Autism Vaccination Ruling

A February 2009 autism vaccination ruling has caused controversy in the autism community. On February 12, the U.S. Court of Federal Claims Office of Special Masters found that the measles, mumps and rubella (MMR) vaccine did not cause autism in Michelle Cedillo, Colton Snyder and William Yates Hazelhurst.

Autism and childhood vaccinations

A week later on February 24, the media reported that the same court ruled that the MMR vaccine caused a brain inflammation in Bailey Banks, who later developed pervasive development disorder not otherwise specified (PDD-NOS) in July 2007.

Autism experts, autism advocacy groups and families of autistic individuals are divided in their reactions to the 2009 verdict and the 2007 decision. The two seemingly contradictory court decisions have also generated some confusion over the role, if any, that vaccines may play in the development of autism. What exactly do these two cases mean for autism and what do they say about any connection between vaccines and autism?

To understand the February 12 decision better, it is important to learn about the structure of the Vaccine Court. The Vaccine Court is the term to describe a section of the U.S. Court of Federal Claims Office of Special Masters that deals with vaccine-related lawsuits. Special Masters are appointed to judge cases in Vaccine Court.

The National Childhood Vaccine Injury Act of 1986 created the National Vaccine Injury Compensation Program (NVICP). The NVICP allows people who were injured as the result of a childhood vaccine to petition the federal government for monetary damages. Parents or caregivers are only allowed to take a vaccine-related injury case to a civil court after petitioning the Vaccine Court.

When the Vaccine Court received over 5,000 claims requesting compensation for autism-related vaccine injuries in 2007, the Special Masters requested three test cases. The request for test cases was a way of preventing the same evidence from being presented for each similar case. This means that the verdict of the test cases has an impact on the numerous similar cases. The Cedillo, Snyder and Hazelhurst families became the three test cases representing more than 5,000 families.

The Cedillos, Snyders and Hazelhursts petitioned the U.S. Court of Federal Claims Office of Special Masters for compensation from the NVICP on behalf of their autistic children in 2007. The families sought compensation from the NVICP because they believed that the MMR vaccine caused their children's autism. A separate Special Master presided over each of the three cases. On February 12, 2009, the Vaccine Court found that the MMR vaccine did not cause autism in the three children. The three families were denied compensation from the NVICP.

The February 2009 Cedillo, Snyder and Hazelhurst rulings are considered major court decisions in determining a link between autism and vaccines. However, it should be noted that this decision only addressed the possible link between autism and the MMR vaccine in combination with thimerosal-containing vaccines, not all childhood vaccinations. In fact, the Vaccine Court is in the process of deciding whether thimerosal, a mercury-based preservative, has a connection to autism.

The Special Masters found the three test cases did not provide sufficient evidence of a connection between the MMR vaccine and autism. While the court decision provides strong support for the recent MMR studies and the theory that the MMR vaccine is safe, it is not a conclusive answer to the possible connection between the vaccine and autism. Future research may reveal a more conclusive answer.

In July 2007, the Vaccine Court awarded the family of Bailey Banks compensation for vaccine-related injuries that led to the development of PDD-NOS, a type of autism. Bailey Banks contracted a brain inflammation, acute disseminated encephalomyelitis (ADEM) after receiving the MMR vaccine as a toddler. The Special Master found that the MMR vaccine caused the complication of ADEM, which ultimately led to the development of PDD-NOS.

The Bailey Banks ruling provides a possible link between the MMR vaccine and autism through the development of ADEM. Many autism experts and families who disagree with the February 2009 ruling point to this case as evidence that the MMR vaccine may cause autism in certain individuals. However, this case is also not a conclusive answer for the prevalence of autism. In fact, it adds to the confusion because the case uses the term non-autistic developmental delay in reference to Banks' condition despite the fact that PDD-NOS is one of the pervasive developmental disorders categorized in the official DSM-IV-TR's diagnostic information about autism.

In March 2008, the Vaccine Court awarded Hannah Poling compensation because her childhood vaccinations aggravated a preexisting mitochondrial disorder and caused autism-like symptoms. Many medical experts argue that this case does not provide a link between autism and vaccines because Hannah has a rare medical condition, mitochondria disorder. Yet some autism advocacy groups see both the Bailey Banks and Hannah Poling cases as proof of a possible connection between autism and vaccines.

The majority of the traditional medical community agrees with the February 2009 ruling and hopes to focus on research into other possible causes of autism. Some doctors disagree with the ruling and believe that the MMR vaccine has harmed certain autistic patients such as Banks and Poling. Parents and autism advocacy groups are divided between support and disappointment.

The only common ground shared by all groups is a concern for autism and a determination to find the true cause and effective treatments.

The February 2009 and July 2007 autism vaccination rulings may provoke more questions than answers about the possible connection between autism and the MMR vaccine. Clearly more research is needed to reach a definitive answer. The divided response among experts and the public provides hope that the search for answers will continue.

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