Wednesday, 26 January 2011

To vaccinate or not?

The MMR-autism link has been in the press again. The doctor whose research 12 years ago sparked the MMR vaccine controversy, Andrew Wakefield, faced what some called his "judgement day" at the General Medical Council(GMC) on Thursday afternoon. In February 1998, The Lancet published a paper written by British physician Andrew Wakefield and 12 co-authors that linked autism to the vaccine against measles, mumps and rubella in eight of 12 children they had studied. Since then, the Lancet, a British medical journal that originally published the study in 1998, retracted it after questions about its accuracy. Another publication, the British Medical Journal, recently reported that the research behind the study was tainted. The Wakefield case raises fresh questions. How rigorous are ethical checks on medical research? Who pays for the science we all read about? And again, questions over peer review, and just how robust this process is, given its aim of questioning new science before it is published.


After the Wakefield publication, panic ensued and vaccine rates in the UK plummeted. By the time it came to vaccinating three years later, the panic had calmed. Subsequent media campaigns from the NHS followed and charged parents with recklessness and implored them to vaccinate their child lest a measles epidemic spread again. The decision to immunise children, in my view is influenced by three things: the parents' willingness, the doctor/health visitor’s attitude and input toward guiding the decision, and the vaccine's availability. Since there was no supply shortage during the study period, the decline can only be attributed to either the parents' or the health care provider's reluctance to vaccinate. Given that the science part is complicated, I was intrigued by the public panic at the time. The study didn't state that the vaccine caused autism but that in 8 of the 12 children studies post vaccination had exhibited a type of autism that was coupled with severe intestinal problems. I read the report at the time and was confused by it's findings and it's conclusion and thought nothing of it until the next day when splashed all over the newspapers and television was a report that giving your child the MMR vaccine could cause autism. The story ran in varying degrees for weeks. A public panic is never generated by one man alone, no matter how elaborate his fraud. Many factors, beyond Wakefield’s designs, contributed to the anti-MMR madness. There was the weakened state of the medical elite, battered by the Bristol and Alder Hey scandals, which felt incapable and/or unwilling to assert its authority over Wakefield’s theories. And there was media cynicism, the media’s desperate search for an anti-government hero whom they could hold up as a beautiful, principled contrast to the dark, ugly forces that govern our lives. Thus did respectable publications get all hot under the collar over Wakefield, with one describing him as a handsome, glossy-haired hero.


Today’s media assaults on Wakefield at best ignore the specific circumstances in which his theories were able to spread, and at worst represent a cynical attempt by some of those who failed to challenge his theories in the late 1990s to now cover their tracks. What I think were seeing is the flip-side of the 90's Wakefield support and it has made me distrustful. Distrustful of the fickle media and of the medical establishment. Where those journalists who fell for Wakefield’s charms tried to turn him into a symbol of Good against corrupt authority, today’s enlightened hacks turn him into a symbol of Evil who apparently set science back 10 years and brainwashed the otherwise perfectly rational middle classes. It’s a nice story. And it will allow anti-Wakefield journalists to feel puffed-up with science-tinged righteousness. But it will do nothing to challenge the political cynicism and suspicion of man’s endeavours that nurtured the MMR panic, and which still exist in different arenas today.


Right folks, I put the above question to you to vaccinate or not and would love your feedback. Whether you have normal or Neuro-Typical children, kids on the spectrum, with Aspergers or otherwise I would love to hear what you think about the MMR scare and its subsequent press. Did it influence your decision to vaccinate your children? Was it something that you ignored? We all panicked in the beginning and then shook our heads as the findings were discredited and the offending scientist struck off but I want to know what you REALLY think. This is something that I've been meaning to post about for a while but I was propelled into writing by a BBC programme last night that asked the question 'do we trust science any more?'. While this question is potentially misleading and it really should have been do we trust the scientists, the MMR debate is only one of a number of recent scares that has weakened the general public's faith in the medical establishment. 







21 comments:

  1. I have an autistic toddler and two NT children, all of them were vaccinated and I have absolutely no regrets. All this 'research' was available when my first was born and I ignored it, tbh I just didn't believe it. Also, I felt the risks of not vaccinating were just too high and I wasn't willing to take those chances. There is no doubt in my mind that ASD is genetic, I can see the traits in myself and know very well where my autistic child got them!! Jen

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  2. When I was 9 I watched my close friend die very slowly from measles. This was completely preventable.

    When it came to my children being vaccinated I didn't think twice.

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  3. A very close friend of mine had measles as a child and suffers from problems with his eyesight and hearing (although he always felt he came off rather lightly); however,in addition several years ago he and his wife discovered their inability to conceive was a result of his infertility caused by the measles.

    I read the report in question (provided by my health visitor) when time came to vaccinate my first child and had no doubt that the findings were of a dubious nature and was also struck by the figures for deaths from measles (many) and from the vaccine (none). Both my children (NT) have had it and barely noticed once the jag was done.

    I know many parents have issues with vaccines but I fail to understand how it is O.K. to put your child's life at risk and potentially the lives of other younger children who are not yet old enough to have been offered the vaccine. I know people whose children have not had it and they rarely have a logical reason for that decision - it is an emotive choice that can affect lives.

    It is so sad that the media leapt on this report and in view of the controversies around giving/not giving children the flu vaccine their irresponsibility in such matters clearly lingers on.

    I do not wish to cause offence by my opinions but I think as parents we need to be as responsible as possible about our children's health (and that of future generations).

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  4. When the paper was published I was working with the National Autistic Society and I can't count the number of phonecalls from worried and concerned parents panicking about having had their children vaccinated and their plans for vaccination. Our standard response was to back what the government said which was that the combined MMR was safe and that there was no proof otherwise. I believed that at the time and still do. Kieran was vaccinated as will Taylor be.
    I am still angry at the confusion, upset and worry so many parents had to go through due to the irresponsible publishing of the offending paper.

    I haven't seen first hand the results of measles but have heard/read and to be honest- the fresh bouts/outbreaks worry me.

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  5. It was total madness at the time. Madness caused in the main by lazy journalism at the likes of the Daily Mail and the Daily Express.

    The panic was then fueled by the fact that, in many cases, MMR time is about the time Autism manifests/is spotted. Add to that the human instinct to blame someone for what's gone 'wrong' with your child. (In my case, on the rebound I mistook spectrum for strong and silent)

    Boy One, 11, is an Aspie, Two, eight, and Three, 20 months are NT. They all had the MMR.

    Madness illustration 1. The day Boy One was going for his MMR I mentioned it at toddlers. Several of them rounded on me and suggested that to do so was tantamount to abuse. I was very shaken.

    Madness illustration 2. When Boy Two was to have his MMR Boy One was on his way to being diagnosed. The practice nurse said: "Oh, yes, if Boy One is suspected of being on the spectrum, do you still want Boy Two to get the injection?" This from a nurse!

    I never understood that people were getting single vaccines when there was no further evidence that they were safe/safer. Obv, there was no evidence at all.

    I took great comfort from the fact that every child in the UK and several other large countries was to get the injection. No governments would risk potential legal action of something that wasn't 100 per cent safe.

    Go vaccinate. Herd immunity is the responsibility of us all.

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  6. @Jen: Thanks for commenting Jen. I agree about the genetic link and when you have your first you have nothing to compare their behaviour to. x

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  7. @Mid30's: What a horrendous thing to witness. Thanks for commenting. xx

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  8. @Ap: I agree with Mid 30's sentiments. Another factor that prompted this post was that we now live in different area from where we lived when A was immunised and I was shocked to find out that immunisation rates are low in this predominantly Middle Class suburban area.

    I welcome your opinions and am grateful that you shared them with us. That was my purpose for posting. xx

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  9. @Nikki: How interesting! The NAS is a wonderful resource for all these types of questions. Fresh bouts worry me too and regularly keep an eye on things. Thanks for commenting. xx

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  10. @Ellen: I was waiting for your response given your career! I identify with your madness illustrations and have experienced both of them again this week. At a local mother and toddler group, people are actually organising a day trip to Glasgow to get the single vaccines despite the NHS' advice regarding the effectiveness of the single doses. Thanks for commenting. xx

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  11. When it was time for my daughter to receive her vaccination I discussed with my husband what we should do. As an ex-biochemist I was quite prepared to believe that the vaccine MAY possibly have caused the autism in the small sub-group of the population studied, while causing no problems at all in the vast majority of cases. The problem in that situation lies in not knowing which group your child falls into until it's too late. Therefore, as our daughter is and always has been the healthiest person I know we felt that the risk from her catching measles or mumps (or giving it or rubella to someone else) was a lot greater than any potential and minute risk from the vaccine. If she had been a very sickly child our decision might have been different, but it proved to be correct, as she suffered no ill effects.

    I agree that the main problem appears not to have been the research itself but the media's reaction to it.

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  12. @Angela: Thank you so much for your comment. We thought the same regarding the measure of risk. xx

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  13. When I had my 3 children, I did not think twice about having them vaccinated. My middle child (12 old boy) is autistic but his symptoms were evident from birth. It appears that autistic disorders have been in my family for generations so for us it is genetic. However, if I was a mum about to vaccinate now, I would still do so but I would want to be better informed/advised than I was many years ago particularly in view of my family's tendency towards allergies. One area of research I would like to see is in the area of allergies, bowel disorders and autism since there appears anecdotal evidence to suggest a link. It looks like I do look to science but good science that is not distorted by the media.

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  14. Scientists such as Wakefield have a societal responsibility to be thorough and beyond reproach. I fear Wakefield lost sight of this. However it was, as you say, the reaction to it which caused the most damage. Certain sections of the press and some celebrities jumped on this issue as an illustration of the tyranny of the nanny state. They don't have to produce fact-based evidence; theirs is all emotive and subjective and won't be tested.
    The fact is, MMR uptake is at levels below which WHO say is required. Untold damage has been done by Wakefield and his supporters.
    Both my children were given MMR in the early 2000's.

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  15. Oh Mammy, I'm shocked and saddened to see the madness continues. I thought it was over. I wasn't aware of it with Boy Three because I took the policy decision to avoid all forms of mums and toddlers madness!

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  16. @Aspie: I agree with you regarding the research. Thanks so much for commenting and I look forward to catching up with your blog soon. x

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  17. @HUN: Thanks so much for commenting. We are still seeing the fall out from the reaction here and a surprising number of parents are not aware of the recent turn around.

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  18. @Ellen: I am just as shocked as you are. Coming from an area where people favour the just enough parenting model to one where Tiger Mothers roam freely, I would have thought that vaccination rates would be higher. My insider info tells me that the rate is well below that needed for herd immunity!

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  19. I too was worried about possible links between MMR and autism. For me though, as my son has a medical condition that means that an infection of measels could have severe reprecussions there was no question of him not having a vacination, rather an issue on whether he would have a single jab privately or the MMR.

    Before I had my son vacinated, I did some research and came to the conclusiion that measels was a definite risk and any link between MMR and autism was, at best, unproven.

    I agree the issues are complex. The role of the media is particulalry interesting.Whilst not wishing to underplay the damage the MMR scare has done to the take up rate of vacinations (the risk of measels is a known certainty)I also think we should be wary of dismissing parental concerns too quickly.

    Why do we feel this way about the (medical) establishment? Why are we so willing to subscribe to conspiracy theories? I must admit, the Government denials reminded me of the Mad Cow Disease scare and those truly awful pictures of John Selwyn Gummer gaily feeding his daughter a hamburger (there's now a vicious internet rumour that he got a civil servant to bite into the burger first).

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  20. Thanks so much for commenting Sarah. It is really interesting to hear everyone's personal opinions and experiences.

    I wish we didn't need to be so skeptical in this age in the first place but then perhaps that shows how much we have evolved?

    xx

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Thanks for taking the time to comment!