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Debate rages on over whether inoculations are to blame for autism spectrum disorders

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It has been a long and bitter confrontation: On one side are the parents who are convinced their children's autism has been caused by inoculations; on the other are the vaccine manufacturers and others who contend there is no reliable scientific evidence to support the allegations.

Vaccine manufacturers have largely been protected from litigation since enactment of a 1986 law that established a no-fault compensation system, including hearings held in a special federal court.

But a Georgia Supreme Court ruling last year that held a vaccine injury case should be heard by a jury could change matters.

Many parents blame their autistic child's condition on the vaccines they received from infancy, contending in some cases that their child was developing normally until receiving such inoculations.

But others point to studies that say otherwise, including a 2004 Institute of Medicine report that concluded “evidence favors rejection of a causal relationship” between autism and either the measles-mumps-rubella vaccine or vaccines containing thimerosal, an organic mercury compound used as a preservative, both of which have been blamed for causing the disorder.

Until l999, when the American Academy of Pediatrics and the U.S. Public Health Service recommended its removal, more than 30 vaccines contained thimerosal, according to the Institute of Medicine.

Plaintiffs in all vaccine cases can file suit in civil court only after their claim has been processed by the Vaccine Injury Compensation Program, which was established by the National Childhood Vaccine Injury Act of 1986. Cases are heard by the so-called vaccine court, a division of the U.S. Court of Federal Claims in Washington.

In February, the vaccine court ruled against plaintiffs in three test cases of whether MMR and thimerosal-containing vaccines can combine to cause autism. The court is expected to release its judgment soon on the separate issue of whether thimerosal-containing vaccines alone can cause autism.

Observers say there have been relatively few lawsuits filed outside the program. Recent attention has been focused on the Oct. 6, 2008, decision by the Georgia Supreme Court in American Home Products Corp. vs. Marcelo and Carolyn Ferrari.

In that decision, the Georgia high court unanimously held the Vaccine Act does not pre-empt all design defect claims against vaccine manufacturers, providing only they “cannot be held liable if it is determined, on a case-by-case basis, that the injurious side effects of the particular vaccines were unavoidable.”

But defendants, who are seeking a U.S. Supreme court hearing in the case, point out that other courts have held differently. For instance, in a Sept. 11, 2008, decision, the 3rd U.S. Circuit Court of Appeals in Philadelphia held in Russell and Robalee Bruesewitz vs. Wyeth Inc. that the Vaccine Act expressly pre-empts design defect claims.

On June 8, the U.S. Supreme Court sought a brief on the Georgia case from the U.S. solicitor general, which observers say enhances its chances of being heard. Observers note, however, that even if plaintiffs win the pre-emption issue, they must convince a jury there is a link between vaccines and autism.

“They have a long, long way to go, regardless of whether the Supreme Court acts or doesn't act,” said Russell O. Stewart, a partner with Faegre & Benson L.L.P. in Denver.