A GP’s view on vaccination

As a GP I gave kids the MMR jab. Now I wouldn’t give it to my own.

The triple vaccine routinely given to children to prevent measles, mumps and rubella has been controversially linked to autism-like symptoms. We asked Dr Richard Halvorsen to investigate. (Sunday Express Magazine 21 May 2000) www.whale.to/v/mmr.html Childhood immunisations, I had always assumed, were safe. The Department of Health (DOH) has repeatedly reassured us that their benefits are far greater than the risks and, as a GP, I have been responsible for the immunisation of many hundreds of children. So, when I was asked by the Sunday Express Magazine to write about the MMR vaccine, I expected to be able to reassure readers that the vaccine was of clear benefit and that side-effects were either not serious or extremely rare. My research unearthed a different story that makes for disturbing reading.

The MMR immunisation was introduced in the UK in 1988 with the first dose aimed at children of 12-15 months, a second at 3-5 years. It is designed to protect against measles, mumps and rubella (German Measles) and works by stimulating the immune system to produce antibodies against the viruses without causing harm. It was well received by both parents and doctors so that over 90 per cent of children were being immunised by 1992.

Most children received the vaccine with no obvious serious side-effects but it grew increasingly apparent that some became seriously ill within a few weeks. These children began behaving strangely, stopped talking and became socially withdrawn, staring into space for hours on end. Many developed a raging thirst, bizarre eating habits, multiple food allergies, hyperactivity and sleep problems. This was usually accompanied by abdominal pain, bloating and bowel disturbances, and some became incontinent of urine or faeces. They did not simply fail to develop but lost what they already had. Now, we all know coincidences happen, but here are thousands of children who had all developed normally until receiving the vaccine, after which they became very unwell in a remarkably similar pattern. The behaviour these children showed was similar to autism, but differed in that they were previously developing normally and then lost the skills that they had developed, such as speech and play, a condition called “autistic regression”.

Most of the parents felt sure that the cause of these devastating changes in their children was the MMR vaccine, but if they mentioned this concern to their doctors it always met with dismissive reassurance that it must have been a coincidence because the MMR was safe. One doctor, instead of dismissing the possibility of a relationship with the MMR vaccine, listened to the worried parents and studied some of the affected children. Dr Andrew Wakefield, from the Royal Free Hospital in north London, published a paper in February 1998 in the medical journal The Lancet suggesting that the MMR vaccine could be the cause of the children’s autism and bowel disturbances, which he calls “autistic enterocolitis”. Dr Wakefield was vociferously attacked for causing unnecessary worry in parents and the MMR vaccine was vigorously defended as being “highly safe and effective”.

The Chief Medical Officer, Sir Kenneth Calman, felt confident enough to say, “I have concluded there is no link between MMR immunisation and autism.”

Questioned in Parliament in 1997 on the possible link between MMR and autism, then health minister Tessa Jowell reassured MPs that: “No vaccine is issued in the United Kingdom unless it passes the highest standards for quality, and parents should have confidence that the vaccines that are provided are both safe and efficacious.”

But I was concerned to find that the safety trials on the MMR followed children up for only three weeks. This could not possibly detect side-effects that appeared after three weeks. This is alarming for a vaccine aimed at millions of healthy children.

In 1999, two studies appeared that the Department of Health claims “reinforce the conclusion that there is no link” between MMR and autism. The first, by the Committee on the Safety of Medicines, involved examining questionnaires sent to the parents who had suspected MMR as a cause for their child’s autism – 1200 questionnaires were distributed and 126 examined in detail. The study concluded: “It is impossible to prove or refute the suggested associations between MMR vaccine and autism”- hardly convincing reassurance.

It is hard to obtain precise figures for the number of children affected with autism because the government does not keep records. But the second study cited by the DOH looked at one area – north London -and found an alarming increase in autism there. The incidence was running steadily at between four and eight of the children born there each year between 1978 and 1985. Then came a dramatic increase to just under 50 of the children born in 1992, the last year studied by Professor Brent Taylor and colleagues at University College London. Curiously, however, they concluded: “Our analyses do not support a causal association between MMR vaccine and autism.”

To others, including myself, the research figures actually support the link between MMR and autism. What has not been adequately explained is the recent massive increase in autism. However, the start of this increase can be traced back to children who were born in the mid 1980s in Britain and the 1970s in the United Sates. These were the first children to receive the MMR vaccine. In California the incidence of autism was running at 150-200 a year until 1980, then it took off to reach nearly 600 in 1990.

In the UK some local authorities have measured the rate of autism and have again found very high numbers. However, the Government still has no plans to monitor the number of children with autism. The lack of willingness of the Government and the medical profession to accept that a problem could exist smacks of complacency at best, and negligence at worst. Not all governments hold the same view. In Japan, MMR was withdrawn in 1993 because of an unacceptably high level of side-effects.

The evidence against MMR is now mounting. Dr Wakefield has studied more children with “autistic enterocolitis”. His research suggests that the MMR vaccine can cause an abnormal immune reaction which, in susceptible children, causes the child’s immune system to damage the child’s gut, allowing it to absorb chemicals that may attack the brain. This is an auto-immune reaction and it may be no coincidence that some research has linked other auto-immune diseases, such as diabetes, with immunisation.

It is looking more and more likely that recent increases in the numbers of children with autistic regression and other developmental disorders may be triggered, or caused, by the MMR vaccine. The illnesses the vaccine is designed to prevent can themselves cause damage, but the use of MMR in this country may be doing more harm than good. Parents from the UK, mainland Europe, Australia, the US~ Canada or Asia are all telling the same story.

The parents of over 2,000 children are planning to take their cases to court. It has been suggested that parents are using the MMR vaccine as a “scapegoat” in a desperate attempt to explain their child’s autism. This strikes me as an insensitive and flawed suggestion: the last thing parents want to believe is that their child’s devastating problems were caused by something they inflicted on the child themselves. The Government gives the impression of not wanting to know and appears to be more concerned with preserving public confidence than in investigating these children. On 10 April this year Professor Liam Donaldson, Chief Medical Officer, sent a letter to every GP in the country in which he repeats that “there is no new evidence that indicates a causal link between MMR vaccine and autism”.

The Hippocratic principle is that doctors should “first do no harm”. At the very least parents must be told of the concerns surrounding the MMR vaccine. Doctors should obtain “informed consent” when offering any medical intervention, especially when the “patient” is not ill to start with. That means discussing the risks as well as the benefits. If the MMR vaccine were a drug, it would be suspended until proper trials had been done to examine its safety. Based on what I now know, I would not give my children the combined MMR vaccine. I would consider either using the vaccines singly (not available in this country but possible in mainland Europe) or not vaccinating at all. It may be safer for healthy children to catch these illnesses rather than run the risk of immunisation. It’s important that girls have either had rubella or are immunised before pregnancy.