MMR from today's Lancet (31 Oct 2003)

[janinlondon]

From today's Lancet:

Separating inflammation from speculation in autism
Sir--The report by Michael Kidd and colleagues (Sept 6, p 832)1 of measles-associated encephalitis in children with renal transplants emphasises the grave risks posed to immunosuppressed children by low uptake of the measles mumps and rubella (MMR) vaccine. Calculations of outbreak size indicate that low MMR uptake has left the UK on the edge of major measles outbreaks.2 Uptake as low as 61%1 makes almost certain the return of endemicity.2 Additionally, the near elimination of congenital rubella syndrome by MMR will surely reverse.
I write as an author of an Early report for The Lancet3 and a paediatric gastroenterologist for many autistic children. Although subsequent studies4 have lent support to and extended the gastrointestinal findings associated with autism noted in this report, the same is not true for any link with MMR; many epidemiological studies have been undertaken, the results of which indicate no causal relation. No other vaccine has ever been studied in such depth, and the evidence for its overall safety is comprehensive. The response by all consultant paediatricians in the Early report3 was to support MMR vaccination without reservation,5 although this fact went largely unreported. The points made by us in this letter remain valid.
This department has continued to assess children with autism on straightforward clinical grounds, since large numbers show improvement in abdominal pain and sleep disturbance if constipation, gastritis, or colonic inflammation are recognised and treated.5 However, not all children with autism show such response, a finding that needs further study. That any reports that characterise gut inflammation in autistic children are reported in the media as supporting the idea that MMR is causative is deeply frustrating, since it is simply not so. I and my colleagues have seen similar intestinal changes in children with no history of regression, in unvaccinated children, and in children whose first autistic symptoms clearly predated MMR administration. Several genes implicated in autism are expressed in the intestine and immune systems, and it is possible that subtle abnormality in these systems is an unrecognised component of autistic-spectrum disorders. This area remains one of legitimate interest, but should be clearly separated from the MMR issue.
MMR immunisation, which should be an easy decision, has become a worrying issue for many British parents. Although this situation reflects in part a broader mistrust of official pronouncements, and has been fuelled by media campaigning, it is founded on the misinformed perception that there is ongoing scientific uncertainty. There is now unequivocal evidence that MMR is not a risk factor for autism--this statement is not spin or medical conspiracy, but reflects an unprecedented volume of medical study on a worldwide basis. By any rational standards of risk/benefit calculation, it is an illogical and potentially dangerous mistake for parents to be prepared to take their children in a car on the motorway or in an aeroplane on holiday, but not to protect them with the MMR vaccine. An unprotected child is not only at personal danger, but represents a potential hazard to others, including unborn children. Unless vaccine uptake improves rapidly, major measles epidemics are likely in the UK this winter.2
Simon Murch

Centre for Paediatric Gastroenterology, Royal Free and University College Medical School, Royal Free Campus, London NW3 2PF, UK (e-mail:[email protected])
1 Kidd IM, Booth CJ, Rigden SPA, Tong CYW, MacMahon EME. Measles-associated encephalitis in children with renal transplants: a predictable effect of waning herd immunity. Lancet 2003; 362: 832-832. [Text]
2 Jansen VA, Stollenwerk N, Jensen HJ, Ramsay ME, Edmunds WJ, Rhodes CJ. Measles outbreaks in a population with declining vaccine uptake. Science 2003; 301: 804.
3 Wakefield AJ, Murch SH, Anthony A, et al. Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet 1998; 351: 637-41. [Text]
4 Horvath K, Perman JA. Autistic disorder and gastrointestinal disease. Curr Opin Pediatr 2002; 14: 583-87. [PubMed]
5 Murch S, Thomson M, Walker-Smith J. Autism, inflammatory bowel disease, and MMR vaccine. Lancet 1998; 351: 908.

There was a Radio programme on last night about Hepatitus B jab, it's bad record with side effects, and the very low risk of babies contracting it in Britiain in particular, and Western Europe as a whole. I got the impression that virtually everyone is low risk for Hepatitus B unless sexually promiscuous or an intravenous drug user.

One of the main side effects they listed were arthritus (that's an official & recognised side affect). There is an alleged link to multiple schlerosis, too. Also, not one of the manufacturer's listed affects, but heart problems have come up quite often on Britain's yellow card system for Hep. B side-effects. The programme mentioned lawsuits in USA & the withdrawal of Hep. B in France. But... the WHO is pushing universal Hep. B vax very hard.

I think it was the File on Four programme, on the Radio 4 website. I'm generally pro most vax, but Hep. B is definitely not one of them, now! HTH.

The MMR was tested for 3 weeks (or was it 4? certainly no more). It was not - what I would call- rigourously tested. The yellow card system is meant to pick up on potential problems - but it misses the majority of adverse reactions.

To quote Dr Jefferson- who is head of the Vaccine division of Cochrane Callaboration (a group of scientists that aims amongst other things to promote high standards in research). He is also a board member of the European Programme for Improved Vaccine Safetly Surveillance set up by the commission. Anyway where was I? He says that although there is no evidence to suggest that any vaccine now in use is dangerous there is a "dearth" (his words) of sound studies on the risks and benefits. He went on to say that the information on the safety of vaccines now routinely given to babies and toddlers is "simply inadequate". He also goes onto say that as more and more jabs are being given at once it becomes much harder to sort out what are real problems. To quote him " It is no use having a situation where someone suggests a possible harm and everyone runs around frantically trying to find bits of evidence. What is required is good-quality information that has been systematically collected and assessed." H

As for the single vaccines not being tested...... The ones used in this country are the same strains as used in the MMR. Exactly the same vaccines. If they are safe in combination then they must be safe singly- surely?

As for three jabs being more painful that one? Well yes, but surely less painful than being vaccine damaged?

As for the hepB? TBH I have never made sense of why it is given at birth. It's sexually trnasmitted or transmitted via blood- I can't see why a newborn baby born to a hep B negative mother would be at risk. However it isn't something I have read a great deal about as it doesn't feature in the UK schedule (yet) so I don't know. I do know some studies have linked it to type 1 diabetes. But I didn't look at the studies so I have no idea how rigorous they are, if at all.

Thanks zebra- I'll listen to that.

Been reading this thread with interst for the last few days. Done all the reserach about the MMR (too much maybe??). DS is 15 mths and has had 3 MMR appointments which I have cancelled due to him being ill at the time. A few weeks ago I thought that I had decided to go for the MMR. Spoke to a number of friends about it whose opinions I totally trust. Now I am back to square one and thinking again about single vaccines. BUt surely if the latest 'measles virus in the gut' story is an issue then even the single vaccine wont stop this??
Jimjam - you mentioned yesterday about 'suspectable' children and the MMR. What do you think the signs are to see whether or not your child would be one of the 'susceptable' ones who might react badly to MMR?
This whole thing does my head in!

news.independent.co.uk/uk/health/story.jsp?story=459621

Interesting article above. It gives the first mention of the problems obtaining and keeping spinal fluid that I have seen mentioned publically in this country. The US radio show mentioned below talked about this and I have heard various things off the record.

charly there is a school of thought which says that people with a strong family history of autoimmune conditions do not do very well with vaccinations (not just from an autism pov). JABS probably have more information on their website. This is the main reason I have decided not to vaccinate ds2 unless absolutely necessary- our family history is riddled with autoimmune conditions.

If you do decide to go for MMR I always say try and avoid chickenpox around the time of receiving the jab (not always possible, but certainly if your child has been in contact with chickenpox and is in the incubation period I would postpone). HTH.

Thanks Jim-jams.

By well-tested, I meant that MMR has been in use in some countries for 15 (or is it 20?) years. I didn't know that the clinical testing stage was so short though. My point was really that there could be some other side-effect of the 3 separate jabs that we don't know about yet.

Also - where are the spinal fluid tests from Autistic children who had the single measles jab?

The single jabs have been used for years as well (the measles and rubella single jabs were used for years in the UK before the MMR was introduced -we didn't use single mumps vaccine, although other countries did)

There aren't that many autistic children who had the measles jab- this is the problem with getting samples. My autistic son had the single measles jab (although it didn't make him autistic). Would I donate spinal fluid for studying? Only if he had to have a sample taken anyway- otherwise absolutely no way. Given the problems they had getting the samples they did get- a large sample size with lots of different groups would be almost impossible (although I agree worth doing).

That does help thanks!!!
I think that I will go for single jabs on reflection

Sorry Jimjams to keep banging on about this: I meant that the rubella vaccine has not been tried in babies, and that the combination of all 3 has also never been tried so close together (even if they do say you should have them x months apart) - that was what made me decide not to go for them.

Incidentally, they have quite a lot of stuff in Private Eye about the samples and possible conspiracy theories etc. Too obviously written by someone who has already made up their mind for my taste, but they did relase a "special report" on the subject.

lucy- I'm really not sure I understand what you mean. It is my understanding that the rubella vaccine given for single jabs is the same as the rubella vaccine in the MMR. So surely it has been tested in babies? Just in combination with mumps and measles? Sorry I may have missed the point- do you mean that giving them seperately may lead to interactions between them not seen if giving them all together?

A quick query.ALmost decided to give ds single jabs after humming and ha-ing for ages. Anyone in the north had sinle jabs?
If so, where do I find out?
Also, should I be worried about what I am reading about single jabs being 'unlicensed'?

Look at the other thread "MMR-single vaccines, info please". There's info there on getting singles in the North.

Thanks forthat Davros!
I will contact JABS for a range of contact numbers.
Why do these things have to be so stressful!