Horizon: Does the MMR Jab Cause Autism?

I found Dr MacAuley's review of the Horizon programme very
interesting, though as I live in Dubai I obviously have not had an
opportunity to see it and cannot comment on its content. However, Dr
MacAuley expresses curiosity as to why the pregramme's producers chose to
do this story now.

The timing may have had something to do with the release of a book
entitled “Evidence of Harm” – Mercury in Medicines and the Autism
Epidemic: A Medical Controversy by David Kirby, a review of which was
published here recently (Gulf News Friday Review Section, May 27, 2005).

The author, who is also a journalist, interviewed several parents of
autistic children who formed an organisation called Coalition for Safe
Minds. The group believes that it is the use of the mercury-based
preservative, thimerosal, that is the root cause of what is described as
an “autism epidemic”.

According to the review, Kirby does point out that in May last year,
a committee from the Institute of Medicine found no causal relationship
between thimerosal-containing vaccines, or the MMR vaccine, and autism.

Competing interests:
None declared

As an SHO in Paediatrics at a DGH, asking the parents of unwell
toddlers and small children about immunisations, I am frequently told
things like, “We read up on it and decided not to give the MMR,” “It’s
herd immunity anyway,” or “His brother got ADHD so we thought we’d better
not give him MMR.”

I find I have to remind myself of some simple received wisdom, before
advising parents to reconsider, or discuss the matter with their GP,
irrespective of whether Autistic spectrum following on from MMR is a case
of ‘post hoc ergo propter hoc’ (it follows it and therefore is because of
it). These are succinctly put by Prof Dick Heller of Manchester
University:

The prevalence of autistic spectrum disorders is 91/100 000 children.
(Roberts R. MMR vaccination and autism. BMJ 1998; 316: 1824).

If as many as 15% of these children had autism as a result of the MMR
vaccine, 7326 children would have to be vaccinated to "produce" one child
with autism.
On the other hand, for measles alone, death rates are 1-2 per 1000
infected people in the U.S. and that 1 in 1000 will get encephalitis (and
some of these will have permanent brain damage). (Watson JC, Hadler SC,
Dykewicz CA, Reef S, Phillips L. Measles, mumps, and rubella vaccine use
and strategies for elimination of measles, rubella, and congenital rubella
syndrome and control of mumps: recommendations of the Advisory Committee
on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 1998; 47(RR-
8): 1-57)

If most children who were not vaccinated developed measles,
complication rates suggest that discontinuing vaccination would do
considerable harm, that would far outweigh any possible benefit from
reducing the incidence of autism. (Tom Heller, Dick Heller, Stephen
Pattison, and Tom Heller, Ethical debate: Dealing with uncertainty BMJ,
Oct 2001; 323: 838 - 840.)

Sincerely.

Competing interests:
None declared

Dr MacAuley, in his review of the BBC Horizon programme, Does the MMR
Jab Cause Autism? [BBC 2, 29 May at 9 pm], repeats what I assume was the
programme‘s determination, “…there was nothing in the MMR and autism story
and many children have suffered unnecessarily from the outcome of the
widespread publicity.”

He also states, “But, I should confess, there was still a tiny voice
in the back of my mind wondering if there might still be a grain of truth
in the story about a suggested link between autism and MMR”.

It is interesting that a GP will admit to a lingering doubt and that
he finally disposes of that doubt on the basis of watching an Horizon
programme.

His final paragraph states, “We have come full circle now, and
immunisation rates are creeping back up. But it is neither scientific
papers nor medical journals that have made the biggest and most lasting
impression. It is witnessing the suffering of others, and our emotional
response to illness. Mums and dads are more likely to have their children
immunised if they see what happens when others are ill.”

This witnessing of suffering presumably alludes to graphic images of
children who have contracted some of the diseases from which they might
have been protected had they been vaccinated against them. I suspect that
the only serious outcomes from non-vaccination would be through infection
with measles. Mumps and Rubella in children are unlikely to produce images
that would be considered graphic enough for TV.

Ironically, he uses his vision of how parents might react by
referring only to the vision of reality when disease strikes. He seems to
forget that many parents have also witnessed the real life experience of
seeing children who have had a severe reaction to vaccination, and this of
course extends beyond MMR.

He should consider that for many years the medical profession
consistently refuted the idea that the DPT vaccination could cause brain
damage and its consequent disability. In addition he should reflect that
government has paid out sums as ‘awards’ to over a thousand children who
have been damaged by vaccines.

The world might have moved on and there are more topical medical
controversies, but this story of the MMR vaccination and its problems has
not been concluded.

Competing interests:
Father of a vaccine-damaged daughter.