Why the MMR-autism ‘war’ is far from over

This blog is about the safety of MMR and the science and politics surrounding this issue. I didn’t have any intention of writing about this until very recently. Let me say up front I have no special interest in this area, other than having met a significant number of people who believe their children have been damaged by vaccines. I mentioned the possibility of vaccine damage in my blog of last Friday which can you read here. This remark came in a post that was mainly about the limited value of the concept of ‘statistical significance’ in the real world.

In summary, my point was that what is deemed ‘statistically significant’ is determined by arbitrary cut-offs known as ‘P-values’. I mentioned MMR vaccination because statistical significance is often invoked when we are being ‘persuaded’ that MMR is safe. But, as I was at pains to point out, just because there is no ‘statistically significant’ link between MMR and some adverse effect, doesn’t prove that MMR doesn’t cause that adverse effect. To provide a graphic example of this I used an analogy: crossing the road may not be linked with a statistically significant increased risk of getting run over, but that doesn’t mean you can’t get run over crossing the road. Accidents can happen, after all.

One of the reasons I chose to focus on MMR last Friday is because it’s an issue where I think some have attempted to use ‘science’ to silence anyone who expresses an opinion that they do not like or disagree with and would like labeled as a ‘dissenter’. Sometimes I have been aghast at the bullying, aggressive, uncaring tone of those who would have us see those who believe their children may have been damaged by vaccination as stupid, or hysterical, or simply looking for someone or something to blame for their child’s illness.

So, I perhaps should have been too surprised when someone took me to task over the merest mention of the concept that MMR vaccination might not be a safe as we are repeatedly told it is. ‘Jdc’ in his comment (number 18) seems keen to show me what he believes are the errors of my ways, and then draws our attention to the UK Government’s dedicated MMR site. Have a look here for the soothing reassurances it offers regarding the safety of MMR.

You can read my reaction to the largely misleading, irrelevant, nonsense written there in my comment number 20 here. It seems clear to me that some will bend over backwards to insist that MMR is safe, even if that means taking people for complete dummies.

Thinking about this yesterday reminded me of how the whole MMR/autism debacle got underway. And anyone who knows anything about this subject at all will be familiar with the name Dr Andrew Wakefield. For he is the doctor often ‘blamed’ for any mistrust in MMR as a result of his study, published a decade ago, which suggested that their might be link between vaccination (the measles component of the MMR vaccine) and bowel disease/autism.

Some of you may know that on and off now for about the last year Andrew Wakefield has been answering charges put to him by the General Medical Council in the UK (this is the body that regulates medical practice in the UK, and it has the power to strike individuals off the medical register). Dr Wakefield stands accused of a variety of charges including conflict of interest (it is alleged he received money from legal sources that he did not declare when he published his paper). He also is accused of subjecting children in his research to unnecessary tests, and not having ethical approval for the research in the first place.

Now, most of us will be aware of the big brouhaha regarding Wakefield’s research, but the reporting on his case with the GMC has been scant to say the least. There are no restrictions on the reporting of this case, so why the near ‘radio silence’? In a quiet and undisturbed couple of hours yesterday I thought I’d find out what I could about the Wakefield case, and report it here.

Looking at press reports, I did find a flurry of activity in April when it emerged that Dr Wakefield had admitted on questioning, that he didn’t know that much about the medical ethics of paediatrics cases. The ‘shock horror’ way this was reported was somewhat surprising to me. Because it seems to me that whether the research was ethical or not was not Dr Wakefield’s call. That was the call of the ethical committee. So, the real issue is whether the research he undertook had ethical approval or not (more on that later). This story was, to all intents and purposes, a non-story.

Since then, from what I can make out, we’ve had no stories in the mainstream press regarding how the case is going. I did find this radio broadcast/podcast though on a site dedicated to autism issues (http://www.autismone.org). It features the accounts of the Dr Wakefield/GMC trial from Dr Carol Stott (a psychologist and friend of Andrew Wakefield) and Jim Moody (a lawyer with a special interest in the area). This piece is hosted by someone called Polly Tommey. The first quarter or so of the piece focuses on the alleged misdemeanours of the journalist Brian Deer, who had investigated Dr Wakefield for the Sunday Times and Channel 4 in the UK, and who some believe instigated the GMC case against Dr Wakefield. This section of the recording is all a bit melodramatic and cloak and dagger for my liking, and its true relevance to the case is somewhat tenuous, I believe. However, I reckon it’s worth sitting through, though, if only to get to the interviews with Dr Carol Stott and Jim Moody.

It appears from their accounts that Dr Andrew Wakefield has put up a very robust defense with regard to all the allegations he faces. From what I could glean here, there really is no case to answer. If you listen to Jim Moody’s interview, he suggests that the prosecution team have made deliberately false allegations concerning Dr Wakefield, or at the very least did not do their due diligence with regard to the case or were just extremely careless.

Other revelations even more significant revelations followed. Dr Wakefield’s research was published in the Lancet medical journal, edited by Dr Richard Horton. Ever since the MMR/autism storm started Dr Horton has been trying doing his level best to distance himself from Wakefield’s research (although, it should be pointed out that the Lancet organised a press conference to trumpet Wakefield’s findings).

Perhaps as part of this effort, Dr Horton has said that if he knew about Dr Wakefield’s alleged financial conflict of interest prior to publication, he would not have sanctioned its publication. Dr Horton testified to this effect in front of the GMC last year. However, listening to the autismone podcast I discovered that evidence has come to light which appears to prove that Dr Horton was aware of the alleged conflict of interest well before the study was published. In other words, it appears Richard Horton is lying (or has a very bad memory indeed). Jim Moody suggests there’s a case for Richard Horton himself to be up in front of the GMC, on a charge of giving false testimony.

To me, this really is news, and of an order of magnitude far, far greater than the fact the Andrew Wakefield has no specific expertise in paediatric ethics. Hands up now, how many of you out there knew about the fact that the editor of the Lancet medical journal (one of the most ‘respected’ medical journals in the World) appears to have committed perjury? I’d be surprised if many of you do, because I can’t find a single reference about this in the mainstream press. Remember, there are no restrictions on the reporting of this trial.

So, while this week I had no intention to write about MMR, I now feel compelled to do so as a result of what I found when I looked: It seems to me that some distinctly shoddy science and no small amount of bullying has been used in an attempt to ‘silence’ those who dare suggest there is a link between MMR vaccination and autism, including countless parents who believe they witnessed the regression into autism of their children after MMR vaccination before their very eyes. And of course someone’s head had to roll, and Dr Wakefield’s was the obvious one to lop off. Yet, it seems that there really was never any case to answer. And now we find it looks as though the editor of the medical journal who published Dr Wakefield’s research is prepared to lie through his teeth to save his skin and ensure that any fingers of accusation point elsewhere. And the press, for some reason, is keen to have Dr Wakefield the pariah, and is not interested in reporting honestly and openly about the case brought against him by the GMC.

But getting back to the safety issue, it is my contention that the science used to ‘prove’ MMR does not cause autism is simply inadequate. And I’m not the only person who thinks so: In my research yesterday I came across this video interview where you can see and hear Dr Bernadine Healy, former director of the National Institutes of Health in the USA, express her concern about the way in which a link between vaccination and autism has been so readily dismissed. She accuses the US Government health officials of deliberately not doing the scientific which would show, once and for all, whether vaccines can cause autism, and if so, what the extent of the risk is (so that parents can make an truly informed choice about whether to have their child vaccinated or not). And Dr Healy also suggests that the reason for why the US Government has not done the definitive scientific work is because it is afraid of what it might find when it looks. The interview concludes by Dr Healy stating that the question about whether vaccination can cause autism has still not been answered.

In the interview, Dr Healy refers to research in primates which has been dismissed. Even this month, research has come to light which finds that subjecting infant primates to a ‘human’ vaccine schedule led them to exhibit autistic symptoms. And on top of this, the US Government recently conceded (out of court) that a child’s (Hannah Poling) autistic state had been significantly contributed to by vaccines she had as a toddler.

The issue of MMR’s safety has not been a debate, more a war. And a brutal one at that. Some, it seems, have attempted to misuse science to bludgeon dissenters into silence. But they have not gone away, and neither should they. And now some dirty great cracks are starting to show in the defense of the pro-vaccine lobby. I might be wrong, but I think the MMR vaccine/autism war is far from over. In fact, I reckon it’s only just begun. And while the reason that the debate rages on is usually put down to the likes of Dr Wakefield and the parents who believe their children were damaged by MMR, the real guilty parties here have been our Governments whose intransigence regarding proper, definitive research in the area has inevitably left a huge question-mark hanging over MMR.

Now, I’ve got a sneaking suspicion that those of the pro-vaccine lobby will want to claim that this blog is scaremongering by making out that MMR vaccination causes autism. So, just to be clear, I’m not saying that at all. What I am saying though is that there’s a huge pile of anecdotal evidence and some experimental evidence too which supports the idea that MMR vaccination might cause autism. The evidence used to persuade us of the safety with regard to autism is simply inadequate. The fact is, I don’t know whether MMR causes autism or not. But then again, it seems neither do those who insist it is safe.

35 Responses to Why the MMR-autism ‘war’ is far from over

  1. Claire 30 May 2008 at 1:12 pm #

    It’s a sad fact of life that few scientists conduct truly rigorous scientific experiments nowadays – few of them have even heard of the ‘null hypothesis’ never mind devise their studies to (dis)prove it. When it comes to medical studies, epidemiology is frequently used with statistical models that may have little bearing on the issue other than to be manipulated to ‘statistically prove’ the probably biased expectations of those conducting or funding the work. Even they ought to be able to acknowledge that a highly significant p value of 0.001 (***) has a 1 in a thousand chance that their conclusions are disproven i.e. WRONG.
    So let’s suppose that there could be an association between autism and vaccination. Why not look very carefully at the health of such children shortly before vaccination? I hypothesise that those subsequently affected are not in fact 100% healthy but have lung, skin or especially gut problems – in Chinese medicine showing a ‘Metal’ picture. Whereas I remain to be convinced of the efficacy of homeopathy, Samuel Hahnemann (the so-called father of homeopathy) appeared to have made some logical and sound observations that disease (thinking not of a specific condition but of the state of health) can be driven deeper and higher into the body by unhelpful interventions (e.g. vaccination or perhaps antibiotics) thus moving from a comparatively superficial level up into the head. If things move the other way then healing is occurring.
    It is not outwith the bounds of possibility that the child’s state of hydration might also influence the outcome of vaccination.

    It might thereby be possible to link certain conditions or states to a increased risk of the possibility of developing problems (such as autism) post-vaccination and to avoid vaccination in those circumstances.

  2. Ross Fitzsimons 30 May 2008 at 1:41 pm #

    Thank you for this thoughtful, well-researched piece.
    Over the past 25 years we have seen an exponential rise in the number of children affected by autism. Please see http://www.fightingautism.org/idea/index.php?s=CA&z=m for 15 years of U.S. data.
    The pro-MMR lobby says there is no demonstrable link between the vaccine and autism.
    But the much more important issue to be tackled is why the 16,000 diagnosed cases in the US in 1992 had grown to 260,000 US children with the condition in 2006.
    And if MMR is not responsible, then what is?
    Also, what course of action would Dr Briffa recommend to a parent reluctant to put their child through MMR?

  3. Belinda 30 May 2008 at 3:45 pm #

    There’s another issue to look at when deciding whether or not to vaccinate with the MMR or any other vaccination…I’m pregnant with my first child and i live in South Africa, which is essentially a third world country. I probably have to take the decision based on the chance that my child will be better off vaccinated than not, living where i do.

  4. Dr John Briffa 30 May 2008 at 3:49 pm #

    Yes Belinda, and I think it’s a shame I think that some appear to have resisted doing the scientific studies that would give you a clearer picture of the risk/benefits of MMR, so that you can make a truly informed choice.

  5. PJ 30 May 2008 at 5:42 pm #

    Many years ago I began reading up, by coincidence initially (happened on the topic, is all) on the ‘alleged’ link between vaccinations and autism.

    What I found was report after report of parents with perfectly NORMAL children who, after a vaccination, regressed into autism very promptly. There is no doubt about this, I mean parents live with children every day their whole life, it’s not like a kid who is normal up to getting a shot and autistic a week later leaves some QUESTION about the actual cause of this, especially when it happens time after time after time.

    There are a variety of rules and regulations about ‘reporting’ which may be different now, but as one mother told me back then, you have to ‘report’ it within like 4 hours for it to be considered potentially related, except of course you’re told kids will be flu-ish for 24+ hours as a norm when they get the shots, plus the evidence is not always obvious merely within hours. There’s other info, like that some families know they’re at genetic risk and every child vaccinated ends up autistic afterwards and still some states don’t want to allow exemption.

    Basically it’s like that big marketing campaign where a cute little boy and a dog were shown and we’re all supposed to agree that to save that cute little boy, we gotta do research on the dog. Except now, your kid is the dog.

    The horror of having my beautiful child put at risk for that because drug companies don’t want to lose money was so disgusting that when choosing where to move, I chose a state (Oklahoma) that allowed both religious and philosophical exemption from vaccinations.

    It’s not like this is just a few people. This is a HUGE subject. There is a near-total media blackout on the subject… follow the money to why. Getting anybody to take it seriously — or if they do, getting them to care more than a hand-waving, “Sorry your kid’s the collateral damage, too bad” — is not easy.

  6. Elspeth 30 May 2008 at 6:21 pm #

    Dr Briffa,

    I have read that many other European countries offer a choice of either 3 separate injections or the combined MMR to avoid a drop in numbers of people immunising their children.

    Do you think that 3 (well-spaced, mercury-free) injections might be a suitable alternative for those parents who are concerned about the MMR, but still believe in vaccination for their child?

    Is it an option here in the UK?

  7. Andrew 30 May 2008 at 6:51 pm #

    The thing is, though, that there’s absolutely no vaguely credible evidence that MMR is even remotely connected to autism. There really isn’t any at all. We have one discredited study and a lot of ranting parents — and I can find you any number of ranting parents you like to support the idea that humanity was created in a week from dust by a magical wizard who lives in the sky.

    With that in mind, a key reason nobody’s done a prospective trial looking at MMR and autism (or “some appear to have resisted doing the scientific studies that would give you a clearer picture of the risk/benefits of MMR” as you put it) is that it would be unethical to do so: if the study group was large enough to show the effect (which even anti-MMR types claim is very rare, even when they’re demanding that all three of their children were hit by it) then you’re deliberately avoiding giving a potentially life-saving vaccination to at least hundreds of children, on the basis that a few ill-informed, untrained, tabloid-reading morons think there might be a risk. There’s no way that would ever get past an ethics committee.

    This research would also be hugely expensive. Certainly most governments could easily afford to do such a trial (in terms of money — the political backlash for letting all those kids get measles would probably be huge), but you’d get nothing for the investment. You’d never convince all the anti-MMR people they were wrong, and if you did, they’d just say “oh, well it must be wifi”, and then you have to do another big expensive study to disprove that (which you can’t anyway because science doesn’t work that way). Then they’ll say it’s phone masts, then videogames, then fast food, then sweets, then preservatives, then nitrogen, then TV, then the Internet, then immigrants, then gypsies, the McCanns, then the KGB, then aliens… You’d end up with an entire government department whose sole purpose would be to assuage the fears of the ignorant. That’s no way to run a country.

    You have to be a little bit detached and just accept that the so-called link between MMR and autism is, in fact, just made up. That doesn’t prove it’s false, but it puts it’s odds at much the same level as other made-up hypotheses, such as “cider causes shortness” or “MRI scans cause blindness”. (I just pulled those out of thin air.) Doing huge studies to attempt to disprove things you’ve made up would be a tremendous waste of time, and that doesn’t change just because they were made up a long time ago by someone else and then relentlessly repeated by bad journalists and angry but unqualified mothers.

  8. Dr John Briffa 30 May 2008 at 8:05 pm #

    Andrew

    By your own admission, the definitive work which proves MMR does not cause autism has not been done. I think you’re right: a study like the one you suggest is unlikely to get ethical approval. But how about study, maybe, where a large group of ‘apparently’ vaccine-damaged children (a few hundred maybe, they won’t be difficult to find) are taken, and assessed in a way that is designed to establish whether or not MMR vaccination can cause autism.

    Now, the US Government recently looked at such evidence relating to just one girl (Hannah Poling) and concluded that vaccination had contributed significantly to her autism. What would be so difficult about repeating maybe this sort assessment on a much larger scale? Nothing, really, though it seems many are reluctant to do the work. Why? I don’t know, but as is suggested above, it’s possibly because some are scared of what they might find when they look.

    Another important point, I think, is that, as you have admitted, there is no definitive evidence in the area. So, it follows that there is NO DEFINITIVE EVIDENCE THAT MMR DOES NOT CAUSE AUTISM. And how are we going to discover the truth if the proper research is not done? Basically, we’re guessing. And we’re gambling ” with people’s lives.

    Now, against this let’s put your assertion that all we have is one discredited study and a ‘lot of ranting parents’. Do you think in the absence of evidence to the contrary, that it is caring and responsible and ‘scientific’ even to dismiss the experiences of countless parents who claim to have witnessed their children regress into autism quite soon after receiving MMR vaccination? Do you not think, at all, that we owe it to these people, their children and everyone wishing to make a truly informed decision about the vaccination of their child to do the relevant research?

    In your preceding post you end with the words “…in a debate where people are actually dying of preventable diseases because they’ve been lied to and told that the prevention causes autism.”

    Can you tell me how you think this ‘think of the kids!’ cry squares with your opinion that parents who believe their children may have been damaged by vaccines are the sort of people who ‘support the idea that humanity was created in a week from dust by a magical wizard who lives in the sky.’

    And imagine now for a moment, that you were not a PhD student in 2D and 3D image analysis (as you tell us here: http://www.apathysketchpad.com/blog/about-me ), but are perhaps a paediatrician with a special interest in autism. Think what it might be like to be regularly consulted by parents who tell, usually very credibly, a very consistent story about how their children appeared to be developing normally, but then spiked a fever shortly after receiving their MMR vaccination, and subsequently went on to regress into autism.

    Imagine, if you can, these parents telling you of how their talkative, happy child, transformed into one that cried a lot, stopped making eye contact, and perhaps stopped talking as well in a matter or a few weeks.

    In the light of no good evidence to prove that MMR does not cause autism, do you really think you could look these parents in the eye, and tell them, hand on heart, that in your opinion, they were simply ‘ranting’?

  9. Julie Craker 31 May 2008 at 2:31 am #

    Dr. Briffa,
    Wondered when you would get to this issue and again thank you for your courage. I had my three children vaccinated when I was ignorant. My granddaughter has not and will not be unless the government forcibly subjects her to it. I have done extensive reading on the subject and was shocked to learn how much evidence points to autism and also sudden infant death syndrome. The rate of autism has grown as the number of vaccines has increased. Some children are not able to release the mercury from their systems and I don’t think anyone denies the toxicity of mercury. Here in the U.S. the mercury is still in some of the vaccines and does anyone know what else is part of what is being injected into the child? I did read accounts of some vaccine in which the monkey component of the vaccine was carrying a disease that later cropped up in the vaccine recipients. I know from my own experience over trivial matters in which the MDs would not listen that most certainly would not acknowledge any adverse affects from a vaccine. It is always the same story with parents, and I have personally met two, the child was perfect then within a week the child’s behavior changed dramatically. One lady represented an organization of several hundred families. She had lost her home from the drugs prescribed which did nothing, and was at a meeting fighting to save alternative therapies which were showing some promise for her son. I can imagine the emotional pain, anger, and frustration to have such a tragic thing happen to your child and then be treated as if you are a parent with impaired judgment. These parents and children deserve our concern and not a cover-up!

  10. PJ 31 May 2008 at 10:40 pm #

    Until a genuine scientific inquiry into the subject, and not just pharmaceutical company sponsored denial and media repression, happens, I have no objective way to measure the likelihood of my kid getting measles vs. my kid getting autism. So “withholding a lifesaving vaccination” seems like hyperbole given that (a) measles are very rare, and (b) people do survive the measles.

    It is possible that the vaccinations happening later when the child has a more mature immune system could help but since nobody will look at the issue with science we may never know.

  11. Pete A 1 June 2008 at 3:31 pm #

    I have to take Dr Briffa’s comments seriously. I went to my doctors 3 months ago and was told statins were safe. Is this ignorance or just the health profession listing to the propoganda put out by the drug companies.

    In the case of autism and MMR, I wonder if the reality is the science has not been done because the vaccine manufacturers would not like to know the results. The anecdotal evidence is there but like most drug interactions it has not been reported to the proper channels.

    Also epidemiology is a science where cause and affect are rarely provable but only the posiblility of a link between cause and effect can be sumised.

  12. Wendy Satterthwaite 1 June 2008 at 6:13 pm #

    Toddlers do not require rubella vacc, prevents blindness in the foetus, mumps is generally amild disease, both of my children went to school with mumps- only realised when I saw the school photos and thought they both had fat cheeks !!! what a twit, they must’ve given it to the whole class, but nobody died!!!
    Measles can be nasty, my brother’s eye lashes fell out, but he was sixty last year complete with eyelashes.
    I was one of four we all had measle around the same time, other kids came in from the village and caught it, nobody died with complications.
    We were poor with no bathroom and had free school dinners,
    would be considered on the poverty line now but we all recovered.
    If the government is so concerned about children dying from measles why not bring back the single measle vacc which we used to have.
    ell done Dr Briffa for listening to these parents god Bless you and Dr Wakefield.
    By the Way Poll;y Tommey wrrites THE AUTISM FILE with her husband and they have an autistic son.
    Wendy Satterthwaite.

  13. Anna 2 June 2008 at 4:14 pm #

    I don’t have a dog in this fight, but I find what Emma has to say about autism and vaccines interesting:

    http://blog.plantpoisonsandrottenstuff.info/

    She has a special interest in Asperger’s Syndrome and autism, and takes a keen interest in all the issues.

  14. Jenny 2 June 2008 at 8:20 pm #

    Dear Dr Briffa

    I, like you have been following the case with some interest and scepticism about the government’s claim that the MMR is safe.

    My son, who is now 10, was diagnosed with ASD at the age of 5. My husband (who is the world’s greatest sceptic) is of the opinion that ‘the lights’ went out at the age of 2. Most ‘scientists’ and ‘behaviourists’ will claim that 2 is the average age most children start exhibiting ‘symptoms’.

    That fact aside, they will also claim that Autism is genetic.
    We have searched back 4 generations in both families and have not found any history of ‘ autism’.

    What I have found is a family history of autoimmune disorder and epilepsy.

    From various tests I have established two main factors. These were 1)severe bacterial and yeast dysbiosis and 2) gut inflammation. These may well have been present at the time of vaccination or a result of vaccination.

    According to my research there is sufficient data available to identify ‘at risk groups’. A responsible government should take cogniscance of this ‘subgroup’ of children and provide an alternative. Failure to take this course of action places untold stress on families trying to cope with our children, an education system that cannot teach our children and a society that does not understand or acknowledge these children.

    According to research this ‘irresponsible’ approach by the government costs £2.4 million per child over his/her lifetime.

    Hello, is anybody out there in the land of reason?

  15. Trisha Burgess 2 June 2008 at 8:34 pm #

    Dr Briffa.
    1. Much is written about Dr Wakefield and his so called failings but if any other papers published in the Lancet – or indeed in any other journals – were examined with the same degree of forensic journalism I suspect that there would be few, if any articles without weaknesses , surely this is the point of peer review? The Sunday Times has continually peddled a viewpoint which is so sympathetic to the government that they ( the government ) could almost have written it themselves?
    2. The whole crisis of herd immunity and the collapse of the vaccination programme could have been avoided had the parents concerned about possible risks with MMR vaccines simply been offered the option of single vaccines within the NHS. Instead many parents with the means have made the choice to travel often great distances to clinics and paid substantial amounts to ensure that their children were protected. Those without the means were forced to choose either to vaccinate with MMR or not to vaccinate at all. This is the stark choice inflicted upon us by the government, not by Andrew Wakefield.
    Incidentally I have no idea whether Andrew Wakefield is correct or not but I was and remain wary of the huge programme of vaccination being forced upon our children. My own daughter was a premature 1.32 Kg baby suffering from failure to thrive, I took her to London for Measles innocculation then again to Exeter when the London clinic was found to have stored the product incorrectly. I have no regrets. I doubt however that the published statistics count her as one of the children innocculated when the government is highlighting the percentage of children without protection against measles and therefore a risk to the general population. They do not have a record of privately treated children so again their statistics are not valid.

  16. cynic 3 June 2008 at 9:25 am #

    This is not an argument, just a request for more information. A couple of posts seem to be saying ‘I had measles and it never did me any harm’ or ‘measles aint that bad’ and I realised I personally know nothing about measles. After a quick google I found this sobering information:
    http://www.unicef.org/immunization/23244_measles.html

    But does that imply that measles isn’t really a threat to otherwise healthy kids with good access to first-world healthcare? (or in perhaps populations were most are vaccinated). I would love to see any info on measles especially incidence and mortality in this or first world countries. Does anybody have such info?

    May be interesting to weigh up the comparative risks

  17. jdc 3 June 2008 at 1:43 pm #

    On my blog I wrote this of your post on statistical significance: “If his readers don’t fully understand or appreciate the arbitrary nature of p-values then perhaps they won’t fully understand or appreciate p-values themselves. If Dr Briffa is going to educate his readership perhaps it would be better to do a more thorough job and explain what p-values are before he tells people that they are arbitrary (which, apparently, therefore means scientific findings are arbitrary).”
    Given Claire’s misconception about p-values, I think my point was an appropriate (perhaps even prescient) one to make. Perhaps you would care to clarify the meaning of p-values, for the benefit of Claire and your other readers. I’m sure Claire’s misconception is a common one and other readers are likely labouring under the same misapprehension.

  18. MinorityView 3 June 2008 at 9:20 pm #

    I’ve also been observing the non-coverage of the Wakefield case over the past few months. The lack of crowing by the blog crew seems to indicate that they don’t have much to crow about. Reticence isn’t their strong suit.

    Thanks for providing me with lots of amusement over the last few days!

  19. David 4 June 2008 at 4:41 pm #

    Cynic, some measles info for Europe can be found in Eurosurveillance.
    http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=18837

    They cover the recent epidemics in central Europe – eg Germany, Switzerland (all driven via unvaccinated cases). In 2005/6 in Germany there were 3 deaths out of about 3000 notified cases (there will be some under-reporting;- the true numer of cases will be greater than this, and in Western countries the measles case fatality is more like 1 in 6000).
    In Romania there were 14 deaths in the same period (though the medical facilities may have been less “first world” here).
    Still, the mortality is sobering – for each death there will be dozens of children with serious disability from encephalitis etc. And remember – if no-one vaccinated against measles, every child would get it.

    Antivaccine campaigners maintain that measles is a trivial illness in the first world. Reliance on personal experience is a very poor indicator of problems. The “I-had-measles-and-it-didn’t-do-me-any-harm” brigade are dangerously deluded individuals with no concept of the impact of disease within populations. I also had measles and survived unscathed. That means nothing. I also fell off my bike as a child and didn’t get brain damage. But that’s not an argument to say its OK for my kids to avoid wearing cycle helmets (and worse, for me to persuade other kids to do likewise).

  20. MinorityView 4 June 2008 at 5:39 pm #

    Here is an analysis of the measles numbers from the CDC. Oddly they give one set of numbers on the parent’s pages (very scary) and a different set of numbers for the medical professionals in the Pink Book.

    http://insidevaccines.com/wordpress/?p=65

    The short answer is that measles can be dangerous to children living in developed countries, but vaccination has, in some ways, increased the hazards of the disease.

  21. David 5 June 2008 at 12:21 pm #

    Minority, at least you admit measles can be dangerous even in developed countries. However, your throwaway comment that that “vaccination, in some ways, increased the hazards of the disease” is totally misleading.

    I presume you refer to the rare instance where someone who was vaccinated may get, through waning immunity, an attack of measles as an adult, which may occasionally be a more severe illness. Adult measles is exceedingly rare, as indicated by the near total absence of adults in the cases of measles seen in outbreaks – take this one in Germany for example:
    http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=615
    (Look at the age-specific incidence in the chart, and also consider the fact that 95% of cases are in unvaccinated people).

    Also consider the fact that if high levels of vaccination are achieved, then herd immunity will protect all those who for medical reasons have not been able to be immunised, and also anyone whose immunity may have waned.

    Vaccination has reduced the risks of the disease many-fold, and only a complete fool would try and promote the view that it is undesireable in the way you are implying.

  22. David 5 June 2008 at 1:25 pm #

    Minority, I’ve just been looking at your website and article on measles. I think you are suggesting that in the prevaccine era in the USA, the CDC report measles caused 450 deaths per year, 28,000 hospitalizations, and 1,000 children with chronic disabilities from measles encephalitis. I guess there is no wiggle room over these figures.

    You have calculated that prevaccine, only 0.007% of measles cases were hospitalised. You are wrong, having made an error in your calculation by a couple of orders of magnitude. You ask the CDC guys to “keep their stories straight”, and you may have a point, but you are unable to calculate percentages yourself?

    You used the numbers of 28000 hospitalisations out of 4 million measles cases annually. This is in fact 0.625%. Elsewhere you readily accept the lower limit of the annual measles estimate for your calculations (3 million cases a year), which gives a hospitalisation rate of 0.93%. Some way from your 0.007% claim, isn’t it?

    True, it is still some way from what you have dug out of a CDC “information for parents” leaflet which says “up to 20% may need to be hospitalised”, but then this leaflet is not from one of their scientific publications, and is likely to be laid on heavy just to help persuade parents to consider vaccination. Not a great tactic, true, but I wouldn’t quote this figure as hard fact, since it is clearly not. For a start it is an upper estimate, in the same way my ISP promises me “up to 16Mb” for my broadband speed. I’d be lucky to achieve a tenth of that.

    The children likely to get measles today are a selected population subgroup, many are unable to be vaccinated because of underlying medical illess, for example, and their risk of complications is greater than is the case for the whole population. Better herd immunity through vaccination would solve this problem.

  23. cynic 6 June 2008 at 1:41 pm #

    David thanks for the measles info.

  24. MinorityView 7 June 2008 at 12:58 am #

    David thanks very much for correcting my arithmetic error.

    You did overlook the hazards of measles to infants, who used to be protected by maternal immunity, now gone with the wind. There was an outbreak of measles in Boston, not terribly long ago, all adults.

    I do find the scaremongering by the CDC problematic. Any parent who digs a bit and discovers that the numbers, not just on measles, but on all the diseases, are fudged to make them scarier, is going to lose trust. Further, on one of the parent’s pages the CDC warns parents to distrust data unsupported by references. Then this same organization proceeds to present page after page of data…unsupported by references. Not only that, but data which cannot be supported by references, because it is, simply, untrue. Not arithmetic errors, like mine, but, conscious, deliberate, on purpose lies.

    Read some of the CDC parent’s pages for yourself. Try to confirm the numbers being presented. You do recognize that 600,000 hospitalizations (20%) is a long way from 28,000 hospitalizations, right? Could this be an honest mistake? An arithmetic error?

  25. heartbrokenmum 28 July 2008 at 4:25 pm #

    If I can save one family from going through what we have done since 1989 then please listen to our story. Our son will never be able to live alone without support, his brother’s life will be severely compromised and as for the the lives of my husband and I, well I don’t know how we get through each day. We believe this was all due to MMR. We saw our son change before our eyes. If I knew then what I know now I’d have taken a chance on all these illnesses. Girls should get immunised against rubella in their early teens like they used to and that would prevent the damage done to unborn babies. Lives are being ruined and you are just left to get on with it. It has cost us our careers, home and any chance of a normal life. Thank God for Andrew Wakefield. He should be given an honour not be persecuted like this.

  26. mandy jones 27 November 2008 at 6:17 pm #

    I have an 11 year old daughter who has not had the MMR but has had other immunisations (except whooping cough). I waited until she was six months for the first set of immunisations after which she developed awful eczema. I am not suggesting there is a link, but she is a small allergic child, with allergies to nuts, sesame and kiwi and viral wheeziness and wheeziness during exercise (the eczema has disappeared but was dreadful for a couple of years). The reason I am writing is that I am being pressurised by the PCT, school and she is being pressurised by her peers into having the MMR. I am also very worried about measles and was wondering whether an alternative would be to give her the single measles immunisation as I am not so worried about the other two (mumps is not so serious in girls and I will have her immunised against rubella later as I’m hoping she won’t get pregnant yet!). There is also pressure for her to have the HPV next year and I was wondering if anyone has any views on that. Does anyone have any information about allergic children and the single measles jab? Is it the measles bit that is dangerous or the combination?
    Help!!!

  27. James 17 January 2009 at 11:26 am #

    I’m seeing a lot of information about the hazards posed by the disease that the MMR seeks to protect against. No one is suggesting that these diseases are trivial. As parents we are objecting to the false promotion of the “protective” measure as safe, and the total refusal of the establishment and medical authorities to look for a safer alternative. Contesting the safety of the MMR on the basis that measles is deadly is a bit like saying that running across a busy road without looking is safe because walking slowly across a busy road is more dangerous.

  28. John Stone 23 January 2009 at 10:56 pm #

    For a comprehensive account of the controversy with a focus on UK politics see ‘Secret MMR Files Forced Open By Legal Action’:

    http://childhealthsafety.wordpress.com/2009/01/13/secret-british-mmr-vaccine-files-forced-open-by-legal-action/

  29. bfg 25 January 2009 at 12:03 pm #

    Theory: Vaccinations are the primary cause of food allergies. Infant formula, infant vitamins, and antibiotics that contain peanut products directly or indirectly may be secondary causes.

    BACKGROUND: This study began as a “wild idea” that vaccinations or medicine could be causing peanut allergy. It soon turned into a horrible realization. A very small amount of food proteins from many sources are considered inert ingredients that fall under trade secret protection and are not on the vaccine inserts. Various studies have shown that injecting an animal with protein is one method of inducing an allergy. Every study done of food allergy that could be located does not disprove this theory. There was a study done on Indonesian and Thai children that has been frequently quoted as saying that there are no peanut allergies in Thailand or Singapore in spite of the high consumption of peanuts. Evidence was presented that Singapore has a major problem with peanut allergy. The study itself says that many children reacted to peanuts in a skin prick test and that it eliminated a number of children from the study. The “hygiene theory” was examined and found to have no merit. Evidence of a long list of food protein that can be used in vaccine production has been found in various patents on-line. The increased childhood vaccination schedule coincides with the increase in food allergies in industrialized nations. The lower incidence of food allergies in less industrialized nations also coincides with a lower vaccination rate. The lower incidence of food allergies in the Hispanic population of the United States also coincides with a lower vaccination rate. The evidence of food allergy in animals has only been found in vaccinated animals. Evidence of ingredients that can be one of the patented adjuvants with various food oils has been presented. Evidence that “pharmacy grade” peanut oil still contains peanut protein has been presented. Package inserts have been examined and found to have ingredients that do not disclose its actual composition. EVERY SINGLE FOOD ALLERGY THAT I HAVE FOUND, I HAVE ALSO FOUND THAT FOOD LISTED AS AN INGREDIENT IN A VACCINE OR MEDICAL PRODUCT.

    Many of these pages were copied from my blog. The blog grew too big and was too hard to follow. The links listed below link to the article in my blog. Use the buttons to the right to go to the article on this website. If you’d like to leave a comment, you can do so on the blog or you can e-mail me by way of the contact page- bfg

    1. Vaccines are given to create an immune response from the body. It only makes sense that the body treats anything in the vaccine as an invader that needs to have an antibody created to combat it. That is why we give vaccines. But if the vaccine has a trace of food in it such as egg or peanut, it only makes sense that the vaccine can cause a food allergy.

    2. Peanut oil is used in vaccines in adjuvants or as a vaccine carrier. The ingredients of adjuvants or vaccine carriers are not listed individually on the package insert. So the physician would have no way of knowing that there was peanut oil in the vaccine. The ingredients of adjuvants is considered a “trade secret” and has the protection of many governments not to be revealed.

    3. Peanut allergy decreases in populations that have decreased percentage of vaccinated children. There are a number of studies that link vaccinations to allergies.

    4. Peanut allergy is almost unknown in Israel. The population eats lots of peanuts. Israel produces sesame oil. Israel manufactures its own vaccines. Sesame is a major allergy there. Hypothesis: Sesame oil is used instead of peanut oil in the vaccines used in Israel.

    5. Study that is frequently cited saying that Indonesia and Thailand people do not suffer from peanut allergies was erroneous. Many children in the study reacted to peanuts in the skin prick test. The study relied on parents of report food reactions. I found a Thai parent quoted on the Internet saying that her child had a peanut allergy. I also found a physician from Singapore stating that peanut allergy is a major problem there.

    6. The “hygiene” theory points out that there is less food allergy in underdeveloped countries. They speculated that the people and environment is less clean so it is the early exposure to bacteria, etc. that protects against allergies. However, children as young as 8 months have been diagnosed with peanut allergy and it is only since 1990 that peanut allergies have become a huge problem. The populations in the underdeveloped countries are also not as compliant with childhood vaccinations which would account for less peanut allergy.

    7. The United States and China are major producers of peanut oil and vaccinations. There are many patents for products used in vaccines that contain peanut oil.

    8. The secondary causes of peanut allergy are due to young children having a “leaky gut”, immature digestive system. Introducing foods too soon can lead to allergies. Medicines given with traces of peanut protein could lead to an allergy. Also antibiotics kill off good bacteria as well as bad and can lead to an overgrowth of yeast which can cause food allergy type problems. I don’t know if any infant formula in the United States contains peanut oil. One website said it was more of a problem in Europe.

    9. Our vaccinated animals are getting food allergies Dogs are allergic to peanuts. Searching the Internet – I found a wild elephant allergic to wheat; the elephant had been immunized. (Wheat germ oil is used as a carrier of vaccines. Wheat protein is used to manufacture vaccines/medicines.)

    10. The statistics for allergies is appalling!! The allergy epidemic increased with every new mandate for more childhood immunizations.

    11. How pure can we make peanut oil? I assume it is highly refined but it only would take a teeny weeny bit of peanut protein in a vaccine to create a problem. That is, of course, assuming that it is ONLY the peanut protein that causes the allergy. Using my “guessing” math, only 1 shot out of 1680 would need to be contaminated to create a peanut allergy in 1 in 70 people in Great Britain.

    12. Vaccine adjuvants/ vaccine carriers contain many other oils/ingredients. These other ingredients could account for allergies to other foods. Fish oil is used. Shellfish can be mixed in with the fish by-products which are used to make fish oil. Wheat germ oil, corn oil, soy oil are used. Milk and eggs are also used in the production of vaccines. I expect that the oils are mixed in the vaccines so that you might get a vaccine with peanut oil and soy oil in it or any number of other oils.

    I keep looking but so far, I have been unable to DISPROVE my theory. And perhaps that is because VACCINES ARE A MAJOR CAUSE OF FOOD ALLERGIES!!

  30. Marisa 7 April 2009 at 8:03 am #

    I am petrified by my inability to differentiate what is good or bad for my child. I qualified as a doctor 12 years ago and, although I do not pratice as a medic, I am still in touch with medicine.
    I have always had the traditional views on vaccines: every child should be vaccinated according to the vaccination calendar. No questioning. However in recent years I started to look closer at the subject, especially after my daughter, now 3, received her 1st MMR. She is completely fine however I felt very guilty after vaccinating her when I was confronted with many facts I was not aware off. I could not distinguish good from bad science, what studies to believe and which ones to ignore. At that time I found out what happened to some researches, not in this area, but whose conclusions on epidemiology did not match what the government had in mind… to say they least they were completely discredited and treated pretty much as ‘criminals’.
    I am no longer sure about the safety of the MMR vaccine. In some occasions friends ring home to ask for my opinion before vaccinating their child, and I don’t know what to tell them. My ‘conventional’ medical training would tell them to go for it, but also, the same conventional training taught me to doubt and question everything. What a helpful answer! The truth is I don’t know.
    As my daughter approaches the time for the 2nd MMR, my husband has no doubts about giving her the vaccine, while I am not so sure.
    I will start given her supplements for children (vit C, E, Zinc etc) prior the vaccine to help her immune system fight it off. But am I making a mistake? There is a lot to answer for and I really hope the evidence against MMR is not true, but with current published work, I can’t see it clear. Marisa

  31. Hysterical Mother 21 April 2009 at 10:19 pm #

    All very interesting but besides having the MMR and not having it WHAT ARE THE OPTIONS? I’ve heard you can have 3 seperate jabs but if this is true is it actually safer? And why is it safer? Do you have to have them spaced out and if so, over what period of time? I’ve noticed the parents posts don’t seem to get replied to…
    If anybody knows please let me know my son is coming up to 1 and I’m concerned. Scientists always seem to think they’re 100% right and objective and then it turns out they’re wrong and peoples kids are damaged. Why is it so difficult to say we don’t know here are the options!

  32. mmrissafe 2 May 2009 at 7:49 pm #

    This comment piece in the Guardian may be of interest:

    http://www.guardian.co.uk/commentisfree/2009/may/01/measles-mmr-vaccination

  33. JANE CHAPPLE 11 July 2009 at 7:35 pm #

    Dr. Briffa
    I read with interest your report re Dr. Wakefield. Has there been an outcome yet? Havent heard anything in the papers as you say not much info regarding this case at all. We refused to let our son who is now 14 have the booster as he had a reaction to the first one (his leg swelled up) and the midwife refused to let him have anymore. Also he was born at 32 wks and weighed just 3lbs 7 and had hydrocephalus. A month before we had lost our daughter in Bristol re heart and also the problems assoc. with that particular hosp. We felt that after the first dose he stopped talking and he also started having fibrile convulsions. Thankfully these stopped at 5. He is classed as special needs and has 5 yr global delay. As one of your writers says (Jenny) it is hard enough trying to get our children educated properly in this country, let alone having to worry and fight for MMR single jabs if required.

    You may be interested to know that I recently had a letter from my GP saying the Dept. of Health had noticed that we had not been given the booster and we should make appt with practice nurse. After he had the first dose all those yrs ago I had to keep sending the booster card back saying I didnt want this and asked about single jabs. I was told by the nurse at the time that we could only get these in France!

    I have also read with interest the following info –
    Thousands of parents have contacted JABS asking how to obtain the single dose vaccines. The Medicines Control Agency (MCA) will allow single dose measles, mumps and rubella vaccines in the following situations:

    a) where a child has already started on a course of single dose vaccines

    b) where the child has a special need, such as an allergic reaction, that makes the licensed product unsuitable.

    Parents should contact their GP who, if he/she agrees, can issue a prescription on a named patient basis and provide medical advice relevant to each individual child. If the GP or other health professional has trouble in sourcing a single dose vaccine please ask them to contact JABS.

    The term ‘Medically indicated’ or a similar phrase on the prescription allows access through the ‘named patient’ procedure. This CAN be done under the free NHS system if your GP is willing to help. The chemist seeing this term on the prescription is allowed to order the single dose vaccine from the licensed importer. When the prescription is seen by the licensed importer it may be allowed, again, under the MCA’s rules. The MCA has asked doctors to explain the medical reason by adding a note to the prescription but this could be seen as breaking patient confidentiality. The doctor may justify the term to him/herself in that the child may be left unvaccinated without the choice of single doses and ‘it is better to offer something rather than nothing’.

    In my case the GP said they did not offer single vaccinations anymore and that I should try the internet!

    It seems that parents are not being kept fully informed about how to get the single jabs.

    Keep up the good work!

    Jane

  34. Victoria Worsley (feldenkrais practitioner) 18 December 2009 at 12:57 am #

    I would relly be interested in hearing your thoughts on the wider issue of immunisation beyond MMR and the effect on the development of a babies’ immune system. Plus last time I looked eg pertussis didn’t fare well in tests either for efficacy or health(a non-specific ill effect on health), nor did the one for tuberculosis whereas tetanus fared well on both counts but that may all have changed.I got most of that from Michel Odent’s lectures when my baby was born but i still worry that i didn’t vaccinate her and periodically I try to catch up with what’s going on to re-assess, but its so difficult to find out – or understand what any of it means.

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