Daily Mail, 7 February 2006

Ever since the MMR controversy burst upon a bemused world back in 1998, the battle lines have been very clearly drawn.

In one camp is Andrew Wakefield, the gastro-enterologist who started the whole furore when he claimed to have discovered a new syndrome in children combining autistic symptoms with a new type of bowel disease.

The affected children’s parents believed that this was the result of their triple measles, mumps and rubella jabs. Mr Wakefield took their fears seriously and suggested that, for the sake of prudence, children should be vaccinated with single jabs rather than MMR.

In the uproar that has ensued ever since virtually the entire medical establishment, headed by the Department of Health, has lined up in the opposite camp to denounce Mr Wakefield’s claims in the most vitriolic terms as ‘junk science’ with no substance to them whatsoever. MMR, said all these experts with one voice, had been proved to be safe.

As a result, Mr Wakefield’s reputation has been systematically trashed and his research is said to be discredited. Yet many parents remain concerned. Only about 70 per cent of children are being vaccinated with MMR, raising fears of epidemics of measles, mumps and rubella. Indeed, as figures published yesterday revealed, in some areas a few as one in ten children has the triple jab.

Yet as the controversy deepened, there was never a chink in the united front the health department presented to the world. It painted the anti-MMR camp as a bunch of hysterical and grasping parents desperate to blame someone for the inexplicable tragedy that had befallen their children, and exploited by a cranky and irresponsible doctor who was putting the health of the nation’s children at risk by terrifying parents into avoiding giving them the MMR jab.

At the very core of the department’s case was its assertion that all the evidence was on its side. There had been no serious corroboration of Mr Wakefield’s claims and all reputable studies had shown MMR to be safe. There was simply no scientific case to answer.

Now, however, that united front has been shattered. A former senior Government medical officer has broken ranks to say that, on the contrary, the evidence suggests that for a small proportion of children MMR is not safe and that the Government is guilty of ‘utterly inexplicable complacency’.

The person who is saying this cannot easily be dismissed. Dr Peter Fletcher, a former Chief Scientific Officer at the Department of Health in the late 1970s, is a former medical assessor to the Committee on the Safety of Medicines and had responsibility for deciding whether new vaccines were safe. For years, therefore, he was at the very heart of the vaccine policy-making and regulatory establishment. If anyone knows how to assess all the available evidence on such matters, he surely does.

But now just look at what he has said. Having agreed to be an expert witness for lawyers of the affected children, he had studied thousands of documents relevant to the MMR issue. And these, he found, revealed ‘a steady accumulation of evidence’ from scientists around the world that the MMR jab was causing brain damage in certain children.

The clinical and scientific data that was now accumulating that MMR could cause brain, gut and immune system damage in a small proportion of vulnerable children was, he said, ‘far too much to ignore’.

In other words, Mr Wakefield’s evidence was in the process of being corroborated. What price, then, the health department’s insistence that such corroboration didn’t exist?

Other assertions by the medical establishment were similarly shredded. They had tried to explain away the ten-fold leap in autism and related brain damage in children over the past 15 years as a statistical illusion arising from improved diagnosis.

But according to Dr Fletcher there was ‘no way’ this could add up – and it failed to address the additional ‘extremely worrying increase’ in inflammatory bowel disease and immune disorders among children in this period. ‘It is highly likely that at least part of this increase is a vaccine-related problem’, he said, questioning why the government wasn’t taking ‘this massive public health problem’ more seriously.

Why indeed? Dr Fletcher himself has suggested the answer: that there are very powerful people who have staked their entire reputations and careers on proving Andrew Wakefield wrong -- and they are willing to do almost anything to protect themselves.

This was a remarkable allegation from someone who was himself at the very heart of that particular establishment. But it is clear to anyone who has studied the evidence – as Dr Fletcher has done – that the bland assurances of the Government are simply not supported by the facts that they claim back them up.

While Mr Wakefield is being subjected to a witch-hunt, and while the parents of the affected children are scandalously denied legal aid to pursue the court case which may well have finally brought to light the truth about MMR, those powerful people in the medical establishment are continuing to misrepresent the evidence.

In particular, they claim that epidemiological studies show it is safe. But these studies are based on population-wide surveys too large and insensitive to get at the truth.

This is because, for the vast majority of children, the vaccine poses no problem at all. Only a very small proportion are said to have been badly affected, possibly through a combination of environmental or genetic factors. Population-wide studies are considered unlikely to pick up small numbers like this.

Worse still, the evidence has actually been distorted. Take, for example, the recent study by the respected Cochrane Library, which was said to have proved that Mr Wakefield was wrong. In fact, far from saying MMR was safe the study said explicitly that the evidence for its safety was not good enough.

Dr Fletcher himself has previously protested at such misrepresentation. In 2001 the Government’s Chief Medical Officer, Professor Liam Donaldson, said concerns over the safety of MMR were considered by the Committee on the Safety of Medicines and other expert bodies to have been refuted. But in fact, the CSM had expressly said it was impossible to refute them and that the question was still open.

In a letter to a clinical periodical Dr Fletcher noted ‘the curious turn of events which has now led to the Department of Health, the Medicines Control Agency, the Committee on Safety of Medicines and other eminent bodies citing negative studies as absolute evidence of safety.’

No-one listened.

He also said at that time that the MMR safety trials conducted before its introduction in Britain were inadequate.

No-one listened.

Instead, the relentless drive to introduce more and more vaccines continues. This week, the Government is reported to be planning to announce yet another jab for babies, this time against pneumococcal meningitis. Vaccination plays a vital role. But are we yet sure that we understand the full effects of so many vaccines on immature immune systems?

Now the Chancellor has urged all parents to vaccinate their children with MMR. Yet we still don’t know the truth about this vaccine. The pieces of this most complex of scientific jigsaws have not yet fallen into place.

What is clear is that the assertions made by the government about its proven safety, and about the absence of any evidence that might cause concern, are simply not true.

Dr Fletcher’s intervention is devastating. As he says, if it is proved that MMR does cause autism after all, this will become one of the greatest scandals in medical history.

Are they listening now?

Posted by melanie at February 7, 2006