LEGALLY

The federal government’s “concession” of a recent case involving the claim that vaccines caused someone’s autism does not mean the government acknowledges a link between vaccines and autism.

In this and every similar case, the government “has maintained the position that vaccines do not cause autism, and has never concluded in any case that autism was caused by vaccination,” said a Justice Department spokesman.

The government’s concession was in effect a settlement, a decision to compensate the alleged victim and, for whatever reason, not challenge her claim.

The settlement will probably not affect the outcome in any other case.

Vaccine cases are handled under the National Childhood Vaccine Injury Act of 1986, which created a no-fault system that requires people to file injury claims against the federal government rather than sue vaccine manufacturers or health care providers.

The claims are heard by a special master appointed by the U.S. Court of Federal Claims.

To get compensated, the person must show that it is more likely than not that the vaccine caused her injuries. That’s the “preponderance of the evidence” standard used in most lawsuits—50 percent plus a feather.

A recent court decision eased that standard a bit by saying someone can meet it by providing three things:

--A medical theory connecting the vaccine to the injury (the theory need not be the only, or even a widely accepted, one);
--A logical sequence of events showing the vaccine caused the injury; and
--Proof that the injury occurred shortly after the vaccination.

The government can rebut the claim by showing the vaccine probably didn’t cause the injury. Otherwise, the claim is approved.

The standard for getting compensated is a lot lower than what would be required to show scientifically that a link exists between vaccines and autism or any other condition. It is strictly a regulatory standard that can be met by complying with certain rules, without further investigation.

MEDICALLY

The settlement does not change the current state of science on the issue of vaccines & autism. There is nothing even implied in the settlement that specifically links the mercury preservative thimerosal to the girl's illness. If indeed the vaccine somehow triggered her encephalitis (and later, autism-like symptoms), there is no way to tell what part of the vaccine may have been responsible.

Is it scientifically possible that a vaccine could have aggravated an underlying medical condition, resulting in this girl's illness? Yes, it's possible.

But there is also no way to tell that she wouldn't have developed autism-like symptoms in some other way, especially if exposure to the viruses in the vaccine caused her fever, encephalitis and resulting autism-like condition. If the viruses were responsible, it is also very possible she would have gotten sick eventually anyway, just through normal daily contact with viruses.

Mitochondrial disorders, such as the kind this girl suffers from, cannot possibly explain the large rise in autism in recent years. Such disorders are extremely rare, affecting a fraction of one percent of all children. Autism is about three times as common as mitochondrial disorders.

However, mitochondrial disorders may be more common among children who have autism. Such disorders are generally inherited, and current studies suggest autism has a very strong genetic component. If and how mitochondrial disorders could be aggravated by environmental factors, such as vaccines, is unknown.