Mumps, Measles and Rubella (MMR) Vaccines

In this fact sheet we give specific information about the MMR and MR vaccines and their side effects. Our objective is two-fold. Primarily we have to operate within the English Legal System, which in this context functions only in terms of financial compensation. Our aim therefore is to help families whose children have been affected by the vaccines to obtain proper compensation for their injuries. We are using law that was introduced into this country in 1988 as a result of European Community directives. This law (the Consumer Protection Act 1987) imposes strict liability on the manufacturers of products which are unsafe.

The MMR vaccine is claimed to cause serious side effects in only one in a million children. Even if that were the case, the risk to the children who are affected is not one in a million, but 100%. An American court[2] has decided that there can be no acceptable level of the incidence of serious side effects from vaccines, and has stated that compensation should be paid in any case where it is proved that the side effect was caused by the vaccine. We would hope that English courts would adopt the same approach.

Because vaccines are such an emotive issue, we have gone further and tried to set the whole subject in context. What follows is an overview of the vaccines, which we hope will give full information not only to the families we are seeking to help but also to those (including medical practitioners) who have found it difficult to obtain detailed information about these childhood diseases and immunization against them.

We have tried to keep a balanced view about the benefits and risks of immunisation, but as we have researched deeper into the issues it has become harder to do so.

We have read and heard many harrowing accounts of the injuries that children (and adults) have suffered after the vaccines have been administered. We have listened to the dismissive comments from representatives of the Government and some members of the medical profession. We are now worried that the safety information about these vaccines may not be entirely accurate.

We are also seriously concerned that safety monitoring for these vaccines appears to fall far short of what the public is entitled to expect and we believe that the information given to parents is certainly lamentably incomplete.

We are concerned that risks associated with the actual illnesses may have been exaggerated, perhaps to frighten people into having their children vaccinated. Some have suggested that we underplay the risks of the illnesses themselves. There is no doubt that, of the three illnesses (mumps, measles, rubella), measles should be regarded as the most serious, but we find it difficult to reconcile the claims now made about the illness: "complications have been reported in one in 15 notified cases."[3] with the reassuring statement we quote in the next section: "In the vast majority of children who catch measles the disease disappears within 10 days" [4]^{, [5]}

We have also included references to and quotations from source material. This represents a tiny fraction of the information we hold, which runs to hundreds of papers and thousands of references on MMR and vaccines generally. Feel free to show this fact sheet to your medical advisors. We believe that we can substantiate every statement made in this fact sheet from mainstream medical literature or official sources. Where possible we have given the source material in footnotes. It is quite significant that many of the medical and scientific findings we have researched are not new: the information about the mechanisms, which cause side effects, was available to the medical and scientific community years ago. We will be happy to supply more information either to you or to your doctor.

Background: Setting the illnesses in context

The "official" perception of the childhood diseases which are the subject of the MMR or MR vaccines (Measles, Mumps, Rubella) has modified over the years – with descriptions of the diseases increasingly emphasising their seriousness.

It is instructive to put the three diseases into perspective. The following extracts and summaries are from two family health guides published 13 years apart:

the MacMillan Guide to Family Health, an authoritative health manual edited by Dr. Tony Smith the deputy editor of the British Medical Journal and published in 1982 [6]; and

the British Medical Association Complete Family Health Encyclopaedia published in 1995 (first published 1990). This is also edited by Dr. Tony Smith.

We have chosen the first publication because it came out some years before MMR vaccines were introduced into this country. Contrast the entries in the two publications:

Mumps

From the MacMillan Guide to Family Health 1982:

"Mumps is a common infectious disease caused by a virus. After an incubation period of 2-4 weeks the salivary glands swell, the parotid gland (just in front of the ear) is particularly infected. Swellings are usually accompanied by a raised temperature and a general feeling of illness. It is probably the most common childhood infectious disease but not as contagious as measles.

"A fairly common risk of mumps is the swelling of testes in a boy or the ovaries in a girl. This is much more common in an adult. Invariably the swelling goes down after a few days leaving no after effects. It is excessively rare for the swelling to cause sterility. A rare complication is acute pancreatitis, which passes within a few days.

"Mumps is generally a mild disease. The usual outcome is complete recovery within about 10 days." [our emphasis]

In contrast From the British Medical Association Complete Family Health Encyclopaedia 1995:

"Mumps is an acute viral illness mainly of childhood... Serious complications are uncommon. However, in teenage and adult males, mumps can be a highly uncomfortable illness in which one or both testes become inflamed and swollen... Most infections are acquired at school or from infected family members. In the US, where many states require proof of mumps vaccination for school entry, the incidence has dropped markedly over the last 20 years. In the UK by contrast, before routine immunisation was introduced in 1988, mumps affected a large proportion of the population at sometime in their lives, usually between the ages of 5 and 10. An occasional complication of mumps is meningitis... A less common complication of mumps is pancreatitis, which causes abdominal pain and vomiting. In males after puberty, orchitis (inflammation of the testis) develops in about a quarter of the cases. Subsequently the affected testis may shrink to smaller than normal size. In rare cases, mumps orchitis affects both testes leading to infertility."

[The book also contains strong warnings about the consequences of older people coming into contact with those infected with mumps.]

Rubella (German Measles)

From the MacMillan Guide to Family Health 1982:

"This is a very mild infectious disease in the majority of children who catch it, it causes no more inconvenience than a common cold. The incubation period is 14‑21 days and the first symptoms are a slightly raised temperature, swollen glands behind the ears and a rash appearing on the first or second day first on the face and then spreading to the rest of the body. By the fourth or fifth day, all symptoms have faded away.”

“It is slightly less common than measles and not as highly contagious so does not occur in epidemics in quite the same way.”

“Like other childhood infectious diseases, German measles carries the risk of encephalitis though this occurs in only one case in 6000. A more common complication, particularly in adults is stiff swollen joints (infectious arthritis).”

“Because German measles is such a mild disease, little specific treatment is required but the disease is known to cause damage to babies developing in the uterus. It is therefore essential to contact any pregnant woman who has been exposed to German measles."

The British Medical Association Complete Family Health Encyclopaedia 1995: The book does not emphasise the seriousness of the illness as much as it does in respect of measles and mumps but does state that vaccines are long lasting in their effect.

Measles

From the MacMillan Guide to Family Health 1982:

"Measles is a highly contagious disease which chiefly affects the skin and respiratory tract. It is a notifiable disease. The incubation period is 10-14 days. The first symptoms are raised temperature, runny nose, red watering eyes, dry cough and sometimes diarrhoea. By the third day the temperature falls and tiny white spots like grains of salt appear inside the mouth. On the fourth and fifth days temperature rises again and the characteristic measles rash appears, starting on the forehead and behind the ears and gradually spreading to the rest of the body but not usually the limbs. By the sixth day the rash is fading and by the seventh day all the symptoms have gone.”

"In the vast majority of children who catch measles the disease disappears within 10 days and the only after effect is lifelong immunity to another attack"[7] [our emphasis]

In contrast 1995 from the British Medical Association Complete Family Health Encyclopaedia 1995:

The following are quotations from the book. Note the difference in emphasis and detail.

"A potentially dangerous viral illness that causes a characteristic rash and a fever… Measles was once very common throughout the world occurring in epidemics. It is now less common in developed countries due to immunisation.”

“Prevention of measles is important because it can have rare but serious complications.... It can also be serious, and sometimes fatal, in children with impaired immunity (such as those being treated for leukaemia and those infected with AIDs virus). In developing countries measles is still common, accounting for more than one million deaths every year, especially in malnourished children whose defences against infection are seriously impaired."

"The most common complications are ear and chest infections. Diarrhoea vomiting and abdominal pain also occur. Febrile convulsions are common with measles and are not usually serious. A serious complication, occurring in about one in a thousand cases is encephalitis (inflammation of the brain).... Seizures and coma may follow sometimes leading to mental retardation or even death. Very rarely (in about one in a million cases) a progressive brain disorder, known as SSPE, develops years after the acute illness. Measles during pregnancy results in death of the foetus in about one fifth of the cases."

"Immunisation against measles is usually offered at about 15 months of age and produces immunity in about 97% of the cases. Side effects of the measles vaccine are generally mild."

[no mention of any serious side effects of the vaccine]

Measles viewed in 1967

Another example of the apparent change in the nature of measles is this extract from a paper by Christine Miller BM B.Ch, of the National Institute for Medical Research London published in 1967 one year before the measles vaccine was introduced on a wide scale.

"MEASLES is now the commonest infectious disease of childhood in the United Kingdom. It occurs in biennial epidemics in which the total number of cases usually exceeds half a million, and between these peaks there is a continuous substantial incidence. There is no doubt that most of these cases in England today are mild, last only for a short period, are not followed by complications and are rarely fatal, but this is not the whole picture and other factors have to be considered.”

"OPPOSING VIEWS: Measles is always a social nuisance whenever it occurs and nearly always an unpleasant episode for the child and the family. Most children develop measles during preschool or early school life, and when more than one child is infected at the same time it is an exhausting and trying period for the mother, especially if she goes out to work. Outbreaks in schools and hospital wards also cause waste of time and inconvenience, and there have been severe outbreaks in the Armed Forces. To the doctor an epidemic of measles means an increase in work in the late winter and early spring when he is already especially busy. A recent survey in a number of areas in this country (unpublished) showed that the majority of measles cases are visited at least twice by the general practitioner, and in many cases more than twice. This is a heavy burden on the National Health Service, which also bears the cost of antibiotics with which most cases are treated.”

“In spite of these factors, some physicians consider that measles is so mild a complaint that a major effort at prevention is not justified. On the other hand, others believe that, on the whole, the implications of an epidemic are serious and that the disease should be prevented if possible. These opposing views are of topical importance in considering what use should be made of measles vaccines"[8].

Measles viewed in 1979

In the well respected publication The Theory and Practice of Public Health [9] it is stated:

"While the infectivity of measles is still very high in all types of population and environment, the results of infection vary greatly. In Britain and many other developed countries today measles has lost much of its severity, but the disease can still sweep through virgin populations with great ferocity... On the other hand immunity is probably lifelong, and when measles has invaded an isolated community, older members have been protected by immunity acquired over sixty years earlier. In developing or underdeveloped countries measles may still cause serious complications and carry a fatality rate of up to 25 per cent."[10]

In contrast 1994 from: MEASLES why every child in school needs to be protected from measles this autumn. 1994 [Health Education Authority/Department of Health Publication][11]

"Unfortunately, measles can be much more serious than most people think. School-age children who get it are likely to be very ill. These children will have a high temperature, a rash, a cough, a cold and sore eyes. Other symptoms are headaches and not liking bright light. Measles can cause pneumonia, blindness, deafness and even brain damage. Measles can also be fatal. In fact it's the disease most likely to cause inflammation of the brain. This is known as 'encephalitis'. Worryingly, four out of ten children who get this kind of encephalitis will suffer long-term brain damage."

Our reason for emphasising this apparent change in the perception of the illnesses is to raise a question‑mark over the rationale for MR or MMR vaccines.

Vaccination is an invasive procedure. Children, once vaccinated, are inevitably put on direct risk (however large or small that risk might be) of vaccination side effects. On the other hand, if nature is allowed to take its course, they may never catch all or any of the illnesses, and they certainly won't catch all three at the same time; and if they do catch any of the illnesses, the evidence suggests that their immunity to further attacks will be far greater than is provided by any vaccine.

Furthermore, there is some evidence that catching measles actually protects children against some conditions, such as allergies. A recent trial in Guinea-Bissau found that 25.8% of participants who had the measles vaccine suffered from allergies, as opposed to 12.8% who had the wild measles.[12]

In the Immunisation Awareness Newsletter of December 1991, other advantages of catching measles are considered, as this passage shows:

"The advent of complications during these diseases essentially depends on the age and the health of the child, as well as on treatment. We have lost the common sense and the wisdom that used to prevail in the approach to childhood diseases. Too often, instead of reinforcing the organism's defences, fever and symptoms are relentlessly suppressed. This is not always without consequences over the development of the disease. On the other hand, given the depth to which the child's organism is affected by the disease measles, for example, there can also be positive consequences. For the child's organism to defeat a disease by its own means, enables it to mature its immune system and develop increased resistance. The latter will be useful for the organism against other diseases during childhood, and likewise in adulthood. Over many generations, parents, doctors, and educators have noted that children may go through an important stage of their development thanks to a childhood disease. Conditions in which heredity is a factor, such as eczema, asthma, or recurring infections of the respiratory system, may be improved or even cured after measles.”

"This 'cure potential' of childhood diseases can be demonstrated by an example. There is a serious childhood disease affecting the kidneys, the nephrotic syndrome, in which the kidneys lose their vital excretion function as a result of disturbed immunological processes. Up until the 1960s, at the Bale University Paediatrics Clinic, artificial infection with the measles was used to treat this syndrome; this brought about at least an improvement in most cases."[13]

The process of vaccination involves submission to a medical procedure for the benefit of a community; not just for oneself or one's immediate family. Therefore, for a vaccination to be justified, there must be:

_ a serious threat from the disease(s), and

_ a significant benefit from the vaccine.

If the diseases are not as serious as they are now claimed to be (and we have found no indication that any of them has become more serious in the past 15-20 years quite the reverse)[14]; and if the vaccines are more dangerous than they are admitted to be, then the risk/benefit ratio is altered. At the very least, parents should know about it.

Behind the scenes, it is acknowledged that vaccines are indeed not as safe as they could be:

"The goals of immunization are to eradicate infectious diseases while minimizing morbidity caused by the vaccine, particularly to prevent neurological damage. The object of the study is to evaluate neurological complications associated with the immunization. Immunization is an important public health measure. Acute reactions warrant support for development of improved vaccines."[15]

There is always room for improvement in any product, but these references to "neurological damage" and "Acute reactions" indicate that in the minds of some there is need for considerable improvement.

The vaccines

MMR Vaccines

The MMR vaccines were introduced in October 1988, as part of a campaign to reduce childhood illness. They are a triple vaccine, using the mumps, measles and rubella live viruses.

Problems with MMR vaccines

Until September 14 1992 there were three types of MMR vaccine available:

Vaccine	Details
IMMRAVAX	Manufactured by Merieux UK Ltd
PLUSERIX-MMR	Manufactured by SmithKline Beecham/ Smith Kline French Laboratories
MMRII	Manufactured by Merck Sharpe and Dohme; distributed by Wellcome (On recent data sheets this product is now shown as being distributed by Pasteur Merieux MSD Ltd)

Pluserix-MMR and Immravax vaccines contain the Urabe strain of mumps vaccine virus; MMRII vaccine contains the Jeryl Lynn strain of mumps vaccine virus.

On 14 September 1992 the Chief Medical Officer announced that there were to be "Changes in the supply of vaccine". From that date onwards, only MMRII would be available. The following is an extract from his letter giving the reasons for withdrawal:

"This change in vaccine supply arrangements has been considered prudent following reports of generally mild transient meningitis caused by the mumps vaccine virus in some children who recently received the Urabe mumps vaccine containing products, Pluserix-MMR or Immravax. The rate of post-immunisation meningitis following Jeryl Lynn mumps vaccine (which MMRII contains) is much lower.

Incidence of mumps virus meningitis:

"Meningitis after natural mumps has been reported to occur at a rate of approximately 1 per 400 cases.”

"Studies recently undertaken in one Public Health Laboratory, and supported by similar studies in several other Public Health Laboratories, suggest that the incidence of virus positive post-immunisation meningitis from the Urabe strain of mumps vaccine virus may be approximately 1 in 11,000[16] immunised children. This rate of vaccine-associated meningitis is appreciable (sic) lower than that reported after natural mumps infection”

"Vaccine-associated meningitis occurs around three weeks after immunisation generally. In those instances reported so far it appears to be a milder and more transient illness than meningitis from wild virus. This is what one might expect with an attenuated virus. The risk benefit ratio therefore remains strongly in favour of the immunisation of all children with any MMR vaccine. However the MMRII vaccine is preferred where this is available because of the much lower risk of vaccine associated meningitis."[17]

Even though the Chief Medical Officer mentioned only "changes in supply", both Immravax and Pluserix have subsequently been withdrawn altogether.[18]

We are troubled that there seems to be a certain amount of massaging of the figures. In the passage just quoted, side effects of one in 11,000 are mentioned. Later, it will be seen that they were brought down to 1/4000[19]. But even that is not the end of the story as this extract from a Japanese study about the safety of MMR vaccines (with the Urabe mumps strain) will show:

"During the 8‑month period extending from April to October, 1989, in Gunma Prefecture, 11 750 children received MMR vaccination according to information supplied by the prefectural public health center. The incidence of MMR meningitis was estimated to be 1.1/1000 (0.11%) in the virus‑positive group and 3/1000 (0.30%) in the three groups. 2640 and 1320 children received MMR vaccination in September and October, respectively. Twelve children in the virus‑positive group, 10 in the serum‑positive group and 6 in the clinical group received vaccination in these 2 months. The incidence of virus‑positive, serum‑positive and clinical meningitis in these 2 months was 3/1000 (0.3%), 2.5/1000 (0.25%), and 1.5/1000 (0.15%), respectively (total, 7.1/1000 (0.71%))."[20]

We have a letter from the Japanese Department of Viral Disease and Vaccine Control which indicates that from April 1993 the use of the MMR vaccine (all types) was stopped in Japan and that vaccines would be available only in their monovalent form (i.e. single virus)[21]

Comment:

The Japanese findings indicate that adverse reactions to these types of MMR vaccine were up to 78 times as frequent as our Government's Chief Medical Officer of Health has admitted[22]. If those figures are correct, then the vaccine is more dangerous than the illness; and it does not give a great deal of confidence that the Government has got its figures (or information about safety or side effects) right. Note also that this article was published in March 1991. Yet the two brands of MMR implicated with these side effects were not withdrawn until September 1992, some 18 months later.

Indeed TRIVIRIX (a MMR vaccine containing the Urabe strain virus) was withdrawn in Canada in May 1990.[23] Why did the UK Government take till 1992 to withdraw it?

The arrival on the scene of the MR Vaccine

In the autumn of 1994 it was announced that the Government feared an epidemic of measles and that it aimed to vaccinate all children between the ages of 5 and 16 with the Measles/Rubella vaccine.

Not everyone agrees that an epidemic was imminent or that such a widespread vaccination campaign was necessary.[24]

The story goes back further than that - to the MMR vaccines.

The two brands of MR Vaccine which were used in the schools campaign are produced by the same manufacturers as were the two brands of MMR vaccine which have now been withdrawn (see above):

Merieux UK Ltd (Measles Rubella Vaccine Live Pasteur) and SmithKline Beecham (Eolarix)

As far as we can tell the active constituents of these two vaccines are exactly the same as those in their withdrawn MMR vaccines, except that the mumps component has been removed. Both brands of MR vaccines each contain 2 viruses - to provide protection against Measles and Rubella.

A new MMR vaccine

In 1997 a new version of MMR was introduced - Priorix manufactured by Smithkline Beecham. We have no information at present about the performance or safety of this vaccine.

Safety of the vaccines.

We deal below with side effects, but we are disturbed at the lack of evidence of long-term safety trials. At the risk of repetition we set out again the extract from the publication referred to in our vaccines general information fact sheet:

"In the course of its review, the committee encountered many gaps and limitations in knowledge bearing directly and indirectly on the safety of vaccines. These include inadequate understanding of the biologic mechanisms underlying adverse events following natural infection or immunization, insufficient or inconsistent information from case reports and case series, inadequate size or length of follow-up of many population-based epidemiological studies, and limited capacity of existing surveillance systems of vaccine injury to provide persuasive evidence of causation. The committee found few experimental studies published in relation to the number of epidemiological studies published. Clearly, if research capacity and accomplishment in these areas are not improved, future reviews of vaccine safety will be similarly handicapped."[25]

So far, most of the safety trials which we have identified, have monitored the children for just 3 weeks after the vaccine was administered; and the longest we have so far been able to find is a monitoring period of six weeks. It means that any adverse effect which occurred after the monitoring period would not have been observed. The safety trials, in the main, have been of the separate components of the vaccines (i.e. Mumps, Measles and Rubella). Trials of the combined vaccine appear to be even thinner on the ground. This is admitted by the Committee on Safety of Medicines:

"Before measles, mumps, rubella (MMR) vaccine was introduced in this country, we carried out a large scale study where adverse events were monitored in the three week period following vaccination in approximately 12,000 children."[26]

This is troubling because there special considerations should be given when more than one live virus is administered as a vaccine at the same time. There is evidence that the measles virus (or vaccine) can cause immunosuppression[27], which in turn might allow opportunistic infection to develop from one of the other viruses (such as rubella). Other concerns have also been expressed:

"Modern vaccine programs seem to ignore the high potential for mutation of viruses. It was established in 1986 that a mixture of non-virulent viruses can produce a disease by means of complementation or recombination. A team from the University of California (Los Angeles) inoculated mice with two strains of non-virulent herpes simplex virus type 1. Most of those that received a 1:1 mixture of viruses died. But the animals which received a 100 fold higher dose of only one strain of virus survived. Virulent recombination’s had been produced. As early as 1984 R de Long warned that mass immunization with several live viral vaccines might increase the probability of genetic recombination and might result in new diseases."[28]

If anyone can help us to identify longer-lasting safety trials we would be grateful to receive details.

We have asked the Committee on Safety of Medicines to supply us with details of long term safety monitoring of vaccines and they have so far been unable to supply them.

Side effects: the official view

There is a concept in medical cases called "informed consent". In simple terms, has a patient been given adequate information to be able to make an informed decision about whether or not to have a particular type of treatment? Because a child does not need to be vaccinated there must be a duty to give very comprehensive information, so that parents can decide. Even chances of several thousand to one against side effects may be unacceptable, particularly as a child is put at risk of side effects as soon as a vaccine is administered.

Yet little information is made available about the side effects of the vaccines. They are always played down, and in the booklets encouraging parents to have their children vaccinated; they are hardly mentioned at all. In the booklet given to families at the time of the Measles Rubella campaign in 1994 the following is the entire information relating to safety of the vaccines:

Will my child have any side effects after the injection

“Side effects are uncommon. They are usually very mild and disappear quickly. A few children may get a mild fever, a rash, sore or aching joints, or feel a bit 'off-colour' a week to ten days after the jab. But this should only last two or three days. Children with these symptoms cannot give anyone measles or rubella.”[29]

No other information giving details of side effects is contained in any part of the booklet.

As can be seen, side effects do certainly exist:

"Reactions from the live [measles] vaccine are usually mild, although convulsions and rare cases of encephalopathy[30] have occurred in connection with vaccination campaigns, but with the improvement in vaccine production reactions are becoming less common. The risk is certainly acceptable in countries where measles is still a killing disease."[31]

We realise that this passage was written in 1979, but by then measles vaccine had been widely used in this country for more than 10 years. It is rather odd, therefore, that the author is talking about an "acceptable risk" in countries where measles is still a killer disease. The same argument can be applied (justifiably) about vaccinations against AIDS, where the risks from the illness are very severe. But deaths from measles in this country have remained low since the 1950s.

The following is the list of side effects taken from the datasheet for one of the brands of MMR vaccine (MMRII). It should be emphasised that this too plays down the incidence of vaccine side effects, but it does give much more information than is generally available to the public:

From the MMR datasheet

"Because the vaccine is slightly acidic (pH 6.2‑6.6), patients may complain or burning and/or stinging at the injection site for a short time."Adverse reactions associated with MMRII are similar to those to be expected from administration of monovalent vaccines given separately. These may include malaise, sore throat, headache, fever and rash, nausea and vomiting; mild local reactions such as erythema, induration, tenderness and regional lymphadenopathy; parotitis, orchitis, nerve deafness, thrombocytopenia and purpura; allergic reactions such as wheal and flare at the injection site or urticaria; polyneuritis; and arthralgia and/or arthritis (usually transient and rarely chronic). Cough, coryza and pharyngitis have also occurred.”

"Moderate fever (38.3'C/101'F) or high fever (above 39.4'C/103'F) may occur following vaccination, predominantly between days 5 and 10. On rare occasions, children developing fev

And

Contents

Mumps

In contrast 1994 from: MEASLES why every child in school needs to be protected from measles this autumn. 1994 [Health Education Authority/Department of Health Publication][11]

Problems with MMR vaccines

Details