Help me make sense of MMR - hype or theory

[felicity10]

OK, so I've been through a few pages of previous posts, I must be missing something because I can't make sense of it!

DD is 1 and I've had a letter about the vacs from the GP. I've heard about the MMR in the news few years ago and about the link to autism, but I just would really value your views.

Single vacs with no mumps or the MMR? Can anyone point me in the direction of key MMR issues?

I just don't want to get to the gp's and then feel like I am getting bullied into having the mmr - it is normally very no nonsense nurses who barely speak english, so will be unlikely to give me a clear answer as to any risks.

I am amazed that we have this lack of clarity in the UK.

Many thanks in advance!

That's a real shame Leonie. I'll miss your comments about maternal intuition and its importance in medical decision making and diagnosis.

Yes, I know. Doesn't always work though does it?

Actually, starlight, i've no need to win an argument. If you looked at my reply to you about screening, it certainly wasn't point scoring but an exploration of the issue. I'd honestly be interested to hear how you thought it'd be implementable.

However, if someone comes on and starts saying that intuition is a valid form of evidence when it isn't and could actually have devastating consequences, of course I'm going to pull them up on it. It's mumbo jumbo.

To repeat what I've said before.

Go to sites that represent the experts in the field for information such as AAP or NHS. Don't tell people to go off to google - that's irresponsible. If you want the original evidence, search pubmed or google scholar so you can see all the evidence. Then discuss with your doctor. If you're not happy, insist on a specialist. I don't see for a second what's wrong with that.

stata, Beachcmber has already told you that a simple screening procedure would have ruled her dd out form having the DTP.

a similar, and simple, few questions (including, in her case, actually looking at need rather than just going for blanket applicaiton) would have saved my dd from her damage.

screening can work.

it can be very simple.

but it is not done.

and parents are not listened to when they say they do not want a jab.

and that is wrong.

First off, point of agreement. Parents should be listened to and concerns addressed.

Secondly, what screening do you suggest?

There are a number of problems with this being implemented.

1. I know you say the evidence is there, and I'm exhausted by this argument so won't go in to it, but none of the advisory bodies think that there is sufficient evidence to warrant such as expense.

2. How would you address the problem of false positives and false negatives which could lead to many children being exposed to potentially dangerous diseases when, in fact, they aren't at risk and also the many children you will miss. This is especially true since you're talking about a very small of children, even by your estimates (and even less by mine if at all) and also if the numbers dropped so that herd immunity is not providing any protection.

You know what, forget point 1. It'll lead back to Wakefield. Point 2 is less contentious.

Bravo RPO on your rather nasty and insidious attempts to discredit me or twist a post to suggest I was saying anything like "better autistic or dead"

a) I didn't say that or anything like it and
b) it was a direct response to Starlight saying this

"If Silverfrog were to agree to vaccinate her second daughter fully, would you be willing to give your child's life in event of any vaccine damage? I mean are you sure enough to risk your child's life for what you believe?"

which

c) I already said was bloody ridiculous but was responding using HER logic to make the point of how stupid (and unrelated to any point being debated) it was

But good on you - good on you for attempting to discredit me. Nice.

Because that really helps get to the truth of the matter doesn't it?

I note you haven't come back on the Wakefield's work being repeated with any evidence of measles being found in association with ASD.

Starlight - you cannot bang on about this alleged sub-group when you cannot define them genotypically or phenotypically. Who are they? How can be be defined? Why do the numbers never reach statistical significance?

Oh and one last thing RPO. I have never accepted that an environmental trigger causes autistic regression but I do accept that well-known, well-documented vaccine related injury does occur in a very small minority of cases. Nobody ever said vaccination was entirely risk-free.

Reminder of rapid increase in measles incidence following drop in MMR take-up

www.nhs.uk/news/2010/01January/PublishingImages/mmr-graph-377.jpg

But, starlight,the number of children potentially involved matters immensely.

If you are going to determine whether a screening programme is going to work, then you absolutely need to know the sensitivity and specificity of the screening test. It matters even more so since you are potentially leaving the false positive children exposed to something far far worse than what you're protecting them from.

Do you have an idea of what kind of prevalence of 'at risk' children you're talking about? And what would be the markers for the screening test?

I have watched this thread descend into accusation and recrimination with some horror. I'm disturbed that a number of different posters have have reduced the very real issues of the possibility of environmental/vaccine damage to a sort of sport. The facts, as they are, support both arguments. The Cochrane report wasn't impressed with the evidence on the safety of the MMR but there appears to be plenty of epidemiology that suggests it is safe. The initial findings of Wakefield's Lancet case series found incidence of gastrointestinal disease which, if you talk to anyone with an autistic child seems to reflect their reality. Initially this brain/ gut link was dismissed by scientists who felt the evidence wasn't there to verify that intestinal damage might be a feature of brain damage - although anecdotally there always was and one of our child's consultants immediately knew what was wrong based on anecdote. Amazingly, many many doctors work from anecdotes because they are a collection of information passed on and not all of them have yet been proven. Today the link is accepted and documented in many many papers including one by Imperial College last year. There are a number of things that seem to have been lost in all of this: The motive of the doctors at the centre of the GMC hearings was never anything but the well being of their patients. If you speak to the parents involved with that first group they will tell you that their children were being well cared for by the doctors at the hospital in question - only later when the safety of the vaccine was questioned was this subject to doubt. I appreciate that many things have been written to the contrary and that a number of posters want to reduce the general concerns about this issue to whether one doctor was good or bad. This reduction serves no one. Another unassailable truth is that thousands of parents all recount and recognise a similar pattern of health breakdown after vaccination. This could be mass hysteria but before this was a wildly debated subject the same phenomenon could be observed. The details that the parents describe is uncannily the same. Anecdotal, I know. There have been posters who have quoted both the BMJ and GMC in defending the remarks they make about these doctors. It is worth reminding the posters that one of those doctors is appealing the GMC's ruling. The doctor most vilified could not risk the prospect that all of the charges against him would be dismissed on appeal as the verdict appeared to his supporters to be politically motivated. Should an appeal fail it could be financially ruinous. Perhaps it is a measure of the care this doctor displayed to the parents and patients that he has so many vocal supporters. On a separate note, I have spoken to a number of distraught parents who have wondered aloud if their concerns might be better considered if their children were to die rather than be autistic. This is not that rare a thought. The blood drawn at "the birthday party" was done, apparently, to create a control group and the protocol was that used for adults rather than children. It was a mistake - one that was admitted openly by the doctor involved. More than one regular observer of the hearing has commented that the judgment of the GMC seemed to go against fact. It is obvious from the heat generated that this issue won't go away - possibly because too many parents/friends/neighbours have anecdotal evidence of what they believe is damage. It's anecdotal and might be a wive's tale but the spectre of Thalidomide looms large and the virulence of the denials of responsibility resonate in our collective consciousness. What is, for me, terrifying is the apparent lack of empathy by some posters. To draw battle lines and use such emotive and/or belittling language seems to be at odds with the ethos of this forum.

Starlight - completely agree. Recognise your words and the world you describe.

I'll give you an example to explain what I mean.

Say you have a population of 100,000 children. And let's say that 1% of the children will be vaccine damaged if they have a vaccine. You have a very good screening test (let's say it was possible) with 95% sensitivity and 90% specificity. So 95% of people with the disease will be identified and 5% will get a false negative i.e 900 children. Out of the 99,000 non-reacting children, 10% will get a false positive i.e. 9900 children. So you've 'saved' 900 children but left 9900 unnecessarily unvaccinated. But 1% is way too high, right? Even you are saying it's more like 0.1% (and I say even lower if at all). So, if we apply the same test now we have 95 reactive children saved out of the 100 (and 5 who will be missed) but out of the 99,900 non reactive children, 4995 will be left unvaccinated unnecessarily. These children are going to be at risk of disease and vaccinating would certainly have been safer for them. And now, before you've even started, vaccination rates are below 95%.

All of this assuming, of course, solid evidence for what you're doing and enough information on markers to reach 95% sensitivity and 90% specificity which I doubt.

I'm very sad that you've had such experiences starlight and thoughtaboutit. I can understand why you're distrustful and skeptical about authority and government but conspiracy theories do your cause no good whatsoever. I've always favoured incompetence over conspiracy in any case. I don't want to go back to Wakefield but I'll repeat that continued support for Wakefield undermines any valid points you may have and he's a liability for you.

What way is that starlight? What markers are you looking for? Any screening test leads to false positive adn false negatives. It's a fact. Especially when you have something where the markers are very unclear.

How would you fix it?

I couldn't agree more about transparency though. Completely.

I'm not a subscriber to conspiracy theories - like you I tend to default to incompetence - the repeated attempts to demean one doctor serves to drown out some of your well articulated points. Similarly, your tendency to lump people together in order to advance your argument does not help. Starlight has described a reality presumably you don't know first hand but her posts do not appear to evidence belief in conspiracies rather a recognition of the state of play.

Oh god, here we go again. Sorry if some of your friends were offended and upset but I won't be browbeaten by group attacks. It's hard not to lump people together when exactly the same people are the ones saying almost exactly the same thing (as well as endless personal attack and rudeness).

If you insist on defending Wakefield and bringing him in to the discussion, then I will respond with the facts as found by the GMC. I don't believe for a second that they are lying. I'd rather not discuss him at all to be honest so let's move on.