The private clinics that advertise unlicensed measles jabs
BMJ 2013; 346 doi: https://doi.org/10.1136/bmj.f2830 (Published 01 May 2013) Cite this as: BMJ 2013;346:f2830
All rapid responses
The Advertising Standards Authority have now upheld my and others complaints against the Childrens' Immunisation Clinic. http://www.asa.org.uk/Rulings/Adjudications/2013/8/Childrens-Immunisatio...
Competing interests: I am the author of the original article
Anita Leedham thinks that MMR is safe for most, though presumably not for all people. Dr Margaret McCartney says that MMR is "safe and effective", presumably for everyone.
Robert Fletcher, now 18 years old, was eventually made a 'derisory' compensation award after being injured by the MMR as a 13-month old child. At the time of the award, The Telegraph reported [1],
"The Department of Health denied any link between his disabilities and the controversial jab, but a medical assessment panel ruled last week that Mr Fletcher became severely disabled as a direct result of the MMR."
The Telegraph report finished with the Department of Health saying,
“The safety of MMR has been endorsed through numerous studies in many countries.”
Who is safe with the MMR?
Was the MR vaccine safe for Christopher Coulter? Christopher was 15 years old when he died in the night, having allegedly had a fit, ten days after vaccination. The vaccine was part of a national immunisation programme implemented by the Department of Health.
One of the government's expert witnesses at the Vaccine Damage Appeal Tribunal Hearing last year was Professor David Salisbury, Director of Immunisation at the Department of Health, the person responsible for the national immunisation programme.
Professor Salisbury apparently acknowledged "the “well known but rare” association between the measles vaccine and febrile convulsions in young children but that he went on to state “such seizures do not occur in previously neurologically normal vaccinated fifteen year old adolescents”". [2] Anne and Harry Coulter lost their appeal.
Who is not safe with the MMR? Do senior officials at the Department of Health know the answer? Is Anita Leedham right to trust our public health authorities with the health of the nation? Are we safe in their hands? I think not.
[1] Blake H. 'Man disabled by MMR vaccine awarded £90,000 after 13-year fight' The Telegraph, 30 August 2010.
http://www.telegraph.co.uk/health/healthnews/7970315/Man-disabled-by-MMR...
[2] Kathryn Torney. Another rejection but parents maintain vaccine is linked to their son's death. The Detail, 11 April 2013. http://bit.ly/ZR4UAr
Competing interests: No competing interests
Like many parents, I find it hard to decide whether to go for the MMR. In my case, this is because my own experience suggests that (1) the evidence being used to assess the vaccination may be incomplete; and (2) the medical profession asserts claims with confidence rather too easily, particularly where it serves the public interest.
When my son was 2 years old, I duly took him along for his MMR without any degree of hesitation. Within 24 hours he suffered what was either a reaction or a coincidental “illness”; we will never know which, because the event was never reported to the relevant authorities to be entered as a possible reaction. Our evidence was excluded from the pool. Naturally, we ask ourselves how many other patients’ reports were excluded.
A very brief history of my son’s reaction/illness: severe vomiting starting within 24 hours of the MMR, continuing for around a week; vomiting ceasing but replaced by chronic diarrhoea; lethargy; a series of minor infections and severe drop in blood count.
I do not suggest that there was a deliberate exclusion of our report, but simply that our experience indicates a weakness in the process for determining the safety of the vaccination. Over the next 6 months while the reaction/illness continued, we raised the question of an MMR link on each visit to our surgery and finally to the university teaching hospital where he ended up. No one would consider reporting the possibility of a link and yet no one could offer an explanation of the cause of his “illness”.
So that is the story of incomplete evidence. And why do I believe doctors express confidence too easily?
Again, each doctor who saw my son confidently diagnosed an unspecified toddler infection. The last doctor to see him just the day before his blood count was found to be just over 4g, said with breathtaking confidence: “There’s no way this child is anaemic”. The next day our own hospital was equally confident: “Your son has leukaemia - sorry the slides are clear –no hope that it’s something else.” And so we were moved to Addenbrookes. Who, at last, showed a touch of humility. Their bone marrow test showed it was not leukaemia but, they thought, probably some other malignancy. And they tested and tested, until at last the conclusion: unknown cause. Could it be a reaction to the MMR we asked? But back came the confident "No". Could it be reported as a coincidence to consider? “No”.
We had other concerns and so we dropped the point. Our son needed a blood transfusion. We had anticipated this on admission and had asked if family members (non-beef eating since the mid-‘80s) could be tested for compatibility since we were concerned about CJD. No need for that, we were told with confidence, blood transfusions are absolutely safe. So he was transfused from that “safe”, anonymous blood. And now I’m holding in my hand my own blood donor letter reminding me of my next appointment and which says: “You must not give blood if you have received blood since 1st January 1980”.
This was all 13 years ago. Our son has not had his 2nd MMR. Our daughter has not had an MMR. We continually review and question our decision. Do I think the MMR is safe? Yes, for most people. Do I trust our public health authorities? Yes, with the health of the nation but certainly not with the health of the individual.
Competing interests: No competing interests
Dear Dr Struthers
Over the past few weeks, you and I have asked several questions, raised several points.
No academic, no epidemiologist, no officer of Her Majesty's Government has replied.
Either we are right and the government is wasting tax payers' money. Or, we are wrong, but the aforementioned experts in public health are in a meeting to decide how to respond?
Sincerely
JK Anand
Competing interests: Search for facts
I had measles in 1963. Nobody was afraid for me, least of all my parents. I had mumps and rubella too, but I've forgotten all about those dreadful diseases. I last saw a patient with measles as a GP trainee in 1985, though I once remember a miserable child with a measly rash some ten days after an MMR jab in the early 1990's. Measles was never a big deal. Margaret McCartney has probably never seen a case. Today, measles has somehow become something to be feared as a disease that kills and maims - it very rarely does - a disease to be hysterically fought off with wave upon wave of jabs. Mumps too.
Meanwhile, the pharmaceutical giant Merck, which has a monopoly on selling mumps vaccine, is now mired in misinformation allegations:
"Merck is the only manufacturer licensed by the FDA to sell the mumps vaccine in United States, and if it could not show that the vaccine was 95 percent effective, it risked losing its lucrative monopoly, according to the complaint" [1]
and,
"Merck has known for a decade that its mumps vaccine is "far less effective" than it tells the government, and it falsified test results and sold millions of doses of "questionable efficacy," flooding and monopolizing the market" ...
The MMR is neither safe nor effective, as the evidence clearly shows. However, one can envisage a situation in the not too distant future when people will be required to have, mandated to have, annual MMR vaccinations because the vaccine itself is of declining effectiveness. MMR is a massive commercial success and destined to be even more so, precisely because it doesn't work. An extraordinary irony! But spreading fear and misinformation is good for peddling vaccines like the MMR.
[1] Reuben Kramer. Class Says Merck Lied About Mumps Vaccine. Courthouse News Service, June 27 2012. http://www.courthousenews.com/2012/06/27/47851.htm
Competing interests: No competing interests
Anne and Harry Coulter are from Hillsborough, Co Down. Their 15-year-old son Christopher was found dead in his bed a week before Christmas in 1994, 10 days after receiving the MR vaccine at school. An inquest held in 1995 concluded that Christopher died from an epileptic fit, even though there had been no personal or family history of epilepsy.
In October last year, 17 years after Christopher's death, a day long Vaccine Damage Tribunal Hearing was finally held in London.
Christopher's mother told 'The Detail':
“The day started with a discussion about whether Christopher met the 80% level of vaccine damage needed before he died. This had not been an issue before the hearing and we found it very hard to understand how they could be considering stopping the hearing on this point. It was eventually decided that they would proceed." [1]
and,
“Going to London to the tribunal was not a route that we wanted to take but it was a way to try and get answers. Unfortunately because the government’s expert witnesses were linked with the vaccination we were never going to get a fair hearing or get those answers that we so want. They were never going to look at it from our point of view. The drug companies even list seizures as a side effect of the MR/MMR vaccine.”
and Christopher's father said:
“The tribunal was the same as the experience we have had since Christopher died. The Department of Health and, in turn, the government, just have a brick wall in place which we cannot get through.”
It took five months for the tribunal to issue their majority decision against the Coulters. However, in 2011, Northern Ireland Attorney General John Larkin QC, ordered a second inquest into Christopher's death. Mr Larkin stated:
“I consider it to be of enormous public importance that the possible role of the MR vaccine in the death of an apparently healthy boy be fully explored.”
[1] Kathryn Torney. Another rejection but parents maintain vaccine is linked to their son's death. The Detail, 11 April 2013. http://bit.ly/ZR4UAr
Competing interests: No competing interests
Editor's note: We originally published a slightly amended version of Dr Struthers's response, which he objected to. We have therefore removed it.
Competing interests: No competing interests
Margaret McCartney does not think that parents should be free to choose a single vaccine over the MMR. However, are parents provided with all the information needed to make a valid choice - particularly in relation to mumps? I think not.
Mumps always was a very mild childhood disease, in fact in many, even the majority of cases, the infection was so mild, you may not even have known that your child had had it. Are parents now made aware of this information? Was a vaccine ever needed?
Have parents been informed of the outcome of a study into a mumps outbreak on Anglesey? I doubt it.
The study described:
"Twenty-three cases of clinical mumps in young people have been reported in North Wales over a five-week period since late December 2008. All cases have social links, and most of them have received two doses of mumps-containing vaccine." [1]
In the discussion it was noted:
"The lack of cases among unvaccinated individuals may reflect the high uptake of vaccine, and an investigation is ongoing to determine coverage rates for the birth cohorts involved".
State propaganda on vaccination dictates that the absence of a licensed, single mumps vaccine in the UK means that those "unprotected" by the MMR will risk the complications of mumps, including deafness, meningitis and male infertility.
The evidence suggests that the risks are minimal. Is the mumps in MMR really needed?
[1] C Roberts, G Porter-Jones, J Crocker, J Hart. Mumps outbreak on the island of Anglesey, North Wales, December 2008-January 2009. Eurosurveillance, Volume 14, Issue 5, 05 February 2009. http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=19109#
Competing interests: No competing interests
Margaret McCartney complains that the Children's Immunisation Centre is unbalanced in the safety information it provides on the MMR, in its failure to link "to NHS or Cochrane review advice".
However, the authors of the latest Cochrane review concluded:
"The design and reporting of safety outcomes in MMR vaccine studies, both pre- and post-marketing, are largely inadequate. The evidence of adverse events following immunisation with the MMR vaccine cannot be separated from its role in preventing the target diseases".
I doubt that linking to such information would bring "peace of mind" to many parents.
[1] Vaccines for measles, mumps and rubella in children. Cochrane Database Syst Rev. 2012 Feb 15;2:CD004407. doi: 10.1002/14651858.CD004407.pub3. http://www.ncbi.nlm.nih.gov/pubmed/22336803
Competing interests: No competing interests
Re: The private clinics that advertise unlicensed measles jabs
Well done Margaret,
Perhaps we can now satisfy the obvious patient demand ( 20000 in that clinic ) by addressing our patients desires directly in public NHS GP practices, without any need for false claims, nor advertising of a POM.
An interesting adjudication on advertising POMs there - Public Health advertises vaccination with MMR everywhere !
Competing interests: Public Health and NHS pressures and threatens me if I suggest that single Measles vaccine was licenced, effective, and used by GPs in the NHS for years before MMR, and should therefore remain on NHS offer.