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Doctor's Handwriting - measles-mumps-rubella vaccine United Kingdom - Brief Article
Ecologist, The, March, 2001 by LYNNE McTAGGART
A monthly column that helps you decipher the medical truth.
Recently, the British government announced that it has spent [pound]3 million in taxpayers' money in defending the measles-mumps-rubella (MMR) triple vaccine. This has mainly been an exercise in damage limitation, to staunch the haemorrhage of parents opting out of this jab. The number of British children covered by the MMR jab has fallen to well below 90 per cent, and the Public Health Laboratory Service (PHLS), which is responsible for vaccine programmes, fears that with such low coverage a measles epidemic could be likely.
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The reluctance of parents to have their children given the MMR vaccine is a completely sensible response to the growing question marks that lately hover over this vaccine. Dr Andrew Wakefield of the Royal Free Hospital in London, a specialist in bowel disorders, first planted this doubt in 1998 by publishing a small study showing an association between the MMR jab and development of chronic inflammation of the colon and autism (The Lancet, 28 February 1998). Since that time, Wakefield and his team have uncovered more than 200 children whose autism is linked to the jab.
Wakefield's team hypothesises that in certain susceptible children, the MMR vaccine may damage the intestinal function, which in turn could allow food by-products, called peptides, to pass through the intestinal walls, disrupting brain function and development.
To counter Wakefield's growing evidence, the government has hauled out a Finnish study, published in the December issue of the Journal of Paediatric Infectious Disease.
The Finnish study, which covered 1.8 million children receiving three million jabs, claims to find no such connection. Indeed, with only 437 side effects from the vaccine reported among this vast population, the study concludes that this is an extraordinarily safe vaccine.
It's important to take a fine-toothed comb to the study. For one thing, it relied on 'passive surveillance'; that is information voluntarily supplied by health providers to the Finnish Department of Public Health. Passive reporting systems are acknowledged to be notoriously unreliable. In America, where the Vaccine Adverse Reporting System relies on passive reporting by doctors, it is estimated that only 10 per cent of the total number of vaccine adverse events get reported.
The study admits that side effects were reported soon after children had the jab. But it has been well documented that major reactions to the MMR typically occur seven to 10 days later. Most of the cases of MMR-related autism occur two weeks after the children receive their jab.
This study was also carried out and completed between 1982 and 1996; well before anyone suspected a link between autism and the vaccine. It's doubtful that anyone would have thought to blame a vaccination for the deterioration of a child's speech, behaviour or development a full two weeks later, as is typically the case.
Even if autism does not turn out to be caused by the MMR, there's no doubt further study was needed before jabbing this concoction into the arm of every child in Britain. Dr Peter Fletcher, former senior medical officer for the Department of Health in the early 1980s, has reported in the January edition of the Journal of Adverse Drug Reactions that the vaccine should not have been given a licence because there was never sufficient evidence of its safety or efficacy. In its pilot study, says Fletcher, the vaccine was only followed up for a matter of weeks. 'Three weeks is not enough,' he said. 'Neither is four weeks.'
Brief as they were, even those early studies showed worrying trends. In the PHLS's own study, convulsions occurred in one in every 400 children given the MMR jab (The Lancet, 1989; ii: 1015-6).
Several critics of the MMR triple jab have suggested that parents worried about possible synergistic effects could give their children the jabs separately. This has been championed by the national newspapers as the solution, and the government has been roundly criticised for not offering this option. Parents interested in single jabs have resorted to flying their children to foreign countries where they are offered.
But the truth is that nobody knows whether giving the jabs separately is indeed any safer. Some evidence points to problems with the live virus used with any measles vaccine.
The real problem here is inventing the problem to sell the solution. What the government has done is to demonise what, a generation ago, was considered a benign disease in well nourished populations. Measles is not a random killer among well nourished children. In the five years between 1989-1994 there were only six deaths among children aged 0-19 with 59,263 cases of measles; an average of one death a year. Children in the West do not die of measles when they are well nourished. Doctors also better understand how to treat complications. Even in Africa, children with adequate stores of vitamin A stop dying of measles.
