The origins of the 'scare' by Dr David Elliman in response to the above article, November 1998.

Before their introduction, vaccines probably undergo much closer scrutiny than any other medical intervention. As a result, we can show how effective and safe they are. MMR vaccine has been in regular use in USA since 1972, in Scandinavia since 1982 and in most of the rest of Europe since about 1988. There is therefore an enormous body of experience.

Reading some newspapers and magazines, one might get the impression that there was a significant amount of research suggesting a big risk of major side effects from the MMR vaccine. Looking a bit closer, one might be surprised to learn that most of the concern originates from one research group in Hampstead and a single scientific paper.

This paper was published in February 1998 and has 12 authors apart from Dr Wakefield (1). In the paper the authors are careful to state "we did not prove an association between measles, mumps, and rubella vaccine and the syndrome described." In a subsequent letter (2) in response to criticism of the paper, three of the authors agreed that a link with MMR had not been proven and said "their points about the absence of hard data supporting the link with MMR were made both within the paper, and forcefully by ourselves at the press conference accompanying publication. We emphatically endorsed current vaccination policy until further data are available." The child psychiatrist on the team, Dr Berelowitz, has appeared on television supporting the current immunisation policy. Interestingly, it was only Dr Wakefield responding separately from his colleagues (3) who defended the supposed link between MMR, bowel problems and autism.

At the time the original paper was published, a commentary on it appeared (4). The authors pointed out many reasons to believe that the paper was flawed. To add to this, a retired paediatrician pointed out that some of the measurements made in the children have been compared with normal levels, not in children, but in adults (5). This is such a basic mistake that it does call into doubt the credibility of the team.

When is autism noticed?

With all this criticism of the original paper, it would hardly seem necessary to look for evidence to counter an inherently flawed theory. What about the suggestion that the autism in these children was in some way abnormal because the parents thought that they were developing normally for one or more years? In one of the largest surveys on autism, the age at which parents became concerned that their children were not developing normally was ascertained (6). Only 16% were concerned while their child was under a year old, 33% became concerned in their child's second year of life and 49% when their child was between two and five years old. This is contrary to what Lynne McTaggart says.

The Finnish study (7)

Lynne McTaggart's account of this study is inaccurate. The general medical records of all children who had had bowel symptoms after the vaccination were checked. There was no requirement for the doctors looking after the children to make a link with the vaccine. It is difficult to believe that a child would have developed autism and it would not have been recorded in their routine health records.

Convulsions and encephalitis after MMR vaccine

Unfortunately Lynne McTaggart's reporting of the evidence in relation to encephalitis is somewhat misleading. Use of the Vaccine Safety Datalink (VSD) Project (8) to monitor 500,000 children 'did not reveal evidence of an increased risk of aseptic meningitis after MMR containing the Jeryl-Lynne strain of mumps.' This is the MMR vaccine we use in the UK. The mumps virus in use in UK has not been shown to cause encephalitis. Convulsions can occur after MMR, but are ten to thirty times less common than after measles disease. The study did not suggest that the diseases listed by Ms McTaggart were caused by the MMR.

What can a parent do?

Talk to the experts—your doctor and GP? Would you go to a market gardener to fix your central heating? If you have doubts, go to the evidence. For almost every statement I have made, I have listed the research paper on which it is based. (References 1 to 8 available from the editor.) Lynne McTaggart suggests some evidence for the success of homeopathic nosodes as alternatives to vaccination. I know of no scientific evidence to support this. Is there any?

Dr Elliman is a Consultant in Community Child Health at St George’s Hospital. He is co-author of the Health Education Authority’s new book Childhood Immunisation: a Review for Parents and Carers. A very easy to read book. It is clear, jargon-free and will help you make your decision. Available for 6.99 from HEA Customer Services, Marston Book Services, PO Box 269, Abingdon, Oxon OX14 4YN, 01235 465565

http://www.familiesonline.co.uk/topics/health/health_mmr_debate.htm