Questions in advance of study analyzing vaccine court cases for autism

20 Apr

A study is in review looking at the records of the vaccine court and, purportedly, showing that a large number of the cases compensated involve autistics. Robert Kennedy Jr. was prepared to give a press conference on the paper, but this got called off. There has been chatter about a study like this for a few years now and I’ve been curious about what the results would be. I was then curious why the chatter basically died down.

The big question I would have for the author of this study and for Mr. Kennedy should he get his press conference is: how many of these children were compensated for a residual seizure disorder following DPT vaccination?

Why ask that question? The “table” is a list of reactions which the Court will assume are vaccine-caused if they happen within the prescribed time after vaccination. The table is created with the best knowledge available at the time. What happens when the best knowledge available changes? After much deliberation, the table changes. That’s what happened to residual seizure disorders as an injury for DPT vaccines. It was part of the original table, but as new research came out showing that residual seizure disorders were not a risk from DPT vaccines, it was removed from the table.

This isn’t a small issue. The idea that residual seizure disorders could be caused following DPT vaccination are basically what created the Vaccine Act, the special Court and the rest of the program as we know it today.

As of today, there have been 2,699 cases compensated within the program. Of those, by far the largest share is due to the DPT vaccine, with 1,267 compensated claims. That’s 47%. Pretty high percentage especially when you consider the DPT (the whole cell vaccine) was discontinued 15 years ago.

Let’s say that there are a lot of cases in the court where autistics have been compensated for injury. How many of these people were compensate for what was an incorrect assumption of fault? Epilepsy is common in autistics. It is certainly reasonable to think that a number of autistics were compensated for residual seizure disorders.

It will be interesting to see how they address this question in the paper, if they address it at all. It will be interesting to see how Mr. Kennedy addresses this problem, if he addresses it at all.

If you want more details on the history, here is some of it, with some links.

Take a look at the original vaccine injury table (from the mid-late 1980’s) for the DPT vaccine:

DTP; P; DTP/Polio Combination; or Any Other Vaccine Containing Whole Cell Pertussis Bacteria, Extracted or Partial Cell Bacteria, or Specific Pertussis Antigen(s).
Illness, disability, injury, or condition covered: Time period for first symptom or manifestation of onset or of significant aggravation after vaccine administration:
A. Anaphylaxis or anaphylactic shock 24 hours
B. Encephalopathy (or encephalitis) 3 days
C. Shock-collapse or hypotonic-hyporesponsive collapse 3 days
D. Residual seizure disorder in accordance with subsection (b)(2) 3 days
E. Any acute complication or sequela (including death) of an illness, disability, injury, or condition referred to above which illness, disability, injury, or condition arose within the time period prescribed

Take a look at the table now for pertussis containing vaccines:

I. Tetanus toxoid-containing vaccines (e.g., DTaP, Tdap, DTP-Hib, DT, Td, TT)
A. Anaphylaxis or anaphylactic shock 1 0-4 hours
B. Brachial neuritis 6 2-28 days
C. Any acute complication or sequela (including death) of above events 4 Not applicable

It’s a lot shorter. Note specifically that “Residual seizure disorder” is now gone. Here is how residual seizure disorderwas defined:

(B) in the case of any other vaccine, the first seizure or convulsion occurred within 3 days after administration of the vaccine and 2 or more seizures or convulsions occurred within 1 year after the administration of the vaccine which were unaccompanied by fever or accompanied by a fever of less than 102 degrees Fahrenheit.

The change came in 1995. The reasons were not arbitrary, as noted here in the announcement in the Federal Register. They were working from recently published and studies:

During the process of analyzing the comments received in response to the NPRM, the Agency became aware of the imminent publication of a 10-year follow-up study to the National Childhood Encephalopathy Study (NCES) (Madge N., Diamond J., Miller D., Ross E., McManus C., Wadsworth J., Yule W. The National Childhood Encephalopathy Study: A 10-year follow-up. A report of the medical, social, behavioural and educational outcomes after serious, acute, neurologic illness in early childhood. Developmental Medicine and Child Neurology 1993; Supplement No. 68;35(7):1–118; Miller D.L., Madge N., Diamond J., Wadsworth J., Ross E. Pertussis immunization and serious acute neurological illness in children. British Medical Journal 1993; 307:1171– 1176, hereinafter ‘‘Miller study.’’).

Because the Miller study looked specifically at the relationship between vaccine administration and subsequent neurological damage, the Department determined that it should not proceed with publication of the final rule until there had been a sufficient opportunity to consider the conclusions of the new Miller study. Accordingly, the Department asked the IOM to convene a Committee for purposes of evaluating the Miller study in light of the conclusions of its initial report. On March 2, 1994, the Institute of Medicine issued a report entitled ‘‘DPT Vaccine and Chronic Nervous System Dysfunction: A New Analysis.’’

The pubmed link to the NCES study (Madge et al) is here. The Miller study is available in full here. The IOM report is here.

To pull one short quote out as to why the table changed:

The consensus of the Commission was that the original table in the statute requires modification to make it consistent with current medical and scientific knowledge regarding adverse events associated with certain vaccines.

Basically, they found that the research which had been used for the first Vaccine Injury Table was wrong to assume cause for residual seizure disorders following DPT vaccines. Again, I await the chance to see if the upcoming paper addresses this important issue. If a large number of the autistics were compensated for an injury which modern science says isn’t really an injury, the readers of the study need to know this.

19 Responses to “Questions in advance of study analyzing vaccine court cases for autism”

  1. Harold L Doherty April 20, 2011 at 10:37 #

    Why don’t you try waiting until a study is done and reported before you try to discredit it? As a neutral in the autism vaccine war I am amazed at how obsessed the authors who publish on this site are at trying to influence the public in to believing that there can never be any neurological damage resulting from vaccines or vaccine ingredients.

    • Kev April 20, 2011 at 10:59 #

      I don’t think anyone’s suggesting there can never be any neurological damage resulting from vaccines or vaccine ingredients in this piece are they?

    • Sullivan April 20, 2011 at 18:03 #

      Harold L. Doherty,

      first, read what Kev wrote. Second, reread what I wrote. Put aside your prejudices and actually read it. I am posing a question which is quite valid, not trying to “discredit” the study. I can wait until the paper is in public and until press conferences have been held, but why? The author, the referees and Mr. Kennedy should know in advance that this question is key to the question they are asking. Perhaps they already know this and have address the question. Had I waited one could argue that I was withholding this question in order to spring it on them after the fact.

      Perhaps I could ask you to address the actual content of the piece. Is there any fault with the reasoning: If one tries to assert that there is an inordinate number of autistics compesated, one must address the question of how many were compensated under an assumption of fault that was later shown to be false. In this case, we know that in the early days of the vaccine program, there was an assumption of fault which was false.

  2. Rose April 20, 2011 at 12:47 #

    Sorry, Kev, but I’ll go to my grave with one eye open to VAERS and the NVICP. Call me an idiot, whatever…Vaccines have saved probably millions of lives, that’s true.It’s hard to look a gift horse in the mouth.

    Still, in regards to my son’s reaction to the dpt, it was not a good day for a brain swelling. I could not accept this until Ben’s pediatrician told me it was probably due to the pertussis, which had not yet been changed. Finally, somebody listened to me. Seems reaction to pertussis is sometimes how Tuberous Sclerosis is identified, too. We’ve been counselled to watch for signs, as we can’t afford genetic testing.

    Until parents are heard, and taken seriously, there will continue to be political animosity on both sides. Parents can take it too far, this is true, and get all messed up in woo…it’s because they are drawn to anyone who will listen.

  3. daedalus2u April 20, 2011 at 15:12 #

    Rose, it isn’t millions, it is billions. Smallpox vaccine alone has easily saved over a billion lives.

  4. Dedj April 20, 2011 at 16:25 #

    “I am amazed at how obsessed the authors who publish on this site are at trying to influence the public in to believing that there can never be any neurological damage resulting from vaccines or vaccine ingredients.”

    I am amazed that you think you can get away with making such a brash and – dare I say it – totally accusatory statement given that the authours of this site have repeatedly had to clarify their posistion in multiple discussions across an extended period.

    If you’re going to pretend to be amazed at the content of this blog, at least try to demonstrate at least a smidgeon of knowledge of what that content actually is.

  5. M April 20, 2011 at 16:34 #

    These articles were really interesting to me.
    http://www.ncbi.nlm.nih.gov/pubmed/16713920

    http://www.ncbi.nlm.nih.gov/pubmed/20447868

    Alleged vaccine encepalopathy is actually a inborn genetic disorder, which usually manifests during first fever in the life, In some cases the first fever in the life was postvaccination fever. Fever after immunization with a whole cell pertussis vaccine was rather common…

  6. Rose April 20, 2011 at 16:56 #

    M:

    I find that interesting, too. So should science. Instead of saying “vaccines don’t cause autism”, locked in a political battle, it would be more appropriate to say, “Why are kids having reactions to vaccines?”, or “What underlying disorder could cause that expression?”. Instead, they prefer to call parents stupid.

    • Sullivan April 20, 2011 at 18:05 #

      “Why are kids having reactions to vaccines?”

      First you must answer the question: did these kids have reactions to vaccines. Autism, in and of itself, is not a vaccine injury.

      Instead, they prefer to call parents stupid.

      Who are “they”? Not people on this blog. Not the scientists doing the work. Not the people in the court handling the cases.

  7. Rose April 20, 2011 at 17:06 #

    M:

    Also, Dravet symdrome, which is indicated in the pub-med studies you showed, has similarities to Adhd/autism/epilepsy/etc. continuum. Possibly a more severe form of underlying “maladaption”. But science has informed thousands that reactions are “coincidental”, and that sets off my BS detector. Your studies encourage my reasoning. Thank you!

  8. Joseph April 20, 2011 at 19:19 #

    If there were any cases of note, we’d already know about them. Do you think AoA would wait? As it stands, we know about Hannah Poling. We know a little about Bailey Banks. Then there’s “the rest.”

  9. Rose April 20, 2011 at 19:29 #

    first you must answer the question: did these kids have reactions to vaccines. Autism, in and of itself, is not a vaccine injury.
    I can’t prove that the reactions weren’t vaccine related. I don’t know that Autism is a vaccine injury. It very well could be that the factors that cause autism make one more susceptable to vaccine reaction. I think the Miller study shows that, but the researchers themselves admit that they don’t have enough incidences following within 7 days of the dpt to show that.

    Okay, as for this

    Instead, they prefer to call parents stupid.,

    I’ll hold my tongue, for now. I can’t think of anyone doing it outright, in a legally definable way…but with inuendo, perhaps. I’m not on the side of the woo parents, either.

  10. sharon April 21, 2011 at 04:32 #

    Rose I think you make a very important point above about parents succumbing to woo because they feel the medical establishment is not listening to their concerns. Have you any thoughts based on your own experience as to what Doctors and scientists could be doing better to address this?

  11. Rose April 21, 2011 at 12:32 #

    One word, Sharon. Empathy.

    Empathy can’t be codified or recreated in a lab.

  12. Rose April 21, 2011 at 15:26 #

    Because science will not treat parents with empathy, it is met with antipathy. It is a battle of yin and yang.

  13. Esattezza April 27, 2011 at 16:01 #

    Rose,
    *Science* cannot treat parents with empathy-It is only a tool. *Scientists* can, however, and those that I know in the field usually do. Speaking from personal experience, many of us are in this field for a reason, often because we have family and friends who are affected by ASD. However, no matter how empathetic we may be to a parent’s belief that this or that caused their child’s autism, or that this or that has cured them, we would be doing a disservice if we abandoned the knowledge we have gained from the powerful tool that is science in favor of what a some parents believe, no matter how well we understand why they want to believe it.
    -Esa

  14. rose May 18, 2011 at 12:44 #

    I know that doctors are distinctly aware of the power of the placebo, and of it’s “magical healing powers”. Surely you’ve learned that by now. What’s the difference?

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