March 6, 2008 -- Neurologist Jon Poling, MD, PhD, is not surprised that the
federal government decided to grant compensation from a federal vaccine injury
fund because his daughter Hannah, now 9, had developed autism-like symptoms after
receiving childhood vaccines.
An experience like that might understandably turn any parent -- even a
doctor -- against childhood vaccines at all costs. Surprisingly, it has not,
Poling tells WebMD.
"I don't think the case should scare people," says Poling, 37, who
emphasizes that vaccines, like all of medicine, carry risks and benefits.
In deciding the case, which has sparked anew the vaccine-autism debate, the
federal government has not said that childhood vaccines cause autism. Rather, federal
officials conclude the vaccines, given to Hannah in 2000, aggravated a
pre-existing condition that then manifested as autism-like symptoms.
The pre-existing condition was a disorder of the mitochondria, the
"power sources" of the cell, according to Poling.
Court vs. Science
Proving the link legally is quite different than proving it scientifically,
Poling says. "When you are talking about the courtroom vs. science, the
burden of proof is different," Poling tells WebMD.
"We showed there was a plausible mechanism, we showed that an injury
occurred shortly after her vaccination. Her growth curve went flat for
To prove something scientifically, rather than legally, he points out, only
a 5% possibility (or one in 20 chance) that something happens by chance is
Decision Made, Questions Remain
In the wake of the decision, Poling, like other experts, says many questions
remain about autism, vaccines, and mitochondrial disorders. "This
mitochondrial issue, is it rare? Is it inherited?" he asks.
Poling says that Hannah's doctor in Atlanta, John Shoffner, MD, who was also
a co-author on a scientific paper Poling wrote about the disorder and its link
with autism, "has a number of cases of children who have mitochondrial
disorder and autism. But he is not sure that the one causes the other or vice
Even so, Poling says, "I don't think Hannah's case is as unique as many
Poling Not Anti-Vaccine
The experience with Hannah, Poling says, has not turned him against
vaccines. "I want to make it clear I am not anti-vaccine," he says.
"Vaccines are one of the most important, if not the most important advance,
in medicine in at least the past 100 years. But I don't think that vaccines
should enjoy a sacred cow status, where if you attack them you are out of
"Every treatment has a risk and a benefit. To say there are no risks to
any treatment is not true.''
"Sometimes people are injured by a vaccine, but they are safe for the
majority of people. I could say that with a clean conscience. But I couldn't
say that vaccines are absolutely safe, that they are not linked to brain injury
and they are not linked to autism."
Poling is hopeful that the decision will trigger government action. "I
hope it will force government agencies to look further into what susceptibility
factors are out there for children to develop brain injury after vaccination,
to look into the susceptibility factors of people at risk."