Wednesday, February 25, 2009

NIH Agency Head: Vaccine-Autism Research is "Legitimate"

David Kirby
Posted February 25, 2009

NIH Agency Head: Vaccine-Autism Research is "Legitimate"

A major health official within the United States Government today endorsed more research into possible links between vaccination and autism, saying that such studies are "legitimate."

The official, Dr. Duane Alexander, Director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), an NIH agency, said scientists must investigate susceptible subpopulations of children, including kids with mitochondrial disorders and those who have trouble metabolizing mercury.

Even as the mainstream media, most pediatricians, and vaccine inventors like Dr. Paul Offit try to shut down the vaccine-autism discussion (and its attendant research), thoughtful scientists who are actually in real positions of power are speaking up to support the important work that still remains to be done.

"One question (is) whether there is a subgroup in the population that, on a genetic basis, is more susceptible to some vaccine characteristic or component than most of the population, and may develop an ASD in response to something about vaccination. We know that genetic variations exist that cause adverse reactions to specific foods, medications, or anesthetic agents. It is legitimate to ask whether a similar situation may exist for vaccines," Dr. Alexander said in a remarkable Q&A with Autism Speaks Scientific Director, Geraldine Dawson, PhD, posted today at the group's website.

"No clear evidence yet exists to implicate a specific relationship, but questions persist about whether there may be subpopulations unable to remove mercury from the body as fast as others, some adverse or cross-reacting response to a vaccine component, a mitochondrial disorder increasing the adverse response to vaccine-associated fever, or other as-yet-unknown responses," he added.

The point about mitochondrial disorders and vaccine-associated fever was a clear reference to Hannah Poling, the little girl with full-blown autism who won her Vaccine Court case last year when HHS conceded that a "vaccine-induced fever and immune stimulation that exceeded metabolic reserves" had triggered her descent into autism.

At a January meeting of the Interagency Autism Coordinating Committee (IACC), a staff representative from NICHD was the only federal panel member to abstain from removing previously approved vaccine-related studies from the Strategic Plan for Autism Research.

As it turns out, research into environmental triggers of developmental disorders like autism "is a major component of our research program," Dr. Alexander said of the NICHD. This includes studying "gene-environment factor interactions," he added.

And, he suggested that epidemiological studies conducted to date (and showing no link to vaccines) may have missed small, vulnerable subgroups of children. "These are difficult to detect," he said, "especially if only a few people have this genetic variant that makes them susceptible. [Instead], large numbers of individuals need to be studied to find enough people with the rare variant."

Fortunately, the Federal government has embarked on the massive National Children's Study (NCS), which is currently recruiting some 100,000 children. Alexander said that researchers expect to find that 600 to 700 of these kids will be diagnosed with ASD by age three.

"We will be able to study the genetic constitution of the children with autism in relation to many environmental exposures (illness, home chemicals, medications, vaccines, and many others)," he said, "and compare them to a control group in the sample without ASD on this whole range of exposures. If there are genetic variations linked to autism related to any of these exposures, this study should identify them if they are not too rare."

Dr. Alexander's words are sure to be warmly received within many quarters of the autism community. He said that vaccine and environmental studies into autism may help science break down subgroups of ASD children into categories that are, "based on cause or response to different treatment approaches." Diagnosis, therefore, could become a wonderful tool in determining "different prevention/intervention/ treatment approaches that could personalize care and markedly improve outcomes."

Dr. Alexander also seems quite determined that conflicts of interest and barriers to full transparency in the research process should not be tolerated, (as they are today, in my opinion), but instead be eliminated. He said that parents, (and pesky, inquisitive journalists) play a critical role as autism research watchdogs.

"The research process at its best is open and constantly questioning. It even reevaluates things that have been accepted for a long time, and is honest enough to be self-correcting when new information develops," Dr. Alexander said. "What is important is that the scientific inquiry moves ahead unfettered but free of conflict of interest so that the public can have confidence in the results. When there is evidence that research may not be free of bias, it is the role of the research community and the public to raise questions and concerns, assure that corrective measures are taken to be sure that results are valid and untainted, and provide assurance to the public that their trust is earned and deserved."

"It is important that there be agreement on the message that no clear causative link has yet been established (between vaccines and autism), although research continues on the question, just as it does for other questions related to vaccines," Dr. Alexander concluded. "There are still legitimate questions to ask about possible vaccine-associated events, and such questions need to be pursued in the interest of both public safety and maintaining public trust."

It all sounds reasonable to me.

But I still predict we will hear howls of protests from people who think they know better than the chief of an NIH agency.

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