The media’s MMR hoax

August 30th, 2008 by Ben Goldacre in bad science, badscience, MMR | 57 Comments »


This is an extract from my new book “Bad Science“, in the Guardian today. It’s out on Monday: my recommendation is that you buy it, and give it to someone who disagrees with you.

Ben Goldacre
The Guardian
Saturday August 30 2008

Dr Andrew Wakefield is in front of the General Medical Council on charges of serious professional misconduct, his paper on 12 children with autism and bowel problems is described as “debunked” – although it never supported the conclusions ascribed to it – and journalists have convinced themselves that his £435,643 fee from legal aid proves that his research was flawed.

I will now defend the heretic Dr Andrew Wakefield.

The media are fingering the wrong man, and they know who should really take the blame: in MMR, journalists and editors have constructed their greatest hoax to date, and finally demonstrated that they can pose a serious risk to public health. But there are also many unexpected twists to learn from: the health journalists themselves were not at fault, the scale of the bias in the coverage was greater than anybody realised at the time, Leo Blair was a bigger player than Wakefield, and it all happened much later than you think.

Before we begin, it’s worth taking a moment to look at vaccine scares around the world, because I’m always struck by how circumscribed these panics are. The MMR and autism scare, for example, is practically non-existent outside Britain. But throughout the 1990s France was in the grip of a scare that hepatitis B vaccine caused multiple sclerosis.

In the US, the major vaccine fear has been around the use of a preservative called thiomersal, although somehow this hasn’t caught on here, even though that same preservative was used in Britain. In the 1970s there was a widespread concern in the UK, driven again by a single doctor, that whooping-cough vaccine was causing neurological damage.

What the diversity of these anti-vaccination panics helps to illustrate is the way in which they reflect local political and social concerns more than a genuine appraisal of the risk data, because if the vaccine for hepatitis B, or MMR, is dangerous in one country, it should be equally dangerous everywhere; and if those concerns were genuinely grounded in the evidence, especially in an age of the rapid propagation of information, you would expect the concerns to be expressed by journalists everywhere. They’re not.

In 1998 Wakefield published his paper in the Lancet. It’s surprising to see, if you go back to the original clippings, that the study and the press conference were actually covered in a fairly metered fashion, and also quite sparsely. The Guardian and the Independent reported the story on their front pages, but the Sun ignored it entirely, and the Daily Mail – home of the health scare, and now well known as vigorous campaigners against vaccination – buried their first MMR piece unobtrusively in the middle of the paper. There were only 122 articles mentioning the subject at all, in all publications, that whole year.

This was not unreasonable. The study itself was fairly trivial, a “case series report” of 12 people – essentially a collection of 12 clinical anecdotes – and such a study would only really be interesting and informative if it described a rare possible cause of a rare outcome. If everyone who went into space came back with an extra finger, say, then that would be worth noting. For things as common as MMR and autism, finding 12 people with both is entirely unspectacular.

But things were going to get much worse, and for some very interesting reasons. In 2001 and 2002 the scare began to gain momentum. Wakefield published a review paper in an obscure journal, questioning the safety of the immunisation programme, although with no new evidence. He published two papers on laboratory work using PCR (a technique used in genetic fingerprinting) which claimed to show measles virus in tissue samples from children with bowel problems and autism. These received blanket media coverage.

The coverage rapidly began to deteriorate, in ways which now feel familiar and predictable. Emotive anecdotes from distressed parents were pitted against old men in corduroy with no media training. The Royal College of General Practitioners press office not only failed to speak clearly on the evidence, it also managed to dig up anti-MMR GPs for journalists who rang in asking for quotes. Newspapers and celebrities began to use the vaccine as an opportunity to attack the government and the health service, and of course it was the perfect story, with a charismatic maverick fighting against the system, a Galileo-like figure. There were elements of risk, of awful personal tragedy, and of course, the question of blame: whose fault was autism?

But the biggest public health disaster of all – which everyone misses – was a sweet little baby called Leo. In December 2001 the Blairs were asked if their infant son had been given the MMR vaccine, and refused to answer, on the grounds that this would invade their child’s right to privacy. This stance was not entirely unreasonable, but its validity was somewhat undermined by Cherie Blair when she chose to reveal Leo’s vaccination history, in the process of promoting her autobiography, and also described the specific act of sexual intercourse which conceived him.

And while most other politicians were happy to clarify whether their children had had the vaccine, you could see how people might believe the Blairs were the kind of family not to have their children immunised: essentially, they had surrounded themselves with health cranks. There was Cherie Blair’s closest friend and aide, Carole Caplin, a new age guru and “life coach”. Cherie was reported to visit Carole’s mum, Sylvia Caplin, a spiritual guru who was viciously anti-MMR (“for a tiny child, the MMR is a ridiculous thing to do. It has definitely caused autism,” she told the Mail). They were also prominently associated with a new age healer called Jack Temple, who offered crystal dowsing, homeopathy, neolithic-circle healing in his suburban back garden, and some special breastfeeding technique which he reckoned made vaccines unnecessary.

Whatever you believe about the Blairs’ relationships, this is what the nation was thinking about when they refused to clarify whether they had given their child the MMR vaccine.

The MMR scare has created a small cottage industry of media analysis. In 2003 the Economic and Social Research Council published a paper on the media’s role in the public understanding of science, which sampled all the major science media stories from January to September 2002, the peak of the scare. It found 32% of all the stories written in that period about MMR mentioned Leo Blair, and Wakefield was only mentioned in 25%: Leo Blair was a bigger figure in this story than Wakefield.

And this was not a passing trivial moment in a 10-year-long story. 2002 was in fact the peak of the media coverage, by a very long margin. In 1998 there were only 122 articles on MMR. In 2002 there were 1,257 (from here). MMR was the biggest science story that year, the most likely science topic to be written about in opinion or editorial pieces, it produced the longest stories of any science subject, and was also by far the most likely to generate letters to the press, so people were clearly engaging with the issue. MMR was the biggest and most heavily covered science story for years.

It was also covered extremely badly, and largely by amateurs. Less than a third of broadsheet reports in 2002 referred to the overwhelming evidence that MMR is safe, and only 11% mentioned that it is regarded as safe in the 90 other countries in which it is used.

While stories on GM food, or cloning, stood a good chance of being written by specialist science reporters, with stories on MMR their knowledge was deliberately sidelined, and 80% of the coverage was by generalist reporters. Suddenly we were getting comment and advice on complex matters of immunology and epidemiology from Nigella Lawson, Libby Purves, Suzanne Moore and Carol Vorderman, to name only a few. The anti-MMR lobby, meanwhile, developed a reputation for targeting generalist journalists, feeding them stories, and actively avoiding health or science correspondents.

Journalists are used to listening with a critical ear to briefings from press officers, politicians, PR executives, salespeople, lobbyists, celebrities and gossip-mongers, and they generally display a healthy natural scepticism: but in the case of science, generalists don’t have the skills to critically appraise a piece of scientific evidence on its merits. At best, the evidence of these “experts” will only be examined in terms of who they are as people, or perhaps who they have worked for. In the case of MMR, this meant researchers were simply subjected to elaborate smear campaigns.

The actual scientific content of stories was brushed over and replaced with didactic statements from authority figures on either side of the debate, which contributed to a pervasive sense that scientific advice is somehow arbitrary, and predicated upon a social role – the “expert” – rather than on empirical evidence.

Any member of the public would have had very good reason to believe that MMR caused autism, because the media distorted the scientific evidence, reporting selectively on the evidence suggesting that MMR was risky, and repeatedly ignoring the evidence to the contrary. In the case of the PCR data, the genetic fingerprinting information on whether vaccine-strain measles virus could be found in tissue samples of children with autism and bowel problems, this bias was, until a few months ago, quite simply absolute. You will remember from earlier that Wakefield co-authored two scientific papers – known as the “Kawashima paper” and the “O’Leary paper” – claiming to have found such evidence, and received blanket media coverage for them. But you may never even have heard of the papers showing these to be probable false positives.

In the Journal of Medical Virology May March 2006 there was a paper by Afzal et al, looking for measles RNA in children with regressive autism after MMR vaccination, using tools so powerful they could detect measles RNA down to single-figure copy numbers. It found no evidence of the vaccine-strain measles RNA to implicate MMR. Nobody wrote about this study, anywhere, in the British media (except for me in my column).

This was not an isolated case. Another major paper was published in the leading academic journal Pediatrics a few months later, replicating the earlier experiments very closely, and in some respects more carefully, also tracing out the possible routes by which a false positive could have occurred. For this paper by D’Souza et al, like the Afzal paper before it, the media were united in their silence. It was covered, by my count, in only two places: my column, and a Reuters news agency report. Nowhere else (although there was a post on the lead researcher’s boyfriend’s blog where he talked about how proud he was of his girlfriend). [EDITED to disambiguate]

Journalists like to call for “more research”: here it was, and it was ignored. Did the media neglect to cover these stories because they were bored of the story? Clearly not. Because in 2006, at exactly the same time as they were unanimously refusing even to mention these studies, they were covering an identical claim, using identical experimental methodology: “US scientists back autism link to MMR” said the Telegraph. “Scientists fear MMR link to autism” squealed the Mail.

What was this frightening new data? These scare stories were based on a poster presentation, at a conference yet to occur, on research not yet completed, by a man with a well-documented track record of announcing research that never subsequently appears in an academic journal. This time Dr Arthur Krigsman was claiming he had found genetic material from vaccine-strain measles virus in some gut samples from children with autism and bowel problems. If true, this would have bolstered Wakefield’s theory, which by 2006 was lying in tatters. We might also mention that Wakefield and Krigsman are doctors together at Thoughtful House, a private autism clinic in the US.

Two years after making these claims, the study remains unpublished.

Nobody can read what Krigsman did in his experiment, what he measured, or replicate it. Should anyone be surprised by this? No. Krigsman was claiming in 2002 that he had performed colonoscopy studies on children with autism and found evidence of harm from MMR, to universal jubilation in the media, and this work remains entirely unpublished as well. Until we can see exactly what he did, we can’t see whether there may be flaws in his methods, as there are in all scientific papers, to a greater or lesser extent: maybe he didn’t select the subjects properly, maybe he measured the wrong things. If he doesn’t write it up formally, we can never know, because that is what scientists do: write papers, and pull them apart to see if their findings are robust.

Through reporting as shamelessly biased as this, British journalists have done their job extremely well. People make health decisions based on what they read in the newspapers, and MMR uptake has plummeted from 92% to 73%: there can be no doubt that the appalling state of health reporting is now a serious public health issue. We have already seen a mumps epidemic in 2005, and measles cases are at their highest levels for a decade. But these are not the most chilling consequences of their hoax, because the media are now queueing up to blame one man, Wakefield, for their own crimes.

It is madness to imagine that one single man can create a 10-year scare story. It is also dangerous to imply – even in passing – that academics should be policed not to speak their minds, no matter how poorly evidenced their claims. Individuals like Wakefield must be free to have bad ideas. The media created the MMR hoax, and they maintained it diligently for 10 years. Their failure to recognise that fact demonstrates that they have learned nothing, and until they do, journalists and editors will continue to perpetrate the very same crimes, repeatedly, with increasingly grave consequences.

· This is an edited extract from Bad Science by Ben Goldacre, published by Fourth Estate on September 1 at £12.99. To order a copy for £10.99 with free p&p, call 0870 836 0875 or visit

Or if you prefer you can buy it off Amazon

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57 Responses

  1. orzr said,

    August 30, 2008 at 8:25 am

    There is another issue here that contributed to the situation. That was the government’s fundamental dishonesty about how vaccines work and why they are needed.

    It seems to me that vaccines achieve their effect through “herd immunity”. i.e. When a high enough percentage of the population is not susceptible to an infection, it doesn’t take hold.

    However, the government has not used this as an argument in favour of vaccination. Instead, it has adopted a fear-mongering tone of “you are putting your child at risk if you don’t have him/her vaccinated!”. They may consider that the end justifies the means but, in this case, it hasn’t worked.

    Let’s get this clear. If the vaccination programme works as intended, no child is protected from M, M or R by their individual vaccination. They are protected because everyone’s vaccination means there is no M, M or R in the community.

    This attitude contributes to the public’s mistrust of anyone in authority giving them health advice and it doesn’t suprise me that people are sceptical. Also, for most of today’s parents, childhood diseases were a fact of life and not very serious. The government needs to do more than adopt a hectoring tone that measles is a killer when that was not most people’s experience.

    Finally, the government never came up with a convincing argument against those parents who just wanted separate vaccines for M, M and R. There was just more bullying and accusations of putting children at risk.

    It would have been far better to have adopted a community-spirited approach and ask everyone to take part in the programme for the sake of everyone else, recognising the benefits for all of us if children don’t have to go through measles etc. (e.g. none of the discomfort, no school time lost, etc.). They could have been honest about the relatively small number of lives that would be saved but acknowledge that this wouldn’t be a factor for most people.

  2. BobP said,

    August 30, 2008 at 9:47 am

    Very thorough – well done. I’ll definitely put the book on my Xmas list.

  3. superburger said,

    August 30, 2008 at 10:50 am

    i thought wakefield’s hearing at the gmc was about the ethics of his research (not the actual hypothesis that he was testing).

    e.g. giving fivers to kids for blood samples at birthday parties.

  4. woodchopper said,

    August 30, 2008 at 11:06 am

    I couldn’t find this article on the Guardian’s web site. I hope that’s because copyright issues prevented them from publishing online parts of the book, and not that the article has been pulled for some reason.

    Or maybe my search skills are just crap …

  5. misterjohn said,

    August 30, 2008 at 11:26 am

    And what do GoogleAds give us on the Guardian website after Ben’s article?
    Three guesses not needed….

    single mmr vaccines
    Consultant led Clinics Nationwide Tel: 0845 130 4595

    Single MMR in Manchester
    Doctor-led clinic fully registered with the Healthcare Commission

    Individual MMR vaccines
    single measles, rubella & mumps at registered Hertfordshire clinic

    Nil carborundum

  6. lilylangtree said,

    August 30, 2008 at 12:03 pm

    Great article.

    However I’m not convinced that the same MMR/autism scare is
    ‘practically nonexistent outside the UK’. I use two messageboards which are predominatly made up of American women; in both cases the vaccination issue is EXTREMELY contentious and the autism issue right there in the forefront.

  7. Ben Goldacre said,

    August 30, 2008 at 12:20 pm

    oops got date of afzal wrong, corrected, and i didnt mean to imply in my mangled sentence that these papers werent covered by bloggers: they most excellently were, and oddly i’ve just been talking about how excellently the anti-anti-vaxxer blogs have covered these issues at the nature science bloggers conference in the RI, where i am sitting right now.

    i should also be absolutely clear, in case it’s not obvious: i’m certainly not impressed by what wakefield has done, but i am much more astonished by the way the media are clearly revving up to blame him for their own mmr debacle.

  8. woodchopper said,

    August 30, 2008 at 12:25 pm

    Scratch the above comment – its now on the site.

    Great article as well.

  9. tialaramex said,

    August 30, 2008 at 12:41 pm

    orzr, you are confusing two things, and maybe that does suggest that we’re not communicating well enough to the public (but I don’t see the media trying to help)

    Immunisation does work on individuals. But it isn’t 100% effective. Giving your child a vaccination means only that they’re less likely to get the associated disease, and in some cases that they’re likely to be less sick if they do contract it. We cannot be certain that a child given MMR won’t later die of Measles, we can only say that it’s hugely less likely. Thus just immunising your child isn’t enough to be “safe” we have to do more.

    But there is an individual reason to choose vaccination, it does make individual children safer to be vaccinated, and our research shows that the price (in terms of the unforeseeable adverse outcomes for a small minority of children who are vaccinated, which in very rare cases could include death) is worth risking for this benefit.

    However the primary Public Health reason for MMR in early childhood is indeed the herd immunity. This is the same individual immunity seen from a population level. Herd immunity means that if you have Measles (for example) most people you meet won’t catch Measles. Without herd immunity, disease races through the population, one sick person quickly becomes hundreds, thousands, even millions. This really used to happen, right here in Britain, and before vaccination no-one could do a thing about it besides wring their hands.

    You might think of the individual and herd immunity factors as being like the difference between stopping smoking, and banning smoking in restaurants. If you stop smoking, you almost immediately begin to see health benefits. But if we ban everyone from smoking in the restaurant then the whole population benefits. But just because we ban smoking in restaurants doesn’t mean you’re fine to keep smoking at home – it’s still bad for you there.

    People who don’t immunise their kids out of irrational fear caused by media hysteria are simultaneously putting the kids at risk as individuals (a small but non-zero increased chance they’ll die of or be permanently disabled by an easily preventable childhood ailment) and being selfish by reducing the local herd immunity, putting kids who can’t be vaccinated (e.g. those too sick from cancer treatment) at risk.

    We need to create a situation where the modern journalist “bullshit” approach to health and science news is openly scorned. I want to see a journalist fired for doing this, and not in a “next week you’ll have a job that pays even better in another newspaper” way, I mean send them back to write articles about the 10km fun run in a Dorset town’s local paper. If journalists want to be a “profession” they need to start acting professionally.

  10. MataHari said,

    August 30, 2008 at 2:42 pm

    Twenty years ago, in 1988, I research a programme on NHS history for the BBC.

    One of the topics I was given was the then vaccine-brain-damage story. It was a big story in its day – when you were knee-high to a kitten – and the govt voted to give compensation to parents of vaccine-damaged children. I think (recall hazy) that the vaccination was for measles.

    I traced the scare to a paper – the lead paper in that issue – of Archives of Diseases of Childhood. The two authors were 1. A person with a middle-east name who was absent from the Medical Directory and Science Citation Index and elxewhere, in other words he had vanished (this was pre-Internet) and 2. the then prof of something at Gt Ormond St.

    The study showed that children were diagnosed as retarded/subnormal a few weeks after vaccination.

    And that was all it showed. Full stop. No attempt at cause-and-effect. No story.

    Martin Bax, who edits Developmental Medicine and Child Neurology, said he would not have published it.

    And the story had originally broken after a conference paper that was reported in the Standard and the Telegraph. But at that stage it hadn’t been peer-reviewed.

    It has been taken up by a bacteriologist whose name I have long forgotten. Patrick Collard, emeritus prof of bacteriology, Manchester, said the bacteriologist was sane in most ways but had an anti-mass-vaccination bee in his bonnet.

  11. used to be jdc said,

    August 30, 2008 at 3:03 pm

    Having published anti-MMR articles by the likes of Peter Hitchens, Richard Halvorsen and Julia Carling, the Mail (in March of this year) wrote of Wakefield: “The doctor who sparked a worldwide health scare over the MMR jab charged £150 an hour to a law firm that planned to sue the vaccine’s manufacturer, an enquiry heard today.”

    The Independent, meanwhile, wrote (in June) that “confidence in the vaccine was dashed by publication of a paper in The Lancet in 1998 by Andrew Wakefield and colleagues from the Royal Free Hospital, linking the jab with autism.”

    I wrote this: “Measles is endemic, Wakefield is up before the GMC and the media are walking away nonchalantly, pretending they were never involved.”

    I also nicked Ben’s line about this being the “Media’s MMR Hoax” for a piece I wrote titled Wakefield – Scapegoated by the media

  12. dropsy said,

    August 30, 2008 at 3:25 pm


    What is this about doing colonoscopies in autistic children

    Presumably an ethics committee/ Institutional review board approved this??

  13. jackdripper said,

    August 30, 2008 at 5:12 pm

    We have just had our 13 month old son vaccinated with the MMR. Thanks to Ben’s persistence with the story I had the facts at hand to allay my wife’s concerns. Even so, lately every time I saw a (usually scary) MMR story in the press or online I would still scoff at the stupidity but also worry a tiny bit, reading the stories in 2005 as a non-parent was viscerally different to reading them over the last year and having a real baby boy to consider (I realise how selfish this sounds, but that’s parenthood!)
    The insidious nature of the sometimes well-argued but just-plain-wrong opinion/quasi-reportage pieces on this issue had me doubting the mountain of evidence and plain common sense.
    So what is the effect of the one sided coverage on parents who come to the issue neutral? The fall in vaccination rates is horrifyingly eloquent.

  14. crgn said,

    August 30, 2008 at 7:24 pm

    Pennslvania also makes MMR a condition of being allowed into schools, as I found when we moved there many moons ago and I had to start at Junior High. Even though both my brother and I had had mumps as toddlers, they insisted we must have all three.
    As a meeja type myself, I frequently despair at the poor scientific knowledge of writers, but it’s really just a symptom of an endemic problem with newspapers. As ever-larger conglomerates take over once-frespected papers, costs get squeezed and you end up with unpaid people taken on for work experience evntually given a job as chief writer for one section or other. It’s not their fault they don’t know this stuff, everyone is just copying and pasting from Wikipedia, anyway, as paying expenses for travel (or in fact anything at all) to talk to someone who knows what they are on abou is forbidden. So the moment some name that can be quoted spouts some toss (I’m looking at you, Holford) it goes straight in. Luckily there are a few conscientious subs around who are ready to tweak the snake-oil claims and stick qualifiers round them, but they have no authority to say “this is bullshit, you know” and get it thrown out.
    Sorry, off-topic a touch there. Looking forward to the book. You, Brooker and the Mighty M in the comic section are the main reason I still buy teh Gaurdian. Kep it up.

  15. JQH said,

    August 30, 2008 at 8:57 pm

    The vaccination rate round here is reportedly somewhere around 60%. TeenH’s school sent a letter round last year about a number of measles cases at the school. It would appear that not only are some of the chattering classes convinced they know more about medicine than their doctors, they are also too stupid to recognise the onset of a serious illness.

    Personally I hold Wakefield and the media equally to blame for the current situation. I agree with Ben that researchers have the right to think unorthodox thoughts *BUT* there must have come a time when Wakefield had realised his conclusions did not stand up. If he’d said “Sorry guys, called that wrong” no blame could be attached to him. But he did not.

    The media carry the lion’s share of the blame for ignoring evidence that proved Wakefield wrong and persisting with their narrative of “Lone crusader v. Evil Government and Big Pharma” long past the poit where it was remotely credible. It wasn’t just the Daily Hate either. Anybody else remember the Observer’s incredible vanishing MMR story?

    Fuck, this is loser length. I’ll shut up now.

  16. McDoz said,

    August 30, 2008 at 10:19 pm

    Nice article Ben, I think you’re right to defend every investigator’s right to be wrong, so to speak. It’s only through getting things wrong 9 times out of ten that science advances at all.

    To MataHari, I think you must be referrring to the whooping cough vaccine / permanent neurological damage scare in throughout the 70s, that was finally resolved in court in 1988. There is an good academic article on this from 2003 by a geezer called Jefffrey Baker
    (Vaccine. 2003 Sep 8; 21(25-26): 4003-10.). To give a brief resume of the article:

    1974 publication of a case-series from Gt Ormond St Hospital suggesting link between whooping cough vaccine and brain damage in infants.

    1977 Whooping cough vaccine uptake had fallen from 77% to 33% nationally.

    1978, 1982 and 1985 major whooping cough epidemics in the UK.

    1977-1981 Big case control study on “every child between 2 and 36 months of life hospitalized in England, Scotland, and Wales for acute neurological illness” concludes that there is a statistically significant increased risk of neurological illness due to vaccination, but the risk is very low.

    1982 onwards, coordinated government publicity to convince people that whooping cough vaccination is safe. To quote from the article again, “The Health Minister’s daughter and Prince William himself were both inoculated amidst great publicity” Rather different from what happened with baby Leo, by the looks of things.

    1990 to present day, vaccination rates high again, no major increase in neurological illness in vaccine-age children.

    None of the papers seem to have learnt anything from this whole story.

  17. Geeb said,

    August 30, 2008 at 11:35 pm


    Interesting point about the lack of a convincing argument against single vaccinations. I’ve heard two rumours, but nothing official:

    1) Individual risk: the massive use of MMR around the world means that we can be pretty confident about the (lack of) side-effects, whereas the single vaccines haven’t been tested to anything like the same extent, and therefore might just maybe possibly be more harmful.

    2) Herd immunity risk: overall immunisation rates would probably end up being lower, as people would often do one or two of the three and then forget about the rest, or fail to get round to it, or decide it’s too expensive, or whatever.

    Would be good to get a view from someone with some actual medical knowledge…

  18. Robert Carnegie said,

    August 31, 2008 at 1:52 am

    I think Tony Blair should have been vaccinated publicly. Leo I accept it’s none of our business.

    Of course there are GPs against combined vaccines. They get paid more for giving more injections, and more yet again for attending the sick and damaged and dying who were not vaccinated. GPs as a body stood against the NHS from the beginning and everything it has achieved.

    It seems to me that an intelligent, thoughtful and moral person who was in the position that Dr Andrew Wakefield was in after he started this thing up would have said publicly and loudly “Hang on, the research that I’ve done doesn’t mean very much.” Instead he went to America to sell anti-autism suppositories. (Well, remedies that if you aren’t intended to stick them up your arse, you might as well.)

    As for herd immunity… have I got this straight? A vaccine confers resistance to a communicable disease, but not everyone will get the vaccine or have it work successfully. Due to “herd immunity” the disease is still eliminated from the population, because it can no longer pass between people when the infectee is protected by the vaccine, so, whether victims recover or die, it runs out of them. On the other hand, a vaccine carries some risk, if only of an unlikely serious needle injury, a different infection in the tiny wound, or the car journey to the doctor. So the wise parent will get everyone else’s children vaccinated, but perhaps not their own. One imagines a kind of adapted air rifle and a sniping position overlooking the school playground.

    There is surely a mathematical cutoff point during a vaccination campaign where the benefit of an individual’s vaccination to them is lower than its risk, as the risk of someone else infecting you reduces. No doubt though the measles vaccine takeup is well below that point. Again.

  19. dw said,

    August 31, 2008 at 4:19 am


    Actually in California, children are not forced to have the MMR vaccination to attend public school. State laws in California and about half the other states of the USA allows parents to register a “philosophical” objection to the vaccination: however school officials usually aren’t too anxious to make parents aware of this situation. Most of the remaining states allow for religious objections. See

    Like you, moved to California from the UK some years ago and I have a new baby. We are planning to immunize our child against measles: I’m not convinced that the benefits of the mumps and rubella vaccines justify the vaccinations. Not because of any concerns about autism, but simply because the diseases, if contracted during childhood, don’t seem serious enough (for what it’s worth, I had all three diseases as a child and I’m only in my early 30s). We’d prefer to let her immune system focus on vaccinations that seem really worthwhile such as pertussis. If our daughter doesn’t acquire immunity against mumps and rubella by the time she’s 10 we’ll vaccinate her against mumps and rubella then.

    I think the NHS’s refusal to provide separate vaccinations is unfortunate. While the combined vaccination may be more convenient and offer better protection, the NHS should come to terms with the fact that a large proportion of the British population has, because of the hysterical media coverage, come to believe that the combined MMR is unsafe. Given that this is the case, surely it is better to get people vaccinated separately, even if a few months late and perhaps with a few no-shows, than not to get them vaccinated at all?

  20. BobP said,

    August 31, 2008 at 11:30 am

    dw –
    a) every time you breathe, every time you scratch yourself you take in a load of bugs and your immune system dutifully zaps them. the extra load induced by vaccination is negligible.
    b) there is an argument that the immune system – liky many other of yr bodies systems – benefits & develops from being “exercised”. I’m not sure if this is backed by evidence though.
    c) there’s a good chance that your daughter will reach adulthood without catching and becoming immune to mumps & rubella. Both are potentially severe diseases in adults – mumps can be debilitating, rubella can severly damage the unborn child of a pregnant woman.
    Check it out here:

  21. Junkmonkey said,

    August 31, 2008 at 11:51 am

    Isn’t Smallpox one word?

  22. Ephiny said,

    August 31, 2008 at 12:21 pm

    “We’d prefer to let her immune system focus on vaccinations that seem really worthwhile such as pertussis.”

    I’m not an expert on this, but I’m pretty sure that’s not how it works.

  23. RS said,

    August 31, 2008 at 10:25 pm

    I don’t know when the changeover happened but the current pertussis (whooping cough) vaccine is the acellular rather than the whole cell variety, which has a much lower rate of side effects. I believe there is genuine evidence for a (very rare) risk of neurological sequalae after whole cell pertussis.

  24. mdimmick said,

    September 1, 2008 at 9:50 am

    As for why not individual vaccines, the NHS ‘MMR The Facts’ website says this:

    “Single vaccines in place of MMR put children and their families at increased and unnecessary risk. The combined vaccine is safer as it reduces the risk of children catching the diseases while they are waiting for full immunisation cover.”


  25. muscleman said,

    September 1, 2008 at 10:41 am

    I have had M, M and R, the latter as an adult during my PhD, my young daughters got it at the same time. They had been immunised for measles and mumps but the rubella came later at school.

    My wife’s younger sister when young had to be rushed to hospital because of measles complications while on holiday. It is no laughing matter, I vividly remember having measles aged about 7 and I would not wish that on any child.

    It is true, those who forget their history are doomed to repeat it. The problem is they condemn the rest of us to experience it too.

  26. fontwell said,

    September 1, 2008 at 11:08 am

    In my opinion its not the scientific understanding of journalists that is the problem, it is the combination of two other things 1) Journalists can rely on a low public understanding the science involved 2) They would rather right up a ‘good story’ than a true one.

    The idea that the MMR vaccine causes autism is obviously a ‘good story’ – look how long it’s run. The only reason it managed to go so long was that they could, to borrow a phrase, rely on herd ignorance.

    To think that the offending journalists don’t get the science but would report it correctly if they did, is basically naive.

    I remember an article by Ben a while ago
    wherein a journo mate of Ben’s wanted to do a ‘Dirty Hospitals MRSA’ piece but was confounded when all his samples came back negative. That stopped him until another journo tipped him the name of the lab to send samples to, if he wanted somewhere that “gives positive results when others do not.”

    The fact that this was known to be the case by journalists and yet still they wrote the stories says it all. Cliche alert; The only purpose a newspapers is to sell newspapers.

  27. K9 said,

    September 1, 2008 at 12:47 pm

    Now then, DW

    As an immunologist, I can tell you that epiphiny is on the right lines. The immune system recognises all foreign (non-self) molecules by having recognition and effector cells (lymphocytes) which, quite spookily, can recognise all possible non-self molecular possibilities. They do this individually and there are enough of these cells in the body to recognise every foreign determinant there is, has been or ever will be (honest). Because each lymphocyte recognises a different foreign molecule (aka antigen) the body can identify and respond to as many antigen challenges as it gets. Epiphiny’s comment about breathing in millions of bugs each hour is completely correct and there is no such thing as immunological overload.

    Whats more, I can give you one more reason to have multiple vaccines; they actually can help the body to respond to each other, by something called the adjuvant effect. This actually improves vaccine efficacy.

    In my line of work (veterinary) we routinely vaccinate dogs and cats on an annual basis and although there are a few conspiracy theory naysayers in the ether, there are rarely any side effects of note. These vaccines are often 5 component shots too.

  28. FlammableFlower said,

    September 1, 2008 at 4:54 pm


    Go conspiracy!

  29. thekumquat said,

    September 1, 2008 at 7:01 pm

    K9 – I only scraped through my first-year immunology course, but I’m now on a number of forums for pregnant women/parents and getting into debate on MMR and other things. I usually refer people here rather than bashing my head in or risking being wrong…

    Can you explain why, given the adjuvant effect and the obvious risk of contracting a disease before the vac is given, we don’t do all the childhood jabs in one go the day the baby is born? Why wait to do MMR rather than mix it with the 5-in-1 shot? Presumably there is some reason that isn’t just ‘cost’?

  30. muscleman said,

    September 2, 2008 at 9:14 am

    For another thing it takes time for the foetal dependance on maternal immunity to wind down as their own immune systems wind up. Give an antigen too soon and there will be no functioning immune system to respond to it.

    To those who think 5 antigens in a vaccine is ‘overload’ just tell them how many epitopes there are on your average viral protein coat. Then tell them about bacteria… The overload hypothesis relies on a combination of ignorance and a lack of thought. A moments push to get people to regard reality can cure it.

  31. K9 said,

    September 2, 2008 at 10:58 am

    Thanks to RS and muscleman for valid points about why we cannot vaccinate newborn babies.

    Also, in young babies/animals there are considerable amounts of hormones floating about which can reduce vaccine priming/efficacy. What is more, polysaccharide vaccines don’t appear to elicit antibodies in newborn babies.

    The ages at which we give many vaccines relates to the age at which the specific diseases are prevalent. For example, in the developed world we give measles vaccine at school age whereas in the developing world it is given as early as possible because there it is a major cause of death in infants.

    On a related and current matter, I do hope the cervical cancer vaccine is taken up fully and I wish the UK schools had come up with a strategy to implement vaccination coverage in a quicker timescale than they are using. For example, my 12 year old daughter will be jabbed next school term, but my 15 year old daughter won’t get it until she is 18. As we know how the papillomavirus is spread (nooky), that seems to be the wrong way round. Also, shouldn’t they vaccinate the boys too; they are the virus carriers after all.

  32. thekumquat said,

    September 2, 2008 at 1:14 pm

    Thanks for the info on newborn babies and vaccines. I still don’t get though why the NHS vaccine schedule spaces out the jabs so much – obviously some are boosters, but why do 5in1 and PCV at two months, but wait a month before doing the first MenC and a year before the first MMR?

    Why can’t the 12-month Hib/MenC booster be done at the same time as MMR and the PCV booster, timetabled a month later?
    For that matter, why can’t the vaccinations be put in the same syringe so only one injection is needed each time?

    I know of parents who see the pain caused to their baby by an injection, weigh that up against what they see as a low risk of a minor disease, and fail to get further jabs done (of course there’s the other parents who worry about vaccine ‘overload’ and want single M+M+R jabs, so the NHS can’t win…)

    NHS vaccination timetable found at

  33. kim said,

    September 2, 2008 at 1:22 pm

    Geeb – when you think about it, it makes much more sense to give the MMR vaccine as a three-in-one jab rather than separately because it means two jabs rather than six.

    Six jabs means:

    1. Lots of parents are going to get fed up and not bother to take their children six times.

    2. As someone else said, while waiting in between jabs, the child could catch the disease it hasn’t been vaccinated against.

    3. It greatly increases the amount of time the practice nurse spends giving vaccinations, which means a greater financial burden on the NHS.

    4. Three separate vaccines are, I would guess, more expensive to produce and to purchase than one single vaccine.

    5. If as a parent you don’t like the “crap” that goes into a vaccine (excuse the technical terminology), your child is going to get three times the amount of crap it would otherwise.

  34. Robert Brown said,

    September 2, 2008 at 1:26 pm

    Does anybody have any thoughts on questions as to Vaccines Mercury and Autism?

    (see abstract below)

    What added products are used in vaccines in the UK? Do they include mercury based products?

    To what extent does mercury accumulate in the brain?

    To what extent do mecury compounds give rise to functional issues in glial cells?

    (see book link below)

    Could additional oxidative stress due to vaccination in some circumstances tip the balance?

    ” Even CDC Director Dr. Julie Gerberding, who has led the campaign to defend vaccines, reassure the public, and belittle parents’ concerns, recently admitted during a CNN interview that vaccines can trigger autism in a certain vulnerable subset of children.

    Vaccines have done much good in preventing many dread diseases, and most children suffer no apparent ill effects from them. But we cannot ignore the possibility that vaccines, particularly the mercury component, may be a factor in the current epidemic among children of neurological disorders, perhaps exacerbated by a genetic or other underlying disposition in some youngsters.

    So what is to be done? To begin, federal health officials should conduct the long-called-for comprehensive studies comparing vaccinated children with unvaccinated ones, such as in the Amish community, where the incidence of autism is said to be almost non-existent.

    At the very least, why not remove mercury and other toxic substances like aluminum, anti-freeze, and formaldehyde as preservatives from vaccinations; space out the schedule of shots, instead of giving so many at once; and delay giving some of the riskiest of them until infants are somewhat older? “

  35. K9 said,

    September 2, 2008 at 1:55 pm

    Robert Brown

    Have you considered sunspots as causes of autism? Probably not. Why is this so? There is as much evidence for this connection as there is for any of the other drivel that is associated with vaccination as a potential initiating cause.

    Let me explain how science works. One has an idea and then designs experiments that try to disprove that idea. If the resulting data cannot disprove this idea then it may be correct. Basically, scientists generate as much relevant data about the idea and then analyse it and make a conclusion. This is then written up and submitted to a scientific journal where international experts will look at the idea, methods, data and conclusions and decide whether or not they justify publication. If so approved, the scientific community then will get to read the work and draw their own conclusions and disseminate them to the public.

    The internet has, unfortunately, created an alternative scientific “community” (I use the term loosely) in which rumour spreaders/false prophets of doom/snake oil merchants/conspiracy junkies decide that something causes something else and then thrash around the internet desperately trying to find evidence, usually anecdotal (ie worthless on its own) to support their claim. Firstly, this is completely invalid as a means of identifying cause and effect (in any situation). Secondly, wouldn’t these efforts be much more usefully channeled into something useful?

    Finally, why do these comments largely seem to come from a large land mass many miles west of the UK?

  36. RS said,

    September 2, 2008 at 2:52 pm

    “Why can’t the 12-month Hib/MenC booster be done at the same time as MMR and the PCV booster, timetabled a month later?
    For that matter, why can’t the vaccinations be put in the same syringe so only one injection is needed each time?”

    While some vaccines have been tested and shown to be safe to administer at the same time (i.e. MMR) other vaccines must be administered many weeks apart (the minimum necessary period is unknown) to avoid interactions that might reduce the efficacy of the vaccines.

  37. RS said,

    September 2, 2008 at 2:59 pm

    “But we cannot ignore the possibility that vaccines, particularly the mercury component, may be a factor in the current epidemic among children of neurological disorders”

    We can ignore it actually. There is no evidence for any current ‘epidemic’ of neurological disorders, nor is there any evidence that thiomersal can cause neurological disordes, nor is there any evidence for an association between currently used vaccines and neurological disorders. And there is evidence against all these propositions.

  38. Ben Goldacre said,

    September 2, 2008 at 3:36 pm

    “I guess he’s in the same position as Ben when the Observer makes a blatant gaff”

    au contraire, they were quite grown up about it.

  39. Ben Goldacre said,

    September 2, 2008 at 3:48 pm

    i met ian hislop once – obviously i was just slightly starstruck – and he had some kind of story about how private eye aren’t really anti-mmr. i can’t remember what it was so it might have been a bit tortuous.

  40. Robert Brown said,

    September 2, 2008 at 4:21 pm

    K9 and RS Thanks for the response.

    Did you look at the book I posted a link to which was raising issues as to the use of thimerosal.

    From your comment about WEB science I assume you did not.

    This is the book

    The Role of Glia in Neurotoxicity
    By Michael Aschner, Lucio G. Costa

    which raises the issue I highlighted in a considered way. It is authored by a neuroscientist.

    Professor of Pediatrics; Professor of Pharmacology; Gray E. B. Stahlman Professor of Neuroscience

  41. RS said,

    September 2, 2008 at 5:44 pm

    Robert, so what? That link contains no evidence at all for the claim you are making it just “raise[s] questions”.

    I’m a neuroscientist too, I can ‘raise questions’ too and it amounts to fuck all just the same.

  42. gadgeezer said,

    September 2, 2008 at 9:02 pm

    @Robert Brown

    What added products are used in vaccines in the UK? Do they include mercury based products?

    Strictly speaking, everything in a vaccine is an added product, including water. However, thiomersal (contains ethylmercury) was removed from UK vaccines some time ago.

    At the very least, why not remove mercury and other toxic substances like aluminum, anti-freeze, and formaldehyde as preservatives from vaccinations

    Aluminium salts are used as adjuvants, they are not preservatives: without them, the vaccines would not be as effective. Aluminium exposure is ubiquitous. Discussion and lots of links to information about aluminium or aluminium salts in vaccines.

    There is not now, nor has there ever been, any anti-freeze in vaccines – that’s a misunderstanding.

    As for formaldehyde, it is an intrinsic metabolic by-product that is already in our bodies. The amount in a vaccine relative to the amount that is already present in a new-born seems to be neither here nor there.

    Assuming an average weight of a 2-month-old of 5 kg and an average blood volume of 85 ml per kg, the total quantity of formaldehyde found in an infant’s circulation would be about 1.1 mg — a value at least five-fold greater than that to which an infant would be exposed in vaccines. Second, quantities of formaldehyde at least 600 — fold greater than that contained in vaccines have been given safely to animals.

  43. Robert Brown said,

    September 2, 2008 at 11:17 pm

    RS Thanks for the response

    I agree the book just raises questions.

    I MADE NO CLAIM in my post. I have no grounds to do so.

    I was simply seeking to raise the questions that were being asked in the book and see if any body could throw more light on the subject in the way of information on thimerosal, current UK policy and usage, views on outstanding questions if any etc.

    I heard a practicing American Neurosurgeon publicly and unequivocally stating in no uncertain terms there were a number of answered questions as to the impact of additives in vaccines on glial function and oxidation and was curious.

    I regrettably do not have time to go and read some of the papers be better informed.

    It seems that some at least believe(d)we do not know all the answers

    Is that significant in the current debate? I am not in a position to form an opinion.

    Many thanks

  44. Robert Brown said,

    September 3, 2008 at 12:48 pm

    Many thanks Gadgeezer for your informative response.

    Based on your response IF thimerosal was ever an issue in the UK it has been sidelined by removal.

    This looks like an informative site on the thimerosal.

    This is a forum expressing concerns about adjuvants and particularly aluminium. It claims insufficient research. The site also asks if over vaccination of children is an issue. I again have insufficient knowledge to form any view, but would appreciate any informed comment.

  45. muscleman said,

    September 3, 2008 at 1:14 pm

    K9 they are looking at vaccinating the boys against HPV, the problem is that under current ethical rules you cannot vaccinate them to protect the girls (though I don’t see why they can’t offer it on a voluntary basis). Apparently there is a possible link between HPV infection and testicular cancer, if they can firm that up then the boys will get jabbed too.

    Robert Brown anyone can write a book and get it published. However to get a research paper published it has to be peer reviewed. So the conclusions you draw have to supported by your results, you have to asked the right questions and used the proper techniques. Even then results in papers are provisional and they are like swallows, one does not theory make.

    So if you have an idea and can’t prove it or even get any sort of decent evidence then, you write a book. So in any such book look to see if there are lots of references to the primary literature (journal of such and such) and not just authored by the book author. Look up the author on PubMed

    and see if they have published primary research papers in the area (ignore those in Review journals). Often eminent people will opine on things outside of their purview (Penrose on consciousness is a good one). Their academic authority when they do is not worth a bean, unless they also have the evidence. Follow the evidence not the Authority.

  46. Robert Brown said,

    September 3, 2008 at 11:45 pm

    Gadgeezer – I am sorry that my post was capable of misinterpretation.

    I am not sure why should not be taken seriously. It supports vaccination. These are its partner organisations listed below(see link below) and a link to the board.

    Professional and public health organizations
    American Academy of Pediatrics
    American Academy of Physician Assistants
    American College of Nurse-Midwives
    American College of Obstetricians and Gynecologists
    American College of Physicians
    American Medical Association
    American Nurses Association
    American Osteopathic Association
    American Pharmacists Association
    Division of Viral Hepatitis, National Center for Infectious Diseases, CDC
    Emory Vaccine Center, Emory University
    Infectious Diseases Society of America
    Institute for Vaccine Safety, Johns Hopkins University
    National Association of Pediatric Nurse Associates and Practitioners
    National Center for Immunization and Respiratory Diseases, CDC
    National Medical Association
    National Network for Immunization Information
    National Vaccine Program Office, HHS
    Office of Minority Health, CDC
    Pediatric Dengue Vaccine Initiative
    Pediatric Infectious Diseases Society
    Society for Adolescent Medicine
    Vaccine Education Center, The Children’s Hospital of Philadelphia

    The comment starting “This is a forum applies to the site below” was meant to apply to the site below the comment and not above it.

    Eg this link

    Now having skimmed some of your aluminium link I have a minuscule understanding of the aluminium issues too. For some reason I had not followed the link earlier. I apologise for that. Had I done so I doubt I would have posted the nvic link.

    Thank you for your response

  47. kim said,

    September 4, 2008 at 12:19 pm

    muscleman “the problem is that under current ethical rules you cannot vaccinate them to protect the girls”

    that’s interesting, because as far as i can tell that’s exactly what they do with the Rubella jab. Technically, I suppose they could argue they’re protecting the boys against rubella, but of course everyone knows that rubella is a mild disease, and the real reason for vaccinating is to stop women contracting it while pregnant.

  48. RS said,

    September 4, 2008 at 12:25 pm

    As far as I’m aware they decided it would be too expensive to vaccinate boys too.

  49. treeofpain said,

    September 4, 2008 at 5:11 pm

    I haven’t bought a Grauniad for ages, what a pleasant surprise! A whole page spread and a bit more. Excellent stuff. Wakefield obviously a berk, but woo-peddling journos should not get away scott free (in this case and all the rest). Can’t graduate journos (the young ones at least) have their degrees taken away: bringing x institution into disrepute, oh well there’s dreaming…

  50. Robert Carnegie said,

    September 6, 2008 at 3:50 am

    If all young women are HPV-proof then the virus will pretty much die out and cease to exist.

    IIRC the vaccine to be used is the cheaper of two by quite a long way but leaves more virus strains uncovered, but I think it will destroy the strains that it is aimed at. And perhaps something better or cheaper again will be available later.