Boost Vaccine Safety

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August 13, 2008 by Not Autism
Filed under Autism News, General
By MARGARET DUNKLE
Published on: 08/12/08In recent months, a vitriolic public health debate has been taking place, sparked by the case of Hannah Poling, a 9-year-old Georgia girl with autism. Her parents, neurologist Jon Poling and his wife, Terry, filed in federal no-fault vaccine court, asserting that vaccines caused their daughter’s condition and asking for compensation for the lifelong care Hannah will require.

Without a formal hearing, the federal government conceded the nine vaccines Hannah received on July 19, 2000, significantly aggravated an underlying medical condition — mitochondrial dysfunction, or an impaired functioning of how cells create energy. This predisposed Hannah “to deficits in cellular energy metabolism and manifested as a regressive encephalopathy with features of autism spectrum disorder.” In simple terms, Hannah has autism.

This concession, which became public in March, has prompted strong reactions. Some government officials are, ironically, fueling public distrust of immunizations by failing to acknowledge — much less address — emerging vaccine safety issues. And every day, more parents and some pediatricians reject the vaccination schedule.

Former National Institutes of Health Director Bernadine Healy has entered the debate, saying the scientific community should never turn its back on a hypothesis out of fear for what it might reveal: If you know there is a susceptible group, she said in a television interview, “you can save those children. If you turn your back on the notion there is a susceptible group … what can I say?”

Yet, amazingly, just last month the Federal Interagency Autism Coordinating Committee refused to mention vaccine safety in its strategic plan.

The matter is urgent. One in every 150 children has an autism spectrum disorder. Mitochondrial dysfunction is not rare among these children. The best evidence suggests that at least 4 percent — and perhaps 20 percent or more — of autistic children have mitochondrial dysfunction.

With stakes this high, it’s time for policy-makers to take five common-sense steps to ensure that more children are not damaged by the very vaccines intended to protect them.

• With Marshall Plan dispatch, Congress should launch a bold, nothing-off-the-table program of basic scientific research on the role of mitochondrial dysfunction and neuro-inflammation in autism and other disorders. Funding — $200 million for starters — must not be taken from the Vaccine Injury Compensation Program.

• Reform vaccine practices so they are as safe as possible for both children in general and susceptible subgroups. Examine the schedule, number and frequency of vaccines, use of combination vaccines, preservatives used and ages at which vaccines are administered. Find ways to identify children for whom vaccination or another event might cause or worsen mitochondrial dysfunction, leading to autism. Study siblings to identify biological markers that could lead to prevention, screening and treatment.

• Piggyback new research onto existing efforts. Use the Newborn Screening Saves Lives Act to propel advances concerning genetic and metabolic disorders. Modify the National Children’s Study to test alternate vaccine schedules. And integrate new analyses into ongoing studies, such as mitochondrial research already under way at Johns Hopkins University and the Cleveland Clinic Foundation.

• Identify children nationwide who have abrupt developmental regressions, including those that are vaccine-related, and speed them into research and intense early intervention. And strengthen the Vaccine Adverse Event Reporting System, including imposing serious consequences for health care providers who do not report bad reactions.

• Improve the Vaccine Injury Compensation Program. Encourage parents to focus on early intervention by allowing longer than three years to file. Update the Vaccine Injury Table, making it easier for families to receive compensation as new discoveries emerge. And explore limiting compensation to the most critical immunizations, returning adverse reactions from other vaccines to the regular court system.

A loud wake-up call from a beautiful little redheaded girl from Georgia has provided policy-makers with a historic opportunity to tackle critical issues of vaccine safety. If they fail to answer, what can I say?

— Margaret Dunkle, Hannah Poling’s great-aunt, directs the Early Identification and Intervention Collaborative for Los Angeles County. She is a senior fellow at the Center for Health Services Research and Policy at George Washington University.