MMR RIP? (we hope)

http://www.timesonline.co.uk/article...931673,00.html

The Sunday Times Magazine

December 14, 2003

MMR RIP? REPORT BY ROBERT SANDALL A conspiracy of silence or paranoid scaremongering? Is the MMR
vaccine a cause of autism  or is it a vital health programme undermined by this medical maverick?

In March, seven mentally disturbed British children and an escort of parents, carers, two doctors
and three lawyers flew to Detroit, Michigan, for a medical test that had been denied them in the UK.
The procedure, a lumbar puncture to extract specimens of cerebral spinal fluid (CSF), is
uncomfortable and requires anaesthetic  but it is routinely carried out in advanced western
countries in the treatment of many chronic ailments, such as leukaemia. In the cases of these
children, all of whom were prone to seizures as well as a range of self-harming antics, an analysis
of the liquid that bathes the brain had been separately recommended by two neurologists.

Over the course of a year, the 246 private and NHS hospitals in Britain equipped to carry out CSF
taps had declined to touch them, usually on the grounds that the test amounted to human
experimentation, not treatment. In November 2002 one hospital briefly assented before putting the
matter before its ethics committee, which decided four months later not to proceed for the same
reason: the children were being used as guinea pigs.

It was an arguable point. Before an illness can be treated, it must be fully understood, and the
root of these children's problems hadn't been ascertained. By the time a hospital outside Detroit
agreed to accept them in March, their parents and advisers were worrying that the tests would never
take place. They were nearly proved right.

On the night before the children arrived at the hospital, lawyers acting for GlaxoSmithKline (GSK),
Merck and Aventis Pasteur MSD, manufacturers of the MMR triple vaccines that have been used in the
UK since 1988, approached a High Court judge in London for an injunction to prevent the CSF taps
going ahead. Two of these combination jabs had been called into question before: Pluserix, by Smith
Kline (pre-Glaxo), and Aventis Pasteur's Immravax were withdrawn in 1992 after the "urabe" strain of
mumps virus used in them was deemed responsible for a meningitis outbreak by the health authorities
in Canada. That strain was replaced and M-M-R II, patented by Merck but licensed to GSK, became the
triple jab most often offered in the UK. Now the possible misbehaviour of the measles component was
at issue. The drug companies wanted a delay because their medical representative needed to be
present at the procedure, but couldn't get to Port Huron, Michigan, in time. The injunction,
however, was denied.

The children were the claimants in a "class action"  legal-speak for a case launched jointly by
victims with the same grievance. If successful, it would validate the claims of 1,300 other British
families and trigger international damages awards that could top $1 trillion. The proposed test, to
look for traces of measles-vaccine virus in the children's CSF, could provide evidence that it can
pass from the gut's lining into the brain, where measles is known to affect cerebral processes.

This is one of the most contentious issues in the row about what, if anything, brings on a disease
described, but not universally accepted, as "autistic enterocolitis". In the UK, the condition was
first identified by Dr Andrew Wakefield, but scientists in Japan, Norway, Ireland and the US
(including Buie, Winter and Kushak, based at Harvard) have also published research supporting a link
between intestinal disease and autism.

The theory that a malfunctioning or "leaky" gut sends partially digested food  in the form of
opioid compounds known as peptides  up to the brain is one of the less controversial aspects of the
hypothesis under investigation. Whether measles vaccine is what gives rise to the gut disease in the
first place is the trillion-dollar question. So far, the sum of Wakefield et al's discoveries has
not met the exacting medical standards that establish causation. All it points to is an
"association". But the importance of the spinal-fluid link was well understood by the defendants in
the class action. Merck's QC had recently referred to it in court as "a significant result when
trying an issue as to whether or not MMR vaccine causes autism".

Time was running out for the claimants. Their action was being financed by the Legal Services
Commission (LSC), a successor to the Legal Aid Board, which had set a July deadline for the
submission of expert medical evidence, after which funding would be reviewed. Having lost a year
trying to get the CSF samples in the UK, they now had to fly seven severely autistic, occasionally
violent children  most of whom had never been in a plane before  halfway round the world.

Another bid by the defendants to secure an injunction, this time in the US, also failed. Then the
hospital called the British party in Detroit to cancel their appointment.

Although lumbar taps on autistic children are common in the US, this batch, Lansing hospital now
felt, constituted unwarranted human experimentation.

But the children's camp had an undisclosed back-up plan. They had made an arrangement with another
hospital in Port Huron, two hours along the shore of Lake Michigan, and this time, despite further
delaying tactics from the lawyers in London, the CSF taps went ahead. One of the seven children
reacted badly to the anaesthetic and couldn't be tested; the other six were fine.

Now the party and the fluid samples had to be flown home for analysis. There was bedlam on the bus
as the anaesthetic wore off: one child tried to exit the moving vehicle by the back door, while
another was restrained by his mother in the toilet. At the airport, the container of dry ice
carrying the CSF was deemed too large to be carried on as hand luggage, and another business-class
seat had to be specially purchased for it.

After the KLM flight had boarded, five US customs officers arrived to take the lawyers and doctors
off the plane  the only passengers they apprehended  for separate, 30-minute taped interviews.
They weren't asked any questions pertaining to passenger safety and their large container: the issue
was why the children hadn't been tested back in the UK. In transit at Schiphol airport in Amsterdam,
they were again singled out for more questioning.

By now, several tired minds were stoking their paranoia that these interventions might, just might,
have been orchestrated to delay delivery of the samples, allowing them to spoil. So when the
virologist in the party, Colin Fink, got them back to his private lab, Micropathology, in Coventry,
he took the unusual precaution of placing an armed guard outside overnight.

The next day the CSF samples were couriered to their final destination: Professor John O'Leary's
laboratory at Trinity College in Dublin, a facility whose viral-testing kit had previously
identified the DNA of measles in the guts of autistic children. Rather disconcertingly, the package
appeared to have been opened en route, but with the war in Iraq only two days old, customs
everywhere were on high alert.

The analysis proceeded: three of the six samples tested positive for the vaccine strain of measles
virus, but only in minuscule genetic fragments  and not enough to count as a valid research sample.
According to medical-research protocol, that result had now to be compared to the CSFs of a
"control" group of non-autistic patients. Acquiring these took several months, during which the
claimants missed the LSC's July deadline and had their funding temporarily suspended awaiting an
appeal on September 30.

When the doctors finally assembled their evidence, the children's lawyers felt confident. Only 1 in
20 of the control group  all leukaemia sufferers, specifically chosen for their high susceptibility
to random viral infections  was found to be carrying measles virus in their CSF.

The defendants' analysis of the same samples, carried out by Dr Peter Simmonds at Edinburgh
University, had found no trace of measles in the children's CSF. But Simmonds had chosen to use a
different viral tracker, Nested, rather than the claimants' TaqMan process. Given the accepted
centrality of findings in this area, they felt that their case against MMR looked strong enough to
take to court in April 2004. But the four adjudicators on the LSC's funding-review committee
disagreed with them. Justifying the £15m already spent as having served the "wider public interest",
the committee stated that the £10m needed to see the action through "would not prove a link between
MMR vaccine and Autistic Spectrum Disorder".

The claimants' lawyers suspected that the committee had made up their minds before considering the
CSF test results, as these offered fresh evidence of just such a link. At the hearing, they were
told to await a decision at the end of the day, and written reasons for it two days later. But if
the answer was yes, they wondered, why would the reasons not be immediately forthcoming?

They were not reassured to discover, when they looked more closely, that the LSC's e-mailed press
release dropping the case had been originated the day before the hearing.In a footnote to editors,
the LSC admitted that its decision reflected a change of policy rather than an assessment of
evidence. "In retrospect it was not appropriate for the LSC to fund research. The courts are not the
place to prove new medical truths." That judgment is itself up for judicial review in the new year 
though the LSC is not bound to accept its recommendations

Paranoia is currently the default mood on all sides of the MMR debate. The British government is so
scared of it that health ministers will not be interviewed on it. The drug companies are on the
defensive against damages claims that, if proven, could seriously undermine their credibility and
their business. And the anti-MMR lobby is convinced a coalition of government agencies, the medical
Establishment and big pharma are against them, X-Files style.

In a leafy southwest-London suburb, the man whose 1998 paper in The Lancet kicked off the fracas, Dr
Andrew Wakefield, would prefer not to talk on the phone. He believes his line was tapped about three
years ago, and now conducts regular "sweeps" to check it for bugs.

Visiting the house whose garage has served as his office since he resigned his post at London's
Royal Free hospital in 2001, it strikes you that Wakefield can't be doing this for the money. From
the outside, his house looks as if it might be the only squat in an otherwise tidy, middle-class
road, its overgrown front garden dominated by a tree stump curiously carved into a V-sign (a message
to the former chief medical officer, Sir Kenneth Calman, he later tells me). Unlike many of the
activists in the anti-MMR camp, Wakefield is a man unscarred by family tragedy. His four children,
the eldest of whom is 13, are as fit as fleas, tearing around the house and back garden. All have
had vaccinations, he says, though not the MMR jab. As he first said in public in 1998, he's a one-at-a-
time man where vaccination is concerned.

In appearance he's like a genial fly half, solidly built, with hooded, watchful eyes, a boyish grin
and an easy manner. What bothers him most, he says, is the way his research has been rubbished by
colleagues who deny gut treatment to children who, he believes, badly need it. On his laptop is a
photograph of Laurence, an autistic boy with a severely distended belly, whose mother has been
accused of starving him and was refused access to a paediatric gastroenterologist. Next to Laurence
in the picture stands his healthy, unstarved sister. This is a classic case of autistic
enterocolitis, says Wakefield. "He's clearly sick. That boy and his mother are being maltreated by
the medical Establishment." Such vehement declarations don't endear him to many of his former
colleagues.

Wakefield feels pretty maltreated himself. Since qualifying in 1985, he has published 128 papers in
"peer-reviewed" journals, articles that are read and assessed for their scientific credibility by an
independent panel of up to five experts before being printed. His CV is a wodge of impressive titles
and tricky acronyms: The Lancet, JAMA (The Journal of the American Medical Association). He has
published 49 papers on aspects of autistic enterocolitis, the most recent in November's Journal of
Clinical Immunology.

Wakefield's big beef is that his clinical findings haven't been properly challenged on their own
terms. He conducts or collates the results of colonoscopies and biopsies of particular children. He
calls this "scoping the kids". His opponents take a different tack: some have failed to replicate
his findings using different clinical procedures and technologies. Others say his samples are too
minute, anatomically and numerically, and examine the statistical incidence of autism versus uptake
of MMR, and any adverse aftereffects. Study after study has found no correlation. Research
published this year in America found a "statistically significant" risk of autism in cases reported
5 to 10 days after MMR, but in general the statistics suggest that Wakefield is making a mountain
out of a molehill.

But the way this data is compiled and analysed is troubling. In Britain, the reporting of bad
vaccine reactions is down to parents and harassed GPs, who have to fill out and forward yet another
form to a national database, the so-called "yellow-card" system. Big studies abroad, in Finland in
1998 and Denmark last year, found nothing to worry about. But a similarly reassuring analysis in the
US, published in the November issue of Pediatrics, has started a firestorm in Washington. A
transcript of a conversation at the federal Center for Disease Control and Prevention
(CDC), obtained under the Freedom of Information Act, revealed officials admitting that data on MMR
could be manipulated to prove, or disprove, anything. The US representative Dave Weldon, a
qualified doctor himself, wrote an open letter to the head of the CDC, noting its "selective
use of data" and pointing out that the lead author of the study left the CDC two years ago to
work for GlaxoSmithKline.

Wakefield, too, has taken a bit of stick from public officials recently. "Junk science"  a term
used earlier this year by a High Court judge awarding in favour of a suit brought by two estranged
husbands against their wives' decision not to give the triple jab to their children  particularly
rankles. Why wasn't he called as the expert witness for the defence, rather than Jayne Donegan, a
homeopath and GP from south London, he wonders. (Donegan was reprimanded by the judge for not
answering the court's questions.) "It was a disgrace. We've published a lot on this in eminent
journals. The first we heard of that case was when it was thrown out of court."

Life was different before he and six of his Royal Free team published their Lancet bombshell, the
unexplosively titled "Ileal-Lymphoid-Nodular Hyperplasia, Non-Specific Colitis and Developmental
Disorder in Children." Up until 1998, Wakefield had been a whiz-kid. His discovery that an
inflammatory bowel disease, ulcerative colitis, can be brought on by arterial problems rather than,
as was previously assumed, by a gut full of germs, made his name. It also established his modus
operandi. As a trained surgeon, he based his research on observation rather than textbook
precedents.

Wakefield's next hypothesis was more controversial: the presence of measles virus in the wrecked
intestines of sufferers of Crohn's disease  a finding that was not replicated in worldwide
studies set up by the World Health Organization in 2000  led him to his first brush with big
pharma. His co-funders, Merck, pulled out just before he published in 1996. Though he had
previously received half a dozen research grants, totalling around $500,000, from Glaxo and Hoffman-
LaRoche as well as Merck, his drug-company funding now disappeared. So he recruited a medical
fundraiser, Robert Sawyer, to tap alternative philanthropic bodies, and ploughed on looking for
gut measles. When Rosemary Kessick, the mother of an autistic child, came to him convinced her
son's problems were related to the chronic diarrhoea he developed after having the MMR jab,
Wakefield listened and looked.

Conventional diagnosis attributed the concurrence of autistic behaviour and severe bowel problems to
coincidence, or held that disturbed minds naturally led to upset tummies. Wakefield wondered if the
reverse might be true. Could "leaky guts" play a role in developmental problems? And if so, could
these problems be alleviated by addressing the inflamed intestines? Other specialists regarded
autistic children as medically untreatable, and none of Wakefield's business: he was a gut man. But
the interventions he proposed seemed to work. Among the 200 or so children he oversaw, on average
four times a year each at the Royal Free, their behavioural problems appeared to subside, though not
disappear, as their guts healed. "These kids were often in extreme pain, and that was why they were
screaming or banging their heads on the wall."

In the 12 cases that he and his team examined in detail, the children's bowel problems coincided
with evidence suggesting that measles was lurking in the intestinal wall. Given the known propensity
of measles to linger in the gut and, in extreme cases, to attack the brain, might this implicate MMR
in their children's autism?

It was, to put it mildly, an awkward question. Wakefield had already raised eyebrows by treating
patients traditionally cared for by psychiatrists, virologists and community paediatricians. One of
the latter had complained in a letter to a colleague in 1987 about "a zealot surgeon who thinks that
MMR is the cause of all the problems in the western world". Now others accused him of over-egging
the Lancet article. "Anecdotal reporting of a biased sample,"one complained. "This has no place in a
peer-reviewed journal."

And soon the fur started to fly. Wakefield had cooked the evidence by concentrating on just 12
cases. His research facilities were contaminated. He couldn't replicate his own results. The last of
these charges was true enough. For the first few years, his research results were inconsistent and
contradictory. He blames this on the measuring technology. He says that changed in 1999 with
Professor John O'Leary and his TaqMan viral detector, a machine sensitive enough to pick up minute
traces of measles vaccine DNA in 75 autistic children with disorderly bowels. O'Leary has refused to
finger MMR but he has demanded "extensive and immediate investigation" into the link. The presence
of vaccine-strain measles, as opposed to the "wild" variety, O'Leary referred to as "a smoking gun".

The Department of Health (DoH) was not impressed. Despite Wakefield's submissions to the then chief
medical officer, Kenneth Calman, six months prior to publication of the 1998 Lancet article, public-
health officials were understandably resistant to a hypothesis that queried their vaccination
programme on the basis of one small group of children in north London. But not as resistant as the
drug companies who, as they generally do in teaching hospitals, sponsored a large chunk of the
Royal Free's research. Everybody, Wakefield and co included, agreed that more studies were needed
before MMR could be shown as a cause of autism. Not everybody, though, was urging that these should
take place.

Over the next three years, Wakefield saw his research funding dry up. He blames his bosses at the
Royal Free for discouraging potential donors. They blamed him for being "evangelical" and needlessly
scaring parents. Two key members of his team, Paul Ashwood and Scott Montgomery, found themselves
with little to do, and took up new posts, in California and Stockholm, from where they have
continued the collaboration.

Not all of Wakefield's team were as convinced as him that MMR was the culprit. One of the co-authors
of the 1998 Lancet paper, Simon Murch, senior lecturer in paediatric gastroenterology at the Royal
Free, recently declared his belief that MMR is safe in a letter to The Lancet headlined "Separating
Speculation from Inflammation in Autism". Murch made his move on the eve of publication of a study,
by himself, Wakefield and others, which compares the aggressive behaviour of gut measles to HIV,
adding more fuel to the conspiracy-theorists' view that scientists connected with Wakefield are
being pressurised to recant. When asked, Murch declined to comment.

Unlike Murch, who stayed put, Wakefield left the Royal Free, "because it became increasingly obvious
that if we were going to get an answer to this, we had to work outside of an environment where I was
getting more involved in personal wrangles and the attrition of grants", he says. Robert Sawyer
jumped ship at the same time to set up a charity, Visceral, that investigates gut-mediated illnesses
and supports projects that test Wakefield's theories.

Visceral's head, and only, office is a converted broom cupboard in the centre of Bath from which
Sawyer describes himself as running "a virtual medical school", one that has paid out £1.8m grants
to 31 lab scientists around the world. His funding sources are mainly small charitable foundations
in the UK and US, set up to support independent research (there are around 50,000 in the UK alone).
Visceral, he says forcefully, will not take money from cranks who believe that all vaccinations are
the devil's work. They are currently funding work on genetic mechanisms that may be perverted by a
malign viral presence in the gut, and which lead the body's immune system to turn on itself 
"aberrant signalling". The search for the virus that sets it off is a clinical whodunnit in which he
and Wakefield still have measles vaccine down as their chief suspect.

Almost everybody who speaks out on MMR has a defined stake in it. My reason for getting into all of
this is simple: Anita and I have a 16-month-old daughter, and we have a tricky decision to make.

How her developing immune system will benefit from getting three vaccines in one go, rather than
having them singly and spread out over a few months, has not been adequately explained. On the other
hand, Wakefield's belief in "viral interference"  a tendency for invading viruses to do more damage
when they're combined  sounds plausible. He quotes three papers published in America and Japan
between 1969 and 1974, identifying the dual presence of the mumps and measles viruses as a factor
that can make the measles more virulent and dangerous.

The DoH derides this as a "myth" but doesn't explain why on its web page: MMR The Facts. And there
is another fact to be considered: the British government's recent acknowledgment that "Gulf-war
syndrome"exists. Most of the military personnel afflicted believe it was brought on by multiple
vaccinations prior to the 1991 conflict. The government hasn't publicly confirmed this but,
tellingly, when British troops were sent to Iraq this year, their jabs were not all given at once.

Multiple vaccinations are not my thing. I am of an older generation that was expected, even
encouraged, to catch measles and mumps in early life and get over them. The first I knew that I had
survived a killer illness was when Edwina Currie, the health minister who introduced MMR in 1988,
revealed that we were "losing a child a month in this country" to measles.

Which was not strictly true. In the year before MMR came in, the Public Health Laboratory Service
counted six deaths from a reported 42,000 measles cases. That rate has subsequently declined from 1
in 7,000 to 1 in 10,000. SSPE (subacute sclerosing panencephalitis), in which measles destroys the
brain in a manner similar to variant CJD, hits about 1 in 8,000 children who catch the disease
before the age of two. Measles epidemics are undoubtedly nasty: 130 children died in the last big
outbreak in the United States in 1989.

When the single measles jab was introduced here in 1968, it was urged not so much as a life-saver,
but as a means of relieving pressure on GPs during epidemics. Its early popularity related to other
side effects that afflict measles sufferers, such as impaired eyesight. Mumps vaccine, on the other
hand, was a harder sell. Mumps can cause sterility in adults but only rarely damages children, and
the single mumps jabs did not catch on. Bundling these two vaccines with the rubella jab, previously
given only to girls at age 12, and offering the package to all children at 15 months, seemed from
the outset to have more to do with administrative convenience than with public health.

In its 1988 HMSO Handbook of Vaccination for Practitioners, the DoH claimed a 95% protection rate
for the rubella-and-measles single jabs. In its 1996 edition, post-MMR, the measure of effective
measles immunity had dropped to 90%  beneath the threshold guaranteeing "herd immunity". But by now
the DoH's data-collection system no longer recognised single jabs in the compiling of individual
health records.

Today we are informed that MMR is more effective than single vaccines, as well as unimpeachably
safe. But government ministers are reluctant to address the issue in detail, preferring to issue
bland reassurances such as the one the health secretary, John Reid, made on GMTV in November: "It is
unequivocal that there is no evidence at all that MMR is linked to autism."

Off the record, however, DoH media briefers acknowledge that MMR has become "too political". After
receiving wobbly guidance on poisoned eggs, mad-cow disease and the anti-arthritic drug Opren, the
public no longer believes elected politicians on health issues, so comments on MMR are kept to a
minimum. David Salisbury has presided over all vaccination programmes for the past 15 years, and
currently advises the junior minister for public health, Melanie Johnson.

Neither of them would speak to me about a successor to MMR that was first revealed in the press in
1998, shortly before the Wakefield paper. This was MMRV  V as in varicella, or chickenpox. The DoH
now denies any interest in this, possibly because research on MMRV has shown it doesn't work. A
study partly funded by GlaxoSmithKline, published last year by the University of Melbourne, found
that quadruply vaccinated children were more prone to suffer fevers immediately afterwards than
those given MMR and varicella vaccines separately. Worse, they did not develop a significant
immunity to chickenpox after 60 days. But the drug companies haven't given up: recent press reports
tell of more tests on MMRV proceeding in Sheffield. The DoH says it is "not aware of such a product
being available for use in the UK".

The row about MMR derives in part from a chronic uncertainty as to what autism describes. A year
after it was identified in 1943, by Leo Kanner in a study of 11 profoundly uncommunicative,
unruly children, a variant  Asperger's syndrome  proposed a less serious version, in which poor
social skills are offset by an obsessive attention to detail that can lead to high academic
performance. For years, autism was thought to be caused by unloving parents, and "refrigerator
mothers" in particular. In the 1960s it was redefined as an inherited brain disorder, and then
came a distinction between classic congenital autism and a regressive variety acquired after the
age of two.

Autism is now referred to as a spectrum disorder, a catch-all syndrome whose symptoms range from semi-
suicidal lunges out of windows to a relatively harmless obsession with order and routine.
Wakefield's theories about leaky guts blur definitions further by challenging the traditional view
that autism is a purely psychiatric problem, and arguing that it can be treated by medical means as
well as by behavioural therapies.

One thing that is apparent is that there is a lot more of it about nowadays. We all know, or know
of, somebody with an afflicted child. Authors, notably Nick Hornby, whose ex-wife Virginia used to
be a trustee of Visceral, have written about their experiences as parents. Official statistics from
the Medical Research Council (MRC) in 2001 revealed the rate had shot up from 1 in 5,000 per head of
population in 1970 to 1 in
165. In 1988, when MMR was introduced, it was 1 in 2,200.

That might be coincidence, and it might be that as the spectrum of the disorder has broadened, we've
got better at spotting it. Wakefield's former colleague at the Royal Free, Professor Brent Taylor,
last year published a statistical analysis of children in north London showing that an autism
epidemic was well under way before MMR. Then it was pointed out by Wakefield and Montgomery that
many children in the survey who appeared, from their date of birth, not to have had the triple jab
but who still developed autism, might have been included in an extensive "catch-up" MMR campaign
targeted at older children in the early 1990s. Taylor later acknowledged this in a letter to The
Lancet, but stands by his broad findings.

In response to my request for clarification, he replied that "the scientific argument on MMR and
autism is over: MMR vaccine is not involved". He urged The Sunday Times to "do something positive"
for MMR and for children with autism, instead of "another half-baked panagyric [sic] for junk
science". I pressed him to explain what he meant by "junk science". He didn't mail me back.

Such reticence from the pro-MMR party does not inspire confidence. Nor do their efforts to identify
alternative causes for the steep increase in diagnosed autism. The Medical Research Council was
given £2.75m by the DoH last year to fund new research. So far, none of that money has been
allocated, though 12 projects are, it says, "under consideration". No details could be supplied.

Meanwhile a three-year study that the MRC commissioned in 2000 from the London School of Hygiene &
Tropical Medicine has not yet reported. Two papers are being readied for publication, one assessing
the rise in autism since 1988 and another looking at possible links with MMR. The scientist in
charge, Professor Andrew Hall, has inspected the GP records of 1,000 children diagnosed as autistic
and sent questionnaires to 400 parents. Since none of Hall's team has been near an autistic child,
whatever he reports is unlikely to silence Wakefield and the "scopers". It's stats against case
studies, the old apples-versus-oranges argument. Again.

On the day the Legal Services Commission announced it was pulling out of the MMR class action, the
DoH endorsed that, stating that "this draws a line" under the controversy. Some hope.

Tomorrow, Five is scheduled to screen a TV drama, Hear the Silence, with Hugh Bonneville as Andrew
Wakefield and Juliet Stevenson as the mother of an autistic child battling to get heard by an
unsympathetic gang of haughty specialists. It is a partisan account of the MMR story, so partisan
that Five has organised a televised discussion afterwards to let the DoH answer back. At the time of
writing, it had not agreed to take part.

The most misleading impression given by the drama is its portrayal of Wakefield as a gallant loner.
In October, I flew to Portland, Oregon, to attend a conference hosted by the American pressure group
Defeat Autism Now! (Dan!), where Wakefield was one of 23 research scientists  all confirmed as anti-
MMR  making presentations to an audience of medics and parents. The last speaker was Rick Rollens,
formerly secretary to the California state senate, and the father of an autistic son.

He presented a torrent of statistics detailing an 800% increase in diagnosed cases of autism since
California introduced MMR jabs in 1979 and made them compulsory, in line with a nationwide Clinton
decree in 1993. The state's Developmental Services Agency now finds that just under half its clients
are autistic, compared with the 3% it dealt with pre-MMR. The epidemic, Rollens said, was
threatening to wreck care provision in the nearly bankrupt public administration of California.

This was a depressing and biased presentation. But at least it dealt in what looked like hard facts.
Shortly after returning from Dan!, I attended a public seminar in London that addressed the
MMR/autism issue in ostrich-like fashion. It was hosted by the PR company Hill & Knowlton, whose
clients includes the three drug companies that manufacture the triple vaccine, and it was introduced
by an online magazine, Spiked, one of whose columnists, the east London GP Michael Fitzpatrick, led
the discussion. The audience was chiefly composed of health professionals, DoH representatives and
media types. Two things stood out.

One was the meeting's concern that anxieties about MMR had been hyped by our old enemy the media.
The other was its refusal to address the evidence that aroused public distrust in the first place.
For these people, immunisation was an incontrovertible religious doctrine. Fitzpatrick rubbished the
work of Wakefield, whose research papers currently outnumber his own by 128 to 0, as a superstition
on a par with astrology. When somebody mentioned the divergence of scientific opinion, Professor
Brent Taylor interrupted, again announcing that "the scientific debate is over".

Andrew Wakefield has no plans to belt up. More studies are in the pipeline  so, no doubt, are more
allegations of cover-ups and conspiracies. If Wakefield is proved right, then we've been poisoning
our offspring, avoidably, since his 1998 study. If he's wrong, then let's hear some intelligible
evidence ASAP, so we can get MMR vaccination rates up  from 67% in the London area and under 80%
across the country  to head off threatened measles epidemics. And single vaccinations need to be
reinstated as an affordable alternative to the worrisome triple jab. A typical price for a private
measles jab is £150.

Having spent £3m on a TV ad campaign urging triple vaccination, with a prowling lion protecting its
young  which didn't work  the DoH's current course is to carry on ignoring Wakefield et al.

A low-profile series of educational road shows and advice sessions in the 20 areas of the country
with the lowest take-up of MMR began in the summer. In London, the country's anti-MMR capital, these
have been almost invisible.

Such a feeble defence of the status quo, and a blanking of public anxieties that might be misguided
but are nonetheless genuine, may suit embattled drug companies and embarrassed government policy
wonks. But it isn't going to silence the enemies of multiple vaccination  nor will it do much good
for anybody's health.

I noticed in the article that he prefers 'case studies' to 'statistics'.

--

Douglas Clark, Bath, Somerset, England .... Lynx: Poetry from Bath ...... ...
http://www.dgdclynx.plus.com/lynx.html

"john" <whaleto@btinternet.com> wrote in message
news:1ad65102.0312141457.1679f6cd@posting.google.com...
> http://www.timesonline.co.uk/article...931673,00.html
>
> The Sunday Times Magazine
>
> December 14, 2003
>
> MMR RIP? REPORT BY ROBERT SANDALL A conspiracy of silence or paranoid scaremongering? Is the MMR
> vaccine a cause of autism

No. Various studies have *not* been able to show that autism is caused by
MMR.

There is much evidence that indicates that MMR does not cause autism.

> or is it a vital health programme undermined by this medical maverick?

It is a vital health program that has nearly eliminated measles, mumps and rubella disease in the US
and many other countries. It has saved thousands of lives.

Jeff

(...)