Intended for healthcare professionals

Rapid response to:

News Roundup [abridged Versions Appear In The Paper Journal]

Increase in autism due to change in definition, not MMR vaccine

BMJ 2005; 330 doi: (Published 13 January 2005) Cite this as: BMJ 2005;330:112

Rapid Response:

Further to Peter Flegg and the TB ref.

Dear Sir,

Further to Peter Flegg's reply. From the first reference he gave us,
which is indeed the study published in the Lancet (although other reports
of this study include other information of relevance), I would draw Peter
Flegg's attention to the following:

Page 64:

"the overall protection by BCG, for all ages was seen to be nil."

....for children 1 month to 9 yrs, was 27% for either strain, 25% for
Danish strain and 17% for French strain, the levels of protection in all
four instances being statistically not significant.

Again, the discussion on page 63 (and 65) is interesting, as they
considered the protective level for 5 - 12.5 years to be 69 percent. Then,
in discussing the discrepancy levels between that, and the two other
groups, they consider it statistically insignificant as well. Perhaps
that's because the confidence levels were so wide, and lie on either side
of zero, if they looked too hard, they might come up with a different

So they opted for the politically correct language, and said that the
numbers should be interpretted "with caution".

In other words, "we don't really have a clue what we are looking at,
because actually it looks pretty bad."

There was also noticed, in children, in a detailed discussion on page
63, excess cases of tuberculosis in the vaccinated children in the first
five years of life, and again, between 12.5 - 15 years of age, a pattern
also seen in another trial at Madanapalle, in South India, where more
cases were seen among the vaccinated during the first three years, and
after 9 years of age...

It is also noted that much of the article was spent trying to find
reasons to explain away the results, and none were found.

The most telling remarks were on Pgs 67-68:

"Thus even if BCG offered protection in those initially uninfected
(which it does not) the public health value of BCG can be only in
preventing childhood mortality caused by disase resulting from
haematogenous spread. The impact on infectious cases can at best be only

In conclusion.... has shown that BCG offer no protection against
adult type bacillary tuberculosis. Consequently BCG cannot be expected to
reduce the transmission due to tuberculosis. This observation of failure
to protect could not be attributed to defects in methodology, inadequate
sample size, prior exposure to environment mycobacteria or to most of the
disease being a result of exogenous reinfection. These unexpected results
have led to several studies which would eventually increase our
understanding of the host responses and immune mechanisms in

This last part in particular, underscores the little "can of worms"
above, which Peter Flegg and others have studiously chosen to ignore.

Which is the fact that not only does Mr Flegg have little idea about
neonatal immunity and the "differences" between neonates, adolescents and
adults,, or how vaccines actually "work" inside the body apart from
supposed final antibody response but...., as this study points out...., Mr
Flegg also has little understanding about "host responses and immune

The problem is that this professional ignorance doesn't just stop
with Tuberculosis.


Hilary Butler.

Competing interests:
None declared

Competing interests: No competing interests

28 February 2005
Hilary Butler
freelance journalist
home 1892, New Zealand.