As a baby, Austin Pope seemed to be developing normally -- even at an advanced pace, saying 75 words at 18 months.

But a month after getting five vaccines in one day, an unusually high number at the time, Austin began regressing, said his mother, Janet Pope of Crestwood.

One morning, he woke up with a stiff neck and just flopped in her arms. Ultimately, he stopped talking, stopped making eye contact and retreated into the world of autism.

Pope, whose son is now 16, tells a common story, one she compares to a recent case that spotlights a long-simmering controversy about a possible link between childhood vaccinations and autism that has been rejected by the mainstream medical establishment.

This month, federal officials conceded that 9-year-old Hannah Poling of Athens, Ga., should be awarded damages from a federal vaccine-injury fund because vaccines worsened a rare mitochondrial dysfunction, a problem involving cell metabolism. This, they said, led to autism-like symptoms.

"I'm hoping this will break the issue wide open," said Pope, 52, a former emergency room nurse and Air Force major.

Boyd Haley, a University of Kentucky chemistry and biochemistry professor who was an expert witness in support of the Poling case, argues that the vaccine preservative thimerosal, which contains mercury, can cause autism and mitochondrial dysfunction.

"This young girl probably didn't have a disorder until'' she was exposed to thimerosal, Haley said.

Autism cases rise
There is little dispute that autism has risen dramatically in recent decades; it now affects an estimated one in 150 children. In Kentucky, more than 24,000 residents have autism spectrum disorder, up from about 1,500 in 1990.

But many experts strongly disagree that vaccines have anything to do with the increase, attributing it instead to wider and better diagnosis. Some theorize that genetic and unknown environmental factors may combine to cause autism, and they view the Poling case as an exception rather than a precedent.

The U.S. Centers for Disease Control and Prevention say "the weight of the evidence indicates that vaccines are not associated with autism" and cite an Institute of Medicine review saying much the same.

The CDC also says that while children get more vaccines than in the past -- five in a day is no longer unusual -- thimerosal generally hasn't been used as a preservative in routine childhood vaccines since 2001. The exception is some flu vaccines, although more than 10 million doses of thimerosal-free vaccine were expected to be produced for this flu season - using prefilled syringes or vials that don't require preservatives.

Despite this change, a January study from California, published in the Archives of General Psychiatry, concluded that there hasn't been any recent decrease in autism in that state.

"There are scores of studies in millions of children that show absolutely no link between any vaccines and autism. Yet this idea persists, and every once in a while this fire is fed fuel," said Gary Marshall, chief of the division of pediatric infectious diseases at the University of Louisville School of Medicine. "The parents latch onto it because they're looking for a cause. 

"The public health emergency is that if parents don't vaccinate their children, it will not be long before we see these diseases raise their ugly heads again."

5,000 pending cases
Almost 5,000 families of children with autism have cases pending through the National Vaccine Injury Compensation Program, which allows people to file claims if they believe a vaccine seriously injured them or their children.

Media reports say the Polings' exact compensation hasn't been decided.

Several Kentucky and Indiana parents, who sat in a circle sharing their stories at a preschool program called Endeavor in Louisville, said they hope the Poling case leads to more money for autism research -- a hope shared by many on the other side of the issue.

"It sends a big, loud message to the medical community," Betsy Gibbs of Louisville said as her daughter Elizabeth, 14, rested her head on her mother's lap.

Gibbs, 43, said vaccines harmed Elizabeth as a baby, and a shot for measles, mumps and rubella "really sent her over the edge."

Rachel Lu of Louisville, 39, also blamed the MMR vaccine, saying her son Noah screamed and suffered severe diarrhea within 24 hours of being immunized as a baby. Now 5, he was diagnosed with autism at age 2, and Lu suspects the disorder also affects her younger son, 3-year-old Chase.

Although Marshall said MMR has never included thimerosal, a British researcher led a high-profile but controversial 1998 study of 12 children suggesting a link between live viruses in the vaccine, bowel inflammation and autism. Several authors involved later retracted their initial interpretations.

Steve and Stephanie Shultz of Louisville, whose 4-year-old twins Ryan and Cody were diagnosed with autism in December, said they think vaccines might have triggered a genetic predisposition in their children.

The boys speak mostly in single words and socialize far less than typical children. On a recent morning at Endeavor, Cody sat perfectly still, oblivious to two nearby teachers, mesmerized by a video showing signs to help children with autism communicate.

As the couple struggles with their children's disability, they said they don't think the government will ever fully concede a vaccine-autism link. "They're going to do all they can to fight any liability they might have," said Steve Shultz, 42.

Complicating factors
Some parents said they believe the link between vaccines and autism is complicated by other factors.

Todd Popson of Sellersburg, Ind., said he thinks his son, Jeremy, had a genetic predisposition and might have gotten too many vaccines at once. A father of six, Popson said he has had his other children vaccinated, but on a different schedule so they didn't get as many at the same time.

Lisa Neal, whose 8-year-old son Jonathan has autism, is one of several parents who said their children might have more difficulty than usual eliminating certain toxins. She had Jonathan tested for heavy-metal toxicity, she said, and the amount of lead and other toxins was "off the charts," despite never having lived in a house with lead paint.

"I do think vaccines played a part in his injury," Neal, 44, said. "But I don't think it was one thing. I think it was everything."

Haley said mercury is the particular toxin at fault and cited several studies showing its toxic effect. "We showed at the University of Kentucky that if you take neurons (nerve cells that send and receive messages) in culture and add thimerosal, it will kill them," he said.

He said the rise in autism occurred just after children started getting more vaccines. "Since 1988," a 1995 CDC report said, "the U.S. childhood immunization schedule has rapidly expanded to accommodate the introduction of new, universally recommended vaccines."

Now that new vaccines don't use thimerosal, Haley said he would expect the numbers of children with autism to eventually go down. But he said many doctors and clinics gave vaccines with the preservative even after 2001, so the California study showing a continuing increase was done too early.
"I'm not anti-vaccine," Haley said. "I'm just for a safe vaccine."

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