Select Committee on Health Minutes of Evidence


APPENDIX V

DEPARTMENT OF HEALTH/HEALTH EDUCATION AUTHORITY MMR FACTSHEET 2 (AUGUST 1998); SOME CRITICISMS

  421.  "Conclusion—measles virus does not appear to be present in Crohn's disease tissues" (page one of MMR Factsheet, sixth paragraph).

  422.  The fact that three groups of researchers have been unable to find measles virus in Crohn's disease tissues, in tests which are acknowledged by all parties to be difficult, does not in itself prove that there is not a link. If there remains even a modest element of doubt, in a difficult area of research, then this should be properly acknowledged.

  423.  "To summarise the scientific evidence . . ." (page two of MMR Factsheet, last paragraph).

  424.  The Department has demonstrated a bias in its trawling for and quoting of evidence. Also, in many cases the research has simply not been undertaken yet. A summary of any present "evidence" must be judged in this light. Also, the Department makes the fundamental philosophical/logical error of concluding that, because there is insufficient hard evidence of a problem, it is safe to conclude that the problem does not exist.

  425.  "The theory (of the Royal Free team) is as follows: MMR vaccine might damage the bowel, and, as a result, chemicals (opiodes) which occur naturally in the bowel, and which would be dealt with without problem by an undamaged bowel, might gain access to the brain and affect development. No proof for this hypothesis has been given and there is evidence against the theory." (page three of MMR Factsheet, second paragraph).

  426.  This is very far from being an accurate summary of the Royal Free work, nor does it acknowledge other published and unpublished research.

  427.  In addition, researchers Sabra, Bellanti and Colon of the International Centre for Interdisciplinary Studies of Immunology, Georgetown University Medical Center, Washington DC, wrote to The Lancet in July 1998, a month before the MMR Factsheet was published, in support of the Royal Free findings. They stated that examination of cases of hyperactive disorder via colonoscopy of the terminal ileum had produced findings matching those of Dr. Wakefield at the Royal Free.

  428.  It is unbalanced of the MMR Factsheet to quote Chen and De Stefano (from February's Lancet) but not Sabra, Bellanti and Colon (from July's Lancet). No mention is made of the work of other researchers, such as Singh or Gupta (see also Appendix III).

  429.  ". . . national data seem to indicate a rise in the incidence of autism, but it started over a decade before MMR's introduction in 1988" (page three of MMR Factsheet).

  430.  As noted elsewhere, there is no accurate "national data". The data on autism incidence in the UK in 1999 is still chaotic. Also, if an increase in autism really did start over a decade before MMR, ie around 1985, we need to be finding out why.

  431.  "A study in Sweden (found that) the incidence of autism did not change as a result of MMR" (page three of MMR Factsheet, penultimate paragraph).

  432.  This refers to the Gilberg study in Gothenburg, published in 1991. It involved three different studies, all with different criteria. The study actually acknowledges an increase in autism in the area concerned. It misses out cases of Aspergers Syndrome. MMR was only introduced seven-ninths of the way through the study. The study also excluded children under four.

    "In conclusion, the evidence is therefore against a cause and effect link between MMR and autism . . ." (page three of MMR Factsheet, last paragraph).

  433.  I would suggest that no such conclusion can be drawn.

  434.  "Has there been an independent inquiry into the possibility of a link between MMR vaccine, Crohn's disease and autism?" (page four of MMR Factsheet, first paragraph).

  435.  The review by the Medical Research Council on 25 March 1998 was to review the evidence, which is not quite the same as an "inquiry into the possibility". The evidence reviewed depended on who was invited to submit it. Professor Pattison's team found that there was no evidence, but this was probably unsurprising as it believed that no actual evidence was offered.

  436.  "Is MMR used in other countries?" (page four of MMR Factsheet, fifth paragraph).

  437.  The Factsheet does not acknowledge that there are numerous parents' action groups, and some doctors, in other countries that share the concerns of the parents of autistic/etc children in the UK. A search of the Internet will reveal numerous parents' action groups.

  438.  "Has the long term safety of MMR vaccine been adequately assessed?" (page four of MMR Factsheet, penultimate paragraph).

  439.  A comprehensive review of published studies on suspected vaccine adverse events, conducted by the American Institute of Medicine, looked at over 7,000 abstracts and 2,000 books, and concluded that the evidence was inadequate to accept or reject a casual relationship between measles-containing vaccine and demyelinating diseases of the central nervous system.

  440.  "Has the long term safety of MMR vaccine been adequately assessed?" (page four of MMR Factsheet).

  441.  The Department has either ignored or been unaware of evidence or research that is discordant with its view. It is questionable as to how proactive it has been in seeing out such evidence.

  442.  "If a doctor suspects a serious adverse reaction to MMR vaccine, he/she can report this to the Committee on Safety of Medicines using the Yellow Card spontaneous reporting scheme" (page five of MMR Factsheet).

  443.  A recent independent study by the West Midlands Centre for Adverse Drug Reactions found that only 6 per cent of adverse reactions were reported. Even the Committee on Safety of Medicines states that only 10-15 per cent of serious reactions are reported. A GP may genuinely not connect an adverse reaction with vaccination because they do not have the specialist knowledge that enables them to clearly make the link, and because a consequence of several weeks or even several months later, such as progressive autoimmune reaction, may not suggest itself to a GP as vaccination-related.

MMR—THE FACTS—LEAFLET PRODUCED BY THE HEALTH EDUCATION AUTHORITY

  444.  The following are quotes from the above leaflet, with my own commentary added.

  445.  "Have children been followed up long enough after MMR to know it's safe?" (first page of leaflet).

  446.  It is remarkable that the paragraph following this question actually completely fails to address it.

  447.  There are also several references to studies, but there is no reference to any UK studies. The leaflet does not properly list all studies that suggest that vaccination and autism may be linked. It is also understood that the follow-up studies undertaken in the UK when MMR was being trialled prior to its introduction in October 1988, monitored the trial children for just three weeks after vaccination. This would probably have excluded any autoimmune-type degeneration. The answer to the Department of Health's own question therefore appears to be at least doubtful, and probably "no".

  448.  A personal message from the Chief Medical Officer . . .MMR is the safest way for you to protect your children against measles, mumps and rubella . . .".

  449.  This may well be true. What is at question is whether this or the monovalent vaccines have caused problems for a very small minority. The leaflet does not address this issue.

  450.  The "personal message" is from a new former Chief Medical Officer who, in October 1998 at the BSE Inquiry redefined his previous use of the term "safe", in the context of beef, as meaning "not without risk".


 
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Prepared 27 July 1999