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by Dr Michael
Fitzpatrick |
After having spent years promoting
public anxieties around issues of health, the UK
government's £3million campaign to reassure parents that the
MMR immunisation is safe is likely to prove
counterproductive.
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The medical top brass, who were assembled
at the Department of Health on Monday 22 January 2001 in an
attempt to reassure the public over the safety of the
immunisation of children against measles, mumps and rubella,
blame one man for the fall in the uptake of the vaccine.
They believe that, by alleging that the MMR vaccine may
cause inflammatory bowel disease and autism,
gastroenterologist Andrew Wakefield has single-handedly
reduced the rate of immunisation below that required to
provide community protection against further epidemics.
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But Wakefield's work only had such an
impact because it encountered a climate of opinion that was
already highly sensitised to health scares. This climate was
not created by Wakefield - though the government and its top
medical advisers have certainly done much to encourage it
over the past decade.
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As I wrote in response to the initial
furore over Wakefield's paper, which appeared in the UK
medical journal The
Lancet in 1998, I think Wakefield is wrong about MMR
(1). But the panic his paper launched has all the elements
of a classic modern health scare (2).
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It raises the spectre of a devastating
condition, confuses an association (autism appearing around
the time of the immunisation) with causation ('MMR causes
autism'), and taps into pre-existing suspicions about the
dangers of immunisation (going back to smallpox, polio and
whooping cough). Desperate parents have seized on the
conviction that the MMR caused their child's illness, and
have often been encouraged by lawyers on the scent of
compensation.
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Over the past three years, the MMR panic
has gathered such momentum that it now threatens to destroy
the national immunisation programme. In response, the
government and the medical establishment have adopted a
two-pronged strategy: to rubbish Wakefield, and to try to
make parents fear that their unimmunised children might die
from measles.
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As this week's conference showed,
demolishing Wakefield's case is not so easy. It requires a
detailed review of academic papers, appraisal of
epidemiological, clinical and pathological data, discussion
of methodological issues. The ultimate problem is that it is
impossible to prove a negative - that MMR does
not cause autism.
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Promoting fears about rampant measles (and
mumps and rubella) is more familiar terrain for the public
health authorities. At this week's conference they cited
recent minor outbreaks in Ireland and in south London, which
resulted in a small number of deaths. But this approach
raises a wider problem.
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It is this sort of official
scaremongering, the promotion of public fears about dread
diseases in the cause of influencing public behaviour, that
has fostered the climate of general anxiety about health
which now nourishes the MMR panic. The fact that these same
authorities are now trying to reassure parents that MMR is
safe means that the future of the immunisation campaign is
now in grave jeopardy.
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Dr
Michael Fitzpatrick is the author of
The Tyranny of
Health: doctors and the regulation of lifestyle,
Routledge, 2000. Buy this book from
Amazon (UK) or
Amazon (USA)
Read on:
MMR: immune system as metaphor, by Dr Michael
Fitzpatrick
Immune to the evidence, by Dr Michael Fitzpatrick
MMR: injection of fear, by Dr Michael Fitzpatrick
spiked-issue: MMR vaccine
(1) See 'MMR madness', Dr Michael Fitzpatrick,
LM magazine,
September 1998
(2) See chapter 2 of
The Tyranny of Health: Doctors and the Regulation of
Lifestyle, Dr Michael Fitzpatrick, Routledge, 2000
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