The Wakefield witch-hunt

 
A couple of days ago, yet another story appeared claiming that fresh research had shown that there was
no link
between the MMR vaccination and autism. This new research was said to have shown that, contrary to the claims made by Dr Andrew Wakefield, the surgeon at the centre of the MMR scare, there was no relationship between gut problems and autism, the core of his concerns. It also claimed that the discovery furthermore damaged the related theory that a gluten-free diet could help children with autism.
Dr Hilary Cass, from Great Ormond Street, said: ‘It is very distressing to have a diagnosis of autism, a lifelong condition.Many families are driven to try out interventions which currently have no scientific basis. For example, advocates of the leaky gut hypothesis offer children a casein and gluten-free diet which as yet lacks an evidence base.’
This particular observation is a telling indication that this study bears little relation to reality. For there are countless families whose autistic children’s suffering from gut problems has only been eased, and their autistic symptoms improved, by the introduction of precisely such a diet. ‘No evidence base’? Tell that to those families. It is their lived experience.

This follows another study which claimed that there is no connection between autsim, enterocolitis and the MMR vaccine by Baird G. et al, published in the Archive of Diseases in Childhood on February 5. That study drew the following response from Andrew Wakefield:
…The study is severely limited by case definition in the context of the crucial ‘possible enterocolitis’ group. For inclusion in this group they required the presence of two or more of the following five current gastrointestinal symptoms:
  • current persistent diarrhea (defined as watery/loose stools three or more times per day >14 days),
  • current persistent vomiting (occurring at least once per day, or more than five times per week),
  • current weight loss,
  • current persistent abdominal pain (3 or more episodes [frequency not specified by authors] severe enough to interfere with activity);
  • current blood in stool;

 

plus:
  • past persistent diarrhea >14 days’ duration, and excluding current constipation.

 

We have over the last 10 years evaluated several thousand children on the autistic spectrum who have significant gastrointestinal symptoms. Upper and lower endoscopy and surgical histology have identified mucosal inflammation in excess of 80% of these children. Almost none of these children with biopsy-proven enterocolitis would fit the criteria set out above. Firstly, these children rarely have vomiting, current weight loss (as opposed to failure to gain weight in an age-appropriate manner), or passage of blood per rectum. The requirement is thus narrowed to a child having two of two relevant symptoms – current persistent diarrhea and current abdominal pain according to their criteria, plus a past history of persistent diarrhea excluding current constipation.

The requirement for the current presence of these symptoms, for 14 or more days continuously, shows a singular lack of understanding of the episodic, fluctuating, and alternating (e.g. diarrhea/constipation) symptom profile experienced by these children. In our experience, ASD children with histologic enterocolitis typically have 1 to 2 unformed stools per day that are very malodorous and usually contain a variety of undigested foodstuffs. This pattern alternates with that of “constipation” in which the unformed stool is passed after many days of no bowel movements at all, and with excessive straining. This group is entirely overlooked by the arbitrary criteria set forth in their paper. With respect to diarrhea and constipation, a detailed discussion of stool pattern in these children is available1 which further highlights the shortcomings of the above criteria. Moreover, the interpretation of pain as a symptom in non-verbal children, as it often manifests as self injury, aggressive outbursts, sleep disturbances, and abnormal posturing, is notoriously difficult. This interpretation requires an insight based upon the correlation of symptoms, histological findings, and response of symptoms to anti-inflammatory treatment. There is no evidence in the Baird et al. paper that these crucial factors were taken into account. This study’s inappropriate symptom criteria would explain the discordance with other reports that have revealed a high prevalence of significant gastrointestinal symptoms in general autism populations2,3.

It is surprising that Dr Peter Sullivan, a co-author on the paper, who presumably provided the above gastroenterological criteria, was not aware of the aforementioned limitations. In his role as a Defendant’s expert in the UK MMR litigation, he will have had access to the clinical records of autistic children with the relevant intestinal symptoms and biopsy-proven intestinal inflammation.

We suggest that the authors might wish to reflect on the ethical implications of setting the bar too high for the investigation of such children by ileo-colonoscopy, with the attendant risk of missing symptomatic, treatable inflammation.

Since the relevant MMR/autism children are considered to be those with regression and significant gastrointestinal symptoms, the appropriate stratification for between-group analyses of measles virus antibody levels has not been conducted; therefore the paper is difficult to interpret, adding little if anything to the issue of causation. Moreover, it is a major error to have presumed that peripheral blood mononuclear cells are a valid ‘proxy’ for gut mucosal lymphoid tissues when searching for persistent viral genetic material.

A further major problem in this study is the number of children who dropped out or who were unable to provide adequate blood samples. We know nothing about either the 735 children who were lost at stage two, or the 100 children for whom blood samples were not available. At the very least, we should be told whether the children who dropped out were likely to be representative of those who stayed in, with regard to the key issues of interest.

For reasons that will emerge in the near future, it would be of interest to know whether siblings of autistic children were included in either of the two control groups. This information is not provided.

As a general observation, this paper contributes nothing to the issue of causation, one way or another. Case definition alone is likely to have obscured the relevant group of autistic children. The study tells us nothing about what actually happened to the children at the time of exposure. We are increasingly persuaded that measuring things in blood many years down the line tells us very little about the initiating events in what is, in effect, a static (non-progressive) encephalopathy unlike, for example, subacute sclerosing panencephalitis, which is a progressive measles encephalopathy. The gut is a different matter, and analysis of mucosal tissues has been very informative, since here, in the relevant children, active ongoing, possibly progressive [AV1]4, inflammation has been identified.

 

The press reports of these studies make no reference to other research which shows a higher rate of gastro-intestinal problems among children with autistic-spectrum symptoms. Both the Baird and Great Ormond Street studies are but the latest in a steady drip-feed of such items which appear to be part of a concerted campaign to ensure that the General Medical Council hearing into the conduct of Wakefield’s research, which is shortly due to resume, takes place in as prejudiced an atmosphere as possible. No stone is being left unturned by the medico-political establishment and its creatures in the media to ensure that this doctor is destroyed.

As I have repeatedly said, I have no idea whether Wakefield is correct or not in his concerns about the possible adverse effects of the MMR vaccine on a small sub-set of vaccinated children. Nor do I know whether any of the charges being levelled against him at the GMC has any legs. But I do believe — as I wrote in my series of articles on the subject for the Daily Mail in 2003 here, here and here — that many of the statements made by the Department of Health and medical establishment about the ‘proof’ of the vaccine’s unchallengeable safety are deeply misleading. And I also believe, having spoken to many parents of such children, that their experiences simply cannot be dismissed as they have been by the medical establishment. No-one has ever suggested that the MMR vaccine causes all or most of the incidence of autism. If Wakefield is correct, it is only a small proportion of children whose immune systems may be unable to cope, for whatever reason, which makes them particularly vulnerable to such ill-effects. And contrary to the message being pumped out by the medical establishment that the vaccine has been proved to be safe — by studies which are all either flawed, inadequate or irrelevant — the fairest and most accurate thing to say is that the jury is still out.

One of the most reprehensible weapons being wielded in the witch-hunt against Wakefield is the claim that anyone who gives any credence whatever to his concerns is responsible for the incidence of measles amongst children whose parents are as a result too frightened to give them the MMR vaccination. There are two obvious points to make in response to this piece of moral blackmail: 1) the whole panic could have been avoided by offering single measles, mumps and rubella jabs rather than the triple MMR, and 2) it is surely just as important as avoiding cases of measles mumps and rubella to avoid causing the kind of catastrophic damage to the brain and gut displayed by the children at the heart of this controversy.


And there is a further and quite appalling point to note. This whole saga started because parents of such children found that their family doctors were dismissing out of hand their children’s gut and brain problems, accordingly refusing to alleviate their suffering. Now, as a direct result of the animosity towards Wakefield that has been whipped up — and the fear that any doctor who suggests he might be right will similarly find him or herself at the receiving end of the medical establishment’s fist — children exhibiting this combination of gut and brain damage are finding it difficult to obtain treatment.

Another letter to the Archive of Diseases in Childhood from John Stone, the parent of an autistic child, makes terrifying and distressing reading:

In this regard it is worth noting the recent warning of the National Autistic Society (NAS):

‘The National Autistic Society is keenly aware of the concerns of parents surrounding suggested links between autism and the MMR vaccine. The charity is concerned that the GMC hearing, and surrounding media coverage, will create further confusion and make it even more difficult for parents to access appropriate medical advice for their children. It is particularly important that this case is not allowed to increase the lack of sympathy that some parents of children with autism have encountered from health professionals, particularly on suspected gut and bowel problems. Parents have reported to the NAS that in some cases their concerns have been dismissed as hysteria following previous publicity around the MMR vaccine. It is crucial that health professionals listen to parents' concerns and respect their views as the experts on their individual children…’

The NAS warning relates to the GMC hearing involving doctors Wakefield, Walker-Smith and Murch which is set to resume on 25 March approaching. I do not think it is being unduly cynical to query the publication of this study at the present time as a media event, bearing in mind that it seems to have been carried out five or six years ago. Moreover, the study has once again been promoted as refuting the Wakefield hypothesis when it in fact tests for a possibility that had not been proposed. Meanwhile, the plight of autistic children with gastro- intestinal symptoms is excluded both from the study and public attention, as if they did not exist. The NAS statement warned of ‘creating further confusion’ and this is precisely what this study and its media exposure has done.
As the resumption of the GMC hearing draws nearer, one has to ask whether this will serve the cause of truth and justice and the relief of suffering — or is it instead merely a show trial which will bring about the precise opposite?

NB: This is a corrected version of my earlier post in which I said that the Great Ormond Street study was a rehash of the Baird study. I had been told that these studies were connected, but my source -- who could not be contacted over the holiday weekend --now accepts that he was mistaken. My apologies for the error, and thanks to the readers below who drew my attention to it.
 

field

March 21st, 2008 3:37am
I've yet to see any convincing refutation of the evidence from the USA showing a very low incidence of autism in Amish communities (that mostly don't vaccinate). There was also a recent case in the USA where a company accepted (or a court decided - I think it was a the former) that vaccination had caused autism or severe mental handicap. We are subject to a strict regime of propaganda on vaccination in the UK.

Chris Brehm

March 21st, 2008 8:26am
Great article! I am so glad to see you highlighting that the risk of autism more than balances the risk of increased measles in all. I researched MMR when my son had to get it, and under presure went ahead with it. My son now has Asergers syndrome. No-one is saying the vaccine gives Autistic Spectrum Disorders to children on its own. It is in combination with genetic factors: being immuno-suppressed and poor at eliminating toxins for example. How many people know that on th MMR vaccine box it actually states that it should not be given to patients with immuno-suppression? Children should be tested for that first, and a gradual one-by-one vaccine programme offered. Also, parents of children who are ill in any other way at the time the vaccine is due should be able to postpone it. Well done Melanie Phillips, you are the voice of reason. We need to get behind Dr Wakefield and press for a proper investigation; one which includes the children to whom this has happened.

Natasa Blagojevic

March 21st, 2008 9:12am
Thank you Melanie Phillips and thank you Spectator for this article. A few weeks ago US Federal Vaccine Court has conceded that 9-year-old Hannah Poling suffered vaccine damage following multiple vaccinations (including the MMR) when she was a toddler, which led to her developing autism. The UK media has largely ignored this groundbreaking story. Coincidence? There are 5000 more vaccine-autism cases pending on the same court, and it is expected that many of those will have the same positive outcome. It will be interesting to watch the hysterical efforts to 'interpret' these court cases as irrelevant to the rest of us, and to convince the public that they should unconditionally trust whoever says that there is really no link between vaccines and autism. "Autism is all in the Head" we keep hearing from those we should trust. The emperor will need some new clothes soon.

edward

March 21st, 2008 9:48am
I think that the press has some responsibility in rushing to condemn the MMR vaccine. Distressed mother refused to have their children vaccinated. As a consequence some children fell ill.
The motivations of the BMA may be negative, but I think I would rather believe the BMA that the media, which tend to love a good story. This is a field of expertise in which even the most distinguished journalists may lack the necessary evaluative skills.

edward

March 21st, 2008 9:50am
I think that the press has some responsibility in rushing to condemn the MMR vaccine. Distressed mother refused to have their children vaccinated. As a consequence some children fell ill.
The motivations of the BMA may be negative, but I think I would rather believe the BMA that the media, which tend to love a good story. This is a field of expertise in which even the most distinguished journalists may lack the necessary evaluative skills.

ross

March 21st, 2008 1:26pm
I really wish old Mel would have the intellectual honesty to admit she has got this one spectacularly wrong. Please. You have done enough damage to vaccination rates already.

Adrian Camp

March 21st, 2008 1:34pm
If it is true that around 10% of children don't get the MMR due to parental concerns, surely we now have two substantial populations which could be compared as to the proportion of ASD diagnoses. If the non-MMR kids have a different rate of occurrence of autism, it should show. This requires merely a count through existing records. I think the medical establishment should have done this work already, does no-one want to be the one to rock the boat? Surely if there was a difference between the populations it would go some way to settling the matter?

Jean Muscroft

March 21st, 2008 1:50pm
Thankyou Melanie for being brave enough to print this article. This is from a parent of an autistic child recovered through the use of biomedical treatments.

Stephanie Grabiec

March 21st, 2008 2:33pm
My son is autistic and has chronic GI problems. I have no idea what caused them but I do know that the witchhunt for Wakefield has effectively shut down meaningful research causing unnecessary suffering to hundreds of autistic UK children who have treatable medical conditions. When is colitis NOT colitis? Seemingly only when the sufferer is also autistic.

plh

March 21st, 2008 3:28pm
Yes, Melanie Phillips; you and some of your equally irrational and scientifically illiterate colleagues may well have been responsible for an increase in the incidence of measles. That is a reasonable interpretation of past events, not a reprehensible claim. And as you are apparently bent on continuing your abuse of the respect many of your readers have for your words, I do not see how asking you to cease your scaremongering, however vehemently, can be interpreted as moral blackmail. Offering single vaccines would perhaps be a way of mitigating the harm you have done and apparently wish to continue doing, but it could not possibly avoid damage that the triple MMR vaccine does not cause.

George Wade

March 21st, 2008 3:59pm
The Americas are still revolutionary countries at heart, if not in their modern appearance. When things get tough many of us think things out for ourselves: mostly practically, because that is what built this new country.

With all our faults -- it is refreshing to think that I can get at least something of the kind of health care I wish for just by reading, listening and doing it. More by paying for it. People around me don't criticise me, too much, for being different: they watch and judge by results.

The present results of that attitude are that thousands of children are being recovered from autisms by behavioural therapies; thousands more by whatever diet, with supplements, works for the individual child. More solid recoveries are based on combining the therapies; then adding in clinical nutrition and even prescription drugs as necessary.

Google DAN! or Autism Research Institute to see how solid Melanie Phillips' article is. Autisms recovery research is now 40 years old in San Diego; starting with Bernie Rimland, one psychiatrist who would not give up on his own autistic son.

Ann

March 21st, 2008 4:02pm
And you know this because you are a professor of immunology, Ross? At which university, pray? We don't know the true situation yet, so to state that MP has got it wrong (let alone 'spectacularly' wrong) is hallucinatory nonsense. Your statement is based on nil empirical foundations. What we do know is that there has been a closing of the ranks in the medical profession, not for the first time, and that government pressure has been brought to bear, not for the first time. Whenever the latter happens, I know that there is more here than science. And mixing politics with science is always a bad idea.

DBCJohn

March 21st, 2008 4:04pm
Adrian Camp suggests a valid and obvious line of research, which has been done. The Centers for Disease Control and Prevention , a reputable American institute reports: ‘Researchers in the UK studied the records of 498 children with autism born between 1979 and 1998. They found: The percentage of children with autism who received MMR vaccine was the same as the percentage of unaffected children in the region who received MMR vaccine. There was no difference in the age of diagnosis of autism in vaccinated and unvaccinated children. The onset of "regressive" symptoms of autism did not occur within 2, 4, or 6 months of receiving the MMR vaccine’. Field points out a low rate of autism in American Amish communities (which seems to be the case). A common view is that autism is a genetic disorder affecting the development of specific cognitive faculties. It is possible that the genetic predisposition towards developing autism is low in the Amish community. I have read one Israeli paper that reports that the prevalence of autism and schizophrenia (another cognitive disorder with a hypothesised genetic basis) is higher in ultra-Orthodox Jews, who also may share a limited gene pool. And, though anecdotal evidence is not to be trusted, my clinical experience suggests to me that autism has a high prevalence in UK ultra- Orthodox communities.

Richard

March 21st, 2008 4:04pm
You are mistaking anecdotal evidence for scientific proof. Please leave the science to those who are trained for it and understand the techniques.

John Stone

March 21st, 2008 4:05pm
With reference to the response of Andrew Camp. The largest epidemiological study of MMR and autism was that conducted by Madsen et al in 2002, which was later criticised in the Cochrane review in 2005 because the data set was misanalysed (in such a way as to reduce the autistic vaccinated group): "The interpretation of the study by Madsen was made difficult by the unequal length of follow up for younger cohort members as well as the use of the date of diagnosis rather than onset of symptoms of autism". http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD004407/frame.html When the study was originally published in New England Journal of Medicine, Samy Suissa - a professor of epidemiology at mcGill Univisersity - wrote a letter to the journal pointing out that correctly calculated the vaccinated group were 45 percent more likely to have autism against the control group, rather than 8 per cent less likely, as reported by Madsen. NEJM refused to publish the letter which Suissa later made available to Andrew Wakefield: http://www.jpands.org/vol9no3/stott.pdf The probability is that MMR is a significant statistical component in the rise of autism.

Rich Scopie

March 21st, 2008 4:06pm
Oh dear Ms Philips, Quoting John "JABS" Stone has destroyed any last vestige of credability you may ever have had. To read more of Mr Stone's frothing-at-the-mouth, you need only to read some of the appalling personal attacks and pseudo-medical rubbish he spouts on the JABS forum - ostensibly a forum for the support of vaccine damaged children, in reality a group of rabid anti-vaccinators competing to see who can shout the loudest rubbish.

John Stone

March 21st, 2008 4:28pm
Rich Scopie I do not see anything like a scientific argument from you, but I do see a personal attack.

Susan Hamlyn

March 21st, 2008 5:31pm
In reply to Richard who says,'You are mistaking anecdotal evidence for scientific proof. Please leave the science to those who are trained for it and understand the techniques.' If it hadn't been for anecdotal evidence precipitating serious hard science, we would never have had investigations into eg smoking and asbestos. The immense tragedy of this terrible saga - and thank heavens for the few journalists who are prepared to keep it in the public eye - is that no proper credence is given to those who know the children best - their parents. It needs to be remembered that the parents who believe their children to have been damaged by the MMR are ipso facto not 'anti-vaccine' - . Those of us who have been grateful for the commitment and dedication of the three doctors at the heart of the GMC hearing know that that there is a case to answer against the MMR and it has not been answered yet. Nor will it be while there is blind faith in the scientific establishment and no faith in parents.

Mark H

March 21st, 2008 5:35pm
Thank you Melanie, My child is also recovering using Diet and Biomed. We see to be in two camps here... those who do not believe and those who have children with autism and chronic bowel disorders.

Larissa

March 21st, 2008 6:18pm
How many parents of autistic children are trying to refer their children to a Gastroenterologist ? plenty I can vouch for that, (I see them every time we have a hospital appointment to see our gastro) how many are being are turned away by 'that old chestnut' bowel problems are common in children with autism, 'WHY', should be the question we are asking. Instead we are encouraged let our child suffer in our experience with one bowel movement a week and in terrible pain. This is NOT un- common. Our children may have autism, BUT they also medically ill, under weight, bowel and gastro problems, epilepsy to name a few but the messege we are given is “that's OKAY because they have austim”! It is not okay, lets start helping our children again like Andrew Wakefield was doing before he was told to leave the country. The medical establishment appear to be scared stiff of how many sick children there are with autism, other wise we would get the real picture that there are now 1:86 children with autism. We help our child with bio medical intervention and it works well, so autism - a neurological disorder - I don't think so. Lets re think and look at how sick our children are. Autism is not a life sentence, Autism is Treatable.

Rich Scopie

March 21st, 2008 7:10pm
@John Stone: That's not a personal attack. That's statement of fact.

John Stone

March 21st, 2008 8:03pm
Rich I do not know a lot about you but I think this must be your homepage. I leave anyone remotely interested in your allegations to make up their own mind: http://www.hyperactive-stage.co.uk/blog/blog_home.asp What readers may have noted was your inability to comment on the substance of what Melanie or I said.

Ann

March 21st, 2008 8:30pm
I am a trained scientist, Richard, and I know a bit about clinical trials - and I reject your sweeping and snide comments about 'anecdotal evidence'. Wakefield and others have not been dealing in 'anecdotes'. More later.

Sandy Gottstein

March 21st, 2008 9:44pm
Thank you, Melanie, for such a fair-minded column. One thing I would like to suggest is that everyone make the comparison, not between incidence of a disease and possible consequences of vaccination, but rather between long-term consequences of disease compared to long-term consequences of a vaccines. The mere incidence of disease is not necessarily something to fear in developed nations, depending on the disease. In fact, the absence of childhood infectious diseases may well be a problem for developing immune systems. I write about fear-mongering a bit more in my recent column "The Power of Fear" (http://www.vaccinationnews.com/Scandals/2008/Feb_11_08/Scandal85.htm), as well as other Scandals columns on the website Vaccination News, A Non-Profit Corporation. All the best, Sandy Gottstein, President, Vaccination News ("Your source for all sides of the vaccination controversy"), www.vaccinationnews.org

Elizabeth

March 21st, 2008 11:43pm
I followed the UK Department of Health's vaccination schedule until my daughter descended into regressive autism within a month of her MMR. That was sixteen years ago and I will NEVER allow her to have the so-called "booster". Doesn't anyone think it deeply suspicious that the parents' reports of adverse vaccination reactions aren't being properly reported by doctors? N.B. My grateful thanks to Melanie Phillips for having the courage to buck the trend and for taking the time to do the research.

Raymond Gallup

March 21st, 2008 11:50pm
Read Eric's Story at http://www.vaproject.org/ The Autism Apocalypse is just around the corner due to the MMR vaccine and other vaccines. The public will pay for this financial mess. Raymond Gallup

field

March 22nd, 2008 2:06am
DCB John : Well yes, you MAY be right that there is a genetic disposition AGAINST autism within the Amish community. One does get such dispositions within such communities. However, I have read that the incidence of autism among VACCINATED Amish is also higher. You also cite a study that concludes: "The percentage of children with autism who received MMR vaccine was the same as the percentage of unaffected children in the region who received MMR vaccine." Well I don't think this is necessarily a valid comparison. Parents concerned about MMR vaccine might well include people who are aware of vaccine damage through examples within their own family. I have never thought MMR was the ONLY threat to health from vaccination. So we have a possible scenario where a susceptible population reduces the risk from MMR but does not exclude it from vaccination in general and thus the higher predisposition plus lower risk, produces an incidence at the same rate as the general population. I think as many people now realise health statistics involve a lot of dubious theorising. I would prefer to work from general principles - and overloading the immune systems of tiny infants seems like not a very good principle to me especially when the risk to health of the vast bulk of children from the actual diseases such as measles has been greatly exaggerated by an alarmist medical establishment.

Natasa Blagojevic

March 22nd, 2008 9:38am
To Raymond Gallup: public is already paying for the vaccine mess. The compensation to be paid to Hannah Poling (and others to come after her) will not be paid by vaccine makers, but out of US federal, read public, funds. The vaccine makers are completely untouchable.

David

March 22nd, 2008 11:29am
There are so many errors in Ms Phillips' diatribe that I really don't know where to start..... Firstly, she says anecdotal "evidence" is sufficient to contradict the findings of this well conducted study. She says: "..there are countless families whose autistic children’s suffering from gut problems has only been eased, and their autistic symptoms improved, by the introduction of precisely such a diet. ‘No evidence base’? Tell that to those families." This is a blatant appeal to the power of personal anecdote, and has nothing to do with medicine or science. Anecdotal stories are not evidence - that is why scientific trials are done, and to the chagrin of Phillips and the antivaccine lobby, for some reason the studies always seem to show they are wrong by exonerating vaccines. Could it just be possible that the science is correct? Is Phillips so beset by her own antivaccine bias that she would never be open-minded enough to change her position in the light of new evidence? (Answers on a postcard please.....) Secondly, Phillips wrongly says this is not new research but a rehash of another study: "despite the way this was presented in the media this is not a new piece of research at all. It is instead a recycled version of a study by Baird G. et al, published in the Archive of Diseases in Childhood on February 5". News for Phillips and the antivaxers: It is NOT the same study at all, as any fool who bothers to look at the papers can see. It comes from a different group of authors from different research centres and is a completely different study looking at a different hypothesis. So whatever Wakefield may have had to say about the Baird study is of little relevance to Phillips' commentary on the current research. Wakefield's views on any research that contradicts his own findings (i.e. virtually all of it) may well be that it is "irrelevant" or "inadequate". That is his opinion, and not that of the vast majority of others. It is also a bit ripe, coming from a doctor whose own paper was based on a tiny sample of highly pre-selected children with autism. Its results have been comprehensively shown to be erroneous, and Wakefield's co-authors have withdrawn their support for his findings. Phillips is also incorrect that the public reaction (and drop in vaccination rate) caused by Wakefield's ill considered utterings on MMR could have been avoided if single component vaccines were offered. Wakefield's original research gave no indication that single measles would be less likely than MMR to cause autism, it was just his indiscrete asides at the press conference that said this. Going by his (now debunked) science, natural measles or single measles could also be likely to cause autism. Also, since single vaccines have been in use, it has been shown conclusively that children are not completing the full course, proving Government fears quite correct, and showing it is best to give vaccines in combination. Finally, I am sorry for Phillips if she found John Stone's letter such terrifying and distressing reading. Perhaps she should confine herself in future to reading the facts about autism and vaccination, rather than contrived speculation.

Natasa Blagojevic

March 22nd, 2008 1:36pm
David, if you ever hit your finger with a hammer, and go to your doctor asking for painkillers, I expect he or she to laugh you off - after all there is no scientific proof that smashing a finger causes pain in every/any individual. Your claim of pain will be based on your anecdotal report and no self-respecting doctor or scientist should look into it or offer anything to ease your pain.

drained

March 22nd, 2008 1:51pm
My baby son screamed for 8 hours after his first DTP shot at 2 months and again after the second dose at 3 months. When we went for the 4 month shot, the doctor said that my son had had a severe reaction to the pertussis (whooping cough) part of the triple vaccine and she gave him only dipteria/tetanus for the third dose, leaving out the pertussis. He did not react to this vaccine. It was clear from 6 months of age that my son was not developing normally. Fearing the worst, we did not allow him to have any further vaccinations. He was diagnosed with autism at 3, and has complex and severe learning difficulties. He is not making any progress and is still functioning at the level of a six month old baby even though he is 7 years old. I recently asked the doctor if his severe reaction to the pertussis vaccine had been reported and he said it had not. I wonder how many other cases like ours are out there, where we strongly suspect that vaccination caused our child's very severe disability, but because they are not being reported, nobody is even looking into a possible link.

John Stone

March 22nd, 2008 10:34pm
David You have made allegations against my letter. Can you substantiate them? Your remarks do not even seem to relate to the quoted passage, which was anyhow closely based on a National Autistic Society statement. I seem to have become a somewhat controversial figure if your remarks and Rich Scopie's are anything to go by, but all I have done is try and maintain an honourable debate when dissent within the profession is being stifled. In the spring of 2004 I wrote to the CMO begging him not to pursue the extremely tenuous allegations against Andrew Wakefield. I told David Salisbury that resolving the controversy in this way would muddy the water so much that nobody would ever know what to believe again. This is what has come to pass, and in particular in the context of GMC hearing which is based entirely on the allegations of a journalist and pursued at the behest of government department, and none of families, who still see the defendant doctors as their friends.

slippinaway

March 23rd, 2008 12:05am
Hi drained, You can guarantee there are thousands like you. I had one son almost die from the pertussis component, he survived and is o.k. But when another son came due for his shots the pediatrician felt that his siblings reaction was not of significance...he now has cerebral palsy and will likely never walk or talk. And, of course, just like your experience, neither reaction made it to VAERS here in the U.S. Any other drug produced, docs (I know, I'm one) pay special attention to familial history. Not vaccines, yet a recent study showed type I diabetes can be causally linked to vaccination(s) and vaccine related type I diabetes was a significantly higher risk for those with siblings of type I diabetes: http://www.vaccines.net/7TOPEDJ.pdf Yes drained, we're all feeling quite drained. Vaccine risks are extremely underestimated as there is no reporting and/or intentional denial and disease risk is overestimated (i.e. subclinical spread in addition to the current measles scare which fails to produce any significant harm). But, what I find almost hysterical is that all the sheep and the officials hair is standing on end when measles is said, but seem to give a hoot about autism temporally associated with vaccines; diabetes; increases in most common childhood cancer (Acute Lymphoblastic Leukemia) beginning in the 1950's in the developed nation. They brush off that millions of americans were innoculated with monkey SV40 virus in the polio vaccine. Let's make a short list of the rather long list of vaccine debacles: 1) Infants under one are now more common to have measles as vaccine era has adversely effected the passing of antibodies from mother to infant. 2) MMR and the urabe strain causing meningitis. 3) Now they're calling for adults to get pertussis due to increasing incidence of whooping cough. Sure glad I took that risk with my son(s). 4) HPV for cervical cancer and the provaccine lobby claiming that 14 year old girls dying and becoming disabled is just a coincidence. I call it some kinda undiscovered 14 year latent regression to grave. 5) One dose of MMR works for 95% of infants (reconfirmed recently by Baird et al.--that's about all that study showed), yet the officionodos will subject those 95% to another dose "just to be sure". 6) HepB vaccine on hour one of life for the masses even though the majority has minimal to null risk factors for HepB. Look up HepB in VAERS, but only do so if you take some prophylactic pepto bismol. I think that's starting to paint a picture. Oh wait, don't forget, that now chickenpox is deadly too.

Clifford G. Miller

March 23rd, 2008 4:01am
David regrettably is a disciple to the flawed approach to evidence applied by the medical profession. Melanie Phillips is quite right in her approach. David’s approach is one promoted by the pharmaceutical industry to remove control over "evidence" from all and to place and keep it in the pharmaceutical industry's hands. As one peer refereed study puts it ‘Distorted use of terms like “gold standard ,” “anecdotal ,”and “empirical” in the discourse in which research methodology is typically presented has disempowered the practitioner’s perspective and discredited the role of case-based knowledge building. ‘ http://pcsp.libraries.rutgers.edu/index.php/pcsp/article/viewFile/892/2260 But as with all erroneous approaches based on flawed logic and thinking, it does allow fun to be had whilst making serious points. "Anecdotal evidence" as used by David includes all observational scientific evidence. The observer observes and the observation is an anecdote of what is observed. Thus, most science is based on anecdote according to David. Similarly, all witness evidence in court is, according to David "anecdotal". "Anecdotal" evidence is little more than personal accounts which have not been subjected to any systematic method of collection and scrutiny. Once that has been done the "anecdotal" ceases to be and becomes witness testimony or in science it becomes observational scientifically collected data and then called "scientific" evidence. So once we start collecting, documenting and substantiating these personal accounts, they cannot be called “anecdotes”. Put them together and you get a case series, in which each independently related case telling the same story reinforces every other and becomes a powerful means of proof. Frankly, to rank personal testimony into the same category as a humour tale told in the pub or at the dinner table is perverse. But then, that’s what happens when you live in pharmaceutical land.

Grasshopper

March 23rd, 2008 12:22pm
I didn't use to think MMR was a problem, but I am now an agnostic sceptic, mainly thanks to intentionally misleading rhetoric such as this from David (Colquhoun?): "Anecdotal stories are not evidence - that is why scientific trials are done, and to the chagrin of Phillips and the antivaccine lobby, for some reason the studies always seem to show they are wrong by exonerating vaccines." Really? Which randomised double-blind placebo-controlled trials of MMR do you refer to? "Gold standard" trials are not allowed, since MMR is "deemed" to be beyond criticism. So your knockdown "evidence" comes from poorly-designed cohort studies that ignore adverse events, because there are no adverse events, of course.

field

March 23rd, 2008 2:06pm
Yes David seems willing to accept that pharmaceutical companies with a vested interest in the outcome should be judge and jury on this. The companies are like drug pushers always trying to interest the customer in a new (more expensive) line - hence the never ending list of vaccines that the industry is dreaming up. Until very recently vaccination involved inserting mercury into the system - a crazy practice. The medical establishment, in cahoots with the pharmaceutical industry, is lying to the public about the risks from diseases like measles. With modern medicine diseases like measles can be treated very and we will not face the same level of fatality or long term damage as in previous ages. Where we do get serious illness or fatality now it is with children who already have serious diseases like leukemia and whose immune response is already seriously compromised by the disease or the treatment they are receiving. This is kept from the public in order to scare people with normal healthy kids that they are really at serious risk of death from measles which they are not. There has to be truth and trust between doctors and public - and we have to get the pharmaceuticals out of the policy field.

mike stanton

March 23rd, 2008 2:14pm
Ms Phillips begins by referring to a piece of research by Dr Cass that tests urine for peptides but thinks it is really a rehash of a study by Dr Baird that tested blood for measles virus. Errors like this do not inspire confidence in Ms Phillips' opinions on the subject of vaccines or autism. http://actionforautism.co.uk/

Nura Aabe

March 23rd, 2008 8:27pm
Thank you Melanie, I have a child with authism and is coming on well with biomedical treatment. But I believe it was MMR that cause my son his authism. I wish all the best to Wakefield.

drained

March 24th, 2008 9:32am
It's really depressing to me that so much time and energy is being spent mud-slinging, with intelligent professionals going all out to discredit one another. I would love to see a fraction of this effort being spent trying to find the true cause of a disability which has destroyed the lives of thousands of families including my own.

Cybertiger

March 24th, 2008 9:49am
It amuses me to wonder whether the honourable Professor David Salisbury, head of the government immunisation programme, will receive a knighthood or be forced to walk the plank ... or both.

field

March 24th, 2008 12:34pm
Drained - My heart goes out to you. I can relate to what you say. Our daughter had a pretty bad reaction to a vaccination. The only time as a child she had convulsions was a day or two after this vaccination. It is horrible to think that these procedures meant to be protecting your child could be causing them real harm. Yours is a dreadful story and thank you for alerting us to the scandal that such reactions are not even being reported. We cannot trust the government or medical establishment on this issue.

Sergey

March 25th, 2008 7:48pm
Somewhat 35 years ago, when I worked in Gamaleya Institute of Epidemiology and Microbiology, a leading Russian center for vaccines development and immunology research, a tragedy happened: our measles vaccine caused an epidemics of encephalitis among vaccinated. Our senior immunologist and virologist, prof. Svet-Moldavsky, was sent to investigate. It turned out that at producing facility they slightly modified protocol, using overgrown rats instead of very young, as was required. Live virus vaccines are made nowdays essentially as in days of Pasteur, by multiple passage on animals brains. So these vaccines can induce antibody production not only to virus antigenes, but to components of brain tissue as well. While antigene composition of human and animals tissues is different, some overlapping exists, so autoimmune response against brain tissue of vaccinated children is possible. This happened in this case. The story never leaked into press, of course, due to Soviet era secrecy, but everybody in Institute knew it.
Measles lethality drastically plummeted in last few decades, from several procents to one case in thousand infected. Most of it was due to concurrent bacterial infection pneumonia, which now effectively treated by antibiotics; these 1/1000 deaths are also caused not by virus itself, but autoimmune reaction on this virus targeting brain tissue. But there are sound reasons to fear that attenuated vaccine virus can induce analogic reactions. Many parents reported onset of autism symptoms immediately (several hours after) vaccination. Too early for viremia, but timing is exact for autoimmune reaction.

Michele

March 25th, 2008 8:46pm
My son has autism, he will continue to get every shot that is necessary to keep him healthy- and gluten free is a farce, along with sugar free, wheat free, and all the other "free" fads. . .my son will always be autistic, and he was already showing signs of it before the "MMR"- what a load of crap these people shovel

John Thurston

March 25th, 2008 10:26pm
There is a recent story in the US where the CDC accepted a link between the vaccination and autism. http://www.laleva.org/eng/vaccines.html

David

March 26th, 2008 9:33am
Thank you Melanie for correcting one of the errors in your original post, and acknowledging that the 2 studies you mentioned are completely unconnected.

Natasa

March 26th, 2008 11:47am
Sergey, thanks for posting that. These things are of tremendous importance, I wish some of the researchers would look into this closely.

Margaret Collins

March 26th, 2008 9:27pm
drained,
My son also reacted badly to the DTP vaccine, of which he received the first dose when his corrected age was only two weeks (and the NHS wanted to vaccinate him even sooner). He had a severe local reaction (massive swelling of the leg with induration) and the GP was called out and witnessed this. Because I was worried, the second dose was delayed and I went back to the GP, saying that I was concerned about the reaction. I was told not to worry, it meant nothing and probably wouldn’t happen again. So my child had a second dose. (He shouldn’t have had this: the Department of Health’s Green Book, issued to every GP’s surgery in the country, stated that if a severe local reaction to the DTP occurred no more doses of the whole cell vaccine should be given.) This time he had a severe general reaction: very high fever and screaming. Neither of these adverse reactions was reported under the Yellow Card scheme, and I am sure that you know that the vast majority of adverse reactions are never reported.
He stopped smiling, his development stalled, went into reverse and at nine months of age he was diagnosed with Infantile Spasms. In retrospect I realise he had a neurological illness for some time months before the fits became obvious. When I raised the possibility that the Infantile Spasms were connected with the adverse reaction to the pertussis element of the DTP the Neurologist said that a large scale study had been carried out some years ago and it was certain that the vaccine did not cause Infantile Spasms.
In fact, the study didn’t say the DTP was safe and it was flawed in its design. However, over the years the Department of Health managed to persuade everyone through its propaganda machine that the vaccine was safe. Only comparatively recently was a possible mechanism by which the whole cell pertussis toxin could cause encephalopathy identified by researchers in Ireland. Another (British) study monitored reactions to the DTP when given to infants born prematurely and discovered severe apnoeic episodes in these infants following the administration of the DTP. They recommended that babies in this group be given the vaccine in hospital and be monitored closely for adverse events.
Dr Bill Inman, who set up the Yellow Card scheme in this country, was very closely involved in all or most of the committees set up to look into the safety of the pertussis vaccine. He wrote about the whooping cough vaccine in his book Don't Tell the Patient: Behind the Drug Safety Net ( ISBN-10: 0967581206). The career of the previously respected doctor who had first raised the question of the safety of the whole cell pertussis vaccine, Gordon Stewart, was badly damaged. Dr Inman independently calculated that 1:30,000 children given the vaccine suffered permanent neurological damage. He says that a colleague of his, following a separate route, later came up with the same figure. Yet officially the whole cell vaccine was “safe” – it is many years since any payout has been made for damage caused by the pertussis vaccine. The route of court action was also closed off.
Since the mechanism by which the vaccine worked was (still is) so poorly understood and since many forms of learning disability and other problems cannot be detected in a young baby it is impossible to prove that the vaccine is the cause of these in a particular case.
My son has autism and severe learning difficulties. I don’t know why. I suspect the involvement of the DTP in his Infantile Spasms; many other parents whose children have had Infantile Spasms have suspected the same. I do know that the Department of Health interpreted and spun the results of a study concerning the whooping cough vaccine until there was widespread acceptance in the medical profession that the vaccine was completely safe. The study didn’t prove this. There are parallels with the way the Department of Health MMR has selectively used the results of studies to claim that the MMR is proven to be safe.