Hannah Poling has been involved in the vaccine-autism “controversy” for a while. Today we learn that she has been awarded $1.5 million, in damages from the vaccine court. Anti vaccine groups are jumping up and down for joy; they think this proves that vaccines do indeed cause autism. That is to be expected of them, however, in order to better understand the Poling case, we need to do a quick review of her story.
Hannah was developing normally until the age of 18 months, at which time, in July 2000, she received 5 vaccines, in accordance with the US Recommended Immunization Schedule. Two of the 5 vaccines she received, the MMR and the DTaP, protect against multiple diseases, and some web sites are breaking those down and claiming that she received 9 vaccines, which implies 9 injections, which is incorrect. Nevertheless, “right after” taking the vaccines, Hannah’s health deteriorated and she developed autism-like symptoms. Time.com reported the following:
Hannah, now 9, recovered from her acute illness but she lost her words, her eye contact and, in a matter of months, began exhibiting the repetitive behaviors and social withdrawal that typify autism. “Something happened after the vaccines,” says her mom, Terry Poling, who is a registered nurse and an attorney. “She just deteriorated and never came back.”
In 2002, Hannah’s parents filed an autism claim in federal vaccine court. In 2008, the government conceded that the vaccines aggravated a cell disorder nobody knew Hannah had, leaving her with permanent brain damage and autistic-like symptoms. According to the Time.com article I linked to above:
A panel of medical evaluators at the Department of Health and Human Services concluded that Hannah had been injured by vaccines — and recommended that her family be compensated for the injuries. The panel said that Hannah had an underlying cellular disorder that was aggravated by the vaccines, causing brain damage with features of autism spectrum disorder (ASD).
At the time, anti-vaccination groups hailed the story as indicative that the government was conceding that vaccines cause autism, which is, to say the least, quite a stretch. Hannah’s case is a very specific case; she has a cellular disorder which, the government panel concluded, was aggravated by the vaccine and resulted in her injury. This does not prove that vaccines cause autism. At best, it shows that vaccines may cause similar problems in children with this sort of cellular disorder. Nevertheless, even that is too big a claim to be settled by one case. The human body is too complex, and large-scale studies are necessary to determine if vaccines have an effect in all children with similar mitochondrial disorders, or if a combination of her disorder, plus other factors unique to Hannah, contributed to her injury. In fact, in the same Time article experts in mitochondrial disorders expressed surprise in the panel’s willingness to make the connections between the vaccine, the mitochondrial disorder and Hannah’s autism-like symptoms.
Vaccines are not absolutely safe, just like any other medicine we use. They do have rare side effects, and Hannah may have suffered from one such rare side effect. In fact, the Government has set up a special National Vaccine Injury Compensation Program, to deal with cases of injury caused by vaccines. The CDC maintains a special web page where it lists the side effects of each vaccine in the schedule today. Systems such as the Vaccine Adverse Event Reporting System (VAERS) have been set up to monitor any adverse side effects that follow vaccination. Why is this important to know? Because, many anti-vaccine people claim, matter-of-fact, that doctors, the government, the medical establishment proclaim that vaccines are absolutely safe and no one couldn’t possibly be harmed from them, which they then follow with a story like Hannah’s in an effort to plant a seed of mistrust in the unsuspecting public; a seed which they will keep feeding with other false claims to help it grow into their preferred conspiracy theory.
Clearly, the “establishment” is quite open about the side effects of vaccines; they do not claim vaccines are perfectly safe, they have set up surveillance systems to gather data about possible injury caused by vaccines, and they have set up compensatory procedures for people injured by vaccines. They acknowledge real vaccine side effects, but they require satisfactory science-based evidence, whereas the anti-vaccine crowd seems happy to rely on hear-say to establish all sorts of causation between vaccines and various ailments.
Can we conclude, from this story, that the government has conceded that vaccines cause autism? Age of Autism seems to believe that to be the case. They say:
The government lawyers mumbled something Orwellian and incoherent about a pre-existing mitochondrial disorder and how vaccines didn’t cause Hannah’s autism — the condition just “resulted” from the vaccines. Translation: The medical industry’s wall of doublespeak, delay and denial is crumbling and today, at least, one child got justice. More, many more, to come.
Does it make sense to say the the vaccines didn’t cause the condition, but it resulted from their use? I can see how this can be seen as word play, but think of peanuts. Some people are allergic to peanuts; that is an existing condition and it is not known why some people are allergic to peanuts, they can have an allergic reaction and even die if untreated. So a person is allergic to peanuts, he comes in contact with peanuts and he has an allergic reaction. Can we then claim that peanuts cause allergies? No,as you can see from the link above, the cause of peanut allergies is not known; peanuts do not cause the allergies, the allergy manifests itself when the person comes in contact with peanuts, but it was there all along, even before the person’s first ever contact with peanuts.
The same kind of logic comes in play here: child has a mitochondrial disorder, she has some sort of reaction after a batch of vaccines and over a few months develops autistic symptoms. Can we say that vaccines cause autism? No, at most we can say that, possibly for children which have this cellular disorder, the combination of the vaccines and the disorder, and some other factor, may result in autistic-like symptoms. Even this though, is simply a hypothesis, when all we have is a single data point. We’d have to look at a large number of such children, and preferably compare the ones that received vaccines with the ones that didn’t and see if there was a higher rate of autism in the vaccinated children vs. the non-vaccinated ones.
Think of this another way: eggs are used in producing vaccines today. In fact, people who have ever had a serious allergic reaction to eggs are encouraged to talk to their doctor prior to getting a shot (page 2, it is highlighted in yellow). Now assume a person is allergic to eggs and they don’t know it. They take a shot and have an allergic reaction. Is it rational to say that vaccines cause egg allergies? No, the person was already allergic to eggs prior to getting the shot. The allergy was not caused by the vaccine, but the reaction was. The allergic reaction “resulted” from the vaccine BUT the allergy was not caused by it.
The same line of reasoning is being used here; the government is accepting the parent’s claim that Hannah was injured by the vaccine, but is saying that here autistic symptoms resulted, but were not caused, by the vaccines. After thinking through it, this claim doesn’t sound very “Orwellian” at all, does it?
What can we conclude from the Hannah Poling case? Well, we can conclude that the National Vaccine Injury Compensation Program is working as intended. The government panel has conceded that the “petitioners are entitled to compensation due to the significant aggravation of Child Doc/77′s pre-existing mitochondrial disorder” by an MMR vaccine. You can read the full, redacted, PDF of the court ruling here. Hannah was awarded $1.5M for life care expenses, lost earnings and pain and suffering, plus an additional $140,000 for past expenses, and a couple of other awards of smaller value.
What we cannot conclude is that this case proves, or that the government concedes, that vaccines cause autism, for the reasons I detailed above. Even the weaker hypothesis, that vaccines represent a higher risk for children with the same, or similar, cell disorders as Hannah, cannot be established through one case. Proper, large, randomized, double-blind, controlled, studies of such children are necessary to establish the causation. For example, it is quite possible that something else, specific to Hannah, in combination with her mitochondrial disorder, and the vaccine may have caused the injury, and that something else may not be present in other children with the same mitochondrial disorder. We just don’t know, and reaching conclusions either way, from one, or even a few, cases is unwarranted.