Date: Mon, 11 Feb 2002 16:03:36 +0000 (GMT)

It may or may not be of help to colleagues to see my
own articles for the Bolton Evening News (circulation
45,000 and each "handed on" to several other people).
These are, for once, full text, because I was asked to
do a longer article. They were written in great haste,
to meet a deadline, so I regrettably did not have time
to go over them to put them into journalese and to
make absolutely sure of my statements - please let me
know of any glaring errors!

They were stimulated by a letter from a local
Councillor when I agreed to have pictures taken by the
Bolton Evening News and by Regional TV) of my
granddaughter having her MMR last week. The Councillor
accused me of a "cynical political ploy to get into
the House of Lords" and of pulling a cheap political
stunt in using my granddaughter as a political
football. He is a Conservative councillor.

I've included my response to his letter for your

Regards to all

Robert Aston
CCDC Wigan and Bolton

Robert Aston, Consultant in Communicable Disease Control
Communicable Disease Unit(Wigan and Bolton Health Authority)
The Pikes Lane Centre
Deane Road
BOLTON BL3 5HP          ENGLAND UK    
                                      Tel (0)1204 874374
                                      Fax (0)1204 874375


Dear Sir

It hurts me that Councillor Stuart Lever calls my motives into question in
his letter of 7 February. For the past fourteen years I have tried as hard
as I can to promote immunisation as the best possible way of protecting the
children of Bolton from serious disease, handicap, and premature death.
That is my motive. Thanks to the hard, dedicated work of my nursing and
medical colleagues in the field, often supported by responsible reporting
by the BEN, we have consistently achieved amongst the highest levels of
protection in the country, indeed in the world. Tuberculosis in the town
was halved in the early 1990s; Hib meningitis (formerly more common than,
and just as dangerous as, the now much dreaded meningococcal meningitis)
disappeared from 1992 after we introduced the Hib vaccine; meningococcal C
meningitis (nearly half of the remaining serious meningitis cases) have
almost disappeared since the new vaccine was introduced in 1999; there have
been no cases of poliomyelitis, diphtheria or tetanus for many years.
Smallpox was eradicated from the world in 1980 by vaccination; the only
condition of any kind that we have so far totally conquered. 

We are now within a year or two of freeing the world of poliomyelitis, and
the same could be true for measles. About a million children still die
every year from measles. In this country, before the introduction of
measles vaccination, there were up to 800,000 reported cases of the disease
and around 100 deaths each year. Thanks to MMR vaccine (from 1988),
measles, mumps and rubella virtually disappeared; we no longer see the
dreadful congenital rubella syndrome (CRS) causing blindness, deafness and
mental handicap, and children no longer die of mumps meningitis. In Bolton
there has been no confirmed case of any of these diseases since 1995, with
the exception of a child who sadly was exposed to measles disease whilst
visiting Ireland, where low uptake of MMR vaccine had resulted in an
outbreak of measles disease with 2000 cases and two deaths. 

Sadly, we now have a situation of measles outbreaks occurring in this
country as a direct result of quite unnecessary public fears of a supposed
link with autism which have been promoted by antivaccination forces,
irresponsible journalists, and some political and public figures 

I have at no time been approached by Councillor Lever for information on
MMR or any other vaccines and it seems to me somewhat unorthodox to be
approached by him through the news media. I have no interest in his
perceived political implications of my celebrating my own grand-daughter's
being protected by MMR (BEN 5 February). Emily Jo is now protected against
these dangerous diseases, and I know that my agreeing to her being shown in
the BEN has reassured some parents. If this means that only a few children
are safely protected who would not otherwise have been, then Emily Jo has
at the tender age of 14 months, supported by her mum and grand-dad, already
made a little contribution to the good of others.

MMR is one of the safest and most effective of our vaccines, and does not
cause autism. An article giving a few of the reasons for this statement,
and why giving separate vaccines would increase the risk of disease to
children, is printed on page (x).

People in a position of influence and responsibility can pose considerable
risk to the health of Bolton's children if they support unfounded scares
and do not act with full knowledge. I repeat the invitation which I have
already given on regional radio in response to his letter to them to come
and meet me so that we can work together for the good of our people.
Politics, as such, does not interest me. Preventing childhood suffering
does - very much.

Robert Aston

Consultant in Communicable Disease Control

Wigan and Bolton Health Authority

MMR - The Truth

MMR vaccine has been used for over 20 years in more than 90 countries with
over 500 million doses given. The scientific evidence for its safety and
effectiveness is enormous and at least as good as for any other vaccine.
Every reputable medical, nursing and scientific organisation in the world
that has looked at the allegations of a supposed link with autism had
declared that there is no such link. 

The present controversy is little to do with these facts. It is to do with
scares and irrational fears and systematic undermining of parents'
confidence. The parents who have become convinced that their children have
autism as a result of MMR are genuine, loving people and I respect their
conviction. Autism, however, typically shows its first signs during the
second year of life, and MMR is given to over 90% of children at the
beginning of that year. We do not know the cause (or more probably causes)
of autism, but there is a deep human psychological need to find a reason
for tragedies in our lives. When antivaccine campaigners consistently and
very publicly state the untruth that MMR causes autism, it is hardly
surprising that parents of autistic children see this as a reason and
explanation for their suffering. But personal conviction, no matter how
sincere and total, is not a good guide to fact.

Let me tell a true story to show this. A young man called Tom died six
years ago at the age of nineteen from a progressively paralysing illness
which started a few days after he had his vaccines at the age of three. On
investigation, he was found to have muscular dystrophy - a condition which
is present from the moment of conception, but which often shows its first
signs around the age of three. His condition had absolutely nothing to do
with his vaccinations. But if Tom had had any condition for which we do not
yet know the cause, such as autism or Crohn's disease, who could possibly
have blamed his parents if they had become totally and sincerely convinced
that it was caused by the vaccines? It is perfectly possible to be
sincerely convinced of something, but be wrong. In case readers should
think me heartless or unaware of the suffering of the parents of children
with conditions like autism, it is important to add that Tom was my own son. 

Truth cannot be determined by personal conviction, no matter how strong and
sincere. Indeed if your conviction is in fact wrong as demonstrated by
world evidence, but you continue to state it publicly as fact, you might
not only be deceiving yourself, but also mislead others. You may be causing
unnecessary alarm and pain to other parents and undermining their
confidence so that they do not protect their own children from dangerous
diseases. Truth can only be found by studying all the proper evidence, as
has been done extensively over the years for MMR. If you want to find out
if MMR causes autism, one way is to look at large numbers of children over
many years and find out if autism is more common in children who have had
MMR. It is not. Another is to look at the levels of autism. This has been
rising over the years, but the rise started well before MMR was introduced.
When MMR levels have remained the same, autism has continued to rise. When
there has been rapid increases in MMR vaccination there has been no
corresponding rise in autism. 


So, why is there so much controversy and public concern? There has been
sustained activity by antivaccination groups (some of them claiming not to
be against vaccination but only ever undermining public confidence in this
safest and best way to protect our children), lawyers who support their
claims, irresponsible media coverage promoting theories for which there is
no evidence, and indeed much evidence to the contrary. This is hardly
surprising in a "compensation culture" supported by irresponsible media
preference for sensational controversy rather than the sober reality of
safety. Sensation sells, safety does not. 

A very similar scare occurred in the 1970s when one medical team, with no
evidence for it, promoted the idea that whooping cough (pertussis) vaccine
caused brain damage. Because true scientific study takes time, it was three
years before it was clear that there no such connection. The Department of
Health gave in to the public alarm and pressure groups (no doubt it would
nowadays also be opinion polls) and agreed to separate the diphtheria,
tetanus, and pertussis vaccines. The result was a catastrophic fall in
take-up. By the time public confidence was restored, the damage had been
done. An estimated 300,000 children suffered from this dreadful disease
because parents had been scared into not having them immunised, and at
least 70 of them died. Sadly, we do not seem to learn from history and are
falling into the same folly all over again with MMR .

Giving separate M, M, and R vaccines would not only give no benefit over
MMR, but would clearly increase the risk of serious disease for our
children. Because of space restriction, these are listed in the panel.
Fuller explanations are available in the Factsheets available from all GP
surgeries, health clinics, or NHS Direct (Tel. 08 45 46 47). 

The overwhelming scientific evidence for the overall safety of MMR vaccine
and of no link with autism has been presented publicly over and over again,
made available through leaflets, public health campaigns, and through
comprehensive fact sheets distributed through doctors' surgeries and health
clinics. I myself have devoted a great deal of time to providing the facts
through the media, not least in many articles in the Bolton Evening News.
If you want reliable information on the internet, please do not go to the
campaigning sites (of which there are many, many masquerading under
deceptive titles). Go to ,, or 

I close with an appeal to the parents of the over 96% of Bolton's children
who have safely had the MMR vaccine by the age of five years. It is
overwhelmingly the norm to vaccinate our children with MMR, and you are
happy that you have done so. You are also the great "silent majority"; you
have no axe to grind, no cause to fight. Please consider taking a moment to
help to stop this current national folly by making your support known. Why
not start by writing to the BEN, your MP, or your local councillor to
support MMR as the best and safest way of protecting our children?






Why not have separate vaccines?

MMR has an unsurpassed safety track record (see main article).
There has at no time been any evidence that autism is caused by MMR, but
plenty of evidence that it is not, and this evidence continues to mount.
Even the study which started public concerns about the supposed link
(Andrew Wakefield, 1998) stated very clearly that it "did not prove an
association between measles, mumps, and rubella vaccine and the syndrome
No country in the world recommends separate vaccines.
There is therefore no experience of how long should be left between them or
in which order they should be given to be sure they are not only effective,
but safe.
Dr Wakefield recommended a one-year gap between them. Some private clinics
are offering them at much shorter intervals. Neither approach is based on
any evidence.
If Dr Wakefield's recommendation is followed, this would mean that a
children would have to have six injections and would not be fully protected
for six years, with risk not only of getting the diseases themselves, but
passing them to others also not fully protected.
Completing a course of six injections would be very difficult for many
parents (though they might well start off with the intention of following
it through). We know from experience that such increases in consultations
and injections inevitably lowers overall take-up and would increase the
risk of outbreaks.
Parents would inevitably "cherry pick" the separate vaccines. For example,
it would not be seen as so important to protect boys from rubella, since
boys do not get pregnant and rubella causes dreadful handicapping disease
when pregnant women develop it. This would mean a return to the days before
MMR, when only the girls were given the vaccine. The unvaccinated boys
continued to get rubella which they then passed on to the unprotected women
and their unborn babies. If we do not maintain high levels of vaccination
against all these diseases, they will continue to go around and cause
disease and outbreaks.
How kind is it to inflict six injections on a small child when there is no
benefit and it increases the risk? The needle itself involves pain and a
small, but real risk.
Even if MMR had been shown to be linked to autism (and it has not been)
there is no evidence that single vaccine would not cause the same problem.
It is completely false to state that the three mild viruses in MMR
"overload the immune system". A baby's immune system is exposed to
countless bacteria and viruses from the moment of birth and indeed needs
this stimulus to develop fully. There is even some evidence that our
over-hygienic society has resulted in inadequate development of our immune
systems and this has been put forward as a possible cause of the rise in
A recent study in one of the most respected medical journals of child
health reviewed the world evidence on vaccines and the immune system. They
concluded that it would not harm a baby's immune system even if 10,000
vaccines were given at the same time.
No country has ever used Measles, Mumps, and Rubella vaccines separately in
sequence for young children.
Japan had to withdraw its home-produced MMR vaccine because of problems
with its mumps part (not because they recommended separate vaccines). They
have continued to give measles and rubella vaccine on the same day and
offer their mumps vaccine separately if parents want it. Because of this
misfortune in their system, there were 79 deaths from acute measles disease
between 1992 and 1997. In the same period, thanks to MMR, there were no
deaths in the UK.
France does not recommend separate measles vaccine. Because of a legal
requirement within the State system that all children must be protected
from measles before entering nurseries to prevent outbreaks, a small
proportion (about 5%) of children are given the separate measles vaccine
because they are under one year of age and MMR is not fully effective till
about 13 months. It is given simply to meet a legal requirement, and on the
understanding that the child will go on to have the full course of MMR at
the same age as those in the UK.
In this country separate vaccines are unlicensed and undergo fewer safety
tests. My colleagues and I can give no guarantees that they are subjected
to quality control, or are stored and transported in conditions that will
ensure their safety and effectiveness.
Worse still, some vaccines may be ineffective or even dangerous. For
example, the Urabe strain of mumps vaccine is not used in this country
because it is linked with an unacceptably high risk of causing encephalitis
(like meningitis).


The MMR vaccine is the only safe option we have for our children today. We
should be aiming to achieve what Finland has already done - the complete
elimination of the three diseases. Contrast this with the tragedy in
Ireland in 2000, when the scares resulted in a drop in the vaccination rate
to 78%. Some 2000 children suffered from measles, and two babies died from

The option is actually straightforward. It is for parents to weigh the
balance of benefits and costs between protecting our children as quickly
and safely as possible against a known, real, serious risk of disease using
the safe and effective MMR vaccine, or leaving them exposed to this risk
and allowing outbreaks to occur, because of supposed "risks" from MMR for
which there is no evidence. The use of separate vaccines would not improve
matters, but make it worse. More children would suffer.