The words “vaccine” and “autism” hit the news again this weekend with the release of the award to compensate the Poling family for pain, suffering, future care and lost wages for their nine year old daughter, Hannah.
Hannah was developing typically until a regressive episode at 18 months that closely followed the 9 vaccinations she received at a well-baby visit. Further testing revealed that Hannah 1) developed autism and 2) had the metabolic signature of a mitochondrial disorder which may have made her vulnerable to injury from the vaccines themselves or the fever that commonly accompanies vaccines and many childhood illnesses.
Although this case has been long fought, the recent award is renewing questions in the autism community.
How common are mitochondrial disorders?
The field of mitochondrial medicine is relatively young, but growing in importance. The United Mitochondrial Disease Foundation (UMDF), with whom Autism Speaks has partnered in an effort to learn more about mitochondrial disorders and autism, reports “while exact numbers of children and adults suffering from mitochondrial disease are hard to determine because so many people who suffer from mitochondrial disease are frequently misdiagnosed, we now know the disease is approaching the frequency of childhood cancers.” Mitochondrial disorders are more broadly defined and therefore possibly more frequent than frank mitochondrial disease, which is typically defined by identifying a known causative mutation. For more on mitochondrial disease and disorders, please see ‘What is Mitochondrial Disease?‘ on the UMDF website.
Testing for mitochondrial disorders is notoriously difficult in part because the field is young and misdiagnoses are common. However, identifying dysfunctional mitochondria in autism and mitochondrial disorders is an area where Autism Speaks has invested in a High Risk, High Impact grant from Autism Speaks awarded to expert clinicians and researchers investigating mitochondrial disorders at University of California at Irvine and University of California, San Diego. Through research and partnership with the UMDF (read story about our recent joint symposium), we hope to shed more light on “mitochondrial autism,” including how it is identified and how best to treat it.
Are there other reports of mitochondrial disorders and autism?
In 2009, John Shoffner, M.D. reported a study of 28 children with an identified mitochondrial disease and autism, looking at the effect of fevers on regression.
One of our investigators in the aforementioned grant, Robert Naviaux, M.D., Ph.D., has written a detailed commentary for the public on these data.
Should this information change my plans to vaccinate my child?
No. The recent award pertains to a legal decision not a new scientific discoveries— it is news and not new science. Therefore, no new recommendations are warranted.
Several epidemiological studies have explored whether either the MMR vaccine or thimerosal, a preservative previously used in vaccines, are linked to autism, and these studies have not supported a link. However, these studies were not designed to identify effects in a small population of potentially vulnerable children due to rare genetic and/or medical conditions.
We are seeking to understand if vulnerable populations exist, including children with unidentified mitochondrial disorders, and if so, how we identify them early so they can be protected from public health threats in the safest manner possible. For more information please see our vaccine statement and an interview with Dr. Geraldine Dawson, Autism Speaks’ Chief Science Officer, about vaccines and autism.
We recognize that this is a sensitive topic in our community. Please be respectful to the opinions of others and especially to the Poling family who has endured the spotlight for too many years.