Autism, Vaccines and Early Intervention
– the Hannah Poling Case
Below is an article Autism, Vaccines and Early Intervention – the Hannah Poling Case written by Margaret Dunkle, Director of The Early Identification and Intervention Collaborative for Los Angeles County (March 12, 2008), offering highlights of this landmark autism vaccine court case.
Autism, Vaccines and Early Intervention
Hannah Poling – from Birth to 19 Months of Age
– the Hannah Poling Case
Hannah Poling is a child who should not have needed early intervention.
She was born healthy and, for the first 18 months of her life, met and often exceeded every developmental milestone.
- Her favorite pal was her brother, 14 months older, whom she would watch with a smile. She would pull his hair, which he encouraged, and they would both go into fits of laughter.
- She loved playing patty cake and “Itsy Bitsy Spider” and would fill in the words.
- At 17 months, she was talking, following directions, pointing to body parts, and making appropriate animal noises upon request.
- At her July 19, 2000 visit, Hannah’s pediatrician noted that she “spoke well” and was “alert and active.” She could even whistle when asked.
Hannah Receives 9 Vaccines at 18 Months of Age
This changed dramatically when Hannah Poling was almost 19 months old and received nine vaccines (5 shots) in one visit to her pediatrician, on July 19, 2000.
Early & Intense Intervention
- She became immediately ill and, within six months spiraled into the solitary world of autism, losing speech, social reciprocity and motor skills, and showing various hyper- and hypo- sensitivities.
- As Hannah’s father said at a March 6, 2008 press conference in Atlanta, six months after receiving 9 vaccines, “we knew Hannah’s beautiful inquisitive mind wasn’t coming back.”
Once Hannah’s parents realized she had autism, they immediately began to provide their daughter with intensive early intervention, first with their Early Start (Part C of IDEA) program in Ellicott City, Maryland, and then with the “Babies Can’t Wait” Special Education Preschool Program in Clarke County, Georgia.
- As a toddler, Hannah had a full-time job – 40-45 hours a week of intense behavioral, speech, occupational and physical therapy.
- Today, at age 9, Hannah is exceptionally verbal and undoubtedly much higher functioning because she received early and intense services.
At their March 6 press conference, the Polings expressed their thanks to all of the family, medical and education support they have received over the years, including: the physicians at Kennedy-Krieger Institute at Johns Hopkins; psychiatrists at the Marcus Institute; the Epilepsy Center at Scottish Rite Children’s Hospital; Hannah’s team of local doctors in Athens, GA; the educators and therapists with the Clarke County, GA, school system; and Hannah’s grandmothers, Doris and Fran, without whom “we would never have made it.” They also would like to “thank Auntie Marg,” the author of this article.
Hannah’s Parents File in Vaccine Court
Believing vaccines caused Hannah’s autism, her parents filed in federal vaccine court. Their case was lumped with almost 5,000 other autism-vaccine cases that are still pending. Last November, they received a notice from the government conceding their case and therefore removing it from the omnibus autism-vaccine action.
About Hannah’s Parents – MD, PhD, JD, RN
Hannah’s father, Jon Poling, has MD and Ph.D. degrees from Georgetown University. He trained a neurology resident at Johns Hopkins University in Baltimore and is a practicing neurologist in Athens, GA. He has a special interest in treating patients with neuro-immunological disease.
- Dr. Poling has just written an important discussion of many of the complicated medical issues concerning his daughter. I’m attaching this piece for those interested in these medical issues.
- Dr. Poling is also lead author of a 2006 article in the Journal of Child Neurology that discusses these issues and describes Hannah as the case study. For an abstract, see http://jcn.sagepub.com/cgi/content/abstract/21/2/170.
Hannah’s mother, Terry Poling, is a registered nurse with specialized training in critical care as well as an attorney with a degree from Boston University of School of Law. She has left her professional practice but continues to use her training in both occupations to care for their daughter, Hannah Poling.
What Happened in Federal Vaccine Court?
The case of Hannah Poling is important because it is considered by many to be the first time the federal government has conceded a connection between autism and vaccines. On March 6, 2008 the Office of Special Masters reported that, on November 19, 2007, the U.S. Secretary of Health and Human Services [the Respondent in this case] recommended an award of compensation to Hannah Poling. The Special Master also reported that the Respondent [the Secretary of HHS] stated that, based on a review of the petition filed by Hannah Poling and her attorney, medical records and affidavits:
“…the facts of this case meet the statutory criteria for demonstrating that the vaccinations Hannah received on July 19, 2000, significantly aggravated an underlying mitochondrial disorder, which predisposed her to deficits in cellular energy metabolism and manifested as a regressive encephalopathy with features of autism spectrum disorder.”
Since autism is defined by symptoms, there is for practical purposes no difference between having the “features of autism spectrum disorder” and having “autism.” In fact, Hannah Poling has a DSM-IV diagnosis of autism.
The Special Master’s March 6 Order goes on to say that, on February 21, 2008, after reviewing an expert report by Dr. Andrew Zimmerman, the Secretary of HHS [Respondent] stated that:
“Having reviewed this additional evidence, [medical personnel at the Division of Vaccine Injury Compensation, Department of Health and Human Services (DVIC)] now recommends compensation for Hannah’s seizure disorder as sequela of her vaccine-injury….”
The Order of the Special Master also says that, based on the recommendation of the Secretary of HHS [Respondent] for compensation to Hannah Poling, “a damages determination is now appropriate.”
What Is the Press Saying?
The government’s concession in this case is a landmark. Relevant press coverage includes:
- Good Morning America, March 7, 2008 – See: http://abcnews.go.com/Video/playerIndex?id=4407825.
Note that the introduction to this GMA piece is in error in one important aspect.
- The Hannah Poling decision by the vaccine court was based on the effects of vaccines, not specifically Thimerosal, the mercury-based preservative that was in many childhood vaccines until it was phased out in the early 2000s; Thimerosal is still in most flu vaccines.
- While Thimerosal was a second theory proposed, the Court chose to make its concession based on the theory that Hannah has an inborn (genetic) metabolic problem: following vaccination, the prolonged febrile reaction produced metabolic stress leading to permanent brain injury as manifested by autism and later seizures. This metabolic susceptibility (mitochondrial dysfunction) may never have manifested as disease if not for the nine vaccinations Hannah received in July 2000.
- Larry King Live, March 6, 2008 – See: http://www.cnn.com/video/#/video/bestoftv/2008/03/07/lkl.autism.vaccine.long.cnn
- CNN Reports & 5 Short Video Pieces, including Sanjay Gupta, MD – March 6-7, 2008 – See: http://www.cnn.com/2008/HEALTH/03/05/autism.vaccines.ap/index.html?iref=newssearch#cnnSTCVideo. For the print CNN story, click “Read” on this same link.
- National Public Radio, Morning Edition, March 7, 2008 – See: http://www.npr.org/templates/player/mediaPlayer.html?action=1&t=1&islist=false&id=87974932&m=87974914. For the print version, see: http://www.npr.org/templates/story/story.php?storyId=87974932&ft=1&f=1003&sc=emaf.
- New York Times Article, March 8, 2008 – See: http://www.nytimes.com/2008/03/08/us/08vaccine.html?th&emc=th
- New York Times Editorial, March 11, 2008 – See: http://www.nytimes.com/2008/03/11/opinion/11tue3.html?_r=1&th&emc=th&oref=slogin
- Time Magazine, this week – See http://www.time.com/time/health/article/0,8599,1721109,00.html
- Atlanta Journal Constitution – March 6, 2008 – See: http://www.ajc.com/search/content/news/stories/2008/03/06/autism0306b.html
- Associated Press story – March 7, 2008 – See: http://hosted.ap.org/dynamic/stories/A/AUTISM_VACCINES?SITE=KPUA&SECTION=HOME&TEMPLATE=DEFAULT
- Web MD stories – March 6, 2008 – See: http://www.webmd.com/brain/autism/news/20080306/dad-in-autism-vaccine-case-speaks-out and http://www.webmd.com/brain/autism/news/20080306/vaccine-autism-debate-heats-up
- CBS Investigative Reports, Sharyl Attkisson, March 6, 2008 – See: http://www.cbsnews.com/sections/i_video/main500251.shtml?id=3915840n?source=search_video
- CBS Investigative Reports, Sharyl Attkisson – June 15, 2007 – See: http://www.cbsnews.com/blogs/2008/03/06/couricandco/entry3913875.shtml?source=search_story
- Statement from Autism Speaks – March 2008 – See: http://www.cnn.com/2008/HEALTH/conditions/03/06/vaccines.autism/index.html?iref=newssearch#cnnSTCVideo
In terms of early intervention:
- Hannah Poling shouldn’t have needed early intervention.
- But, since she did, she was fortunate to have parents who aggressively sought early intervention. Hannah was also fortunate that her parents found strong community programs – the Early Intervention (Part C of IDEA) and the Preschool Special Education Program – to provide Hannah with effective intervention early on, when it could do the most good.
- Hannah has benefited greatly from early intervention. However, she still has autism.
There are many biomedical, policy and legal issues connected with the Hannah Poling case, including early intervention. Her family came forward to share their story, raise these important issues, and provide information and hope to other families.
Director, Early Identification and Intervention
for Los Angeles County and
Senior Fellow, Center for Health Services Research & Policy,
George Washington University
2195 Beverly Glen Place
Los Angeles, CA 90077
This article is shared here with permission.
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