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New claims of vaccine danger rebutted

Department of Health furious over paper linking MMR jab with autism

Sarah Boseley, health editor
Monday January 22, 2001
The Guardian
http://society.guardian.co.uk


New salvoes were fired yesterday in the war between a scientist who believes there is a link between the MMR vaccination and autism and the medical establishment, which has consistently rebutted the hypothesis.

Andrew Wakefield, a consultant gastroenterologist at the Royal Free hospital in London, is now alleging that the combined measles, mumps and rubella vaccination was not tested thoroughly enough for safety before it was introduced in Britain in 1988. In a paper shortly to be published in the medical journal Adverse Drug Reactions, he claims that children given the combined jab were not followed up for long enough to be sure that there were no side-effects.

The renewed battle over the MMR will dismay public health officials, who have warned that there is the danger of a potentially fatal measles outbreak if parents do not take their children for vaccination. Only 88% of children are now being vaccinated because of public uncertainty. In Ireland and the Netherlands, low vaccination coverage last year led to deaths from measles. The World Health Organisation says 95% coverage is advisable to prevent an outbreak.

Yesterday the Department of Health produced a long and detailed rebuttal of Mr Wakefield's latest allegations, based on reviews of his work carried out by independent scientists on the joint committee on vaccination and immunisation and the committee on the safety of medicines.

The paper by Mr Wakefield claims that children given the MMR jab in the pre-licensing trials were not followed up for longer than 28 days and therefore long-term side effects of the vaccinations would not have been picked up.

The Department of Health said yesterday that this was "factually incorrect". Most of the trials followed children for four to six weeks, one particular trial monitored them for six to nine weeks and a minority of children in the trials were followed up for a year. The department accused Mr Wakefield of biased reporting. "Studies that fail to support the author's views are not mentioned," it said.

Mr Wakefield's thesis, which caused a furore when published in the Lancet in 1998, is that the MMR jab can trigger Crohn's disease, a bowel disease, in certain susceptible children, which in turn can lead to autism. He claims in the new paper that some small trials in the US showed that significant numbers of chil dren developed stomach bugs, but that in spite of this, the follow-up period was reduced to 21 days from 28 days.

His original work was on just 12 children whose parents said they showed no signs of autism until after their MMR jab. Mr Wakefield's opponents point out that the vaccination takes place at around 18 months, the same time that autism is usually noticed. A study of all the autistic children in part of north London was commis sioned by the Department of Health, which concluded that there was the same rate of autism in children who had been vaccinated with the MMR and those who had not.

Mr Wakefield and colleagues claimed to have found signs of the measles virus in the gut of autistic children. But nobody has been able to replicate this finding. A panel of top scientists, convened by the medical research council at the request of the Department of Health, reviewed Mr Wakefield's data and found no evidence to substantiate his claim of the link between MMR and either bowel disease or autism.

But many parents of autistic children, searching to understand and explain what has happened to them, are convinced the MMR vaccination must be to blame. Mr Wakefield said yesterday that he now has 170 children on his books, instead of the original 12, and that in most cases the parents could show the autism appeared after the MMR.

Professor Brian Duerden, medical director of the public health laboratory service, said yesterday that he could find "no hard scientific basis at all" for Mr Wakefield's claims. "He is a fervent believer in his views on this," said Prof Duerden. "One person's idiosyncrasy and interpretation puts the vaccination programme and the need to protect children at risk."

http://society.guardian.co.uk/health/news/0,8363,426286,00.html

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