In response to
BMJ  2004;328:602 (13 March), doi:10.1136/bmj.328.7440.602-c
News roundup
Authors reject interpretation linking autism and MMR vaccine

AND in response to
 Clifford G. Miller,
Solicitor & graduate physicist

Re: When will this pantomime end? 19 March 2004 --John Daniel Stone,
34 Outram Road, London N22 7AF
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Re: Re: When will this pantomime end?

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 Irrespective of who is scientifically correct and who is wrong, I would
like to pose the question why it is that we cannot have a tolerant and open
professional debate on this issue? Dr Wakefield's professional isolation is
often cited in the media, but it is by no means absolute on international
basis and could not even be supported with reference to the Rapid Response
columns of the BMJ. On the other hand the near 100% unanimity of the
profession in this country is sustained by the extraordinary professional
consequences that are likely to ensue from open dissent. In pure academic
terms this unanimity is for this reason all but meaningless. Equally, the
reporting of it in the media has been largelynaieve, to the point of

Equally puzzling has been the selective and one sided reporting of this
affair. It emerged on 27 Febuary (seven days after the present paroxysm
began) in The Independnt that Andrew Wakefield had written to The Lancet as
long ago as 2 May 1998 to declare his involvement in prosecution case, the
letter was published and no one at the time had thought any further about
it. However, this has not been reported by the BBC, Times Newspapers, The
Lancet or The BMJ, although it is a matter of simple public record and of
material value.

You wonder at this stage whether anybody ever professionally believed that
a serious charge was being brought against Dr Wakefield. Indeed, to have
declared this matter as "an interest" might have been considered highly
irregular and exceptional. However, it has obviously been greatly exploited
for its effect on public opinion.

Finally, we must also look with concern at the political dimension.
Irrespective of whether Dr Wakefield is right or wrong no one can really
look back at the events of four weeks ago and say that this was a wholesome
model for dealing with differences of scientific opinion. People who
thought that Dr Wakefield was scientifically wrong ought to have been
shocked by this extraordinary parade of people ready to condemn him ahead
of any hearing. Some newspapers broke ranks to some extent from the
official lines of recent months (The Daily Telegraph, The Independent), but
not one of our 659 MPs stood up and declared their reservations (although I
am sure many had them). The question is, how can we trust a scientific or
political community that deals with dissent in this way?

Competing interests: Parent of an autistic child
Evidence based medicine 23 March 2004
Alan J Mulcahy,
Management Consultant
Dublin, IReland
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Re: Evidence based medicine

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 Dr Wakefield raised a serious question about a small subset of autism
cases. It is important as the first piece of apparent evidence of a link.
However in the wider question of vaccine safety, it does not claim to give
an opinion.

Other studies appear to show that there are problems with vaccinations.
These are simply ignored by the authorities, who seem to believe in dogma
based medicine, rather than evidence based medicine.

There is no study showing that a population of vaccinated children is
healthier than a population of never vaccinated children.

The Danish study is the closest we have to this. However as the previous
use of the DPT for the autistic population was not considered, the study
seemed inconclusive to me. If the Danish data really does show no
relationship those who have been vaccinated with MMR or DPT and autism,
then the finger will probably still point to Mercury poisoning from vaccines.

Until there is a cause found for the autism that is prevalent today, then
the vaccines remain the prime suspect (I assume that the Autism associated
with systems thinking is natural).

Competing interests: None declared
Re: Evidence based medicine 23 March 2004
John Daniel Stone,
34 Outram Road, London N22 7AF
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 Interesting that Alan Mulcahy declares no interest. It is not my
experience that there are many parents of autistic children who are anti-
vaccine, only some who have become a little more than sceptical as to
whether the present policy is as safe as it should be. It would obviously
be rash not to administer the DPT (but also rash, perhaps, to administer a
big and unnecessary dose of mercury in the cocktail). Confronted by serial
charities such as 'Sense', 'Sense about Science' and now, believe it or not
'Inject Sense' it is as well to point out that many of those who have
doubts about the safety of MMR or thiomersal/thimerosal are deeply sensible
people, with a perfectly legitimate and completely unanswered concern. The
patronising tone of these organisations is a cheap and repulsive shot -
bearing in mind what these children and their families have to endure. It
would, of course, be folly to abandon an immunisation programme altogether,
and entertaining it as an intellectual possibility purely whimsical.

Competing interests: Parent of an autistic child