“Shaken baby syndrome”, also known as abusive head trauma, is made up of a triad of medical findings that suggest child abuse: subdural hematoma, brain swelling, and retinal bleeding. But alternative reasons for these findings have been suggested, both in the literature and in legal trials concerning child abuse (1). Researchers at the Children’s Hospital of Philadelphia (CHOP) decided to investigate one such claim – namely, that vaccination injection can cause retinal hemorrhage (RH) in young children. The study authors assert that there is currently no plausible mechanism to explain how RH might be caused by vaccination – one hypothesis is that vitamin C deficiency, coupled with the foreign proteins introduced by vaccines, leads to elevated histamine levels and causes capillary fragility, bleeding, and bone fractures, but there is currently no data to support this.
To investigate the hypothesis, dilated fundus examinations of 5,177 outpatients at the CHOP pediatric ophthalmology clinic, aged one to 23 months old, were reviewed. Of the study group, nine children had RH, a prevalence of 0.17 percent – but all nine had abusive head trauma diagnosable without the ocular findings – making an RH prevalence of zero if these children are excluded. In children with full immunization records (a subset of 2,210 children), none had RH within a week of vaccination, one had RH within two weeks, and no additional children had RH at three weeks. Based on these results, the researchers found no temporal association between vaccination injection and retinal bleeding (2).
The study authors conclude that RH is rare in children under two years, and excluding cases where there are other known conditions, such as a history of intraocular surgery, the most likely explanation for its presence is trauma, and advise that “ophthalmologists noting incidental retinal hemorrhage on an outpatient examination should consider a child abuse evaluation in the absence of other known ocular or medical disease.” If further study confirms these findings, the consequences could be far reaching, as the vaccine theory has not only previously appeared in the literature, but it’s also been used as a defense argument in the courtroom.
References
- W Squier, “The ‘shaken baby’ syndrome: pathology and mechanisms”, Acta Neuropathol, 122, 519–542 (2011). PMID: 21947257. G Binenbaum, et al., “Evaluation of temporal association between vaccinations and retinal hemorrhage in children”, JAMA Ophthalmol, [Epub ahead of print] (2015). PMID: 26335082.
