Private Eye No 1021, 9-11 Feb 2001

NOW that some doctors as well as parents are beginning to question ministers and health officials’ assertions about the safety of the MMR vaccine, the debate over the triple jab has assumed a spiteful edge.

Not content with rubbishing Dr Andrew Wakefield (see last Eye), whose only offence has been to champion his young autistic and curiously bowel-diseased patients, raise questions about the vaccine and demand more research, vitriol is now being poured on parents whose concern for their children’s safety is making them ask for single doses.

Documents circulating under the title of MMR Vaccine Myth and Fact among health authority immunisation officers and GPs as part of the current push to restore MMR confidence include the suggestion that parents who do not have their children vaccinated are selfish, reckless criminals. "An unimmunised child is the infectious equivalent of a drunk driver," it states.

The author of this report is one Mike Watson —medical director of Aventis Pasteur MSD — who as a manufacturer of MMR is naturally keen to spread the good word. Except that in his attempts to sort fact from fiction, Watson himself seems to have been more than a little "economical with the actualité".

For example, in his "myth three" attempt to dissuade parents obtaining separate measles, mumps and rubella vaccines from Europe, Watson suggests they might be buying a second rate strain of the mumps vaccine, of which there is a choice of three. The Urabe strain, he writes, was replaced here in 1992 after it was "rarely" associated with "severe headaches".

Actually the Urabe strain was used in the MMR vaccines, Immravax and Pluserix, in this country between 1988 and 1992. Both were hastily withdrawn in 1992 after they were found to cause not "rare" but unusually high rates (more than I in 11,000) of potentially fatal aseptic mumps meningitis— er, a little more than a "severe headache", the Eye would suggest. And Watson should know because his company, then Merieux UK, manufactured the dodgy Immravax. Smith Kline Beecham produced the other.

And here are two more important "facts" he left out. When those MMR vaccines were licensed here in 1988, an identical vaccine containing the Urabe strain produced by Smith Kline Beecham and called Trivirex had already been withdrawn from Canada because of suspected links to aseptic mumps meningitis. This no doubt would have passed unnoticed by our government scientists responsible for licensing because — as we now know courtesy of the BSE inquiry — the department was then a shambles. But it could not have passed unnoticed by MMR manufacturers.

Yet as late as 1997 the Smith Kline Beecham Urabe MMR jab was used in a mass vaccination programme in Brazil and caused, yes, an outbreak of aseptic meningitis.

In "Myth 4— MMR vaccine has been banned in Japan", Watson happily states that an MMR vaccine containing the Urabe strain of mumps was withdrawn "due to high rates of aseptic meningitis". No doubt there he can call a spade "meningitis" and not "severe headaches" because the vaccine was of Japanese manufacture and not of his company. He suggests that because no other alternative MMR is available in Japan, "they were forced to recommend single measles and rubella vaccines". Actually the Japanese health authorities considered alternatives and have decided they did not want them.

That a drug company representative produces contentious material is not perhaps surprising. That the department of health is also circulating similar material as part of its £3m campaign to restore faith in the MMR vaccine is.

A fortnight ago, after Andrew Wakefield published his second paper which questioned the swift decision to license the vaccines because they were not adequately tested over a sufficient period of time, the department of health (which had had his paper for several months) issued a 15-page response in which it accused Dr Wakefield of being "highly selective". "It is easy for scaremongering to sap public confidence by biased presentations that are conuary to the large amount of data that provide real reassurance," it said.

But as the last Eye pointed out, the "large amount of data" the department has been relying upon and which it repeats in its 15-page document — a study in Finland, a Committee for the Safety of Medicines review of reports from parents and doctors and the Taylor report — do nothing to address any issues of regressive autism, rare bowel disease and vaccination.

In fact "highly selective and biased" could equally apply to its 15-page document. For example, it records that the Medical Research Council brought in experts to review Dr Wakefield’s original work in 1998. They concluded that "there is no evidence to indicate any link between MMR vaccination and bowel disease or autism and there is therefore no reason for a change in the current MMR policy".

But minutes of the meeting show it concluded there was "CURRENTLY no evidence to support a link" and that "further research, probably on an international basis to include a sufficiently large number of patients, would be needed to settle the question of any possible association between autism and MMR vaccination."

The 15-page paper — like Watson — also cites the Japanese experience, with its system of separate vaccines, and says that between 1992 and 1997 there were 79 Japanese deaths from measles, while during the same period in the UK there was none. Except that statistics from the Public Health Laboratories reveal 10 deaths in the UK from measles during that five-year period.

The paper also cites a 1971 American study as proof that Wakefield’s claim that most pre-licence studies had a maximum follow up on only 28 days is incorrect. The health department said it had a six to nine-week follow up for adverse events. Except that the six to nine weeks only applied to a pilot study of 30 children. The bulk, 680, were monitored for only 28 days.

And in January 1990 Dr David Salisbury, in his role as senior medical officer on the Committee of Safety of Medicines, admitted that before the MMR vaccine was introduced "we carried out a large scale study where adverse events were monitored in a three-week period in approximately 12,000 children".

And so the war of words goes on. This is no help to parents trying to weigh up the risks of vaccination against the risks of serious and potentially killer diseases. But £3m went on proper research instead of spin would be a help.

Instead we find out, courtesy of Tony Blair, that the government is coughing up only £344,000 to "fund one of the largest studies ever attempted to find the causes of autism", led by Professor Andrew Hall.

Blair admits in a letter written in December to MP Stephen Ladyman about what the government was doing to address the issue of autism, that there has been a large increase in the number of children with autism in recent years, for which the full explanation is "not clear". As the Eye reported last week, it has shot up to l in l00 in some areas.

On the issue of MMR and autism Blair concludes: "MMR is the safest way for parents to protect their children against potentially serious diseases." No doubt Leo will be having his.