Do Vaccines Cause Postural Orthostatic Tachycardia Syndrome (POTS)? Review of Cases in the National Vaccine Injury Compensation Program

IF 3.2 3区医学 Q2 CLINICAL NEUROLOGY

Pediatric neurology Pub Date : 2024-09-27 DOI:10.1016/j.pediatrneurol.2024.09.025

Waqar Waheed MD, Gregory L. Holmes MD

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引用次数: 0

Abstract

Purpose

The National Childhood Vaccine Injury Act of 1986 created the National Vaccine Injury Compensation Program (VICP), a no-fault alternative to the traditional tort system. Since 1988, the total compensation paid exceeds $6 billion. While postural orthostatic tachycardia syndrome (POTS) is a frequent reason for filing a claim, there has been no review of the process and validity of the legal outcomes given current medical information. The purpose of this study was to review vaccine-related POTS and assess the rationale behind decisions made by the court.

Methods

We identified 102 unique cases with POTS. All published reports were reviewed for petitioner’s theories supporting vaccine-induced POTS, respondent’s counterarguments, the final decision regarding compensation and the rationale underlying these decisions. The primary goal was to determine which factors went into decisions regarding whether vaccines cause POTS.

Results

In deciding the cases the Special Masters hearing the cases places a high reliance on expert witnesses for both the petitioners and respondents. Petitioners’ experts frequently implicated vaccines, primarily human papillomavirus vaccine (HPV) as causing POTS through autoimmunity induced by molecular mimicry. However, in none of the 102 cases was POTS considered to be directly caused by a vaccine.

Conclusion

Despite the lack of epidemiological or mechanistic evidence indicating that childhood vaccines covered by the VICP result in POTS, these cases continue to be adjudicated, at considerable cost to the government. Unless there is emerging scientific support for implicating vaccines in POTS it is time that the VICP stop considering these cases.

查看原文本刊更多论文

疫苗会导致体位性正位性心动过速综合征吗？国家疫苗伤害赔偿计划案例回顾》。

背景：1986 年《全国儿童疫苗伤害法案》创立了全国疫苗伤害赔偿计划 (VICP)，这是传统侵权制度的一种无过失替代方案。自 1988 年以来，支付的赔偿总额已超过 60 亿美元。尽管体位性正位性心动过速综合症（POTS）是一个经常被提起索赔的原因，但鉴于目前的医疗信息，还没有对法律结果的过程和有效性进行审查。本研究的目的是审查与疫苗相关的 POTS，并评估法院做出裁决的理由：我们确定了 102 例 POTS 病例。我们对所有已发表的报告进行了审查，以了解申请人支持疫苗诱发 POTS 的理论、答辩人的反驳、关于赔偿的最终裁决以及这些裁决背后的基本原理。主要目的是确定哪些因素会影响有关疫苗是否会导致 POTS 的决定：在裁决案件时，审理案件的特别法官高度依赖申请人和被申请人的专家证人。请愿人的专家经常暗示疫苗（主要是人类乳头瘤病毒疫苗）会通过分子模仿引起自身免疫而导致 POTS。然而，在 102 例病例中，没有一例 POTS 被认为是由疫苗直接引起的：结论：尽管缺乏流行病学或机理方面的证据表明 VICP 涵盖的儿童疫苗会导致 POTS，但这些病例仍在继续审理，政府为此付出了巨大的代价。除非有新的科学证据证明疫苗与 POTS 有关，否则现在是时候让 VICP 停止审理这些案件了。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric neurology 医学-临床神经学

CiteScore

4.80

自引率

2.60%

发文量

176

审稿时长

78 days

期刊介绍： Pediatric Neurology publishes timely peer-reviewed clinical and research articles covering all aspects of the developing nervous system. Pediatric Neurology features up-to-the-minute publication of the latest advances in the diagnosis, management, and treatment of pediatric neurologic disorders. The journal''s editor, E. Steve Roach, in conjunction with the team of Associate Editors, heads an internationally recognized editorial board, ensuring the most authoritative and extensive coverage of the field. Among the topics covered are: epilepsy, mitochondrial diseases, congenital malformations, chromosomopathies, peripheral neuropathies, perinatal and childhood stroke, cerebral palsy, as well as other diseases affecting the developing nervous system.