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2.30 am

The Parliamentary Under-Secretary of State for Health (Miss Melanie Johnson): I congratulate the hon. Member for Lewes (Norman Baker) on securing this debate on his constituent and the MMR issue. Many other hon. Members and I care greatly about the health and safety of children. Many of us, as parents, well understand the difficulties of deciding whether to have children vaccinated and, indeed, the concerns that any parent must have about the health of their child.

Of course, autism can have a devastating impact on children and their families, and it is only natural that the parents of autistic children want to find out what has caused their child's condition, but it has proved difficult to find such a cause. The Department of Health has already asked the Medical Research Council to consider the evidence. The MRC produced a clear and authoritative picture of what scientific research has revealed about the occurrence and causes of autistic spectrum disorders. The MRC report clearly reflected the current state of knowledge. Like other authorities, the MRC identified a strong genetic component in the causation of autism.

The Government have demonstrated their commitment to finding out more about the causes of autism by allocating a further £2.5 million to the MRC to help it to take forward the recommendations of the report. However, we know that some parents genuinely believe that their children's lives have been damaged by the MMR vaccine. Clearly, the hon. Gentleman's constituency is one of them. Of course, they want to know what has affected their child. However, I have to reassure the hon. Gentleman and others that all the scientific research from around the world comes to the same conclusion: there is no credible evidence linking MMR and autism. That may not be a comforting conclusion for parents who believe that their child's autism was somehow triggered by MMR, but I cannot ignore the evidence and the scientific advice that we have received from around the world.

Perhaps I can put the introduction of the MMR vaccine in the UK into context. The MMR vaccine underwent a thorough licensing programme and a review was carried out in 2001, which was prompted by concerns raised by Andrew Wakefield in a publication in 2000. The Committee on Safety of Medicines concluded that standard procedures were followed and that MMR vaccines were licensed on the basis of satisfactory standards of safety, quality and efficacy.

Pre-licensing trials are normally not large enough to detect rare adverse reactions. That is why procedures are in place to monitor vaccine safety after licensing. Therefore the retrospective call for the original MMR clinical trials carried out in the 1970s and 1980s to be able to detect an increase in autism postulated in the 1990s is not sensible or justified. None of the studies carried out subsequently, however, has provided any support whatsoever for the claims that either bowel disease or autism is associated with the MMR vaccine.

The hon. Gentleman touched on the withdrawal of the MMR vaccines containing the urabe strain of mumps vaccine in 1992. The identification of this issue

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four years after the introduction of the vaccines is not proof that the clinical trials were inadequate. When the Department of Health became aware of the existence of a potential safety issue with that vaccine strain, it immediately asked the Public Health Laboratory Service to instigate detailed monitoring of possible vaccine-associated cases of aseptic meningitis. Initially, some 28 vaccine-associated cases were identified, which were all in recipients of MMR vaccines containing the urabe mumps strain. This indicated a risk of one case of aseptic meningitis in 11,000 vaccinees. As soon as those data were available in 1992, an alternative vaccine became available which did not have that level of risk and was equally effective. The vaccines were replaced in September 1992. Very rare adverse reactions sometimes cannot be identified until a vaccine is used in a wider population, which is precisely why we have the monitoring arrangements that we do.

To turn to the monitoring arrangements—the yellow card scheme—I cannot go into all the detail in the time available to me, but as soon as the strain was identified, vaccines were withdrawn. That demonstrates clearly that if we identify a problem, we are able to act and respond—[Interruption.] I cannot hear what the hon. Member for Epping Forest (Mrs. Laing) is saying from a sedentary position. If I could, I might be able to respond.

A number of studies cannot find any difference between the rate of autism in children receiving MMR and in those who do not receive it. Other studies have found no sudden increase in autism associated with the introduction of the MMR vaccine in the UK in 1988, no difference in the age of diagnosis between MMR-immunised and un-immunised children, no difference in the MMR immunisation rates between those children with autism and the general population, and no link between the timing of MMR and the onset of autism.

Norman Baker: One thing that I did not mention was some staggering figures on the incidence of autism in the United States, which tend to suggest, taking all the states on average, that there has been an overall increase of 870 per cent. between 1992 and 2002—from 12,000 cases to 118,000 cases in just 10 years. Has the Department of Health made any studies as to what the reasons might be for that gigantic increase in the US? Has that been investigated at all?

Miss Johnson: Obviously, I am not responsible for health care in the US, although I appreciate that its experience may be relevant to ours. In the UK, vaccinations are not compulsory but voluntary. I do not have an analysis with me this evening of the US figures that the hon. Gentleman has quoted, and I cannot therefore comment on their validity or on what the scientific community has said about them.

It is not just this country that has come to this conclusion about MMR—a huge number of countries around the world that use the vaccines have done so, as has the World Health Organisation, which states that MMR

"has an outstanding safety record".

The hon. Gentleman will have heard the recent views from Dr. Murch, who was one of the authors of the original papers that triggered the MMR debate. His words speak for themselves:

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"No other vaccine has ever been studied in such depth and the evidence for its overall safety is comprehensive . . . There is now unequivocal evidence that MMR is not a risk factor for autism."

He was one of the authors of the original report. He continues:

"This statement is not spin or medical conspiracy, but reflects an unprecedented volume of medical study on a worldwide basis."

I now turn to the question of measles virus in samples from autistic children, which the hon. Gentleman also raised. Some parents of children with autism have chosen to have samples of blood and tissue analysed privately. The hon. Gentleman referred to the fact that, in some cases, the measles virus consistent with the vaccine strain has been found in blood and other samples taken from the child. The detection of that has become the focus of much attention over recent months.

There is only one laboratory of which we are aware that claims to find measles virus in tissue samples from autistic children. However, the head of that laboratory in Dublin, Professor O'Leary, issued a press statement last year because he was concerned about the way in which certain newspapers had reported the results of his work. He said that the newspaper reports were

"misleading, erroneous, and are causing unnecessary concern among parents."

He added:

"I and my research team have consistently advocated the use of immunisation and the use of MMR to protect the nation's children from measles, mumps and rubella."

Much evidence has been put into court about parallel testing of blood and other samples both by Professor O'Leary and other experts advising the court. The results of those investigations need to be put into the public domain, so that everyone, including the parents involved in the court cases, can see all the evidence and not just selected parts of it. We need to be careful about accepting just part of the story.

The hon. Gentleman might also like to know about the test results of the recent court case taken against the manufacturers of MMR. He will be aware that three test specimens were claimed to have proved positive when tested by the laboratory on behalf of the claimants, and this became the centre of attention in a number of media stories claiming that Dr. Wakefield believed this to be the strongest evidence yet linking MMR to autism. However, the hon. Gentleman will also be interested to know that the results of the analysis of the same samples carried out by other expert laboratories were that no measles virus could be detected in the samples. I am not sure how the stories were run in the newspapers, but they probably did not serve the public's best interest. Scientists and the responsible media need to look at the evidence dispassionately, both for and against a theory, and not risk the idea that they suppress results.

On legal aid, it is important to understand the process that has led to the decision by the Legal Services Commission to withdraw funding for the MMR litigation. After all the evidence from both claimants and defendants was put into court, I understand that the Legal Services Commission took the view that there was insufficient evidence to proceed with any prospect of success for the claimants. This decision was appealed by the claimants' lawyers and it was reviewed by the

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funding review committee of the LSC. The committee is an independent body made up of solicitors and barristers from private practice, including a Queen's counsel with expertise in this sort of litigation. The decision to withhold further funding was supported on appeal.

We should not forget that the LSC had already made an investment, which the hon. Gentleman mentioned, of £15 million in this case. Despite this investment, medical research had not proved a link between the MMR vaccine and autistic spectrum disorders and no link had been proven by any other medical authority. I also think that it is important to note that the LSC has said that, on further consideration, it regrets embarking on funding the scientific studies that have contributed to the £15 million costs.

It is important to ensure that this £15 million investment of legal aid does not go to waste. I am sure that hon. Members will agree that it is imperative that experts look at this evidence, as they have with all evidence on MMR over the years, to reassure themselves that no evidence of a link has been overlooked. We also have the evidence about the view of the claimants' chances in court.

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