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Hear the Silence

BMJ 2003; 327 doi: https://doi.org/10.1136/bmj.327.7428.1411 (Published 11 December 2003) Cite this as: BMJ 2003;327:1411

Rapid Response:

Re: To the Point - Tapestries of destruction

In response to Lisa C Blakemore-Brown’s request for an opinion about
children who die within 10 days of a vaccination, my first thought is that
all children differ in their responses to any foreign protein that enters
the brain. Indeed the vaccine itself will vary from batch to batch and
even within a batch.

When the particular elements of the vaccine and their products enter
the brain, the site at which they cause damage is again variable and from
child to child. Just as it is hardly possible to predict if a certain
child will respond unfavourably to vaccination, so it is also impossible
to predict, if they do, what damage will occur, what the sequence will be,
and whether the outcome will be a return to normality, neurological injury
or death.

For brain cells to be damaged in this way there usually needs to be
pyrexia following the event of vaccination. A fairly recent study of the
clinical characteristics and risk factors for a complex first febrile
convulsion showed that any acute febrile convulsion should be abbreviated
soonest possible as neurological abnormalities, which may be signs of
cerebral insult become more likely with increasing duration of seizures.
The increased incidence of acute neurological deficits detected in
children with complex febrile convulsion appeared to be more related to
focality and duration of seizure rather than to multiplicity of seizures.

Children with focal seizures were often associated with Todd’s
hemiparesis, (it is thought that in patients with hemi-convulsions and
Todd’s paralysis, the prolonged cerebral hyperfusion may be the result of
impaired vascular auto-regulation and its effects on cerebral function [1]
) explaining their higher propensity to neurological deficits.

From this study, the risk of developing neurological deficits
increased with increasing duration of seizure. Although all children in
this study, with neurological deficits, made uneventful recoveries, this
finding indicated that prolonged duration of the seizure might be a more
important factor in causing insult or injury to the brain compared to
multiple but short seizures. [2]

Just as all vaccinations are not safe, all seizures are not fatal.
The problem with the 10-day issue is that in many cases the progress of
the child’s condition is not monitored to a degree that can allow
aetiological certitude. Often the parent’s judgement and instinct may be a
reliable factor however, this does not gain enough of the Court’s respect
compared to the statements of expert witnesses.

[1] M Kimura, H Sejima, H Ozasa et al [ Shimane Med Univ Japan]
Technetium - 99m - HMPAO SPECT iin Patients with Hemiconvulsions followed
by Todd’s Paralysis. Pediatr Radiol 28; 92-9, 1998.

[2] Ling, S G. Clinical Characteristics and Risk Factors for a
Complex First Febrile Convulsion. Singapore Med J 2001 Vol 42(6) : 264-267

Competing interests:
Father of a daughter who was brain damaged by the DPT vaccine and has autisic syndrome.

Competing interests: No competing interests

10 February 2004
Alan Challoner MA (Phil) MChS
Retired
LL18 5UR