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Vaccine Court Decision Does Not Change Vaccination Practice

Financial settlement in one case does not prove a causal association between vaccines and autism.

In 1986, Congress passed the National Childhood Vaccine Injury Act (NCVIA) to ensure an adequate vaccine supply by limiting vaccine manufacturers’ liability for adverse outcomes from recommended vaccines. Provisions of the NCVIA include arbitration and, in some instances, compensation for vaccine-related injuries or death. In a recent highly publicized case, a special vaccine court established by the NCVIA ruled that administration of recommended vaccines might have worsened a child’s underlying mitochondrial disorder and led to autism-like symptoms.

According to U.S. Department of Health and Human Services documents released to the Associated Press, the child received five vaccines on 1 day in 2000 at the age of 19 months that aggravated her mitochondrial disorder. The child’s development was reported to be normal before she was vaccinated, but, afterward, she exhibited autism-like behaviors. Details of the child’s medical history, the mitochondrial disorder, and the terms of the settlement are not available in public documents.

Comment: This recent news story has created many headlines, but it does not and should not change our vaccination strategies and practices. Many mitochondrial disorders have underlying neurologic signs and symptoms that might have been precipitated or uncovered by the vaccines or by fever induced by the vaccines. Although compensating this family for events that fall within the purview and injury definitions of the NCVIA is appropriate, the court’s decision only reflects the fact that an injury occurred and not evidence of a link between vaccination and autism.

Vaccines given to children to prevent diseases are not harmless. Serious side effects occur in rare cases. However, the medical and scientific communities agree that significant benefits outweigh the potential risks associated with each immunization. Recent controversy has focused on whether thimerosal (a preservative used in vaccines) or measles, mumps, and rubella (MMR) immunization causes autism in susceptible children. However, the Institute of Medicine and the AAP support the conclusion of the scientific community that evidence of a clear association between thimerosal or MMR vaccine and autism is lacking (Journal Watch Pediatrics and Adolescent Medicine Jan 23 2008 and Nov 25 2002). Further, although thimerosal was still used in many vaccines in 2000 when this child was vaccinated, thimerosal no longer is used in most vaccines for children, yet the incidence of autism continues to increase. All children, including those with encephalopathy disorders, are more likely to suffer central nervous system injury from a complication of an infection than from a side effect of a vaccine that might prevent the infection or disease.

— Martin T. Stein, MD, and Peggy Sue Weintrub, MD

Published in Journal Watch Pediatrics and Adolescent Medicine April 2, 2008

Citation(s):

Marchione M. Government Concedes Vaccine Injury Case. Associated Press Mar 5 , 2008. (http://tinyurl.com/3yaeed)

U.S. Department of Health and Human Services. Statement by the Health Resources and Services Administration on Autism and the Vaccine Injury Program. Mar 3 , 2008. (http://newsroom.hrsa.gov/releases/2008/vaccinestatement.htm)