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Headlines are tricky things.

They are written to catch readers' attention and give them an idea of what the stories are about. But if readers read no further than the headline, they may take away the wrong message.

Such was the case last month when federal health officials agreed to monetarily compensate a mother and a father from Georgia because the childhood immunizations their daugther received may have contributed to her autism-like symptoms. Readers who didn't read beyond the headlines may have assumed that federal officials are now saying vaccines are linked to autism.

This is in fact how many vocal anti-vaccine advocates have connected the dots. But that conclusion is wrong. The case involving Hannah Poling and her parents Jon and Terry Poling from Athens, Ga., does not clear up the ongoing public debate about whether vaccines are linked to autism. Indeed, it only adds to the confusion.

"Some things are clear, and some things are less clear based on this case," says Louis Cooper, MD, a vaccine expert, former president of the American Academy of Pediatrics, and a member of the steering committee of the National Network of Immunization Information. "What's clear is that vaccines still remain the best protection we have against serious infectious diseases. What's less clear is the meaning of this single case."

Federal officials say that Hannah, who is now 9, had an underlying mitochondrial disorder when she received several vaccinations at once when she was about 19 months old, The officials concede the vaccines may have stressed her body and aggravated the mitochondrial disorder, which in turn led to her autism-like symptoms.

But the parents say that the mitochondrial disorder may have been caused by the preservative thimerosal, which was used in the vaccines at the time. Thimerosal has not been added as a preservative to routine childhood vaccines since 2001. An exception has been the flu vaccine, although there are ample supplies of thimerosal-free flu shots.

The Poling case has many other medical and legal facets. For nurses and physicians, it has an unusual twist because both Terry and Jon are highly educated healthcare professionals themselves. Terry is a nurse and a lawyer, and Jon is a neurologist with an MD and a PhD. What has been lost in the headlines is that the Polings are saying children should still be immunized. In a transcript from the Poling's appearance on the "Larry King Show" on March 6, Jon Poling says, "I'm certainly not anti-vaccine. I think vaccines are one of the most important medical developments within the past century-plus. What we're trying to say, and the theory of what happened to our daughter Hannah, is that she has a susceptibility to injury from stress of vaccination or potentially stress with the mitochondrial disorder or other potential insults."

Unfortunately, there is no way to currently test for or screen children for mitchondrial disorders. Even experts on mitochondrial disorders say children should still be immunized. All the scientific evidence to date indicates there is no direct connection between vaccinations and autism, Cooper says. The best knowledge available tells us children need to be immunized.

So if someone asks you about the link between childhood immunizations and autism, make sure you read more than just the headlines. For more information about immunizations, go to www.aap.org or www.nnii.org.

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Janet Boivin, RN, is the editorial director of the New England edition of Nursing Spectrum. To comment, e-mail jboivin@gannetthg.com.

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