May 27, 2008

What Does the Hannah Poling Case Prove?

I figured I'd take a minute to address the Hannah Poling case since it deals with a topic I've covered here multiple times; the link (or non-link) of vaccines and autism. Earlier this year the Department of Health and Human Services (DHHS) was sued by the Poling family under the Vaccine Injury Compensation Program (VICP) and won. They successfully argued that vaccines Hannah had received, specifically diphtheria-tetanus-acellular pertussis, Haemophilus influenzae type b (Hib), measles-mumps-rubella (MMR), varicella, and inactivated polio, caused her to develop autism spectrum disorder.

Ok, that's a lot of medical mumbo jumbo, here's the important part; the Vaccine Injury Compensation Program (VICP). This program was created in 1986 because lawyers had sued almost all pharmaceutical companies out of existence, claiming vaccines were the reason for cases of sudden infant death syndrome to epilepsy. By the time it came into existence there was only one manufacturer of the diptheria-tetanus-pertussis vaccine left in the market. The government stepped in with the National Childhood Vaccine Injury Act, which included the creation of the VICP. The Act called for an excise tax on every vaccine and the VICP compiled a list of compensable injuries. If studies supported the notion that vaccines caused a negative reaction -- thrombocytopenia after receipt of measles containing vaccine -- children and their families were given a fair reimbursement quickly and fairly. The number of lawsuits against vaccine makers decreased.

Unfortunately the VICP has recently turned its back on science. In 2005 a woman successfully claimed that a tetanus vaccine caused her optic neuritis. Although there was no evidence, published or otherwise, to support her claim, the VICP ruled that if a petitioner proposed a biologically "plausible" mechanism by which a vaccine could cause harm, as well as a logical sequence of cause and effect, an award should be granted. This opened the door to compensation being given for a whole new host of conditions which have no set of data to prove or disprove the claims.

In 2006 the VICP deviated farther from its original standards than it ever had before when Dorothy Werderitsh successfully claimed that a hepatitis B vaccine caused her multiple sclerosis. By the time of the ruling, several studies had shown that the hep B vaccine neither caused nor exacerbated the disease, and the Institute of Medicine even concluded that "evidence favors rejection of a causal relationship between the two." But the VICP was less impressed by the scientific literature than it was with an expert's proposal of a mechanism by which hep B vaccine could induce autoimmunity (an ironic conclusion, given that Dorothy Wederitsh never had a detectable immune response to the vaccine).

Here are some facts: Natural infections will exacerbate autism spectrum disorder in patients with mitochondrial enzyme deficiencies (what Hannah Poling has), vaccines haven't shown the same. Children with this disorder are especially susceptible to infection so it is recommended they receive all vaccines.

A belief that multiple vaccines overwhelm the immune system is floating around the anti-vax camp. But a century ago children received one vaccine, smallpox, which contained 200 structural and nonstructural proteins. Today, the 14 vaccines given to children contain a total of 150 immunologic components.

Maybe the most important point of this case is that the government has eroded the confidence in the vaccination system without any concrete evidence of mass panic. The problem with letting a few kids skip out or having parents opt out of vaccination compromises herd immunity, a pillar of the vaccination theory. Consequences should be weighed next time a decision like this is made instead of caving to media and political pressure, a precedent has been laid down.

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