been important for them to share it within the company with the experts there, so they can review it. Some of you may have questions. You may have given a copy, but I think if we will all just consider this embargoed information, if I can use that term, and very highly protected information, I think that was the best I can offer." Roger Bernier, Ph.D., CDC’s associate director for science
Link for transcripts
Dr. Verstraeten is a perfect example of why many people are skeptical about the official studies. His is often quoted as one that disproved the link but in a very odd manner. What apparently happened was his study was showing a clear link and he told people this. Then later when the final study came out he showed no link at all. Much later people found out that midway through the study he started working for Glaxosmithkline. But see this was hidden and not disclosed as a possible conflict of interest. When the data from the initial study was requested people were informed it was unfortunately lost.
Maybe people don’t believe these transcripts are real. If so let’s hear it because I have yet to.
Autism is very complex for example my son just got done regressing for about 3 weeks and is recovering. We think we gave him too much sugar (and an egg yolk in a cake-he is allergic to egg whites) for his birthday party and it caused him to regress the next day. Regression for me is his sudden loss of words, garbling, and stimming. You can see it happen over the course of one day even. One minute he will be saying things like "look 4 pink flowers" and within a few hours he will be saying "look (garble garble garble-with head shaking) flower". Reduced to one or two works with mashed garbling in between. Here is one of the very interesting parts. The regression is combined with very odd/bad smelling breath, as well as crying in pain during the night(from his belly). Two days ago I suddenly noticed his breath smell was gone/fading and the next day his words and normal behaviors start to come back. It is a slow progress back and we know he will be hit again, he always is. Its two steps forward and one back for the little guy.
I point this out because why would I spend time on a thimerosal study when we are unable to risk having another child? What I do know without any doubt is that part of the autism is in his gut somehow. Probably damage to his intestinal immune system and by controlling things of that nature we "get at" the autism. I am not altruistic and have never made claims of that sort. I am on the computer all day and night for work so it's easy for me to argue on blogs, anything else takes to much energy I don't have.
I'm Aspie. I have some personal experience living with it, and I don't see it as much of a problem. You're welcome to drop me a line if you want. I can put you in touch with further resources.
Furthermore, I'm speaking as someone who doesn't have the time or interest to really become informed. But, I can provide some feedback to you as someone who has a few NSF grants, and a DOE grant. I have never applied for a NIH grant, though I have a on-again/off-again collaborator who has. I have served on a number of NSF proposal review panels. I have reviewed a number of proposals using computer science techniques to help study human disease.
So, my point is to provide some perspective from the scientists in the trenches (though not from the NIH, where it would of course be most relevant to autism research).
To the contrary. My level of trust in government is varied, mostly extremely sceptical.
You are right, past performance for instance regarding smoking have made me reluctant to accept CDC or WHO findings at their face value. Having said that, neither am I ready to uncritically accept interpretations by advocacy groups. I definitely do not believe in any conspiracy theories.
How about the 5 studies cited here? I can not find that the Phila. childrens hospital has an axe to grind other than helping children.
Beyond the question of who is right and who is wrong, what about the implications of activist litigation on the general public? Why not work with equal intensity for private relief after a bad outcome, rather than impose your opinion on everybody quite possibly doing more harm than good? Unless you advocate zero defect policies - an unattainable goal.
Poling was conceded by the government on the basis of "aggravation," that a covered vaccine more likely than not caused a pre-existing condition to be unmasked or made worse. And that conclusion rests on acceptance of the parents' self-serving testimony about when the child's symptoms began in relation to receipt of the vaccines. They claim that it happened with fever a couple of days after their daughter received her immunizations and she showed dramatic neurologic regression at that time (stopped talking and walking). Yet, they didn't seek medical attention for their daughter until nearly two weeks had gone by, and then it was not on account of neurologic changes. That might strain credulity, especially since it is hard to be more neurologically informed than the father, who did a neurology residency at Johns Hopkins and has a PhD to complement his MD degree.
This is not the first time that the Vaccine Injury Compensation Program has conceded legal liability on account of "aggravation" of an underlying mitochondrial disorder. So nothing of "precedential" significance in this. Sometimes these vaccines do cause fever, especially the old version of pertussis (DTP rather than DTaP), and fever is a non-specific metabolic stress of the sort that can cause injuries, but it might have happened in the face of an ordinary common cold, and almost certainly would have happened sooner or later, with or without vaccines anywhere in the picture.
Another part of the story is that the child may not have the features of "classic autism," just autistic-like features. So any generalization from this instant case to cases of cases of true autism spectrum disorders or pervasive development disorders and inferences about causation of the latter are wholly unwarranted.
But if you and that learned medical scientist Ron Paul don't believe me and the rest of the credible medical community, believe whatever you wish to believe. (Are you the physicist with the MD PhD immunologist wife, or was that another "free-thinker" poster?)
Well, that was more than I expect to say about this, but a good deal less than might be said about it. The public interest is very poorly served by this, and unfortunately the law crafted by Congress 20+ years ago (the Vaccine Injury Compensation Act of 1986), with its presumptions of causation and general lowering of the bar for scientific evidence and testimony has contributed greatly to this sad state of affairs.
These parents noted that the complications from the pre-existing mitochondrial defect happened shortly after vaccination.
I've also heard many other reports of very young children, including one of my own kin, whose severe autism-like symptoms first occurred during or immediately after an otherwise common childhood illness, usually involving at least mild fever.
All the cases (illness and vaccination) have in common the immune response to bacteria or viruses or parts thereof.
What puzzles me is that researchers seem to focus presence or absence of Hg, or some other possible "toxic contaminant".
Why isn't some research focusing on the possibility that some particular genetic condition(s) might cause an ordinary immune response, or some otherwise ordinary response to an infection, to do something terribly wrong?
What am I missing here?
neurodoc, I am admitted ignoramus about many things. However I don't see anything of real interest in your post. I am convinced from our past interactions that you are just as self serving as the parents you accuse(you really think they are after the money?). You are part of a system of authoritarian medicine and you love that power. I doubt there is anything that would pry your fingers from your power structure. Anyway I have already busted up your fallacies in the past. You can rave about the perfection of the IOM and CDC all you want but the reality of their historical records and failures therein are dispute enough for your vision.
Since autism is defined by a set of behaviors by the medical establishment I find it odd that you quibble about the difference between true autism and autistic like features. Just like last time you slide past the Simpsonwood transcripts. Care to comment on them this time?
Bill, maybe. In our case it was regressive autism and frankly we didn't see it coming. You are warned about fevers and other issues after the shots and in our case and many others I think the last thing you think about then is some sort of permanent damage. It isn't until your child doesn't recover much later that you realized something happened and you cast back your mind to try and think what events happened around that time that could have caused it. It is of small comfort to hear regressive autism is not true autism when the symptoms are the same. Perhaps later it will be discovered they are from different causes, are different illnesses, and have different cures. I agree that it is interesting and unfortunately there is a lot of resistance to even accepting the reality of regressive autism. Perhaps that is the nut that parents like us are glad to see from this case. That admission that it even exists.
Concerning this case: It’s possible vaccines caused Hannah’s mitochondrial defect but I assumed she had a pre-existing defect that was aggravated by vaccines. Frankly, it doesn't really matter to me which is the case. Clearly, the first option is more troubling but the second is also cause for concern because it illustrates that pediatricians don’t know who can safely be vaccinated and who can’t. If it does anything, I hope Hannah's case helps pediatricians and others in the medical community do more to identify children who should receive a second look before they are vaccinated.
Yet [i]they're[/i] the ones with neurological disorders.
I've got no problem with useful delusions, but I don't see blaming the evil vaccine-wielding doctors as being anywhere near a useful one.
Looking at Fub and DRJ's posts as being more or less the same thing from different people...
A friend told a story of how, when he was 12, he got a funny sickness, and then he was diabetic. That sounds odd, but it's actually fairly common, called Type 1 Diabetes.
It could be that in some cases it's an immune system response. We've already seen what it can do to the pancreas.
I actually took some time to understand the whole Thimerosal question. It seems to me from what literature I can find that the actual mercury dosage from a vaccine is approximately one day's allowable mercury intake. It's not that many times the typical mercury exposure.