Saturday, February 14, 2009

Mixed reactions from parents on court ruling of no vaccine-autism link

From the San Diego Union-Tribune:

A federal court's unprecedented declaration yesterday that childhood vaccines don't cause autism landed like a punch to the gut for Rebecca Estepp of Poway.

“It's just another system that is turning its back on children with autism,” said Estepp, the mother of an 11-year-old son with autism (pictured with her son, Eric). “I'm feeling quite discouraged.”

But the reaction of UCSD psychology professor Laura Schreibman registered on the other end of the wide chasm between those who agree that immunizations lead to the developmental disorder and those who do not.

“There has not been any scientific evidence that supports that link. It's nice to see that the court has upheld that position,” said Schreibman, who heads a program at the University of California San Diego that studies behavioral treatment methods for children with autism.

Far from settling the debate, the ruling by the U.S. Court of Federal Claims in Washington, D.C., became the latest salvo in a battle waged, ferociously at times, for more than a decade. People on both sides said the well-being of hundreds of thousands of children might be at risk.

Public health officials said yesterday's decision should help erase any hesitation that parents might have about inoculating their children.

“It validates the information we continually give about the safety of vaccines,” said Dr. Wilma Wooten, San Diego County's public health officer.

At the same time, she expressed sympathy for Estepp and other parents who desperately want to know what caused their children to become so different from others.

“I would expect (the ruling) will be terribly disappointing to parents with autistic children,” Wooten said.

The evidence for connecting autism with vaccination “is weak, contradictory and unpersuasive,” concluded Special Master Denise Vowell, a member of the court. “Sadly, the petitioners in this litigation have been the victims of bad science conducted to support litigation rather than to advance medical and scientific understanding.”

Vowell and two other special masters each presided over one of three test cases. They all ended up backing years of research by organizations such as the National Institutes of Health, the American Medical Association and the American Academy of Pediatrics.

Through their attorneys, families in the cases had argued that a combination of the measles-mumps-rubella vaccine and other shots triggered autism.

The special court's decision affects only a portion of the more than 5,500 claims filed by families seeking payments through the government's Vaccine Injury Compensation Program, but it was widely seen as a precursor to how subsequent cases might be judged. The claimants are hoping to tap a $2.5 billion fund built up over the years by a 75-cent fee on every dose of vaccine.

Estepp has filed a claim with the compensation program, and her son's case was not among those covered by yesterday's action.

Autism is best-known for impairing a child's ability to communicate and interact. Recent data suggest a tenfold increase in autism rates over the past decade, but it's unclear how much of the surge simply reflects better diagnosis.

Autism strikes about 1 in 150 children, according to agencies such as the federal Centers for Disease Control and Prevention.

Concern about a vaccine link first arose in 1998 when a British physician, Dr. Andrew Wakefield, published a medical journal article tying a particular type of autism and bowel disease to the measles vaccine.

The study was later discredited, however, and British medical authorities are considering charges of professional misconduct against Wakefield.

Still, many parents remain skeptical of the overwhelming amount of research disproving the theory, instead believing that such studies are biased or flawed.

Some of them have decided not to immunize their children despite warnings from health officials that doing so increases the risk of triggering disease outbreaks.

That pattern appears to be more prevalent in San Diego County, where 2.5 percent of children had not been inoculated by the time they entered kindergarten in 2007, according to the county's Health and Human Services Agency. The figure was higher than the 0.96 percent rate for Los Angeles County and 1.6 percent for the entire state.

Only a year ago, an unvaccinated boy became infected with measles during a trip to Switzerland and brought it back to San Diego, sparking the region's first outbreak of the disease since 1991.

Hilary Chambers' daughter, Finley, was quarantined for three weeks after another child at her day care center in San Diego became ill with the highly contagious disease. Finley had just turned 1 at the time.

Yesterday, Chambers said she worries about the potential side effects of vaccinations but has given the shots to her daughter anyway because not doing so would put others at risk.

“If parents choose not to vaccinate, they have a huge responsibility to the greater community to take precautions,” she said. “They might have to change their lifestyle. Maybe they need to home school. Maybe they can't travel internationally.”

If nothing else, the court ruling should persuade government officials to commit more money for research into the causes of autism and treatments for it, said Steve Edelson, director of the Autism Research Institute in San Diego. That includes funding more studies of childhood vaccines.

“We feel that most of the research in the past hasn't been very good, and it has been mixed,” Edelson said. “We really have to figure this out once and for all.”

But even with more research, suspicions about immunizations will linger as long as science can't explain precisely why autism occurs, said Schreibman, the UCSD psychology professor. It's a natural reaction from parents who want to understand their children's problems so they can fix them.

“Until science comes up with a cause or a group of causes, people will hang on to this kind of theory,” Schreibman said.

Estepp said she doesn't need more studies to explain what happened to her son Eric.
“When he received his normal childhood vaccinations, I saw reactions and later he was diagnosed with autism,” she said.

Eric can hold conversations, do math, ride a bike and ski, but he has trouble focusing his attention and lacks normal social skills.

“His senses aren't integrated, and that makes it more difficult to concentrate,” Estepp said. “He would much rather play with 5-or 6-year-olds. The 10-and 11-year-olds are far too challenging.”

She said yesterday's court decision reinforces the helplessness felt by many parents who spend time battling school districts, government agencies and insurance companies for the resources to deal with autism in their families.

“And then today, the federal government failed us,” Estepp said. “It's very disheartening.”