Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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A plague on both your houses: come clean!
- Harry Hall (24 June 2009)
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Adverse reactions to vaccines are well known
- Lisa C Blakemore-Brown (26 June 2009)
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Trust and fiscal partiality
- Mark Struthers (26 June 2009)
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Before criticising other people do your own research
- John Stone (26 June 2009)
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Vaccines: Pro & Con
- Hugh Mann (27 June 2009)
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Half-Truths and Baloney.
- Bill Welsh (28 June 2009)
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The origins of antivaccine activism
- Peter J Flegg (28 June 2009)
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Re: Vaccines: Pro & Con
- Michael D Innis (28 June 2009)
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Re: The origins of antivaccine activism
- Lisa C Blakemore-Brown (29 June 2009)
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Re: The origins of antivaccine activism
- John Stone (29 June 2009)
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Bogus medical history
- T Vemmer (29 June 2009)
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The origins of antivaccine activism
- Isabella Thomas (30 June 2009)
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A plea for a balanced discussion on immunisation
- Richard T Halvorsen (30 June 2009)
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He has a right to criticise who has a heart to help!
- BM Hegde (1 July 2009)
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Measles, the death penalty and how the vaccine wars are fought
- Mark Struthers (1 July 2009)
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Bilateral Folly
- Richard J Primavesi (1 July 2009)
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Re: The origins of antivaccine activism
- Peter J Flegg (7 July 2009)
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How accurate are papers data even when totally “honest”?
- John Fryer (7 July 2009)
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Re: Re: The origins of antivaccine activism
- Lisa C Blakemore-Brown (8 July 2009)
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The arrogance of the vaccine policy maker
- Mark Struthers (8 July 2009)
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Re: Re: Re: The origins of antivaccine activism
- Peter J Flegg (9 July 2009)
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Re: Re: Re: Re: The origins of antivaccine activism
- John Stone (10 July 2009)
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Vaccine expertise: the good, the bad, and the downright ugly
- Mark Struthers (10 July 2009)
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Harry Hall, Retired physician EX1 2HW
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It's a shame that the polarisation has become so absolute that neither side dare admit that the other's case has any merit. I have some reservations about the so called side of the angels- ie, science, overall benefit to children, etc mainly because of an experience I had some years ago when I tried to extract from the Dept.of Health information about the efficacy and side effects of the current influenza vaccine. Working up through my GP, local public health consultant, dept of health, medicines control agency, and Prof. Salisbury himself I was unable to obtain the relevant figures. Various reasons were given but it was clear that commercial confidentiality was the excuse. I think if such figures, that is showing actual experience, with sources, numbers and statistical applicability were freely available about the current vaccine it would go a long way to relieving anxiety about its suitability or not. Indeed, anything less than this is really not on, especially if compulsion is entering the equation Competing interests: None declared |
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Lisa C Blakemore-Brown, Psychologist UK
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Everyone working in public health knows that there are adverse reactions to every drug and vaccine that's ever been manufactured. These reactions are multiple and have been studied by medics for decades. What is shocking is that instead of admitting this, extraordinary efforts have been put in place to damn those who dare to mention them, including the innocent parents who took their child for vaccine and watched them react. Ms Coombes, sad to say, joins the ranks of the establishment who will do anything rather than admit that sometimes vaccines cause adverse reactions to some people. That includes blaming the parents and hounding them to their own graves. It is helpful and timely that Ms Coombes has picked up the Trinidad and Tobago case from The One Click website. The baby in question had a nose bleed following vaccine before he died. This is not an isolated incident following vaccine. A glance at VAERS reveals that there have been over 350 reports relating to people of all ages (so not just children before Ms Coombes blames Barbara Loe Fisher for directing parents there} who have suffered from Epistaxis following vaccine (amongst other things). What is tragic is that, of the infants who reacted in this way, many died, compared to just one reported death amongst older people. Clearly those infants could not cope with the assault on their vulnerable systems. Surely, instead of turning their backs on these children, "science" should be establishing why they reacted, not turning blind commercial eyes to them, thus increasing their suffering. Competing interests: None declared |
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Mark Struthers, General Practitioner Bedfordshire
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In 1991 the Tory government introduced a target system of payment for GPs to carry out childhood immunisations. And I distinctly remember the very large drop in income that was incurred when a small number of children missed their jabs. The targets and the potential losses certainly focussed the mind and encouraged the GP’s powers of persuasion over wavering or dilatory parents. But congratulations to the Department of Health: the fat financial carrots dangled in front of GPs did absolute wonders for vaccine uptake around the country. But since 1991, where has the concerned parent been able to go for impartial medical advice about vaccines for their children? The well informed parent will have come to understand that the GP’s advice would be very much tainted by financial self interest. And the perceptive GP would have realised that hard won trust between doctor and patient would steadily - and inevitably - leak away. Competing interests: None declared |
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John Stone, Contributing editor: Age of Autism London N22
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Rebecca Coombes' article 'Vaccines disputes' [1] side steps the science and resorts to personal attacks. Yet, Ms Coombes' own mastery of the subject patently lags far behind any of the people she assumes such superiority over. Perhaps I can help her a little. 'A large body of evidence has built up to discredit the decade old Lancet paper that linked the measles virus with irritable bowel syndrome and autism.' Coombes obviously has not read the paper, and does not know the difference between 'irritable bowel syndrome' and 'inflammatory bowel disease'. The paper made no pretence to establish a link. [2] She goes on: 'This includes a 2005 Cochrane systematic review of 139 studies to assess the effects of the MMR vaccine in children, and a 14 year long Finnish study that concluded that the vaccine was not dangerous...The study, which followed 1.8 million people, found that serious adverse events were rare and greatly outweighed by the risks of disease.' Cochrane [3] which selected only 31 of 5000 related studies is riddled with contradictions but in fact condemns the science behind MMR: "The design and reporting of safety outcomes in MMR vaccine studies, both pre- and post-marketing, are largely inadequate." "We were disappointed by our inability to identify effectiveness studies with population or clinical outcomes." So, no scientific basis for either safety or effectiveness. This statement from Cochrane is troubling: "Low risk of bias evidence did not support a causal association with Crohn's disease, ulcerative colitis or autism." bearing in mind that none of the six autism studies included were rated of low risk of bias. They did admittedly favour a study looking at bowel disease (Davis 2001) which, however, was funded and financed by the US Centers for Disease Control, and therefore not remotely independent. Cochrane did not apparently consider the "Finnish study" worth including, it did not collect data for autism or bowel disease, and was supported by MMR manufacturer Merck [3,4]. Coombes writes: "The One Click Group was hostile when I approached them with some straightforward questions. I was directed to another charity and, bizarrely, Peter Fletcher, former chief scientific officer at the Department of Health." However, this is not bizarre at all bearing in mind Fletcher's statements to the Mail on Sunday in 2006 [5]: "A former Government medical officer responsible for deciding whether medicines are safe has accused the Government of "utterly inexplicable complacency" over the MMR triple vaccine for children. "Dr Peter Fletcher, who was Chief Scientific Officer at the Department of Health, said if it is proven that the jab causes autism, "the refusal by governments to evaluate the risks properly will make this one of the greatest scandals in medical history". "He added that after agreeing to be an expert witness on drug-safety trials for parents' lawyers, he had received and studied thousands of documents relating to the case which he believed the public had a right to see." "He said he has seen a "steady accumulation of evidence" from scientists worldwide that the measles, mumps and rubella jab is causing brain damage in certain children." "But he added: "There are very powerful people in positions of great authority in Britain and elsewhere who have staked their reputations and careers on the safety of MMR and they are willing to do almost anything to protect themselves."" Prof Offit's rotavirus vaccine has notched up 136 deaths on the US Vaccine Adverse Events Reporting System in less than 3 years [6], so no clear benefit. There can be no comparison between confirmed cases of measles in 2008 and 1996 when there was little laboratory testing. Notified cases were 5,614 in 1996, as compared with 3,700 in 2007, the last year for which data is available. A quick glance at the HPA table shows that the statement that the death in 2006 was the first for 14 years is simply untrue [7]. So, Coombes has not done her research. What Coombes' article documents is not acccountable science but overwhelming and arrogant hostility towards anyone who reports, or investigates vaccine damage, as manifested by her own attitude to these people. Why is not Prof Salisbury politely listening to us rather than dismissing everything we tell him out of hand? Uncorroborated accusations of intimidation and uncivility are made by Coombes in her article, but what does she think she's doing? We are all being told to go away and not talk like good little children. These are just a few points. [1] Rebecca Coombes, 'Vaccine disputes', British Medical Journal 22 June 2009, http://www.bmj.com/cgi/content/full/338/jun22_2/b2435 [2] Wakefield A J et al, 'Ileal-lymphoid-nodular hyperplasia, non- specific colitis,and pervasive developmental disorder in children', http://www.autismresourceconnection.com/documents/Ileal-colonic- lymphoid.pdf [3] Demicheli V et al, 'Vaccines for Measles, Mumps and Rubella in Children' Cochrane Library 2005, http://mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD004407/frame.html [4] Peltola H et al, 'No evidence for measles, mumps and rubella vaccine-associated inflammatory bowel disease or autism in 14 year prospective study' Lancet 2 May 1998, http://www.freenetpages.co.uk/hp/gingernut/lancet/Finland%20May%201998.pdf [5] Sue Corrigan, 'Former science chief: 'MMR fears coming true'', Mail on Sunday, 22 March 2006, http://www.dailymail.co.uk/health/article- 376203/Former-science-chief-MMR-fears-coming-true.html [6] http://tinyurl.com/3xstxj [7] http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1195733835814 Competing interests: Autistic son |
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Hugh Mann, Physician Eagle Rock, MO 65641 USA
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Vaccines are a mixed blessing. They can stimulate our immune system and generate an immunity to acute disease, but they can also overwhelm our immune system and generate a susceptibility to chronic disease. The question about vaccines is not whether they work; the question is whether the cure is worse than the disease. Are we better off with the artificial immunity that results from vaccines? Or are we better off with the natural immunity that results from the usual childhood diseases of measles, mumps, and chickenpox? Let’s re-visit this question in a calm, objective manner, without polarizing, ad hominem arguments. Competing interests: None declared |
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Bill Welsh, President Autism Treatment Trust, ATT Clinic, 29A Stafford Street, Edinburgh. EH3 7BJ.
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I regularly tell parents of vaccine damaged children that when the infamous Finnish study (1) is quoted in any article as ‘proof’ that the MMR vaccine is unconnected to autism it reveals two things, 1) that the journalist has not carried out the necessary research and 2) that the article itself will likely be festooned in government half-truths and baloney. “Vaccine Disputes” by Rebecca Combes offers splendid confirmation of this theory. Firstly we can forget Sir Sandy Macara’s BMA debate on introducing mandatory vaccination, it is an exercise in kite flying, a ploy to re- affirm the establishment position re MMR (as safe) while demonstrating that the medical profession is, in the main, of a liberal persuasion (no compulsion). What we cannot ignore however are some of the other statements in the article attributed to Dr David Salisbury, director of immunisation at the Department of Health. He says “Why should I accept it? This degree of personalisation." when referring to the threats he claims he has received. Is this the same Dr Salisbury who has placed himself at the very forefront of government vaccination policy, and made himself the face and voice of MMR by appearing frequently in the media? Surely it is not so surprising that parents, rightly or wrongly, have identified him as the person most likely responsible for their child’s unforgivable MMR vaccine damage? Perhaps if he had remained out of the limelight, as civil servants normally do, he would not be receiving the flack he claims. As the French essayist said: “Fame and tranquillity can never be bedfellows”(2). Another quote: "For some campaigners no study is acceptable if it continues to show no link—you get answers by rote: the study was weak, didn’t look at the right children, didn’t use the right method.” Fact is parents today will not be fobbed off with studies that are designed to dismiss the hypothesis of vaccine involvement. The director of immunisation has been told that the epidemiological studies he uses are actually designed to promote the MMR as safe and unconnected to the upsurge of bowel disease and autism worldwide----not to investigate its role. These epidemiological studies are also inappropriate as ‘safety’ studies. In referring to studies such as these, what is generally meant is that the authors have carried out large-scale population based studies, either by comparing cases (with autism) and controls (no autism) in terms of MMR exposure, or by comparing those exposed and unexposed to MMR in terms of autism or Autism Spectrum Disorder as an outcome. Whilst it is tempting to assume that studies of large populations are somehow ‘better’ by virtue simply of their size, this is by no means necessarily the case. The failure of the population based studies that are frequently cited as supporting the safety of MMR is in their total lack of reference to the original hypothesis formulated by Wakefield. In a presentation at the International Meeting for Autism Research (IMFAR) last year Dr Carol Stott (3) produced evidence to indicate that of over 50 studies claiming to test what can be referred to as the Wakefield hypothesis, only 5 actually addressed it fully, and four of these supported it, at least in part. Of these four, two were clinical studies and two were ‘population’ based. Another significant failing is that whilst population based evidence from case-control or cohort studies might indicate a possible association between two or more factors – and to some extent be used to indicate causality - it can obviously not be applied to prove that in any particular case X did not cause Y. We are also told in Rebecca Coombes article that: "Here (in the UK) vaccine was an individual, narrow, problem; when the science unpicked it, and Andrew Wakefield was in turn unpicked by press, it became very difficult to advance the argument that MMR causes autism.” It is of great concern that the public is being mis-informed that “science has unpicked it” (the original study). It has done no such thing. Let me quote Dr Richard Horton, editor of the Lancet, and one of the architects of the ongoing GMC trial of Dr Andrew Wakefield, Professor John Walker-Smith and Professor Simon Murch: 'The essential clinical findings remain unchallenged as far as their accuracy is concerned' (4). The peer reviewers and other witnesses at the GMC trial have been most praiseworthy of the science, science that could benefit hundreds of thousands of autistic children worldwide. Lest we forget, Dr Andrew Wakefield and his team identified a new form of bowel disease affecting autistic children, an incredible discovery and one that has been lost in the ensuing brouhaha. Another informative quote: "The government did not appease—we didn’t change policies. We did not offer a choice, despite the existence of single vaccines. We had no close links with dissenters." Is this is the language we associate with public health policies? It sounds more like the language of an embattled government fighting Taliban terrorists. The UK is in fact the only country on the planet ever to ban single vaccines. Think about that! The tenor of Rebecca Coombes article suggests that the MMR/bowel disease/autism controversy has dissipated. Nothing could be further from the truth. In the context of issues of public concern this debate has now extended beyond eleven years and understandably the media has wearied. Importantly the parents of MMR vaccine damaged children while living with the reality of a damaged child are faced with a level of opposition previously unmatched---three of the world’s largest pharmaceutical companies, Central government, the medical hierarchy and all combined with a deluge of publicly funded misinformation and propaganda for which the Third Reich would have been proud. And still the issue has not gone away. Over three years ago I opened a clinic in Scotland to assist autistic children and their parents. Never did I expect to see in my lifetime so many British children who had been harmed in such an appalling way. Children who are now non-verbal, unable to concentrate, often in considerable distress and pain, with gastro-enterological problems (bowel disease, reflux etc) and all with autistic symptoms plus much more. Many of these defenceless children have been abandoned by the state, disenfranchised from gastro-enterological services and treatments, and all because they had the misfortune to take ill following MMR vaccination. They are a living contradiction of the government mantra that MMR is safe and unconnected to bowel disease and autism. They are living proof that MMR is a crude experiment using the world’s most precious asset, our children. They are the reason that this issue will never be allowed to go away. References. (1) Patja A, Davidkin I, Kurki T, Kallio MJ, Valle M, Peltola H. Serious adverse events after measles-mumps-rubella vaccination during a fourteen-year prospective follow-up. Pediatr Infect Dis J 2000;19:1127- 34.[ISI][Medline] (2) Michel De Montaigne. Essays. (1580-88).Bk 1, ch. 39. (3) A novel form of Inflammatory Bowel Disease (IBD) with Pervasive Developmental Disorder: A Systematic Review of the state of the evidence" Poster Presentation, IMFAR, London 2008”. Stott CM. (4) Personal communication with Dr Carol M Stott. Competing interests: Grandfather of an MMR vaccine damaged boy. |
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Peter J Flegg, Consultant Physician Blackpool, FY3 8NR
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Rebecca Coombes has written a succinct and superb summary of the efforts of the antivaccination lobby to decry the scientific evidence about MMR’s benefits and risks. But it fails to explore the question as to why the various groups have resorted to the tactics they have. Since the days of BSE (and probably before) there has been an unfortunate but understandable distrust of the Public Health diktats handed down to us by those in authority such as the Department of Health. Regarding MMR, parents preferred to believe the worst, thinking they were acting in the best interests of their children (when in fact the opposite was true) and little was done at the time to prevent this. It is hardly believable to realise that in 2002, based purely on unevidenced, media- generated froth about MMR causing autism, one in four parents believed that “The weight of scientific evidence supports a link between MMR and autism” (1). One could hardly find a more sobering indictment of the failure of those in authority to effectively counter baseless scare- mongering about the vaccine. It is no wonder that some parents (particularly those unfortunate enough to have an autistic child) and activists who bought into the propaganda about autism/MMR felt strongly enough to set up campaign groups and to promote their own brand of vaccine “science” of the sort that comes courtesy of the University of Google (with no medical expertise necessary). Eleven years after Andrew Wakefield’s now discredited paper was published, there has been no replication and not a jot of properly validated scientific evidence to support their claims, and they see their arguments progressively slipping away from them. Mired in the cognitive dissonance of unreason, it appears that many of them find it difficult to respond in a measured manner, and the result has been the vilification of the scientists and doctors who have done nothing but put children’s best interests first. Rebecca Coombes’ piece paints a very graphic picture of what it means today to be someone who is prepared to stand up and be counted as a proponent for vaccination. Respondents such as John Stone have misinterpreted her article completely. It is not intended to be a scientific investigation into the risks of autism from MMR; science has already spoken on this point, and the vaccine is completely exonerated. Instead Coombes’ article does exactly what it says on the box, namely “investigates the role played by the antivaccine lobby”, and it does so brilliantly. Stone does some nit- picking over wording, trots out his usual canards and cherry-picks quotes of his own, but comes nowhere near to responding to the thrust of Coombes’ expose. Instead he says she makes “uncorroborated accusations of intimidation and uncivility” by antivaccinationists towards doctors. I am surprised Stone calls these accusations “uncorroborated”, since I know he has seen these for himself in the past on the JABS forum where he has been a regular poster. If his memory is still lacking, I would be glad to provide links to the relevant archived webpages. For those wishing to read a further exploration of the vaccine/autism story as it unfolded in the United States, might I recommend this article on the “Vaccine Autism Wars” (2). (1) http://www.comminit.com/en/node/177710 (2) http://www.plosbiology.org/article/info%3Adoi%2F10.1371%2Fjournal.pbio.1000114 Competing interests: None declared |
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Michael D Innis, NA Home
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Gone are the days when all the kids in the neighborhood were invited to a party if one of them had measles or mumps or chicken pox. In those days the HLA system was trusted to take care of the virus and it usually did - I know because my children were party goers. But now, as John Stone , Mark Struthers and Lisa Blakemore-Brown have pointed out the children must take their chances with MMR - and hope for no adverse reactions. A bit of advice from Alan Clemetson and Archie Kalokerinos - always give the child vitamin C before immunization and never immunize an unwell infant. Competing interests: None declared |
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Lisa C Blakemore-Brown, Psychologist UK
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Dr Flegg. Here's a simple question - have there ever been adverse reactions to vaccinations? Competing interests: None declared |
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John Stone, Contributing editor: Age of Autism London N22
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Perhaps Peter Flegg can advise on the correct medical course if a parent reports an adverse reaction to vaccine followed by ill-health, mental regression or death. Or, perhaps he would simply advise re- education? Perhaps he could also tell us whether adverse reactions to vaccines should be carefully monitored (because I can assure him they are not). Meanwhile, I think he should be troubled by the factual inadequacies in this article, and the prejudicial tone. Hard, of course, to argue with someone who uses such maniloquent phrases as "science has already spoken on this point". Evidently, Peter Fletcher was not so convinced: http://www.bmj.com/cgi/eletters/329/7472/939#80961 http://www.bmj.com/cgi/eletters/329/7472/939#81928 But, then, Rebecca Coombes did not interview him, did she? Competing interests: Autistic sone |
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T Vemmer, Consultant Pain Physician Montagu Hospital, S64 0AZ
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Rebecca Coombes puts the wrong disease in the explanatory parentheses: << They look at these black and white photographs of children [with tuberculosis] in an iron lung, ...>> That should have been polio, surely. Hope the rest of the article is better researched. Competing interests: None declared |
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Isabella Thomas, Parent Somerset BA3 4TE
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Could Dr. Flegg give evidence on his quote 'Andrew Wakefield’s now discredited paper was published? How was it discredited? That paper was about bowel problems in Autistic children and still stands unless Dr. Flegg knows better. Dr. Flegg should listen to parents who are on the front line of vaccine damage when it happens. The 'high pitch screaming' within hours of MMR vaccine etc. It is so very easy to call parents of vaccine damage children as 'anti- vaccine' when we DID give our children their vaccines. We are responsible parents. Who is responsible for the children when they are sick? Who is responsible when children become 'brain damaged'? Who is responsible when something goes wrong with a vaccine? Doctors like you talk the talk but do NOT know anything about our children or are bothered to find out the 'hell' our children are going through. All you are fixed on it that any talk of vaccine damage and there is a panic that all parents would stop vaccinating their children. We all believe is 'safe' vaccines but our children should NOT be the 'sacrifice' of the many. What would you do if it was one of yours? Competing interests: Two vaccine damaged children |
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Richard T Halvorsen, GP WC1N 3NA
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Any hope for a rational discussion on the benefits and risks of vaccination
was not helped by Rebecca Coombes' less than objective critique of what she
refers to as the "anti-vaccination lobby".[1] I, too, deplore personal attacks
that are made on Paul Offit, David Salisbury or any other enthusiastic
proponent of vaccines. But I am also concerned when I hear that those who
simply question the value of vaccines, like many of the parents I meet every
week in my immunisation clinic, have been patronized and bullied into
vaccinating their children by my fellow health professionals.
Any discussion about vaccines is liable to get heated - on both sides of the debate; and that's a great shame because it prevents us from having the open, honest discussion that this important subject demands. Those who speak determinedly in favour of vaccines are just as much to blame as the "anti-vaccination lobby". In the same edition of the BMJ, Iona Heath challenges the benefits of breast screening and the one-sided propaganda that is put out to encourage women to have their mammograms.[2] Many of Dr Health's arguments could equally apply to vaccination. In particular, she quotes David Sackett's description of the arrogance of preventive medicine, of which immunisation must be the pre-eminent example. "Preventive medicine displays all 3 elements of arrogance. First, it is aggressively assertive, pursuing symptomless individuals and telling them what they must do to remain healthy . . . Second, preventive medicine is presumptuous, confident that the interventions it espouses will, on average, do more good than harm to those who accept and adhere to them. Finally, preventive medicine is overbearing, attacking those who question the value of its recommendations." All 3 elements apply to immunisation. There is an arrogance amongst some doctors that doubters simply need to be told "the facts" to be persuaded of the clear and overwhelming benefits of immunisation. I have spent much time studying "the facts" in the form of published peer-reviewed research papers. These, in general, do demonstrate the benefits of vaccines, but these benefits are usually less than widely claimed, the risks greater than admitted, and the diseases that vaccines aim to prevent often less serious than portrayed. The disease Ms. Coombes mentions most in her feature is measles, a disease that can be serious and fatal. However, when I was a child, in the 1960s, we all caught measles and certainly did not live in fear of it. A BMJ editorial of 1963, prior to the introduction of the single measles vaccine, whilst asserting the need for the vaccine in underdeveloped countries, stated, "But the need or desire for a vaccine for the general population of Great Britain is much les certain. Measles is now a mild disease, and many parents and doctors may feel that no protection against it is required."[3] It is true that during that period between 50 and 150 people died every year from measles (many of these suffered form chronic health problems, for whom the case for immunisation was stronger), but these figures must be balanced against the evidence that catching measles prevents allergic disease - including asthma, which kills over 1,000 people every year in the UK.[4] The case for vaccination needs to be put in perspective. And why are we immunising the whole population against mumps when a 10-year survey of 2,482 of the most serious cases of mumps (those admitted to hospital), found just five cases of long-term complications - of deafness due to involvement of the eighth cranial nerve? The authors concluded, "It seems clear from the results of this survey that there is little need for general vaccination against mumps."[5] Just as with breast screening, the current public health message is unequivocally in favour of vaccination and never puts the counter argument. Ms Coombes' assertion that JABS is "anti-vaccine" is incorrect. Indeed the JABS web site clearly states this. And yes, the JABS web site does still maintain - correctly - that "some children have and will continue to be damaged by combined and single dose vaccines." If this were not the case, the UK Vaccine Damage Payments Unit would not have paid out 1367 vaccine damage awards between 1978 and 2005. It is an unspoken truth that mass vaccination programmes necessitate sacrificing the few to protect the majority. Those who question the benefit of mass immunisation are not all irrational non-believers. Most support vaccination but are concerned at - and question the necessity for - the large number of vaccines and the early ages at which these are given. Many have studied the research, only to find - as I have - contradiction and uncertainty. They deserve to be treated with respect and given the opportunity for an open and honest debate. [1] Coombes R. Vaccine Disputes. BMJ 2009;338:1528-31. [2] Heath I. It is not wrong to say no. BMJ 2009;338:1534. [3] Anonymous. Vaccination against measles. BMJ 1963;5360-1. [4] Rosenlund H et al. Allergic Disease and Atopic Sensitization in Children in Relation to Measles Vaccnation and Measles Infection. Pediatrics 2009;123:771-778. [5] Anonymous. A retrospective survey of the complications of mumps. Journal of the Royal College of General Practitioners 1974; 24:552-6. Competing interests: Author of The Truth about Vaccines. Medical Director of BabyJabs children's immunisation service. |
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BM Hegde, Editor in Chief, Journal of the Science of Healing Outcomes. Mangalore-575 004.
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Thomas Kuhn, in his book The Structure of Scientific Revolutions, argued that when the scientific effort expended on a problem increases—yet productivity declines—then the difficulty may lie with the assumptions (paradigms) on which the research is based.” The fight in the name of “science” of vaccination has reached this point with both the sides sticking to their points of view and not willing to understand the opposite point of view. It is time now to question the very hypothesis that vaccinations help always! Measles, a mild disease, is known to give protection against a whole range of allergic diseases including asthma. What will measles vaccine do other than the supposed protection against measles based on statistics? The latter is not pure science, anyway. One could dispassionately compare the disability and death statistics on either side of the fence-measles and the vaccine-primum non nocere. The whole science of immunology is still in its infancy. Let both sides sit across a table and argue without malice to sort this controversy in the best interest of the future generation. If the recipients, the infants, had a say in the matter after getting all the facts from both sides, I feel they would not be too enthusiastic to have the jab! Vaccine protection against a disease hypothesis has many loopholes in it. True protection could come only from a disease. This might have to do with the cell function in individual cells. Our idea of Mendelian inheritance alone might not work as there are significant functional elements out with the nuclear nDNA. They have a significant role in disease and its management. They are the mitochondrial mtDNA. Has the time come to reexamine our ideas of aetiopathogenesis, pharmcodynamics and pharmacokinetics with this backdrop? Blame game should stop and should be replaced by understanding as propounded by the Danish philosopher, Spinoza. Further reading: Douglas C. Wallace. Mitochondria as Chi. Genetics 2008; 179: 727-735. Competing interests: None declared |
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Mark Struthers, GP working in a secure environment Bedfordshire
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It is now forty five years since I fought off measles as a young child. I barely remember the event and my mother vehemently denies having any anxiety over my ultimate survival. Mumps and German measles were innocuous childhood episodes and I survived all three maladies with my faculties relatively intact. But my, how things have changed! Over the years, the anger of the provaccine groups has vastly increased the virulence of the measles virus - through a mechanism of forced antigenic drift amongst others. The diagnosis of measles is now tantamount to a death sentence, or worse. However, to decline the MMR for one’s own child (because science has conferred MMR safety on most, but not all children) is now tantamount to handing down a death sentence on all those other innocents whose parents ‘responsibly’ allowed the vaccine. Competing interests: My rapid response record is testament to the fact that I am vehemently against capital punishment, even for those guilty of vaccine war crimes. My children were lucky survivors of the MMR, with primary doses given in 1988 and 1992 respectively. |
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Richard J Primavesi, paediatrician 11 Devonshire Place W1G 6HT
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Like the author of Spirit on the beehive, Victor Erice I believe a man's name should appear in print on only two occasions in his life - on his birth and death notices - hence I write to you with a degree of trepidation. The “Feature" by Ms Coombes however provokes. I have been giving now single measles, mumps and rubella immunisations to my patients whose parents request it for over 12 years. Indeed it is the only ethical course that I can follow - if I have at my means the ability to protect children safely and effectively from dangerous disease who would not otherwise be protected ( their parents will not give them MMR) then to deny them this protection - as many doctors do is clearly unethical. I issue the usual caveats that their child will remain at risk from mumps and rubella until these vaccinations are given (I give measles first because this is the most serious.) I used to say that there was no evidence that the vaccines were safer in terms of side effects when given singly ( the books - which are wrong, say that there is a 1/1000 risk of a febrile convulsion following single measles or MMR immunisation ) - nor was there evidence to suggest that the vaccines were more effective when given singly. I now counsel parents that the vaccines are safer when given singly - my own results over a 12 year period _ no hospital admissions within 3 weeks in any child being immunised - despite immunising an "at risk" group _ those with other medical conditions, a personal or FH of febrile convulsions, adverse reaction to previous vaccines or multiple allergy. They are also a little more effective in terms of inducing antibody response. Both these observations have been presented in front of my peers and abstracts published. They are also available on my website www.healthychild.co.uk. Rebecca Coombes' article makes much of the outlandish claims of the anti vaccine lobby but also -inadvertently quotes the now notorious Finland Study which was once championed by the pro immunisation lobby because it was a country wide study involving 4 m children who had MMR and no cases of autism were discovered .This was very impressive until you learnt that there were no cases of autism in Finland before MMR was introduced. It is now nolonger championed. What parents need is an honest opinion and I know they feel that find that increasing difficult listening as they do to two groups who are either fervently behind (and profit from - immunisation) or those who, very often because of ghastly personal experience, rightly or wrongly attributed to vaccine administration, are feverently against. What we need to say to parents is that giving the MMR is not without its dangers but is safer than not immunising. These dangers can be to a great extent be eliminated by giving the vaccines singly. There was not a problem when the single vaccines were available on the NHS - and indeed vaccines when given are invariably more effective than when not. The old adage that parents will "forget or pick and chose" has not been my experience. Indeed I have given many of my patients BCG and chickenpox immunisation neither of which are generally available on the NHS. And yes I am one of those few unspeakables (and probably inedibles) who have relinquished my NHS responsibilities to follow a self enriching career in private practice. Yours sincerely Richard Primavesi FRCP FRCP(CH). Competing interests: None declared |
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Peter J Flegg, Consultant Physician FY3 8NR
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Isabella Thomas is quite correct, I don't have first hand experience of the "hell" an autistic child or their family goes through. But that fact hardly disqualifies me from having an opinion on an alleged autism/vaccine link anymore than not seeing a child die from measles disqualifies her from having opinions on vaccination. However if she would like to know the opinion of a doctor who has walked in her shoes, might I suggest she looks at what Dr Michael Fitzpatrick (author of the book "MMR and autism; What parent's need to know" and the father of an autistic child) has to say on the matter (1). Apart from his incisive comments about vaccines and autism, she might like to know that as long as 5 years ago he also pointed out the abuse doctors have had to suffer at the hands of those who campaign against MMR and who support Dr Andrew Wakefield(2): "It seems that the vociferous and well-organised group of parents supporting the Wakefield campaign have effectively intimidated many of the prominent authorities in the field. The consequence of appeasing these parents have been serious. ...While Dr Wakefield has been lionised in the press and on television, these doctors have been subjected to scurrilous personal abuse, particularly through the internet. They include community paediatricians Brent Taylor, David Elliman and Helen Bedford, vaccine specialists Elizabeth Miller and David Salisbury, and, from the world of autism, Christopher Gillberg and Eric Fombonne." Regarding the "discrediting" of the Wakefield Lancet paper, I really don't want to open up that particular can of worms in any depth as it's not really the subject of this particular debate. Suffice to say there are issues about significant conflicts of interest, allegations of serious professional misconduct relating to the study (currently under GMC review), allegations about data manipulation, questions about misrepresentation of bowel biopsy results that formed the cornerstone of the paper's claims, the revelation that Wakefield knew the bowel samples did not contain any measles virus RNA, the retraction of the interpretation of the paper by 10 of Wakefield's co-authors, and a statement from the then editor of the Lancet that the paper was "fatally flawed" and should never have been published. But that aside, the paper itself when judged entirely on its own scientific merits fails to make the grade, as Professor Trish Greenhalgh explains (3): "In conclusion, the Wakefield study was scientifically flawed on numerous counts. I am surprised that neither the editor nor the reviewers spotted these flaws when the paper was submitted. Had they done so, the public would have been saved the confusion and anxiety caused by false credibility conveyed by publication of the study in this prestigious journal." Finally, it would seem that Dr David Salisbury is fully justified in complaining about veiled threats that capital punishment would be appropriate for him, when one can read Dr Struthers implying vaccination proponents are “guilty of vaccine war crimes”. Is it any wonder that some activists overreact when they read such inflammatory comments? If Dr Struthers uses such language in relation to the administration of vaccines, I must imagine he wrestles mightily with his conscience as a GP whose job it is to recommend children get MMR. Then again, perhaps he doesn’t advise it. Maybe he could enlighten us. (1) http://www.spiked-online.com/index.php?/site/issues/C30/ (2) http://www.spiked-online.com/index.php/site/article/1855/ (3) http://briandeer.com/mmr/lancet-greenhalgh.htm Competing interests: None declared |
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John Fryer, Retired Chemist France 22100
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How accurate are papers data even when totally “honest”? Two studies or countries studies used to support the hypothesis that vaccines and autism are definitely not related are Denmark and Finland. One Finnish study talks of 5 serious adverse effects per 100 000 while a Denmark paper shows nearly 20 000 episodes of convulsions alone from less than 500 000 children vaccinated. Does this mean that a “convulsion” after a vaccine is not a serious event? Denmark admits to 1 autism in 2 200 which of course changes with time. The Finnish study proclaims no autism after vaccines and some take this as no autism at all in this country. The national statistics for Finland separately shows autism here at 1 in 719 children again subject to change with time. Diabetes also is noted to have exploded in Finland. Along of course with increases in vaccinations. As we learn from the death of Harry Clark six hours after a vaccine it proves nothing. But how do you expect to find adverse events if you write them out of a study? In Finland, convulsions mean "nothing" after vaccines, so 19 975 are effectively put down as “trouble makers” if they report their child for having a convulsive fit after a vaccine? Or are the figures from this study totally useless to decide anything? One lady who went to Dr Wakefield complained of a convulsion after an MMR vaccine. Unfortunately the child died before anything could be done. The amount of work to show that particular vaccines were given to this child even before trying to link, associate or prove causality is enough to put off most people from doing more than grieving for a lost child not harmed by their trusted doctors. The Finnish studies are nearly always supported by Merck and after counter papers put out by Dr Wakefield but again that's just association, temporal and proves absolutely nothing. Competing interests: None declared |
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Lisa C Blakemore-Brown, Psychologist UK
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Such a lengthy reply - yet no answer to my simple question directed at Dr Flegg Have there ever been any adverse reactions to vaccines? His silence speaks volumes. Competing interests: None declared |
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Mark Struthers, GP Bedfordshire
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David L Sackett, a retired Oxford University epidemiologist, is one of the very big cheeses of ‘evidence based medicine’ and a man of obvious independent thought and integrity. Of course, David Sackett is well aware that epidemiology is a very inexact science when it comes to nailing the causes of disease and the real truth behind preventing ill-health and extending life. Epidemiological studies can only provide hypothesis generating evidence. Andrew Wakefield’s small case series published in the Lancet in 1998 only generated a hypothesis that MMR might be linked to bowel disease and regressive autism in a subset of genetically vulnerable children - a link that science is yet to disprove. However large or well designed, observational studies have a fundamental limitation – they prove absolutely nothing - they simply cannot determine the cause - or provide proof that one event is the cause of another. In August 2002, David Sackett referred to the preventionists as ‘presumptuous’, aggressively assertive’ and ‘overbearing’ in the way these medical “experts” arrogantly attacked those who questioned the value of their recommendations. [1] So who are the villains, asks Sackett. Who is to blame for the widespread application of “preventive” interventions that cause “disability and untimely death?” Sackett blames the medical “experts” “who, to gain private profit (from their industry affiliations), to satisfy a narcissistic need for public acclaim or in a misguided attempt to do good, advocate "preventive" manoeuvres that have never been validated in rigorous randomized trials.” And Dr Sackett finishes his article by saying that, “Experts refuse to learn from history until they make it themselves, and the price for their arrogance is paid by the innocent. Preventive medicine is too important to be led by them.” [1] The arrogance of preventive medicine. David L. Sackett. CMAJ • August 20, 2002; 167 (4) http://www.cmaj.ca/cgi/reprint/167/4/363.pdf Competing interests: None declared |
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Peter J Flegg, Consultant physician Blackpool FY3 8NR
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Lisa Blakemore-Brown asks "Have there ever been any adverse reactions to vaccines?", and says my failure to answer "speaks volumes". Of course vaccines have side effects. These are extensively researched and well documented. I don't know of a single medically trained person who says any different. I ignored the question because (a) the answer has never been in doubt, and (b) I felt it was merely an irrelevant fishing expedition to lead us away from the focus of the review under discussion. Competing interests: None declared |
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John Stone, Contributing editor: Age of Autism London N22
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Peter Flegg is in error. Routinely, adverse reactions to vaccine are not recorded, monitored or investigated. There is only a passive recording system. Official NHS advice is to ignore even severe reactions and come back for further doses. Five years ago (almost to the day) I posted on MMR the Facts advice to this effect in BMJ Rapid Responses [1] which remains unaltered on-line with one or two temporary adventures[2]: "Q:My son had a sever [sic] reaction to the first MMR jab. Does this mean that he is well protected from these diseases, or is a second dose still necessary? "A: If a child has responded to all the components of the vaccine the first time, he will not have a problem being exposed to the viruses again. It’s like any one of us who is already immune meeting someone with the disease – the infection can’t get established. If he hasn’t made protection to all three diseases after the first time, then he would still be susceptible to those natural infections, and still needs the 2nd dose. Reactions after the 2nd dose are essentially the same as after the 1st dose, but if they do occur they are even rarer. There are no new side effects after the 2nd dose that do not occur after the 1st dose. The advice is therefore that it is safe for your child to have the 2nd dose in order that he is properly protected." The advice was taken down for a brief period of months in late 2004 early 2005, and then early last year a line was added that you might want to consult your doctor in the event of a severe adverse reaction, but it was changed back again shortly afterwards. If you had rung your doctor you would probably (in my experience) have been given the bad tempered suggestion that you might want to give your child some Calpol but to stop making a fuss. The advice is unambiguous evidence that recording of such events is pre-empted as a matter of policy and the data simply never collected: and almost certainly this goes for the entire schedule, not just MMR. The absence of data is then cited as evidence of safety. The DH and the NHS have had every opportunity to amend this folly but they simply persist and demonstrate their arrogance and recklessness. [1] http://www.bmj.com/cgi/eletters/329/7456/0-g#65971 [2] http://tiny.cc/7vA7g Competing interests: Autistic Son |
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Mark Struthers, GP Bedfordshire
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“But I do not regret publishing the original Wakefield paper.” So said Richard Horton, esteemed editor of the Lancet in his book ‘Second Opinion, published by Granta Books in 2003. [1] In this excerpt, Dr Horton went on to say, “Creating the conditions for a resurgence of measles is bad medicine. Or is it? Good medicine, by this definition, means forcing families to immunize their children with the MMR vaccine. Fortunately, we do not yet live in a police state where public health doctors dictate what we can do (exercise and eat fruit) and what we cannot (smoke and eat burgers), even if their advice is wise and reasonable. If one of the results of freedom of choice is an adverse outcome for the public’s health, that is a regrettable but necessary consequence of our democracy. The responsibility rests with public health experts to educate and to persuade with understanding and compassion - not to berate with anger and frustration.” And then Dr Richard Horton finished by saying, “The MMR vaccine paper was published not because peer review indicated that the findings were true - peer review can never prove truth, only indicate acceptability to a few experts, as was indeed the case with Wakefield’s findings - but because the issue raised was so important for public health and so in need of urgent verification that not to publish with appropriate caveats would, in my view, have been an outrageous act of censorship.” [1] MMR: The Lancet Fiasco. Richard Horton glorifies Wakefield, with "no regrets" over discredited MMR paper. http://briandeer.com/mmr/horton- wakefield.htm Competing interests: None declared |
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