By Shankar Vedantam
Washington Post Staff Writer
Friday, February 13, 2009
A special federal court ruled yesterday that vaccines do not cause autism and that thousands of families with autistic children are not entitled to compensation, delivering a major blow to an international movement that has tried for years to link childhood immunizations with the devastating disorder.
The ruling closes one chapter in a long feud that has pitted families with autistic children against the bulk of the scientific establishment. Those who believe passionately that routine childhood shots are to blame for the rising toll of autism feel they are locked in a David-and-Goliath struggle against vaccine manufacturers, corrupt scientists, federal agencies and the mainstream media. It remains to be seen whether yesterday's ruling will end the controversy -- or be seen as just more evidence of what some call a conspiracy.
The vast majority of credible scientific studies have shown -- and all federal health agencies have strenuously argued -- that there is no connection between vaccines and autism. And public health officials have repeatedly warned that fewer immunizations will endanger children's lives.
Nevertheless, concerns about vaccines such as the "MMR" shot, which protects children against measles, mumps and rubella, have grown so widespread that some parents are choosing to forgo vaccinations. About one in 12 children does not receive the MMR vaccine in the United States, according to the National Center for Health Statistics.
Yesterday's ruling involved three separate cases, each of which explored a different mechanism by which vaccines might cause autism. Working independently, three special masters acting as judges in the federal "vaccine court" issued separate but similar rulings that found no evidence that the vaccines had caused the children's disorders.
The decisions are especially telling because the rules of the vaccine court did not require the plaintiffs to prove their cases with scientific certainty -- all the families needed to show was a preponderance of the evidence, or "50 percent and a hair." To the extent that these cases are representative of the claims made by some 4,800 other families seeking compensation, those cases would appear to be on shaky ground.
Ruling on a case brought by Theresa and Michael Cedillo of Yuma, Ariz., special master George L. Hastings used italicized words for emphasis and wrote that his extensive analysis of the evidence showed that the Cedillos' vaccine-autism theory was "very wrong."
"Unfortunately, the Cedillos have been misled by physicians who are guilty, in my view, of gross medical misjudgment," Hastings wrote.
The Cedillos contend that their daughter Michelle abruptly fell sick a week after she received an MMR shot when she was about 16 months old. Today, at age 14, she requires round-the-clock care, suffers from seizures, has lost nearly all her vision and has constant abdominal pain.
"We are terribly disappointed by the decision," Theresa Cedillo said in an interview. Referring to Michelle, she said, "I feel she was vaccine-injured and should be entitled to compensation."
The rulings are subject to appeal, and Kevin Conway, a lawyer representing the Cedillos, said there was no question of throwing in the towel.
In another test case, special master Denise K. Vowell heard charges brought by Kathryn and Joseph Snyder of Port Orange, Fla., who argued that the MMR vaccine, or a mercury-based preservative in it called thimerosal, had triggered in their son Colten pervasive developmental disorder -- part of the "autism spectrum."
"The evidence presented was both voluminous and extraordinarily complex," Vowell wrote in her ruling. But she added that there was little doubt about the right answer: The experts contending there is no link between autism and vaccines "were far more qualified, better supported by the weight of scientific research and authority, and simply more persuasive on nearly every point in contention."
In the third test case, special master Patricia Campbell-Smith heard a claim by Rolf and Angela Hazlehurst of Jackson, Tenn., parents of William Yates Hazlehurst. They charged that the MMR vaccine or a component of it had caused "regressive autism" in their son. Agreeing with the other special masters, Campbell-Smith said that she was "moved as a person and as a parent by the Hazlehursts' account," but that their evidence fell short.
The three cases involved some 5,000 pages of transcripts, 939 medical articles and 50 expert reports, and the three decisions ran to more than 650 pages altogether.
The ruling was welcomed in statements by the Department of Health and Human Services and the American Medical Association.
"This is a real victory for children and a great day for science," said Philadelphia pediatrician and vaccine expert Paul Offit, in a statement issued by the vaccine advocacy group Every Child by Two. "I hope that this decision will finally put parents' fears to rest and that we can once again concentrate on protecting children from the resurgence of deadly vaccine-preventable diseases such as measles and whooping cough."
The vaccine court was set up by Congress in 1986 as part of the National Vaccine Injury Compensation Program to compensate people who suffer the occasional side effects of vaccines. Rather than have victims sue vaccine-makers in civil court -- potentially putting them out of business and jeopardizing a major component of the country's public health infrastructure -- the court has a "no-fault" system that requires victims to prove to a special master only that vaccines harmed them, and not that anyone intentionally caused the harm.
It is unclear what effect the ruling will have on the determined grass-roots effort that insists there is a connection between vaccines and autism, a movement that has been embraced by several celebrities and politicians. In June 2005, Robert F. Kennedy Jr. wrote an article in Rolling Stone charging a "government cover-up of a mercury/autism scandal."
Two years later, Rep. Dan Burton (R-Ind.) told fellow members of Congress: "I believe, as do many credible scientists and researchers, that the clear correlation between the dramatic rise in the number of autism cases, and the rapid expansion of the childhood vaccination schedule during that 20-year period, points to the mercury-based preservative thimerosal -- routinely used in pediatric vaccines during the period -- as a contributing factor to our country's literal epidemic of autism. In fact, I firmly believe my own grandson became autistic after receiving nine shots."
James Moody, a lawyer advising the plaintiffs and director of SafeMinds, a research and advocacy think tank that endorses a vaccine-autism link, predicted that the autism cases would be appealed and eventually wind up in civil court, where plaintiffs could make their cases to a jury and get access to government documents.
"The government does not fund the science to show a connection between vaccines and autism, and the courts say there isn't enough evidence to show a connection," Moody said. "When the vaccine court says you haven't met the standard of evidence, that is a call for more science, not that this controversy is at an end."