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DR. JON POLING TO DR. STEVEN NOVELLA ON AGE OF AUTISM

PolingsBy Dr. Jon Poling, father of Hannah Poling.

OPEN LETTER TO DR. STEVEN NOVELLA
IN RESPONSE TO "Has the Government Conceded Vaccines Cause Autism?"

Dr. Novella,

Thank you for generating interesting discussion regarding my little girl, Hannah Poling.  I would like to give you additional information in order to generate further productive discussions on this matter amongst the neurology community.  This information should assist you, Dr. DiMauro, and Dr. Trevethan, who have also commented publicly, to formulate better theories as to the significance of Hannah’s mitochondrial dysfunction in relation to her autism.

1. Mito Dysfunction or Mito Disease?  Chicken or Egg?

To begin with, I would like to point out that the spectrum of mitochondrial dysfunction is probably considered more broad and complex than the spectrum of neurobehavioral abnormalities seen with autism. Dysfunction of the mitochondria, specifically dysfunction of the oxidative phosphorylation pathway, most likely contributes, but may not be the cause of many diseases—including Parkinson’s disease, Friedreich’s Ataxia, Alzheimer disease, etc.  Thus, it is probably incorrect to refer to  mitochondrial dysfunctional and mitochondrial disease interchangeably. Indeed, the role of the dysfunctional mitochondrial are yet to be clarified in these diseases. Thus, I will refer to Hannah’s metabolic condition as a mitochondrial dysfunction, not a mitochondrial disease.

2.  Mito Genetic Finding?  Mito mtDNA ‘red herring’ ?

ADDITIONAL GENETIC TESTING NOT AVAILABLE IN THE J CHILD NEUROL CASE REPORT:  Dr. Shoffner performed genetic testing on both Hannah’s muscle and her mother’s leukocytes subsequent to our case report. Hannah (muscle mtDNA) and her mother (leukocyte mtDNA) were both found to be HOMOPLASMIC for the mtDNA T2387C transition mutation.
Our analysis of this genetic finding in the mtDNA was significantly different than those of other physicians that I’ve seen in scientific blogs or commentary.  I suspect it would have been fatal to both Hannah and her mother if this homoplasmic mutation was pathogenic since (as I am sure you are aware) the mutation is on the 16S ribosomal subunit which is highly conserved. Thus, this mutation probably represents a benign polymorphism rather than pathogenic mutation. It is unlikely, but possible, that the mutation is significant to Hannah, but in such a case, it must work in concert with other nuclear genes to cause her mitochondrial dysfunction.  To our knowledge, this point mutation has not been reported in cases similar to Hannah’s.

3.  Encephalitis? Metabolic Encephalopathy? Or “Regressive Encephalopathy with Features of Autism Spectrum Disorder”

The other interesting term you used was encephalitis rather than encephalopathy.  We are not sure that she had an “-itis” but we did clearly document a regressive encephalopathy based on not only our parental reporting, but also based on the pediatrician’s documents, affidavits from other family members, and the growth curve measurements (injury pattern).  Early on in the regression we did note back arching (opisthotonus), fever, and disrupted sleep. Although fever occurred a lumbar puncture was not performed.

An interesting developing story in autism research is the immune/inflammatory connection.  In her senior resident thesis, Dr. Anne Comi, a former JHU colleague, along with Dr. Andy Zimmerman, reported, the increased prevalence of autoimmune disease in families of autistic offspring. Interesting, Hannah also has a maternal family history of autoimmune disease. Dr. Carlos Pardo, another one of my former chief residents, along with Andy and Dr. Vargas, published a beautiful study in the Archives of Neurology, demonstrating neuroinflammation on autopsy of brain samples and inflammation cytokine markers in the CSF of individuals with Autism.  The interesting thing was that inflammation was demonstrated in autopsy specimens from adults as old as 44 years of age.  The conclusion was that further research would be required to determine if inflammation was a primary disorder in autism or; alternatively, if inflammation and microglial activation was secondary to neurodegeneration.  Dr. Sudhir Gupta at UC Irvine has a nice model of how the two pathways of neuroinflammation and mito dysfunction may not be mutually exclusive.  This remains to be seen; however, study of mitochondrial dysfunction and neuroinflammation hold the promise of treatment development.  The two avenues of research deserve funding at the highest levels.

4.  How many Hannah Polings are out there? 

The short answer is that nobody knows.  However, there is emerging data to suggest that she is not alone.

Dr. Shoffner will be presenting his experience with 37 patients with combined autism and mitochondrial dysfunction at the AAN meeting in Chicago this April. 65% of his referrals are positive for mitochondrial dysfunction.  Of course, his yield is subject to referral bias as a mito expert, so the prevalence of mitochondrial dysfunction in Autism is surely less than 65%.

The best estimate to date of the prevalence of mitochondrial dysfunction in autistic patients comes from Oliviera et al. in a population of 120, 5 of 69 (or 7.2%) showed mitochondrial dysfunction.  If this is generalized to the US estimate of 1 million patients with ASDs, then the number of kids like Hannah could be 72,000!  Isn’t this worth further study?

Dr. Shoffner furthermore advocates, along with us, that vaccination is important even for kids with mitochondrial dysfunction.  I would argue that you should not give nine at one time and that none of them should contain Thimerosal (mercury). 

5.  Thimerosal—On or Off the Table?

I don’t want to dwell on mercury, as this theory is not why HHS conceded Hannah’s case (imo).  Dr. DiContanzo just wrote an interesting blog about how his opinion of mercury in vaccines has changed (http://drugs.about.com/b/2008/03/08/mercury-in-vaccines-and-autism-the-burden-of-proof-may-shift.htm).
 
My opinion is that mercury is a potent neurotoxin. Therefore, don’t inject it into kids!  Interestingly, basic research studies have shown that Thimerosal toxicity occurs through mitochondrial pathways.  Officials point to the large epidemiology studies as proof that there is no link between thimerosal and autism.  However, these studies are not powered to disprove the null hypothesis when considering that the mitochondrial autistic population may be just a small percent of the case totals.  Remember that while the CDC sponsored Verstraten study is hyped as a negative study, it DID find a statistically significant increase in childhood tics in those exposed to higher doses of thimerosal. 

6.  Hannah was destined to regress? Or was she?

Some experts have already stated that ‘mitochondrial disease’ is degenerative so the vaccine reaction was just the start of an inevitable decline.  This was neither the opinion of Dr. Richard Kelley at KKI nor Dr. John Shoffner.  In fact, the markers that led us down the mitochondrial trail (inc AST but not ALT, low serum bicarbonate, and slight increased CK, increase in the alanine to lysine ratio on PAA) are no longer present.  Furthermore, in our pilot study (unpublished but mentioned in the J child neurol paper), Dr. Frye (the statistician for our study and also a child neurologist) found a non-significant trend that AST decreased toward normal with increasing age.  With further studies we hoped to examine the hypothesis that this abnormality may be representative of a developing/immature biochemical pathway present in some children.

7.  Triple Hit Hypothesis—#1Underlying genetic susceptibility #2Insult must occur during specific developmental period #3 A certain vaccination or combination thereof is the environmental trigger  (?vaccine component like thimerosal ?direct immune stim/fever reaction ?live virus reaction?)

The implication is that Hannah’s type of autism requires a genetic susceptibility and properly timed insult to manifest disease.  We have not subjected Hannah to another muscle biopsy or re-examined ox phos functional assays that were published in the paper.  I can inform your readers though that the serum biochemical markers have resolved, growth resumed and continues along a normal trajectory, and there have been no other episodes of regression since 2000.  We are however left with autism and later in 2006, epilepsy.
It is recommended that studies be initiated immediately to screen siblings of cases to identify biochemical markers so as to identify potential screening tests.

I agree with the mainstream that my daughter’s case has raised many intelligent discussions and questions.  I’m very proud of her for starting this discussion.  Our hope is that further research into this case and others like it, we will be also to find screening tests to prevent what happened to my daughter from happening to anybody else.

(Dr. Poling acknowledges the editorial comments and insightful suggestions of Dr. Richard E. Frye.  He also would like to declare his conflicts of interest.  First of all, he is the father of Hannah Poling.  Dr. Poling has also accepted consultancy or speakers honoraria from Pfizer, Eisai, Ortho-McNeil, Biogen, Teva, Immunex (now Amgen), and Allergan.)
PS While I thought it useful to clarify some of the neurological issues raised by the government's concession of my daughter's case, please understand that I will not be able to respond to individual comments posted.  Thank-you. Jon

Comments

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Joan Petty

It is a known fact that Congress omitted Product Liability for Prescription drugs, in 1962 when they amended the FDA to include FDCA ACT as Public Law. All vaccines are prescription drugs. There is no remedy for a defective prescription drug that kills or injuries any innocent consumer. Our Congressmen and Representatives have knowledge and they deleted from the Product Liability Fairness Act Prescription drugs everytime it came up for Healthcare Reform. including vaccines. There is NO LAW, No State Law or NO Federal Law. Congress preempted it from the FDCA ACT and you as a consumer and your children are at risk while Drug manufacturing companies are protected by a shield of protection called immunity. Congress can keep the cost of Medicare and Medicade and Social Security and any healthcare reform price up in cost by allowing the drug companies to continually and intentionally injuring and killing off the population all in the name of Good Healthcare. Who is immune? YOU or Merck? Show me the Law! There is NONE.

Lisa Tampa

I have an 11 year old son with Tourettes Syndrome. I have often wondered about the connection of vaccines, environmental toxins and Tourettes syndrome in addition to the information out there about Autism and Vaccines. Not only has the rate of Autism increased but the rate of Tourettes Syndrome among children is increasing in astronomical proportions. My son's friend who lives a few houses from us was also diagnosed with Tourette's syndrome recently and I have to say I notice many other children, boys in particular, in his school with Tic symptoms as well that I think are not being diagnosed. I truly believe Tic disorder numbers are higher than the 1 in 200-250 children that is being reported on currently. I wonder how long it will take for the Government to admit to and try to correct what has gone wrong with our environment. Will it take 8 out of every 10 children displaying neurological and other anomalies before they admit something has gone very wrong? I fear within the next few generations we just may come to those types of ratios the way things are increasing now.

CAROLYN

my heart goes out to you with a child with autism-I losted my Mother And Aunt with c. o. p.d. they pass away in my home my moter-in-law and father-in-law also pass away in my home it has been hard to see them pass but then I THINK OF YOU AND I PRAY TO GOD TO PLESE HELP YALL I JUST WANT YOU TO NO THEIR ARE STILL ONES THAT CARE AND WE PRAY FOR YOU AND YOURS

JOAN M. PETTY

WHY DID MERCK & CO. INC. DISTROY ALL THEIR 3 IN 1 VACCINE THAT THE HAD STORED AFTER THE FDA ORDERED A RECALL. DR. POLING DID YOU EVER GET A COPY OF THE WARNING LETTER TELLING MERCK THE MANUFATURERE OF THE VACCINE TO RECALL THE VACCINES.?? WHY DID MERCK DUMP ALL THE VACCINES IF THE 3 & 1 WAS NOT DANGEROUS? OUR RESEARCH DISCOVERED THAT MERCURY IN THE VACCINE DOES CAUSE EVERY 5TH CHILD TREATED WITH THE VACCINE IS THE ONE WHO GETS THE LARGEST DOSE OF MERCURY. CHECK THIS RECORD OUT. MERCK HAS FRAUDED MANY REPORTS TO FAST TRACK DRUGS. THIS IS A PROVEN FACT AND EVIDENCE. my phone is 863-465-1200.

Kelli Ann Davis

Terri,

You Rock! The designated "welcome wagon" greeter for AoA. Love it!

Please e-mail me again. My computer didn't save your e-mail from last time.

This time, I'll put you in my address book -- I promise.

You, girlfriend, are someone I can definitely relate to!

Best,

Kelli

Terri Lewis

Question Vaccines,

Welcome! (I don't believe I've seen you here before?) Welcome one and all to an enlightened community that's taking action daily, and making news daily.

My motto: We no longer need to debate the ignorant.

As David Kirby put it so beautifully on Larry King Live on April 2, 2008: "THE DEBATE IS OVER."

Thus--we now join together for change. I still can't believe how many parents are right here, right now, and bringing about the changes we have so long needed.

Welcome! And forgive me if you've been here longer than I have. . .I'm just so excited to see so many knowledgeable, powerful, active people now gathered in one place.

Terri L.

Question Vaccines

I guess this Dr Novella is not aware that babies are actually given their first dose of a neurotoxin while in utero, via the flu vaccine given to their mother, laced with mercury. And that assault continues as the relatively new recommendations ensure that infant will get a couple more doses by the age of 6 months, and most likely, will also be laced with mercury. Clinical trials are looking at vaccinating them even younger.

My own son received his 3rd dose of DPTH and 1st dose of Hep B at the age of 7.5 months, and deteriorated from that day forward. Stopped eating, wasted away before my eyes, and all I got from the medical profession was denial. Just sickening what is being done to our children.

Patricia

I have a 9-year old with Tourette's Syndrome/ADHD and an anxiety disorder. She was given the Hep B at birth and 5 shots at one time with mercury. Autism is always in the media but what about the explosion of kids with tic disorders? There are at least 5 kids with tic disorders in the lower grades at my daughter's private school of 300 children...and those are only the ones I am aware of! The Verstraten study PROVED mercury causes an increase of tics in kids exposed to it! This is called a "rare" disorder? Tics are embarrassing, life changing and at times, debilitating, just like autism. It touches not only my poor daughter but our entire family due to her difficult behavior and learning disabilities. Let's add the Tourette's kids to the list of autistic kids that are harmed and make the list even longer.

Icing on the cake

"It is likely (although this needs further research) that children excrete ethyl mercury more quickly than adults, and the safety buffer that was in place was more than sufficient to accommodate the increased vaccine schedule."

This particular one deserves the Nobel Prize. Maybe we ought to send it to David Letterman and ask him to do a Top 10 List on vaccine safety ridiculous answers. I can "see" it, just give it a year or two. At the most.

Kelli Ann Davis

“It is likely (although this needs further research) that children excrete ethyl mercury more quickly than adults, and the safety buffer that was in place was more than sufficient to accommodate the increased vaccine schedule.”

You’re right Kim, what a crock – or as Mark would so eloquently say, “That’s bullsh**!”

And what exactly is the “increased” level that the safety buffer is designed to handle, doc?

You gotta “magic” number for us? “Nothing up my sleeves, presto – here’s one.”

Now THAT’S what I call hard science.


kim

I posted an easy question over there for Dr. Novella. Here's the most ridiculous answer I've ever been given after personally talking to many pediatricians, a CDC epidemiologist, a board member of Every Child by Two and some neurologists. Can you say HUH?

#

Dr. Novella,

As the parent of a child who has been diagnosed with autism and mercury toxicity, I have quick questions for you. I found this quote of yours,

“I’m always open to new evidence, if they can show it works. I
think the burden on any practitioner is to show it’s safe and effective
before it’s used.”

So here are my questions:
Where’s the safety data on thimerosal? Where’s the safety data on vaccines used in combination? Especially for infants, like for example, one at birth, 4 at 2 months, 4 at 4 months and 3 at 6 months?
#
# Steven Novellaon 15 Mar 2008 at 6:59 am

Kim,

I agree that the vaccine schedule was increased without first conducting additional safety studies on the cumulative effect of the increase, specifically the increased total dose of thimerosal. Approval was based upon data that individual vaccine combinations (like MMR) were safe. Also, vaccine safety has been monitored by various methods, specifically the vaccine safety datalink.

This is certainly an important point going forward, and it is reasonable to require safety studies on the entire vaccine schedule not just individual vaccines.

However, this is a separate question from whether or not vaccines, as they have been given, can be linked to autism or other neurological disorders. The data here is very clear - there is no association between vaccination and risk of autism. It is likely (although this needs further research) that children excrete ethyl mercury more quickly than adults, and the safety buffer that was in place was more than sufficient to accommodate the increased vaccine schedule.

So now we do have the data in retrospect.

Angela S.

Terri Lewis,
You are absolutely right. Debating the ignorant is unproductive.

Jeanne

Terri,

I emailed Gerberding-a-ling-a-ding-dong. Gave her a what-for! ;-) I will continue to email "The Gerbil," as well as the Prez, VP, Speaker of the House and Mrs. Bush every day until someone tells me it's time to stop.

:-) Power to the People!

Hilary

Sorcha,

You miss the point.

It's not just mercury which can twig mito disorders.

the issues go far far deeper than that. Mito, is only one problem, and to think that's the only one, is to ignore the other 4,999 jigsaw pieces.

Hilary

To Sandy Gottstein:

I totally agree. I'd never vaccinate my children, and believe that there should be studies comparing vaccinated and unvaccinated.

But taking down the myopic wall of density within which vaccinologists reside is a "one brick at a time" job. Gregory Poland, who loves to pillory those who don't vaccinate is involved in a field called vaccinomics. His findings confirm that the people who don't respond to vaccines, are the very people who would become seriously ill or die in a disease, because they have genetic and immunological factors which predispose to that. His response to that, is to develop at least 13 patented products in order to "more effectively" vaccinate the non-responders!

There is no thought given to the fact that the majority of vaccinated who respond to the vaccine, are the very people who never needed it in the first place BUT they might be the very people with a genetic polymorphism which might predispose them to serious damage from a heavy metal or other "incipents" in the vaccine.

The whole theory of vaccination is seriously flawed because they ignored "unintended consequences" and "the law of uncertainty". Vaccines has already lead to a world wide situation where in developed countries, children are sicker than ever before with chronic diseases which have a price far higher than a bout of measles, whooping cough, mumps or chickenpox in a health child.

Just ask any of the older immunologists whether, in their early days of practice, or when they were adolescents in school, whether they or their mates were as sickly and unhealthy as kids are today.

Not all of this is due to vaccines, but they are the lynchpin for a baby, because anything that has any negative effect just after birth, will have a domino effect spreading out, for the rest of that person's life.

The only way we are going to get immunologist, and vaccinoologists like Gregory Poland to stop criticising us, and to take their heads out of the sand is to find a way whereby science can prove to them in each, single, painful area, that they are wrong, wrong, wrong, wrong, and wrong.

Unfortunately the history of the medical profession is such that it will take nothing short of multiple mini cluster hand grenades to get these people off their pedestals let alone out of their bunkers.

Terri Lewis

KarenAtlanta,

Thank you for summarizing it so beautifully:

"Why must we debate the ignorant?"

My answer?

We no longer have to.

Instead, we have to fight the powerful and corrupt who have allowed this to happen and who continue to allow this to happen!

It is evil, pure and simple.

The autism epidemic is man-made, for the most part, and could be reversed to a large degree tomorrow.

But only if we stop debating the ignorant.

And only if we start to fight the corrupt and powerful.

As the kids used to say: "It's a no-brainer."

So--I called the White House (again), Laura Bush, the CDC, the CDC "hot line" and e-mailed Ms. Gerberding herself.

Of course, most of them are the very powerful and corrupt we need to fight. . .it does present a bit of a Catch-22. . .but we have to start somewhere.

Surely to goodness, even in Washington, there may be a single good and honest person somewhere!! (Some of them, I think, are the young kids manning the phone lines. I try to educate them when I can.)

So--I ask again--who's with me to see to it that Julie Gerberding steps down?

Jenny McCarthy, are you still there?

Hello?

Anybody still on our big push that we only just started on Monday this week?

Terri Lewis

Rebecca K.

I agree with the mito marker screening on all children with autism like symptoms. We have to start somewhere to find out the cause of this condition.

KarenAtlanta

Hilary:
While at the CDC ACIP it had been mentioned that a Herpes Zoster related meningitis was experienced by trial subjects in South America - if I remember right. We know for a fact some clinical trials in the States are utilizing illegal immigrants.
The whole system goes so unchecked all the way through the pipeline.
Firestone tires blow up SUV owners sue. Congress investigates! Toxic pet food is cleared from shelves. Lettuce with ecol i pulled.
Vaccines failing...nonsense.
The sad reality is this...
Vaccines remain intertwined with big government money.
There is almost no recourse for the consumer faced with mandated shots.
Pharma downloads campaign funds and the US government indemnifies them from all liability.
As citizens, consumers and taxpayers we need to raise our voice and prioritize children's health and well being.
This is unacceptable.

Sandy Gottstein

Some of you may be interested in the continuing blog w/ Dr. Novella. A few of us have been commenting: http://www.theness.com/neurologicablog/index.php?p=203

And thank you Sorsha for thanking me, but I think you are referring to Hilary's comments. I did mention in an earlier post, however, that the one NIH study on chelation excluded those with toxic levels of mercury, which supports Hilary's point.

Also, to clarify once again, biomedmama7 was not the person who got confused about your quote Angela S, it was me. Sorry for creating an ongoing misunderstanding!

Sorsha

Sandy,
Thank you for pointing out that vaccine trials are only conducted on healthy children - but are then applied to the entire population without question.

Secondly, why is so much being made of the fact that Hannah received 9 vaccines in one day? The CDC recommended schedule currently recommends 7 shots for 9 diseases at every 6 month well-visit.

And lastly, I personally don't need to see pre-screening before vaccines at this point. The schedule is just too dangerous to only screen for mito markers. Too many children will still be vulnerable. I for one continue to repeat the mantra 'vaccinated vs. never-vaccinated study'. Nothing will happen until the CDC admits that vaccines are causing increased rates of autism among all children.

KarenAtlanta

Why must we debate the ignorant.
Many of these Ivy League sellouts are spokespeople who earn cash for grant money.
The science is there, the regression happened. HHS concedes.

I think the Polings need to write a book detailing their nightmare.
Then we could all push a mass buying like Evidence of Harm.
It seems like a waste of time to argue with the Novella & the Skeptic Society that has a whopping 200 members, when every day more kids become a Hannah Poling.
1:4000 and one born every 15 minutes will have a mito disorder that the GOVERNMENT concedes can be aggravated by vaccines.
So lets rally to get kids screened for Mito OR take the mito deleting substance (Thimerosal) out of vaccines!
If that brick comes out of the wall, the bloated schedule, the live viruses and the conflict of interest will be scrutinized by the public and press next. The entire country needs to ask "Why so many sick kids???" Then take steps to protect our children from environmental toxins.
Choose reasonable precaution over profit.
When children are exposed to toxins in the environment already, why inject them with more? It beggars belief.

I am convinced money is invested by vaccine makers in these "elite" talking heads, specifically to distract the media from the hard core toxicity science.
Just like Dr. Peter Hortez hijacking our Washington Rally with a closed door CDC press conference.
The CDC fawned over him, father of an ASD child. The man had an 18 million dollar grant for Hookworm vaccine development! Of course he would puppet for the CDC!!! The press was not privy to his blatant conflict of interest. He produced no evidence to his statement that his daughter wasn't injured by vaccines.(metal tests, organic acid tests,viral and immune testing etc.)Yet void of any science, his statement was taken at face value and splashed across newspapers.
Enough of the Rhetoric!!!!
The CDC and vaccine manufacturers are no better than Michael Jackson buying his way out of abusing children.

It is amazing that you get spin when vaccine related regression happens to a nurse and Johns Hopkins neurologist. "An unusual genetic disorder."
However when the CDC pays off a George Washington University talking head the press covers it as gospel.
It's time to take Hannah Poling seriously and the rest of us who survived the nightmare of vaccine related regression.
PLEASE, WRITE A BOOK DR.POLING!
Thank you for your bravery and courage.
No child should have to endure the pain Hannah went through.

biomedmama7

Angela S, I did not post that comment to you. Having already read Dr. Poling's statement, I knew which words were his.

Jeanne

Dr. Poling,

Thank you.

doodle

The only two interesting things Dr. Novella says

1 "The possible connection between mitochondrial dyfunction, genetic predisposition, and vaccine (or other) trigger is interesting and certainly deserves to be further studied." Thanks, some pretty basic questions should be answered now. So can we say that there is an environmental factor in autism, and if there is, can it be treated, and possibly there may be a real increase in autism?

2. "But this cannot and should not be used to justify prior claims that autism is essentially misdiagnosed mercury poisoning.". Always fighting Kirby... Always fighting the little battles instead of the the big ones. Point 1 should have been enough for Novella to rethink his positions but no, he has to go back and fight the old enemy. Is it possible that mercury can cause mitochondrial dysfunction, maybe setting the stage for something later. Nah. no way... we won't look into it.

In the end though, why even bother trying to convince a skeptic who loiters with the quackwatch thugs. Just a quick glance at the commenters should be enough to see the usual suspects.

Teresa Binstock

As Hannah's biochemical pathway into autism becomes further delineated, we should consider that gimpy mitochondria may not be the only category of increased susceptibility. Vaccine inserts contain warnings the seem too often ignored in the rush to increase rates of vaccination coverage. A policy used to be, Don't vaccinate sick or recently sick children; but that was changed so as to increase compliance rates (William Egan, M.D., CBER, FDA; personal communication). While Hannah's case history is important and her parents' bravery to be commended, a broader issue needs be contemplated by parents, physicians, and researchers: What are other (non-mitochondrial) determinants whereby a fetus, infant, toddler, or child would be at increased risk from vaccinations?

Hilary

Dr Novella and Dr Poling.

Here is the bottom line.

Go to clincaltrials.gov, and look at ANY phase trial of ANY vaccine combo to be inserted into the schedule.

Study the EXCLUSION criteria, and you will see that every time, any child who might possibly have any sign of problems is excluded from vaccine trials. That will leave a tiny proportion who might have minor problems which might not "activate" until further down the line.

The only thing that vaccine trials tell us is that the vaccine is supposedly safe, in a self-selected group of babies and children who might only be compared with children like themselves. They do not bear any relationship to the vast spectrum of children in the big wide world.

Contrary to Dr Novella's post on his blog, vaccines ARE NOT well tested. That is a myth easily dispelled by anyone who reads study protocols.

So when anyone, be it a Hannah Poling or anyone else with "something" was weeded OUT of a trial comes along, is given a vaccine, has a reaction, they are told that the vaccine doesn't do that and the reaction was coincidental.

This is a very unscientific response, Dr Novella, and you should know it.

I'm sure, Dr Poling, that your case was conceded for two reasons. Legally, to take it out of the precendent catagory and strategic, because both you and your wife are medical and articulate. If you asked for it to be removed, then I have to wonder why. If you didn't, I'd like clarification on that.

The situation which exists with regard to inadequate vaccines testing leaves all the rest of the people who may have children just like Hannah, or with some other genetic disorder, perhaps even as yet unclassified, but whose "representatives" in a potential trial, would have shown as undefined ill-health resulting in their not being included in a trial population.

What about these people? if they get vaccines, and the result is a reaction because a vaccine maybe methylated a relevant gene the experts didn't know about, and the reaction is denied, then what do we learn? Nothing.

Until the medical profession gets real about the correct way to trial vaccines, and gets real about vaccine reactions, there will be very few people like yourselves, who have the priviledge of having your case conceded.

Your explanations are very interesting and enlightening, at least in Hannah's case, and as that may or may not relate to autism.

But we need to resolve the current problems created by the totally unscientific methods by which vaccines are tested. Anyone with half a scientific brain should be able to see that the exclusion criteria which operates in all trials in the past and today, will result in completely different reaction outcomes to that shown in the trials.

Those vaccine trials therefore "blind and prejudice" doctors into unjustly disbelieving parents, and in some cases treating the parents as if they have the problem, not the children.

So while your comments add meaningfully, to the discussion about autism, nothing of any meaningful nature will come about, until people like you pressure the medical profession to go back to square one, and design vaccine trials which reflect the huge diversity in biochemistry, polymorphisms and immune systems which exist in the real world, rather thant the narrow self selected world of clinicaltrials.gov.

Only then will immunologists and parents start to get some idea as to which pretesting might identify children who might react to vaccines at some point in their lives.

Until that happens, medical practice will continue to misfire on the basis of unscientific circular illogic.

Sandy Gottstein

Dr. Poling, You and the rest of your family are shining lights and have given us hope. Thank you.

Teresa Conrick

Dr. Poling,

Thanks for posting this very helpful information. My gratitude and admiration for all that you and your family have faced, challenged, and accomplished.

Teresa
parent to 15 y.o. redheaded Megan

Kent Heckenlively

Dear Dr. Poling:

I want to thank you and your wife for your amazing courage and dedication to your daughter and this great cause. I know all of us welcome the extensive medical training and insight you bring to this issue. Together we will not only prevent future heartaches, but hopefully we can help our own children.

All the best,
Kent Heckenlively

Lisa

Thanks Dr. Poling. I know you and your family did not want to become the "poster" family for autism but here you are. And what an amazing job you have done. Thank you. Hannah's story will help thousands and thousands.

Richard

What I see is simply this, Hannah had 9 vaccines after which she became autistic. Hannah did not become become blind,deaf or dumb,she did not develop cerebral palsy,muscular distrophy or a million other possible conditions. Hannah developed the same symptoms as 4900 other children awaiting justice in the compensation court and that is no coincidence.

Angela S.

biomedmama7, I guess you didn't see those weren't my words they were Dr. Novella's words in his response to Dr. Poling. They are from Dr. Novella's blog at http://www.theness.com/neurologicablog/index.php?p=203

Sandy Gottstein

I see that Dr. Novella made those comments. (I misunderstood because there were no quotations marks.)

Because they were his comments, I reiterated my response directly to him on the blog.

Kelli Ann Davis

Jon,

Thank you for this clarification.

Trust me, I'm no scientist but I found this idea absolutely fascinating:

With further studies we hoped to examine the hypothesis that this abnormality may be representative of a developing/immature biochemical pathway present in some children.

And it seems the evidence you cite backs it up.

A "eureka" moment for me.

biomedmama7

You-hoooooo.......Dr. Nouvella..............

http://www.fda.gov/cber/vaccine/thimerosal.htm

http://www.chhs.ca.gov/News/Documents/Thimerosal%20Exemption%20Belshe%20Statement%2011-2-06.pdf

Sandy Gottstein

With all due respect, Angela, thimerosal was not removed from all vaccines. Please review Professor Boyd Haley's comments for a better understanding of the issue: http://www.vaccinationnews.com/boyd_haley_1-8-08.htm

And as you can see from this CDC generated table (http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/B/excipient-table-2.pdf), even they would have to agree that there is still thimerosal in many vaccines.

biomedmama7

To prove or disprove the role of Thimerosal as causal in mitrocondrial dysfunction, however, children/babies will have to be tested before receiving Thimerosal containing vaccines...?

Thank you Dr. Poling.

Angela S.

I see that Dr. Novella has responded at his blog. http://www.theness.com/neurologicablog/index.php?p=203

#
# Steven Novellaon 11 Mar 2008 at 7:59 pm

Jon,

Thanks for the additional information. It confirms my opinion that this case is complex and generates more questions than it answers, and certainly cannot be used with current knowledge as a precedent for the conclusion that vaccines cause autism.

Regarding thimerosal, since this was removed from all routine childhood vaccines by early 2002 the question of whether or not to expose kids to thimerosal is no longer an issue. The fact that the current evidence shows that removing thimerosal did not decrease the rate of increase in autism diagnoses (replicated in other countries as well) means that thimerosal is not a significant contributor to the total number of autism cases, and was not responsible for the increase in autism rates over the last 20 years. Of course it is correct that such studies can never rule out a small effect - they can only set limits on how large an effect statistically is likely, but the data certainly rules out a significant effect from thimerosal and contradicts the predictions of many anti-vaccine activists that thimerosal was responsible for an epidemic of autism.

The possible connection between mitochondrial dyfunction, genetic predisposition, and vaccine (or other) trigger is interesting and certainly deserves to be further studied. But this cannot and should not be used to justify prior claims that autism is essentially misdiagnosed mercury poisoning.

white house call in day2?

let's end the controversy? Perhaps its time to demand that EVERY child with autism-like symptoms be screened for mito markers?

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