Gut feelings no guide

It's time to trust in science on MMR vaccine, says Gerard Killoran

hen I suggested that the MMR controversy needed to be revisited I didn't expect that it would hit the headlines again in such a spectacular way but it's nice to be topical. It was eighteen months ago when Ken Livingstone attacked the MMR vaccine with arguments of such ignorance that I felt inspired to join the fray but he's sensibly kept his mouth shut since. The pot has been stirred by a strange alliance of the Daily Mail and Private Eye's Paul Foot, with the heat turned up by a recent Channel 5 drama Hear the Silence starring Juliet Stevenson as the mother of an autistic child who blames MMR for her son's condition. The title gives away the real thrust of the argument, which is that the government and the medical establishment are ignoring parents who believe that the MMR vaccine harmed their children.

I think there is another level to this, that the opinions of parents should override scientific advice based on how strongly the opinions are held. In the post drama debate one parent repeatedly stressed how well she knew her own child as if this was evidence in itself. But how well do parents know their children? In the excellent BBC documentary, 'The Autism Puzzle' the story of one mother was revealing. Unusually she had two sons with autism and it came as a shock to her to see symptoms of the condition appearing in the second child at a much earlier stage than she had seen them in the first. The difference was that unlike most parents of autistic children, she now knew what to look for and how to interpret what had seemed before to be normal behaviour. The children could have developed autism before taking MMR.

It is one of the paradoxes of modern life that as we obtain the best ever medical treatment, live longer and survive illnesses and serious injuries as never before, there is a corresponding distrust of modern medicine and a resort to 'alternative medicine'. The Observer, once a serious newspaper, devotes whole pages to the latter including one to the self-styled 'Barefoot Doctor' whose output reads so much like a spoof that he has been dubbed 'the Ali G of alternative medicine' but seems to take himself as seriously as his deluded readership. Homeopathy which claims to cure you with nothing more than water is available on the NHS for reasons I do not understand. For homeopathy to work we would have to rewrite the laws of Physics, Chemistry and Biology and anyone who proved its efficacy would win every Nobel prize including Peace and Literature. Strange isn't it how few scientists are prepared to devote their lives to studying the curative powers of water.

Despite his scientific background, Ken Livingstone was quoted as saying, "It seems to me that a child of those months, just 14 months is incredibly vulnerable. I remember having all these jabs separately - often you had quite a severe reaction. Why whack them all into a child at the same time?" A little thought would suggest how vulnerable would the child be to the diseases themselves? Some research would have revealed that the single measles vaccine was not given to children in the UK until 1968 when Ken was too old to be in nappies at 23 years of age, and that the body's immune system has to deal with many more diseases simultaneously. Ken should watch his young child putting all sorts of objects into his mouth, most of them covered in bacteria and wonder how his immune system copes. Besides it is known that, "An upper respiratory viral infection exposes a child to 4-10 antigens, and a case of 'strep throat' to 25-50." (U.S. Centers for Disease Control and Prevention).

Unlike Ken, I can actually remember my childhood where I was also born too early to benefit from modern vaccines and had to make do with the diseases themselves. Take my word, they weren't better for me. Perhaps we are at the stage now when many parents were protected from the diseases and are unaware of the amount of distress and suffering measles, mumps and whooping cough can inflict on a small child, to them an injection seems to be much worse. Thank goodness we haven't had a Polio vaccine scare, in Ireland they're down to the last person in an Iron Lung and the disease almost eradicated, too late for a member of my family who had to wear callipers all her life. Sadly, as I write there comes news of a boycott of the polio vaccine in northern Nigeria with a consequent increase in children going down with the disease. We shouldn't feel in any way superior as the evidence cited by the Nigerian Muslims opposed to vaccination is based on not much more flimsy evidence than that provided by the unfortunate Doctor Wakefield.

Its time to go back to science. Science is difficult to understand and more difficult to carry out properly. Even scientists have had to develop so-called 'blind' tests because they have found that their own expectations can affect and distort the results of their experiments without them knowing. Of course it was science itself that made this discovery. On the best available evidence, MMR is as safe as any other similar medication we give our children, much safer than paracetamol which can kill in large doses. Nor are gut feelings a guide to the causes of gut diseases.