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Abstract
On April 11, 2008, the National Vaccine Advisory Committee took an unusual step: in the name of transparency, trust, and collaboration, it asked members of the public to help set its vaccine-safety research agenda for the next 5 years. Several parents, given this opportunity, expressed concern that vaccines might cause autism -- a fear that had recently been fueled by extensive media coverage of a press conference involving a 9-year-old girl named Hannah Poling. The VICP's concession to Hannah Poling was poorly reasoned. First, whereas it is clear that natural infections can exacerbate symptoms of encephalopathy in patients with mitochondrial enzyme deficiencies, no clear evidence exists that vaccines cause similar exacerbations. Indeed, because children with such deficiencies are particularly susceptible to infections, it is recommended that they receive all vaccines.