The test case is being closely watched by nearly 5,000 families of autistic children who have lodged similar claims for compensation from a federal fund.
The case of Michelle Cedillo, of Yuma, Ariz., is the first alleging a vaccine-autism link to be heard in the U.S. Court of Federal Claims. It and eight other test cases are important because they will guide the handling of the other pending claims. Most contend that a mercury-rich preservative called thimerosal is to blame for the impaired social interaction typical of the disorder.
Should they prevail, the families will be eligible for compensation from a federal vaccine injury fund established by Congress to ensure an adequate supply of vaccines by shielding manufacturers from lawsuits. No autism claim has been paid from the fund thus far.
Large scientific studies have found no association between autism and vaccines containing thimerosal.
Government attorney Vincent Matanoski dismissed much of what the plaintiffs are expected to present during the three-week hearing as conjecture or speculation.
"You'll find their hypotheses untested or, when tested, have been found false," Matanoski said.
Theresa Cedillo said her daughter suffered five days of fever, her temperature often spiking to 105 degrees, after receiving a measles, mumps and rubella vaccination at age 15 months. Michelle was a happy, robust, responsive and loving child - in short, normal - but hasn't been the same since, her mother told the court.
Wearing noise-canceling headphones, Michelle was brought into the courtroom in a wheelchair at the start of the proceedings. She stayed only a short time, moaning audibly several times. Besides autism, Michelle suffers from inflammatory bowel disease, glaucoma and epilepsy. In addition, her bones, weakened by years of malnourishment, are prone to breaks, Theresa Cedillo said. Everything she eats is pumped in through a feeding tube, except for crackers and water.
"Clearly the story of Michelle's life is a tragic one," Special Master George Hastings Jr. said in thanking the family for allowing theirs to be the first test case. Hastings pledged he and two other special masters would listen carefully to all evidence.
Theresa Cedillo and husband Michael allege thimerosal-containing vaccines weakened their daughter's immune system and prevented her body from clearing the measles virus after she was immunized. That theory is one of three alleged by the thousands of plaintiffs. The others claim either thimerosal or the measles vaccine alone caused their children's autism.
"We hope to find out what happened and hopefully get the help she needs," said Theresa Cedillo, who takes care of her daughter full time at home.
The burden of proof is easier than in a traditional court. Plaintiffs only have to prove that a link between autism and the shots is more likely than not, based on a preponderance of evidence. But many parents say their children's symptoms did not show up until after their children received the vaccines, required by many states for admission to school.
"These are families who followed the rules. These are families who brought children in for vaccines. These are families who immunized their children," Cedillo attorney Thomas Powers said. Later, outside court, he cast aside any suggestion his clients were anti-vaccine.
Autism is characterized by impaired social interaction. Those affected often have trouble communicating, and they exhibit unusual or severely limited activities and interests.
In 1999, the U.S. government asked vaccine manufacturers to eliminate or reduce the use of thimerosal in childhood vaccines to limit infant exposure to mercury. Today, the preservative is no longer found in routine childhood vaccines but is used in some flu shots.
The nine test cases will be heard consecutively over the next year. A ruling in the Cedillo case could take months or longer, attorneys said.
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