After years of insisting there is no evidence to link vaccines with the onset of autism spectrum disorder (ASD), the US government has quietly conceded a vaccine-autism case in the Court of Federal Claims.
The unprecedented concession was filed on November 9, and sealed to protect the plaintiff's identify. It was obtained through individuals unrelated to the case.
The claim, one of 4,900 autism cases currently pending in Federal "Vaccine Court," was conceded by US Assistant Attorney General Peter Keisler and other Justice Department officials, on behalf of the Department of Health and Human Services, the "defendant" in all Vaccine Court cases.
The child's claim against the government -- that mercury-containing vaccines were the cause of her autism -- was supposed to be one of three "test cases" for the thimerosal-autism theory currently under consideration by a three-member panel of Special Masters, the presiding justices in Federal Claims Court.
Keisler wrote that medical personnel at the HHS Division of Vaccine Injury Compensation (DVIC) had reviewed the case and "concluded that compensation is appropriate."
The doctors conceded that the child was healthy and developing normally until her 18-month well-baby visit, when she received vaccinations against nine different diseases all at once (two contained thimerosal).
Days later, the girl began spiraling downward into a cascade of illnesses and setbacks that, within months, presented as symptoms of autism, including: No response to verbal direction; loss of language skills; no eye contact; loss of "relatedness;" insomnia; incessant screaming; arching; and "watching the florescent lights repeatedly during examination."
Seven months after vaccination, the patient was diagnosed by Dr. Andrew Zimmerman, a leading neurologist at the Kennedy Krieger Children's Hospital Neurology Clinic, with "regressive encephalopathy (brain disease) with features consistent with autistic spectrum disorder, following normal development." The girl also met the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV) official criteria for autism.
In its written concession, the government said the child had a pre-existing mitochondrial disorder that was "aggravated" by her shots, and which ultimately resulted in an ASD diagnosis.
"The vaccinations received on July 19, 2000, significantly aggravated an underlying mitochondrial disorder," the concession says, "which predisposed her to deficits in cellular energy metabolism, and manifested as a regressive encephalopathy with features of ASD."
This statement is good news for the girl and her family, who will now be compensated for the lifetime of care she will require. But its implications for the larger vaccine-autism debate, and for public health policy in general, are not as certain.
In fact, the government's concession seems to raise more questions than it answers.
1) Is there a connection between vaccines, mitochondrial disorders and a diagnosis of autism, at least in some cases?
Mitochondria, you may recall from biology class, are the little powerhouses within cells that convert food into electrical energy, partly through a complex process called "oxidative phosphorylation." If this process is impaired, mitochondrial disorder will ensue.
The child in this case had several markers for Mt disease, which was confirmed by muscle biopsy. Mt disease is often marked by lethargy, poor muscle tone, poor food digestion and bowel problems, something found in many children diagnosed with autism.
But mitochondrial disorders are rare in the general population, affecting some 2-per-10,000 people (or just 0.2%). So with 4,900 cases filed in Vaccine Court, this case should be the one and only, extremely rare instance of Mt disease in all the autism proceedings.
But it is not.
Mitochondrial disorders are now thought to be the most common disease associated with ASD. Some journal articles and other analyses have estimated that 10% to 20% of all autism cases may involve mitochondrial disorders, which would make them one thousand times more common among people with ASD than the general population.
Another article, published in the Journal of Child Neurology and co-authored by Dr. Zimmerman, showed that 38% of Kennedy Krieger Institute autism patients studied had one marker for impaired oxidative phosphorylation, and 47% had a second marker.
The authors -- who reported on a case-study of the same autism claim conceded in Vaccine Court -- noted that "children who have (mitochondrial-related) dysfunctional cellular energy metabolism might be more prone to undergo autistic regression between 18 and 30 months of age if they also have infections or immunizations at the same time."
An interesting aspect of Mt disease in autism is that, with ASD, the mitochondrial disease seems to be milder than in "classic" cases of Mt disorder. In fact, classic Mt disease is almost always inherited, either passed down by the mother through mitochondrial DNA, or by both parents through nuclear DNA.
In autism-related Mt disease, however, the disorder is not typically found in other family members, and instead appears to be largely of the sporadic variety, which may now account for 75% of all mitochondrial disorders.
Meanwhile, an informal survey of seven families of children with cases currently pending in Vaccine Court revealed that all seven showed markers for mitochondrial dysfunction, dating back to their earliest medical tests. The facts in all seven claims mirror the case just conceded by the government: Normal development followed by vaccination, immediate illness, and rapid decline culminating in an autism diagnosis.
2) With 4,900 cases pending, and more coming, will the government concede those with underlying Mt disease -- and if it not, will the Court award compensation?
The Court will soon begin processing the 4900 cases pending before it. What if 10% to 20% of them can demonstrate the same Mt disease and same set of facts as those in the conceded case? Would the government be obliged to concede 500, or even 1,000 cases? What impact would that have on public opinion? And is there enough money currently in the vaccine injury fund to cover so many settlements?
When asked for a comment last week about the court settlement, a spokesman for HHS furnished the following written statement:
"DVIC has reviewed the scientific information concerning the allegation that vaccines cause autism and has found no credible evidence to support the claim. Accordingly, in every case under the Vaccine Act, DVIC has maintained the position that vaccines do not cause autism, and has never concluded in any case that autism was caused by vaccination."
3) If the government is claiming that vaccines did not "cause" autism, but instead aggravated a condition to "manifest" as autism, isn't that a very fine distinction?
For most affected families, such linguistic gymnastics is not so important. And even if a vaccine injury "manifested" as autism in only one case, isn't that still a significant development worthy of informing the public?
On the other hand, perhaps what the government is claiming is that vaccination resulted in the symptoms of autism, but not in an actual, factually correct diagnosis of autism itself.
4) If the government is claiming that this child does NOT have autism, then how many other children might also have something else that merely "mimics" autism?
Is it possible that 10%-20% of the cases that we now label as "autism," are not autism at all, but rather some previously undefined "look-alike" syndrome that merely presents as "features" of autism?
This question gets to the heart of what autism actually is. The disorder is defined solely as a collection of features, nothing more. If you have the features (and the diagnosis), you have the disorder. The underlying biology is the great unknown.
But let's say the government does determine that these kids don't have actual "autism" (something I speculated on HuffPost a year ago). Then shouldn't the Feds go back and test all people with ASD for impaired oxidative phosphorylation, perhaps reclassifying many of them?
If so, will we then see "autism" cases drop by tens, if not hundreds of thousands of people? Will there be a corresponding ascension of a newly described disorder, perhaps something like "Vaccine Aggravated Mitochondrial Disease with Features of ASD?"
And if this child was technically "misdiagnosed" with DSM-IV autism by Dr Zimmerman, how does he feel about HHS doctors issuing a second opinion re-diagnosis of his patient, whom they presumably had neither met nor examined? (Zimmerman declined an interview).
And along those lines, aren't Bush administration officials somewhat wary of making long-distance, retroactive diagnoses from Washington, given that the Terry Schiavo incident has not yet faded from national memory?
5) Was this child's Mt disease caused by a genetic mutation, as the government implies, and wouldn't that have manifested as "ASD features" anyway?
In the concession, the government notes that the patient had a "single nucleotide change" in the mitochondrial DNA gene T2387C, implying that this was the underlying cause of her manifested "features" of autism.
While it's true that some inherited forms of Mt disease can manifest as developmental delays, (and even ASD in the form of Rhett Syndrome) these forms are linked to identified genetic mutations, of which T2387C is not involved. In fact little, if anything, is known about the function of this particular gene.
What's more, there is no evidence that this girl, prior to vaccination, suffered from any kind of "disorder" at all- genetic, mitochondrial or otherwise. Some forms of Mt disease are so mild that the person is unaware of being affected. This perfectly developing girl may have had Mt disorder at the time of vaccination, but nobody detected, or even suspected it.
And, there is no evidence to suggest that this girl would have regressed into symptoms consistent with a DSM-IV autism diagnosis without her vaccinations. If there was such evidence, then why on earth would these extremely well-funded government attorneys compensate this alleged injury in Vaccine Court? Why wouldn't they move to dismiss, or at least fight the case at trial?
6) What are the implications for research?
The concession raises at least two critical research questions: What are the causes of Mt dysfunction; and how could vaccines aggravate that dysfunction to the point of "autistic features?"
While some Mt disorders are clearly inherited, the "sporadic" form is thought to account for 75% of all cases, according to the United Mitochondrial Disease Foundation. So what causes sporadic Mt disease? "Medicines or other toxins," says the Cleveland Clinic, a leading authority on the subject.
Use of the AIDS drug AZT, for example, can cause Mt disorders by deleting large segments of mitochondrial DNA. If that is the case, might other exposures to drugs or toxins (i.e., thimerosal, mercury in fish, air pollution, pesticides, live viruses) also cause sporadic Mt disease in certain subsets of children, through similar genotoxic mechanisms?
Among the prime cellular targets of mercury are mitochondria, and thimerosal-induced cell death has been associated with the depolarization of mitochondrial membrane, according to the International Journal of Molecular Medicine among several others. (Coincidently, the first case of Mt disease was diagnosed in 1959, just 15 years after the first autism case was named, and two decades after thimerosal's introduction as a vaccine preservative.)
Regardless of its cause, shouldn't HHS sponsor research into Mt disease and the biological mechanisms by which vaccines could aggravate the disorder? We still do not know what it was, exactly, about this girl's vaccines that aggravated her condition. Was it the thimerosal? The three live viruses? The two attenuated viruses? Other ingredients like aluminum? A combination of the above?
And of course, if vaccine injuries can aggravate Mt disease to the point of manifesting as autism features, then what other underlying disorders or conditions (genetic, autoimmune, allergic, etc.) might also be aggravated to the same extent?
7) What are the implications for medicine and public health?
Should the government develop and approve new treatments for "aggravated mitochondrial disease with ASD features?" Interestingly, many of the treatments currently deployed in Mt disease (i.e., coenzyme Q10, vitamin B-12, lipoic acid, biotin, dietary changes, etc.) are part of the alternative treatment regimen that many parents use on their children with ASD.
And, if a significant minority of autism cases can be linked to Mt disease and vaccines, shouldn't these products one day carry an FDA Black Box warning label, and shouldn't children with Mt disorders be exempt from mandatory immunization?
8) What are the implications for the vaccine-autism debate?
It's too early to tell. But this concession could conceivably make it more difficult for some officials to continue insisting there is "absolutely no link" between vaccines and autism.
It also puts the Federal Government's Vaccine Court defense strategy somewhat into jeopardy. DOJ lawyers and witnesses have argued that autism is genetic, with no evidence to support an environmental component. And, they insist, it's simply impossible to construct a chain of events linking immunizations to the disorder.
Government officials may need to rethink their legal strategy, as well as their public relations campaigns, given their own slightly contradictory concession in this case.
9) What is the bottom line here?
The public, (including world leaders) will demand to know what is going on inside the US Federal health establishment. Yes, as of now, n=1, a solitary vaccine-autism concession. But what if n=10% or 20%? Who will pay to clean up that mess?
The significance of this concession will unfortunately be fought over in the usual, vitriolic way -- and I fully expect to be slammed for even raising these questions. Despite that, the language of this concession cannot be changed, or swept away.
Its key words are "aggravated" and "manifested." Without the aggravation of the vaccines, it is uncertain that the manifestation would have occurred at all.
When a kid with peanut allergy eats a peanut and dies, we don't say "his underlying metabolic condition was significantly aggravated to the extent of manifesting as an anaphylactic shock with features of death."
No, we say the peanut killed the poor boy. Remove the peanut from the equation, and he would still be with us today.
Many people look forward to hearing more from HHS officials about why they are settling this claim. But whatever their explanation, they cannot change the fundamental facts of this extraordinary case:
The United State government is compensating at least one child for vaccine injuries that resulted in a diagnosis of autism.
And that is big news, no matter how you want to say it.
NOTE: Full text of the government's statement is posted here.
David Kirby is the author of "Evidence of Harm - Mercury in Vaccines and the Autism Epidemic, A Medical Controversy" (St. Martins Press 2005.
Autism ruling fails to convince many vaccine-link believers - CNN.com
Lessons From The Vaccine-autism Wars
Court Says Vaccine Not to Blame for Autism - NYTimes.com
YouTube - Robert Kennedy on the Vaccine Autism Coverup
Vaccine War: Autism, Flu and Science - Wellness - TIME.com
NIP: Vacsafe/Concerns/Autism/FAQs-Autism and MMR
Parents in the autism community worry about H1N1 vaccine
Vaccines And Autism: What Can Parents Do During This Controversy?
NIH Autism Study to Leave No Stone Unturned
Top US Panel: Some Vaccine-Autism Research is "Appropriate," "Worthwhile" and "Warranted"
After listening to the following wonderful interview, I want to take back any recommendation about getting any vaccination at this stage, till the kids are older or further information becomes available.
http://www.autismone.org/radio/mediafiles/022908%20Teri%20Arranga%20w%20David%20Kirby%20Mark%20Geier.wma
http://mwebworldhealth.blogspot.com/2008/03/how-to-avoid-autism.html
Wow.
( http://www.infowars.com/articles/science/autism_none_for_unvaccinated_amish.htm )
http://commons.ucalgary.ca/mercury/
In the months that followed, I developed an oxidative stress syndrome that eventually developed into multiple chemical sensitivities. I became so sensitive to the disinfectants I worked with in healthcare, I had to leave my career of 20 years to get away from them.
After experimenting with antioxidants for about a year, I found "Polyenylphosphatidylcholine" (PPC) Trade names "PolyPC" (from Jarrow) and "PhosChol" (from Nutrasal)... I really believe this stuff saved my life! PPC promotes integrity of cell membrains and protects against glutathione loss. This single supplement, more than anything else I have found has gotten my chemical sensitivities under control, and I now live a relatively normal life.
I believe this supplement may be helpful in treating toxic induced oxidative stress and mitochondrial injury. PPC is safe and has no side effects. I can even take it on an empty stomach without problems. I would recommend this supplement be tried by anyone who has suffered toxic effects from vaccinations.
I knew all along it had to be something the government wasn't telling us. As a former member of the media, I am also outraged that there hasn't been more coverage on this story. Sre, I've seen Jenny McCarthy and Rodney Peete's wife on TV talking about their own children---but what about the average person who doesn't have the financial resources they have?
This is an excellent article which was forwarded to me by a friend. I'll have to thank him!
Another thing to remember is that not all vaccines are bad. Just do your research beforehand. Don't accept the cocktails because a child's immature immune system can have difficulties with these. No, get one shot a time, allowing time between each shot to allow yourself to observe and see the child's reactions.
And don't worry. You are his grandparent, and your child is his mom or dad. You guys have more rights in this than the doctor, and you also have the right to tell him no.
And for crying out loud don't count on Jenny McCarthy for medical advice. I can't believe that a grown person needs to hear that.
David, thank you. You are a Godsend.
What we all need to realize is that this article has a very large point that is important to all of us who have children that were injured through the negligence of the Government.
That point is this: The government has conceded and acknowledged a case where a child was injured by vaccinations. Yes, it is that simple. There is no refuting the facts here...they would not have rewarded the settlement to the family if there were no evidence of a link. Considering the amount of the settlement, it is a pretty big acknowledgement.
Here is a link to the full text:
http://tinyurl.com/2wlpvo
It doesn't matter that the condition was pre-existing. IT STILL AGGRAVATED IT!!!!
I think the likely explanation is that the test case does not come close to proving the link. Which means Mr. Kirby's claim is suspect. He needs to release the document he supposedly has, otherwise his claim will remain suspect. How would that help our kids if Kirby's keeps everyone guessing and speculating? There's an easy way to end this right now.
The document?
http://www.ageofautism.com/2008/02/full-text-autis.html
This child has a mitonchondrial disorder, as diagnosed by one of the foremost experts in the field. Learn & understand mito, and realize this case has NOTHING to do with the views you have regarding autism & vaccines.
I know most here are energized by this case's decision, but there is no connection whatsoever to this child's case and the majority of you here. Furthermore, if you read the case information and educate yourself on mitochondrial disorder, it becomes apparent that solely blaming vaccines, even in this case, is utterly inappropriate. I am dumbfounded by the decision made here. With all that is known about mitochondrial diseases, its symptoms and patterns, it cannot be said whether this child would not have had a regression without the vaccines. Additionally, who is supposed to be held accountable here? This child has a DISEASE that affects every organ in her body, no one knew that when she had her vaccines. Whose fault, exactly, is that?
I've been keeping a close eye on this case because this has a direct effect on me and my family. Nearly every parent of an autistic child can pinpoint when the child began showing symptoms, and almost all of them will tell you that its within 3 days of a vaccination.
Nearly all of them? Evidence?
I am a former food process engineer who believes, because recent studies have implicated genes which code for glutamate synapses in ASD, we should investigate the effects of both INGESTED and INJECTED excitatory free amino acids (glutamic acid and aspartic acid) on children with these “autism genes”.
If excitatory free amino acids affect ASD children, it would explain both the impact of GF-CF diets AND a vaccine link. Vaccines have free glutamic acid added to preserve the virus. It is found in extremely high amounts in processed wheat and dairy products – so much so that food manufacturers use these two items routinely to produce free glutamic acid in foods but with a “clean label”.
Consequently, a child may not improve on a GF-CF diet alone, because it doesn’t limit all potential sources of free glutamic acid – like soy. Children are tested at birth for PKU and phenylalanine is limited until the brain is hardwired by the age of 7. Why not treat the predisposition for autism similarly and limit the glutamic and aspartic amino acids in the diets of children with autism genes?
ASD also includes errors of metabolism for sulfur containing amino acids – like cysteine. Cysteine is converted to taurine and glutathione by the liver. Taurine regulates heartbeat and osmotic balance as well as bile production and was found to be low after a seizure. In ASD, symptoms include arrhythmias, digestive disorders and a high rate of epilepsy – suggesting that taurine production may be compromised. Glutathione levels are also lower in ASD leading one to conclude that possibly, cysteine metabolism may be responsible for the myriad and seemingly unrelated additional symptoms of ASD. It should be noted that glutamate interferes with the handling of cysteine. When cysteine metabolism is compromised, homocysteine levels may increase. The lower levels of glutathione may put ASD individuals at risk of mercury poisoning, since glutathione helps eliminates mercury from the body.
It should be noted that the NMDA receptors that respond to both glutamate and aspartate are found in the amygdala - part of the limbic system involved in the perception of taste and smell as well as fear. Activating the amygdala in ASD, causes gaze avoidance. ASD children may also over-react to smells and tastes and face to face encounters can overwhelm them with fear. Limiting excitatory amino acids that target the amygdala may help.
Japan consumes more MSG, and fish (a dietary source of mercury) than nearly any other country. Compared to the amount of mercury consumed in fish and the amount of MSG consumed in the diet, the MMR contribution was probably small compared to a typical Japanese diet. In Japan, the MMR vaccine was stopped in 1993. Autism rates still increased. Perhaps in Japan, the diet plays more of a role in autism than the vaccines. Children from other countries with a lower consumption of fish and MSG may find a stronger correlation between vaccines and autism.
New research studies into ASD should include people who are sensitive to the food additives MSG and aspartame. MSG-sensitive persons have reported a distinct lessening of symptoms by using taurine, ibuprofen, CoQ10, Vitamins B6 and B12, sugar, foods high in butyric acid – like butter, and Magnesium. Perhaps they share some of the same genes that predispose a child to ASD. New treatment studies should look into these easily available, inexpensive and relatively safe compounds.
Based on what I have observed, here are my recommendations:
1. Treatment of ASD?
REMOVAL of excitatory amino acids (glutamate, aspartate) from VACCINES.
Glutamate and aspartate restricted diet (similar to treatment for PKU) in addition to GF/CF diet.
Supplementation of taurine, glutathione, vitamins B6, C, magnesium, CoQ10.
Increased carbohydrate
Labeling of free glutamic and aspartic acid on food labels.
Glutamate blockers, anti-histamines and leukotriene blockers for children already suffering or getting vaccinated
We should calm their surroundings, encourage quiet tasks and less-threatening contact to enhance communication. We need to give them space and not overwhelm them.
2. Diagnosis of ASD?
Test for autism genes preferably AT BIRTH like PKU
Tests for aspartic acid, glutamic acid, glutathione, taurine, cysteine, homocysteine
3. Risk factors for ASD?
Autism Genes
Sensitivity to excitatory amino acids,
Low taurine, low glutathione
Sulfite Sensitivity
Vaccination with glutamic acid as a preservative
Damage to the microglia
Overactive immune system
“Junk food” diet
Aspartame in medications or vitamins or foods Multiple food allergy
4. Biology of ASD?
Excess CNS sensitivity,
Inability to handle sulfur-containing amino acids,
Overactive immune response – linked to Nerve Growth Factor
5. Other areas of ASD research?
Common genes in Alzheimer’s, Parkinsons, ALS, MS, and excitatory amino acid sensitivity.
Study persons without ASD who suffer from overactive CNS or neurodegenerative disease and sensitivity to excitatory amino acids. See if they share same genes.
Could Alzhemier’s sufferers simply be ADS children whose brains were hard-wired before damage by the environment?
Please see this webpage that clearly shows why a wheat and dairy based processed food diet may be very harmful to a child sensitive to excitatory amino acids.
http://www.msgtruth.org/avoid.htm
David, I hope they really investigate vaccines now - I rest my case! :)
Because if they can't argue that these drugs are "therapeutic", then the risk/benefit model crashes. The drugs would have to be regarded merely as chemical controls, nothing more. Some families might still choose this route to control dangerous behavior, though clearly fewer would do so if the risks were presented as the only proven effects of the drugs. There would be no supposed amelioration of brain chemicals to outweigh the massive adverse effects in any case.
Of course, like the adaptive viruses that they are, the pharmaceutical companies will attempt to fit some theory to developing views as an attempt to "scientifically" justify regarding the drugs as "therapeutic" all over again. But it really is a blow to profits if the mechanism of a condition is understood to the point that it is preventable and treatable by means tailored to the actual mechanism of harm.