Hannah, Jon's daughter, was born in 1999 and received five vaccines in one day in 2000 at the age of 19 months; this occurred because she had fallen behind on her vaccine schedule as a result of a series of ear infections. According to Kathleen Seidel, the Poling family filed a case with the National Vaccine Injury Compensation Program on October 25, 2002. In 2006, Jon, along with three other researchers, all of whom were affiliated with Johns Hopkins at the time, published a case report and chart review retrospective series regarding the association of mitochondrial disease and autism in the Journal of Child Neurology. In 2008, after the government conceded his daughter's vaccine injury case, Dr Poling said, “Many in the autism community and their champions believe that the result in this case may well signify a landmark decision as it pertains to children developing autism following vaccinations. This still remains to be seen, but currently there are almost 5,000 other cases pending.” Hannah's case had originally been placed with the almost 5,000 Autism Omnibus cases pending hearing 5 years before her case was conceded administratively. Others have speculated that in the Poling case, all that was really conceded was that "the vaccines, given to Hannah in 2000, aggravated a pre-existing condition that then manifested as autism-like symptoms." Similarly, Rahul K. Parikh contended that "...this was not a case of vaccines causing autism. Rather, this is a case where the court deemed it plausible that vaccines aggravated an underlying disease caused by bad mitochondria, and that some of the symptoms Hannah showed were similar to autism," and Julie Gerberding said, "Let me be very clear that the government has made absolutely no statement indicating that vaccines are a cause of autism." It has also been noted that Hannah's mitochondrial disease is very rare, and that no evidence proves that it is possible for vaccines to cause or worsen mitochondrial diseases, with Chuck Mohan of the United Mitochondrial Disease Foundation noting that "there is very little scientific research in this area." In addition, Paul Offit has argued that the VICP's concession to Hannah was "poorly reasoned" and contended that this program had "turned its back on science" in recent years. Offit also noted that "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." Another unclear aspect of Hannah's case is whether she had a pre-existing mitochondrial disorder that vaccinations aggravated, or whether vaccinations caused that disorder. Hannah's mother, Terry Poling, has stated that "The government chose to believe the first theory," but added that "We don’t know that she had an underlying disorder." However, the Polings' neurologist, Andrew Zimmerman, wrote in a letter to the Polings' attorneys that there was a pre-existing mitochondrial dysfunction. Dr. Zimmerman wrote, "The cause for regressive encephalopathy in Hannah at age 19 months was underlying mitochondrial dysfunction, exacerbated by vaccine-induced fever and immune stimulation that exceeded metabolic energy reserves." On July 21, 2008, Steven Novella posted an article on Neurologica, his blog, in which he briefly mentioned the Poling case, saying, "The case was settled because both sides realized it was a special case that could not be extrapolated to other vaccine-autism cases." In response, Dr. Poling wrote a letter to Dr. Novella in which he states, among other things, that "The only thing unique about my little girl’s case is the level of medical documentation--5 to 20% of patients with ASDs have mitochondrial dysfunction." Novella's response to this letter, posted on July 23, 2008, argued that "Hannah Poling’s history has many features that are not typical of autism – like a history of otitis media with frequent fevers, seizures, and what sounds like a rare encephalitis that probably did result from vaccines. Even if we put her mitochondrial mutation aside – this is not a typical case of autism." On September 3, 2010, autism blogger Matt Carey broke the story about the settlement deal including a $1.5M initial payment and an annuity to cover costs of the life care plan. On September 9, 2010, Sharyl Attkisson also reported that the Poling family were going to receive $1.5 million for the first year alone, and might receive a total of over $20 million over Hannah's lifetime.
