The truth will out

Alan Coughlan explores the furore around the MMR vaccination, and whether there is any truth to its reputed dangersNobody ever likes what is good for them. Nutritious vegetables or hours spent studying are enough to make the average person protest. Intuitively, an awful taste or negative feelings let people know what they don’t want to do. Intuition might also tell a person that taking a small dose of a disease is a bad idea. At face value this seems a reasonable assumption, but just beneath the surface lies a wonder of medicine that helps to protect us all.Vaccination is a staple of modern healthcare. In a given population when a vaccination is administered thoroughly it should neutralise a target disease and grant immunity to that population. An uptake level of 95 per cent is recommended to allow a vaccine to be effective. At levels below this, problems can occur.With a large enough pool of susceptible hosts, a disease can propagate, infect, kill and most significantly, mutate. If any disease, be it bacterial or viral has the chance to propagate and mutate into a new form, it can bypass current vaccinations and then everyone is at risk, not just those who are unimmunised.Andrew Wakefield in 1998 published a paper in The Lancet which purportedly found a link between autism and certain gastrointestinal disorders, and the administration of the Measles, Mumps and Rubella (MMR) vaccine. In the wake of publication, fear amongst parents of young children spread quickly and it took only a few years for signs of its damage on public health to emerge. Initially Wakefield had called for a suspension of the three-in-one vaccine until more research could be carried out, stating “if you give three viruses together, three live viruses, then you potentially increase the risk of an adverse event occurring, particularly when one of those viruses influences the immune system in the way that measles does”.The problem with what he said was that it fuelled people’s fears and perpetuated the myth around the toxicity of vaccinations. One of the chief suspects in the debate was a compound known as Thiomersal, a preservative used in many vaccinations. Approximately 49 per cent Mercury by weight, it was immediately singled out as the primary cause of adverse effects. In 2002 Thiomersal was removed from vaccines in the United States. A study published in 2008 looked at the rates of autism within California. The study found that the number of cases had been increasing at a steady rate over the previous few years even after the removal of Thiomersal from the childhood vaccine schedule. If Thiomersal was the cause of the problem, the number of new cases of autism should have fallen. So why have the number of cases been increasing? According to Dr Stephen Novella, “there is no real increase in the rates of autism, it is just a case of increased surveillance and an increase in the scope of the diagnosis.”In America Jenny McCarthy (former Playboy Playmate) has become the leader of the anti-vaccine movement.  She has publicly blamed her son’s autism on the MMR vaccination he received around the time of his first birthday. She has been quoted as saying her child was perfect until the day he got his MMR vaccine and then she “saw the soul go out of his eyes”. In a separate TV appearance she read a list of the so called ‘toxic’ ingredients of vaccines and listed Hydrochloric acid as a harmful additive.Whilst, in isolation, such a substance would be harmful to the body, she showed a complete lack of scientific knowledge of an issue in which she has become a central figure. Hydrochloric acid is used in a process of titration to balance the pH of the vaccine so that it is neutral when it is injected into the body. The problem with her public statements about vaccines is that they lack proof or intelligence and undermine decades of scientific research. She is given a soap box in the form of TV interviews and an opportunity to milk her celebrity status in order to get her message across. In today’s celebrity-obsessed world it seems people are ready to take medical advice from a Playboy bunny before a doctor.This furore about the MMR vaccine of course began with Andrew Wakefield’s research paper. However in the years following its publication it was discovered that he was receiving a large amount of money from trial lawyers.  These lawyers were involved in lawsuits against physicians for alleged vaccine injuries.In 2004 ten of the twelve co-authors on the paper withdrew their names and support from it. Wakefield was also exposed for performing very poor science in taking figures from a very small pool of samples.  It was also discovered that he paid £5 to every child at his son’s birthday party who allowed him to take a blood sample to use in his analysis. Perhaps most damning, was the evidence that Wakefield had applied for a patent for his own competitive vaccine. The conflicts of interest inherent in this type of behaviour are astounding.At the beginning of this year the General Medical Council in England ruled that “Andrew Wakefield acted both dishonestly and irresponsibly in doing his research”. In reaction to this ruling The Lancet retracted Wakefield’s original paper from the published record. There is a high possibility of him being struck off the register however he is already practicing medicine in the U.S. Even though the evidence against Wakefield and his work is strong, the damage has been done to vaccination programmes. With diseases that were once under control and even partially eradicated once again on the rise and a large anti-vaccine movement still growing it is today’s newborns that are now at risk.