When The Augusta Chronicle began following the Mann quadruplets in October, there was little attention being paid to autism outside of the advocacy community and some researchers.
That all changed in March when it became public that attorneys for the U.S. Department of Health and Human Services conceded late last year that 9-year-old Hannah Poling, of Athens, Ga., had "features of autism spectrum disorder" caused in part by a series of vaccinations she received in 2000.
The girl has a rare mitochondrial disorder and her condition was aggravated by the shots, the government contended in a court filing.
The department, however, was quick to point out that it was not an admission that vaccines cause autism, and the federal Centers for Disease Control and Prevention held a teleconference to emphasize that all of the science points to no link between the two.
The U.S. Court of Federal Claims is scheduled to begin a test trial Monday in the Omnibus Autism Proceeding on whether the preservative thimerosal in vaccines causes autism. That trial, which is expected to last through the month, is meant to settle some of the central questions to about 4,800 claims related to autism filed with the National Vaccine Injury Compensation Program.
To advocates and some parents of autistic children, including Leslie Mann, the Poling case is an admission from the government that they have long awaited.
"We've always been strong proponents that the vaccines are implicated in this," Mrs. Mann said. "I think it's a positive thing that somebody is finally looking at it and looking at it case by case."
Because the Mann boys were born prematurely, they were probably still undersized for their age when their vaccinations started, which might have contributed to the damage. It is not only the number of vaccines but also the age at which children get them that concerns Mrs. Mann, a pharmacist.
"I think that children are vaccinated way too early," she said. She has stopped her sons' vaccinations and has a medical waiver to keep them from getting more.
But the Poling case is one in which the disability stems from the underlying mitochondrial disease, not vaccine-created problems, said vaccine expert Paul Offit, the chief of the Division of Infectious Diseases at the Children's Hospital of Philadelphia.
"Anyone who reads (Hannah Poling's) story, who has a child with autism, would not see their child in her story," he said. And although he can't understand why the government would have conceded, it's still not evidence of a link between vaccines and autism, Dr. Offit said.
"This was not some scientific truth or medical truth. It was just a court making a decision based on the information they had," he said. "If you want to answer the question about whether vaccines cause autism, do studies."
Dr. Offit can point to more than a dozen comprehensive studies that failed to link a vaccine or thimerosal to autism. The disease is genetic, he said, and the fact that the Mann boys show various levels of it is typical of all genetic diseases.
Though multiple births and prematurity showed up more often in families with autism than those without in a study of New Jersey families, the sample size was too small to draw any conclusions about multiple births being a risk factor, said lead author Michael Brimacombe of the University of Medicine and Dentistry of New Jersey.
Mrs. Mann, who believes thimerosal was a factor, says there was probably also some kind of genetic predisposition involved.
"Then I think it is the domino effect of other things going on at the same time," she said.
That some cases might be caused by a multitude of factors working together is probably true, said Andrew Gerber, a research fellow and autism researcher with the New York Psychiatric Institute and Columbia University.
"These complex illnesses like autism that are many different types of illness clearly have a myriad of factors. That part of the theory I would not want to lose," Dr. Gerber said. "It's the part that says that one of those important factors is the vaccine that I think that you have to listen to the science and the lack of evidence to support it."
That autism and vaccines have received attention from presidential candidates is further heartening to Mrs. Mann.
"Now these are real issues," she said.
Reach Tom Corwin at (706) 823-3213 or firstname.lastname@example.org.