Kristie McNealy, MD

Over the past few days, I’ve heard and read a several news pieces about the family of Hannah Poling, who was recently awarded a settlement by the federal vaccine court. Her family holds that the award vindicates their assertion that their daughter’s autism was caused by vaccines. The CDC, and other groups say this isn’t the case. What has been left out of many of the radio reports I’ve heard is the fact that the settlement was awarded on the basis that vaccines aggravated Hannah’s underlying medical condition, resulting in the development of autistic features.

What was this underlying medical condition you ask? Hannah has a metabolic disorder which affects her mitochondria. According to case documents which were leaked on the web, the Division of Vaccine Injury Compensation concluded that five shots Hannah received in July 2000, “significantly aggravated an underlying mitochondrial disorder” resulting in a brain disorder “with features of autism spectrum disorder.”

While this case has added a lot of fuel to the fire in the vaccine-autism link debate, it really just leaves us with more questions. If the vaccine reaction is linked to Hannah’s metabolic disorder, then while parents of children with similar disorders might want to give vaccinations a second thought, this case should not be cause for alarm in most families.  People with metabolic disorders often respond in a severe way to what would normally be mild illnesses. Depending on the specific disorder, buildup of toxic metabolites resulting from metabolic disorders can also cause loss of milestones and developmental delays.

Hannah’s regression and development of autistic traits is clearly a tragic event which will have lifelong consequences for her family.  However, it’s unclear how her situation applies to the majority of children in the US and around the world.

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