Friday, March 7, 2008

The VICP and the Autism Rule

Just a few days ago I was working on an article about the National Vaccine Injury Compensation Program (VICP), so I became very familiar on how the court works. This is an excerpt of what I wrote:
The VICP compensates people a federal court determines to have met legal standards for having been injured by vaccines; these standards do not need to meet the standards of scientific causation. People who file claims are not required to prove negligence on the part of the health care provider or the manufacturer.

Funds from a tax on each dose of vaccine are placed in a trust fund to be used to pay the compensation awards.

The VICP is a no-fault alternative to the traditional tort system. The U. S. Court of Federal Claims decides who will be compensated. Some are compensated based on the Vaccine injury Table.

The Table—developed by a panel of experts—consists of a list of injuries and conditions presumed to be caused by vaccines, and the time periods in which the first symptom of these injuries and conditions must occur after receiving the vaccine. Unless a different cause is found, the court presumes that the condition was caused by the vaccine if the first symptom occurs within the listed time periods.

Earlier this week, a media report started circulating saying that a federal court had conceded that vaccines caused one child's autism. It turns out that the government cannot discuss the details of the case (for obvious privacy issues) so it cannot respond directly to the claims in the media. But here's what the Health Resources and Services Administration said in a press release:
HRSA has reviewed the scientific information concerning the allegation that vaccines cause autism and has found no credible evidence to support the claim. Accordingly, in every claim submitted under the Act, HRSA has maintained and continues to maintain the position that vaccines do not cause autism, and has never concluded in any case that autism was caused by vaccination.

HRSA will present its views on the allegation that vaccines cause autism in an "omnibus" autism proceeding in May of this year. The expert testimony in that proceeding will be available to the public, with the consent of the parties.

So what is this all about? In short, the court conceded that a nine-year-old Georgia girl's mitochondrial condition was worsened by the five childhood vaccines she was given on a single day eight years ago, leading to problems with brain function "with features of autism spectrum disorder."

As I said, all the details have not been released yet, but from my conversations with some of the people involved I assume that the Court awarded the claim based on a condition listed in the Table, such as encephalopathy. If you think about it, many brain function problems can be labeled as leading to ASD features--poor language and social skills, etc.

Does that mean that vaccines cause autism? Hardly, given the overwhelming scientific evidence collected so far that shows no causal association between vaccines and autism.

This is a tricky vaccine risk communication issue, especially with the constraints that HRSA has in discussing the case and the complexity of communicating the role of the child's mitochondrial condition.

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