http://news.independent.co.uk/uk/health/story.jsp?story=140083
Health Check: Jeremy Laurance
MMR fears stem from a scientific bungle, not a
media plot
26 February 2002
You might think there was absolutely nothing left
to say about MMR – and then you hear something so odd, unexpected or surprising
that it pulls you up and leaves you wondering where the argument can possibly
go next.
I have had this experience several times in the
past week (after being away on sabbatical for three months writing a book). The
big change in that time is how the debate has shifted from the level of
scientific debate to the level of anecdote.
You can read a sheaf of scientific papers, talk to
all the experts and weigh up all the evidence. But, ultimately, you want to know
what your neighbour, friend, doctor or Prime Minister are doing with their
babies. Anecdotes are very powerful, and personal anecdotes are the most
powerful of all.
That is why I was fascinated to read the letter in
this week's Lancet from Professor John Walker-Smith, the senior author
on the original 1998 research paper by Dr Andrew Wakefield that started the MMR
and autism scare. Professor Walker-Smith, who is now retired, is one of the
most distinguished paediatric gastro-enterologists of his generation. When the
Royal Free Hospital succeeded in poaching him and his research team from St
Bartholomew's Hospital in the mid-1990s, it caused a major upset.
The last time I saw Professor Walker-Smith was at
the press conference at the Royal Free in February, 1998, called to publicise
his research team's findings. It was one of the biggest public relations
disasters I have witnessed. Five doctors were present, all eminent in their own
field, and all with a different opinion.
I learnt later that the five had earlier rehearsed
the press conference and agreed the line they would take, which was to
recommend the continued use of MMR vaccine, pending on further research to
investigate the causes of the inflammatory bowel disease and autism that they
had found in 12 children.
But, in the actual press conference, under pressure
of questioning from reporters including myself, that carefully constructed
consensus fell apart. At one extreme, Dr Wakefield advised parents to choose
single vaccines administered a year apart, while at the other, Professor Arie
Zuckerman, adviser to the World Health Organisation on vaccination, insisted
MMR had been given to millions of children world-wide and was safe.
We hapless reporters were left to fashion a
coherent story out of diametrically opposed views and, news being what it is
(generally bad), the headlines next morning highlighted the warning about
potential risks of MMR rather than the reassurance about its safety. The rest,
as they say, is history.
I labour this point, at risk of being charged with
special pleading, because the press is now being accused of fomenting the
current panic over MMR. While some of what has been published is, in my view,
indefensible, that charge cannot be laid at the original stories on the 1998 Lancet
paper. The responsibility for setting this particular hare running lies
squarely with the researchers, not with the reporters. It was a monumental
scientific cock-up, not a media conspiracy.
I do not remember what Professor Walker Smith had
to say at that press conference four years ago. As I recall, he kept pretty
quiet (it was difficult to get a word in). But in his letter to this week's Lancet,
the first time he has broken his silence since, he says he continues to support
MMR, "as have all the Royal Free paediatricians from the beginning",
and that three of his own grandsons have had the triple vaccination.
To me, the fact that a senior scientist, who was
actively involved in the research that led to the autism scare, has allowed his
own grandchildren to have the MMR jab is a pretty impressive anecdote. If there
is a risk there at all, and Prof Walker-Smith clearly believes that there is,
it cannot be a very large one.
I say he believes there is a risk because, in his
letter, he also calls for further research into Dr Wakefield's claims. He says
there is now a "high priority" to conduct scientific studies to
ascertain "whether there are factors that place a very small but important
group of children at risk".
In the current fevered climate, I fear that, no matter
how small that group of children is, or how small the risk, it will not be
small enough to reassure most parents, even though it has reassured Prof
Walker-Smith enough to opt for the triple vaccine for his own family.
Also from the Health
section.
Doctors want nurses to take over as NHS
'gatekeepers'
Heart surgeon to lead hunt for foreign
doctors
Doctors warn of rise in sexual diseases
Global envoy for the NHS to be charged
with hiring £200,000-a-year foreign consultants
Kid-life crisis
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