Fears and frustrations over MMR
Monday December 15, 2003
I applaud Ben Goldacre’s efforts to highlight how much scientific evidence is available to prove the safety of the MMR vaccine and how much damage has been done to the public’s confidence in the vaccine by poor understanding of the science behind autism (Never mind the facts, Life, December 11). The threat of a measles epidemic grows ever larger and programmes such as Channel 5′s Hear The Silence only hasten the day when that tragedy occurs. I have an autistic son and yet did not hesitate to have my daughter vaccinated with the MMR vaccine. Even if there was a slight risk with MMR, then the risk is far outweighed by the very real risk of contracting measles.
As a parent agonising over the MMR booster decision, I’m prepared to consider Andrew Wakefield wrong. But Ben Goldacre seems to blame it all on the press. What influences parents to reject MMR is their personal experiences of autism and those of friends and acquaintances. This leads them to believe autism is increasing and is a serious form of brain damage. Medical establishment claims such as Goldacre’s that “autism is a disorder of communication” are seen as trivialisation, so doctors are trusted less and these personal experiences more. Claims that rising rates of autism are due to people “using the diagnosis more” are seen as a denial of the data. Goldacre symbolises the disconnect between medics and parents. His concern throughout is MMR. Parents’ concern is autism. Put aside who is right; the best way to deal with the hypothetical measles outbreak and to satisfy parents would be to find a non-MMR cause – and better still a cure – for autism.
I was heartened to read Ben Goldacre’s account of the controversy and that attention was drawn to the poor quality of media coverage. Following the publication of Wakefield’s first Lancet paper, a snowball of conjecture and innuendo has lead us to a wholly unacceptable scenario today where MMR immunisation rates have now fallen to 84% nationally. For this, the tabloid (and some of the broadsheet) press must be held responsible. Their offence is clear: anecdotal and unscientific data has been given credibility by the sheer volume of coverage, while evidence-based factual results refuting the claims have been swept under the carpet. Should this be a surprise to those of us attempting to uphold the integrity of science as a respected and trusted institution, when “80% [of articles in newspapers regarding MMR] were written by non-specialist reporters” between January and September 2002. Reporting the conclusions of such non-reproducible, subjective studies is as irresponsible and dangerous to public health as any potentially rogue element in vaccines.
Institute of Ophthalmology
Surely Ben Goldacre’s concerns should lie with the increasingly common practice of peer-reviewed journals such as the Lancet, in line with the current culture of evidence-based medicine, of publishing small-scale trials which may or may not later be shown to have any scientific validity. If we are to begin to encourage more accurate media reporting of scientific findings, we this is a fundamental issue.
Dalgety Bay, Fife
My friend and colleague, Paul Shattock, criticised by Dr Goldacre, is a pharmacist who has devoted a lifetime to the study of autism disorders and who has his own severely autistic child, now 28. Paul is pro- not anti-immunisation – but in a manner that is safe for the child.
At a Defeat Autism Now conference in May, Andrew Wakefield presented a comprehensive review of all his work, which has been replicated by Dr Krigman. The science was compelling and made all the links between the MMR vaccine and the severe enterocolitis, coupled with autism, identified in some children. The dilemma for parents is: will this severe consequence of vaccination happen to my child and is there any way of avoiding it? The work at Sunderland has, much to my surprise, profound implications for a number of chronic illnesses with which I am involved, including organophosphate poisoning, Gulf war syndrome, and ME-CFS.
Dr Goldacre should attend to the concern and experience of many parents. Epidemiology is no alternative to the careful study of sick children, which has been studiously avoided in this country for reasons that have never been made clear.
(Prof) Malcom Hooper
University of Sunderland
The MMR debate will only cease when there is sufficient statistical data one way or the other. It seems that now, when some 20% of children in this country are not receiving the MMR, but have had all the other vaccinations, is a good time to make such an analysis. Autism is usually evident from 12 to 18 months, so a proportion of those who have not been immunised in the last few years will by now be diagnosed as being on the autistic spectrum. Thus a comparison between those who have had the MMR and those who have not can be made. As a grandparent with six grandchildren, only one of whom had the MMR and developed a severe form of autism, maybe as a result of it, but maybe not, I would like to know the answer.
The following appeared in Corrections and Clarifications on the 16th December 2003:
The lead letters in yesterday’s paper addressed a recent feature on the MMR vaccine written by Ben Goldacre (Fears and frustrations over MMR, page 17). Unfortunately his first name appeared as Rob (once) and his second name as Oldacre (twice).