Vaccine Court Decisions

20 02 2009

At PKIDs, we believe that it’s important to use vaccines as part of one’s arsenal against disease.  Many of our parents have children who were not vaccinated, for various reasons, and who were subsequently unnecessarily infected with a preventable disease.  Some of these children have fully recovered, some have life-long health problems due to their infections, and some children have died.

Vaccines aren’t perfect.  They don’t always provide full protection and, in just a few people, they can cause harm.  For instance, the oral polio vaccine (OPV), being a live virus, mutated in very rare cases to cause polio itself, resulting in about 10 cases of paralytic polio each year among the millions immunized and their contacts, according to William Egan, Ph.D., one-time deputy director of CBER’s Office of Vaccine Research and Review. Once epidemic polio was under control and the more effective OPV wasn’t needed, the government switched to the inactivated polio vaccine, eliminating the risk of paralysis.  Some felt the switch wasn’t made soon enough.

In the past year, the science of vaccines has collided with the vaccine courts.  The vaccine courts are part of the National Vaccine Injury Compensation Program (VICP) set up by the government.  If you feel you’ve been injured by a vaccine, you can’t just sue the vaccine manufacturer; you first have to go through a vaccine court. 

The vaccine courts started out by requiring a preponderance of scientific evidence to prove the petitioner’s case, but now, if one can identify a biologically plausible mechanism by which a vaccine could cause harm to an individual, then the courts feel that’s good enough.

One day, about a year ago, a family whose young daughter began exhibiting neurologic signs of an autism spectrum disorder sued for compensation under the VICP and won, based on the biologically plausible mechanism theory.

The girl’s parents, and certain others in the autism community, felt this court’s decision proved what they’d been saying all along – vaccines cause autism.  It didn’t matter that there is an overwhelming body of scientific evidence which says there is no connection between vaccines and autism.

Most of us didn’t know what to think.  The U.S. public health officials had told us that vaccines didn’t cause autism, and then a vaccine court said they did cause autism.

Just a few days ago, for another case, Special Master George L. Hastings Jr. of the vaccine court wrote in his ruling, “The evidence advanced by the petitioners has fallen far short of demonstrating such a link” between autism and vaccinations.

Confused, I asked Paul Offit, MD, to help me understand the conflicting rulings so that I could get it down on paper (or at least virtual paper).  Dr. Offit is a noted vaccinologist, a co-inventor of a rotavirus vaccine, and he is somewhat famous for his ability to translate complex medical issues into a more palatable language for non-scientists.

In response to my asking him which of the courts’ rulings we should heed, he said, “I think that we shouldn’t depend on the courts for either.  These are scientific questions that can only be answered in a scientific venue.  Sometimes the court supports the science.  Sometimes it doesn’t.  But when the court doesn’t support the science, that doesn’t change the science, it just makes it more difficult for the public to understand what’s going on.”

I agree with this.  A legal ruling doesn’t determine if science is or is not correct.  As a parent, following the science to determine what is safe for my family seems the reasonable action to me.

You might find help in understanding the courts’ rulings by reading these two articles written by Dr. Offit: Inoculated Against Facts, http://www.nytimes.com/2008/03/31/opinion/31offit.html and Vaccines and Autism Revisited – The Hannah Poling Case, http://content.nejm.org/cgi/content/full/358/20/2089





STDs

18 02 2009

The Centers for Disease Control and Prevention (CDC) reports that new cases of common sexually transmitted diseases (STDs) are on the rise in the United States. 
 
Almost 19 million of these new infections occur each year, and about half of those infected are between the ages of 15 and 24.  This is the age group that usually bears the brunt of new infections, with women and minorities more likely to be affected. 

About 10 years ago, the CDC began an all-out national effort to eliminate syphilis as an ongoing health problem and nearly succeeded, but the last two years have shown an increase in infections, rather than the expected decrease.

CDC surveillance indicates that reported cases of chlamydia and gonorrhea together surpassed 1.4 million in 2007.

As with so many types of infections, someone can look perfectly healthy but be living with one of these diseases.  If you’re sexually active, get tested a couple of times a year.  Don’t be shy about asking your healthcare provider to test you.  It’s better to identify and possibly treat an infection than let it go until it causes potentially serious and long-term health problems.

Take control of your life.  It’s the only one you’re going to get!

The report, “Sexually Transmitted Disease Surveillance 2007,” can be found at http://www.cdc.gov/std/stats07/toc.htm for those interested in delving deeper into this subject.