Will a 9 year old change the vaccine debate?

April 12, 2008, 4:39 pm
Will a 9-Year-Old Change the Vaccine Debate?

Hannah Poling (W.A.Harewood/Associated Press)

There’s no question that the case of 9-year-old Hannah Poling of Athens, Ga., has fueled the controversy about childhood vaccines. But what’s less clear is whether it will help unlock the mysteries of autism.

Hannah was 19 months old and developing normally until 2000, when she received five shots against nine infectious diseases. She became sick and later was given a diagnosis of autism.
Late last year government lawyers agreed to compensate the Poling family on the theory that vaccines may have aggravated an underlying disorder affecting her mitochondria, the energy centers of cells. (To read more about the decision, click here.) Vaccine critics say the Hannah Poling settlement shows the government has finally conceded that vaccines cause autism. But government officials say Hannah’s case involved a rare medical condition, and there is still no evidence of a link between vaccines and autism.

Hannah’s father, Dr. Jon S. Poling, a practicing neurologist in Athens and clinical assistant professor at the Medical College of Georgia, says the case has shifted the autism debate forever and points to a promising new area of research.

Writing in The Atlanta Journal-Constitution on Friday, Dr. Poling says there is compelling evidence that mitochondrial disorders, like the one his daughter has, are strongly associated with autism.

To understand Hannah’s case, it is important to understand mitochondria, which act like batteries in our cells to produce energy critical for normal function…. Emerging evidence suggests that mitochondrial dysfunction may not be rare at all among children with autism. In the only population-based study of its kind, Portuguese researchers confirmed that at least 7.2 percent, and perhaps as many as 20 percent, of autistic children exhibit mitochondrial dysfunction. While we do not yet know a precise U.S. rate, 7.2 percent to 20 percent of children does not qualify as “rare.” In fact, mitochondrial dysfunction may be the most common medical condition associated with autism.

Dr. Poling urges the Institute of Medicine and public health officials to pursue research into mitochondrial conditions, which he describes as a “breakthrough in the science of autism.'’ He writes: National public health leaders, including those at CDC, must now recognize the paradigm shift caused by this biological marker with regard to their current position of dispelling a vaccine-autism link. In light of the Hannah Poling concession, science must determine more precisely how large the mitochondrial autism subpopulation is: 1 percent, 7.2 percent, 20 percent?

To be sure, many health experts do not agree with Dr. Poling’s conclusions. The case has “added nothing to the discussions of what causes or doesn’t cause autism,” said Dr. Edwin Trevathan, director of the National Center on Birth Defects and Developmental Disabilities at the Centers for Disease Control and Prevention.

On Friday, many of the main players involved in this debate — including Hannah’s mother and her grandparents, prominent vaccine skeptics and some of the government’s top vaccine researchers — took part in the federal government’s first-ever public meeting to discuss a government-wide research agenda to explore the safety of vaccines.

To read Dr. Poling’s complete essay, click here. Last month, Dr. Paul A. Offit, chief of the infectious diseases division of the Children’s Hospital of Philadelphia, explained his view that the Hannah Poling case has been mischaracterized by vaccine critics. To read the piece, click here. Hannah Poling’s parents wrote this response to Dr. Offit’s report. Last month, The Atlanta Journal-Constitution wrote this profile of Hannah and her parents.