Health advisory: Vaccine Injury Compensation Ruling, March 7, 2008

• Autism is actually a group of developmental disorders which have a diverse range of symptoms, not a single disease. An underlying genetic disorder has been identified in a minority of autism cases, but the cause of most cases is not known. The decision made to provide compensation for this family was not made on the basis of thimerosal exposure in vaccines and the Department of Justice and the United States Public Health Service have not decided that vaccines cause autism as alleged in statements made by some individuals to members of the press.
  
  
• Children who have mitochondrial disorders can appear normal initially but are actually somewhat predestined to have a regression of neurological function when placed under stress, including from the types of infections that we routinely vaccinate against. Although most children with mitochondrial disorders do not have autism they have other serious neurological problems such as severe epilepsy or severe problems with movement.

The settlement in the claim does not indicate that vaccines or any of their ingredients cause autism, but that the vaccines may have exacerbated an underlying mitochondrial disorder. However, there is no established link between vaccines, mitochondrial disorders or autism and it is not known if the underlying disease would have progressed in this way even if the child had not been vaccinated.

• Scientists believe that in cases in which a mitochondrial disorder causes a child's brain function to deteriorate, the disorder exists and then is worsened by a fever, infection or other stress on the body. It is not known if a vaccination — independent of fever or infection — can cause such a stress. "There are no scientific studies documenting that childhood vaccinations cause or worsen mitochondrial diseases, but there is very little scientific research in this area," according to Chuck Mohan, executive director the United Mitochondrial Disease Foundation, a Pittsburgh-based group that raises money for research. According to CDC, most children with autism do not have a mitochondrial disorder, making this a rare association.

The Director of the Centers for Disease Control and Prevention clarified that, "The government has made absolutely no statement about indicating that vaccines are the cause of autism, as this would be a complete mischaracterization of any of the science that we have at our disposal today".

• A large body of scientific evidence has found no relationship between autism and mercury containing vaccines. An exhaustive 2004 report by the Institute of Medicine concluded that thimerosal (a mercury containing preservative) in vaccines does not cause autism, a conclusion also reached by countries around the world. Since 2004, additional evidence that there is no relationship between vaccines and autism continues to accumulate.
• Even though no scientific evidence indicates that thimerosal in vaccines is a cause of adverse events in vaccine recipients or to children born to women who received vaccine during pregnancy, mercury-based preservatives have been removed from all routinely administered childhood vaccines with the exception of some influenza vaccines beginning in 1999. Since 2001, all routinely recommended vaccines manufactured for administration to infants in the U.S. have been either thimerosal-free or have contained only extremely small amounts of thimerosal.
• Fish and shellfish are the main sources of methylmercury exposure to humans, including pregnant women and young children.

Vaccines are among the most successful and cost-effective public health tools for preventing disease, disability, and death. Not only do they prevent children and adults from potentially serious diseases, vaccines routinely recommended for children also help protect the entire community by reducing the spread of infectious agents. Recommendations on the importance of childhood vaccinations have not changed because of this case. The father of the child, a neurologist, recognizing the importance of childhood immunizations, has stated that if he could do it all over again he would still immunize his child (although he would spread the immunizations out more than is currently recommended).