Hear the Silence
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I was going to leave this matter with my last contribution but I fear
we must draw wider conclusions than David R Sherman suggests. Perhaps he
is, understandably, most focussed on the immediate practical issue of
whether he can risk exposing his child to MMR vaccine.
At the time 'Hear the silence' was screened I was opposed in
principle to these important moral and scientific issues being aired in a
controversial fictionalised format and believed it would only succeed in
muddying the waters. But in the past week I have felt more and more like
the Juliet Stevenson character who simply cannot get the answers to honest
and proper questions. It has - despite a certain inevitable kitschyness -
come to represent a truth.
So, now, on the one hand no one can apparently deny that Dr Wakefield
has a group of patients with measles antigen in their gut, and a UK health
minister has conceded this, and on the other it is very hard to see the
relevance of the epidemiological data which has been produced to support
the case for safety. At the same time the epidemiological data has been
shown to be flawed and everyone is silent on that too. No one will come
out and defend it. We know that Prof. Brent Taylor felt personally injured
by the drama(1), which is human and understandable, but he has not
answered serious criticisms I have made of his research. No one has
defended the serious criticism David R Sherman has made of the much quoted
Danish survey. I wondered whether Hershel Jick and James Kaye would
protest this weekend about the use made last week in the Sunday Times of
their research, but again they are silent.
So, apparently no one thinks there is any need to explain themselves.
But this is a bad weekend for the reputation of Government Science: a
weekend in which a theory which was supposed to be scientific turned out
to be pure whimsy, with the result that thousands of families worldwide
were for two and half decades cruelly broken up and hundreds of
unfortunate mothers wrongfully imprisoned for the murder of their infants.
No scientist apologises, and ministers - past and present - shift around
uneasily. As we know, also, many mothers of autistic children had them
snatched by the state on this basis. We are told it is "just one of those
things", but it is not.
Prof. Colin Blakemore of the Medical Research Council, dismayed by
public mistrust of science, recently wrote an article calling for better
education and better public understanding of science(2) but the reality is
that without common sense, open discussion and fair debate it will keep on
going wrong. I do not know for certain what the truth of MMR and autism
is, but I know that we are not getting a balanced and fair debate, and
this is very dangerous. What we need from scientists - for all science's
great and beneficial achievements - is not to be brow-beaten, but for them
to show a little more humility. Then people will trust them. But for the
moment, the rest is silence...
(1) Ham & High, (January 2, 2004)
(2)'Where would we be without boffins', The Observer (December 28,
2003)
Competing interests:
Parent of an autistic child
Competing interests: No competing interests
Having read John Daniel Stone's posts and the threads in totality, as
well as other items on the web, I believe it all comes down to one
question:
Having denigrated the methods, statements, evidence, intentions and
character of Wakefield and having stated that the research does not
support the hypothesis and the evidence is incomplete:
Why not redo the current research (with Wakefield) and any further
research that it suggests or is required?
Competing interests:
None declared
Competing interests: No competing interests
Regarding the Sunday Times story I note further how confused is the
data that Jonathon Carr-Brown presents. He writes that "a leading medical
team has solved the mystery of Britain's four-fold rise in cases of
childhood autism", but on the trends quoted incidence of autism increased
on a numerically accelerating basis by nearly six times over only eight
years while "behavioural disorders" declined eleven-fold on a numerically
decelerating basis, so none of the figures match up. It is unfortunate to
say the least that British readers are subject to a garbled version of an
apparently unpublished piece of research for avowedly polemical ends. Nor
is it right that anyone has made the claim that all of Britain's rise in
autism is due to MMR - I do not believe that this has ever been said. So I
ask David Elliman, Helen Bedford and Mike Fitzpatrick whether they think
this is helpful?
I also ask them whether they accept with the Minister for Health and
Social Care that Dr Wakefield's patients have measles antigen in their
gut? And do they agree with me that it is important, if this is the case,
to find out how it got there?
Competing interests:
Parent of an autistic child
Competing interests: No competing interests
It is worth returning to the claim that the rise is due to greater
awareness, better diagnosis and changes in organisation. None of these
claims seem to be supported by any documentation of substantive changes in
diagnostic criteria, or procedure. An exponential rise from the birth
cohorts of 1979-1992 suggests some continuous process, and it is not
really clear what continuous institutional process was afoot in
paediatrics in the years 1981-96 to produce this peculiar result. This is
a hypothesis without documentation and it ought not to be good enough to
dispel concern.
I note along the same lines is a report in yesterday's Sunday Times
(Jonathon Carr-Brown, Janury 18), "Autism rise may be a myth":
"Two American academics say they have proved that the rise over the
past decade is explained by the way doctors diagnose behavioural
disorders. Their research flies in the face of the belief - by a small
number of scientists - that the new cases are linked to the single MMR
jab, introduced in 1988.
"It is the first study to provide a valid alternative explanation for
the rise in utism and provides the government with concrete evidence that
the MMR is safe.
"Epidemiologist Hershel Jick and James Kaye, of the Boston University
school of medecine based their research on 280 GP surgeries with 3m
patients.
"They say the data show that the rise in autism cases corresponds
with a decline in the diagnoses of other development disorders. They do
not rule out the possibility that MMR or another drug might trigger autism
in an individual child, but they say it cannot be responsible for the
large rise.
""This represents compelling evidence that the children haven't
changed but the diagnosis has," said Jick.
"From 1993 to 2000 the number of children diagnosed with autism rose
25% a year while the number diagnosed with behavioural disorders fell by
25% a year".
It is evident that this report has a certain propaganda edge, first
of all linking spuriously the issue of the general rise in autism uniquely
to the introduction of the MMR in order to be able to knock it down (and
pointing the finger at unnamed scientists). Secondly, it is not clear how
the 25% annual rise of one figure over 8 years, and a 25% annual decline
of the other figure over the same period could be numerically equivalent
(although it sounds good in newspaper report). Thirdly, and most
disturbingly, this is armchair science and not based on familiarity with
the situation on the ground, where a generation of children with hugely
intractable problems seemed to emerge from nowhere. We have to ask,
reasonably, how the system could have lost so many desperately compromised
people and why even in late adolescence and adulthood it is failing to
diagnose them in balancing numbers - although, no doubt, tragic cases come
to light.
My own feeling is that this is rather a flippant way of dealing with
such a serious matter. We need extensive, properly funded, and independent
research on the ground to resolve these matters, and we need unfettered
clinical investigation of the disorder. To waive people's concerns aside
in such an unaccountable manner is irresponsible and insulting.
Competing interests:
Parent of an autistic child
Competing interests: No competing interests
1.
MMR The Facts (http://www.mmrthefacts.nhs.uk) has a
"News" section in which it publicises "evidence" -
allegedly from a neutral position - which supports the use of MMR.
2.
Medicines and Healthcare products Regulatory Agency
(http://www.mhra.gov.uk/) who's mission statement is:
"The Executive
Agency of the Department of Health protecting and promoting public health and
patient safety by ensuring that medicines, healthcare products and medical
equipment meet appropriate standards of safety, quality, performance and
effectiveness, and are used safely."
On the one hand we have the MHRA trashing a paper by Dr Andrew Wakefield and Dr Peter
Fletcher because:
a)
The
paper by Dr Wakefield does not present any new data - it merely reviews a
number of published articles.
b)
It is
highly selective as opposed to the scientific standard of being systematic, and
studies that do not support the author’s views are not mentioned.
c)
No
search for all relevant publications has been done.
d)
It is
easy for scaremongering to sap public confidence by biased presentations …
Then, on the MMT The Facts site we
have numerous documents that are a “review of published papers” – how can a
review present and new data? It may draw different conclusions but is this
data?
As for b, c and d: the MHRA
statements apply equally to the NHS site.
As for rigourness of papers, I am
currently awaiting a response from the NHS Site as to why they quote the Danish
Study as substantiating the case for MMR when different strains are used
compared to those used in this country. Were anybody who opposes MMR to attempt
the same trick I am quite sure that the DOH / NHS would castigate them for
doing so ….
Competing interests:
None declared
Competing interests: I found the article by John Daniel Stone so familiar. I have(as a lay person) been trying to reconcile the two camps of opposing evidence.In doing this I have checked some of the "official" web-siteaddressing the subject and two in particular are interesting.
My attention has been drawn to this very interesting and continuing
correspondence. I have several points to make but the single over-riding
point is the different standards of proof and safety which apply on the
one hand in support of the current official position and on the other to
those who offer any criticism of it.
For instance, in an interview for 'Epolitix' the on-line journal Dr
Stephen Ladyman, UK Minister for Health and Social Care (1), makes the
following criticism of Andrew Wakefield:
"All he's done is identified portions of measles virus in gut tissue
of people with autism...Well, he doesn't have any reason to believe that
that antigen came from MMR, it could just as easily got there from single
vaccinations, from native, from wild measles, and if it did come from a
vaccination programme, he's got no reason to link it to the autism itself,
he simply makes an intuitive leap without evidence as part of his process
of hypothesising."
It is interesting that the Minister actually concedes the presence of
the virus. But if there is no record of the patient having a single jab
(although this might have happened in early cases) and no patient history
of wild measles (as is unlikely) then MMR remains the most obvious and
likely source. A third possibility is that everyone has measles antigen in
their gut, but it would be possible to check this hypothesis by having a
control group, and the Department of Health (DOH)perhaps does not want to
go that far into the matter. Nor is it the case that Dr Wakefield has made
a wild, intuitive leap, he has simply followed normal clinical practice in
discussing the onset of symptoms with the patients or their
representatives. This may not be conclusive proof of vaccine damage, but
acting with proper caution it is the basis for urgent further research
rather than for burying the issue. Contrary to the official DOH line it is
entirely "credible", just not complete.
This is an example of the DOH failing to act with due care while
demanding extraordinary standards of proof. I have by contrast yet to
receive any response to my published criticisms of a recent DOH sonsored
paper 'Prevalence of autism and parentally reported triggers in a north
east London population'(2). The paper documents the exponential rise in
autism incidence from the birth cohort of 1979 to the birth cohort of
1992, but then offers the remarkable and unsupported conclusion that the
rise was not real but due to institutional changes and better diagnosis.
It is hard to understand how this leap survived peer review. They also
failed to respond to my criticism that the data would be flawed by non-
reporting of local reactions to vaccination and stereo-typical diagnoses
of autism being handed out (in fact both happened in the case of our son
though the reaction was to DPT and not MMR). Finally, if the authors were
uncertain whether autism was rising exponentially (as they documented) or
incidence was static (as they for no particular reason believe) it is
difficult to see within such a wide margin of error how they could be sure
the trend was not influenced by the introduction of MMR. The paper was
exceptionally weak and should probably never have been published: instead
it was second item on the BBC news on the morning of 22 July.
Typical too is the hard-nosed and incautious approach by the DOH to
the unnecessary use in the DPT and other vaccines of the mercury based
preservative Thiomersal/Thimerosal, now banned in the US. They can cite no
trials to support its safety, no DOH statement refers to the US ban, nor
do they ever try to replicate any of the research that has led to concern.
They simply blank out all representations. So a two month-old infant
receives a dose of mercury 43 times greater than the amount considered
safe by the Food Standards Agency for the consumption of fish (albeit in a
different form)(3).
My own conclusion is that there is a terrible institutional warp to
what is considered to be "good science".
(1) Epolitix, 14 October 2003.
(2) Lingam R, Simmons A, Andrews N, Miller E, Stowe J, Taylor B.
Arch.Dis.Child. 2003. Aug 88 (8): 666-70.
(3) BBC, File on Four, 24 June 2003.
Competing interests:
Parent of an autistic child
Competing interests: No competing interests
Subsequent to my posting entitled “Epidemiology - Relevance and
Usefullness”, I received in the post today an anonymous A4
envelope whose addressee was “David R Sherman, CV5 7FB” containing a copy of
the “Denmark” report from the New England Journal of Medicine[1].
The address leads me to (strongly) suspect that it has been
sent by someone who has read my posting(s). Unfortunately, as the sender
included no other details I not only have no idea who they are but also have no
idea whether this was intended to support the MMR jab or provide indications as
to any dangers.
It was nonetheless interesting reading – once I had got over
the disappointment that anyone could think, having read my posts, that I needed
more obscure numbers to digest!.
As I have made plain previously, my interest is that of a
parent – not as a member of the medical profession. I have not previously
indicated my expertise (or otherwise) in respect to statistical analysis – a
situation I will happily correct: I am numerate and, after 25 years working
with computers, logical but not statistically experienced (at least with
respect to Epidemiology). In this light I read, and tried to
understand, the Danish Study.
I have read Gary S. Goldman’s posting[2] in which
he seems to question the validity of the conclusion drawn in the Danish report
because of erroneous statistical techniques. His criticisms may or may not be
valid. However, from what I have read, the Danish study is oft quoted as one of
the most authoritative studies on the subject and therefore has to taken
seriously if it is correct.
I have 4 questions that bear on the reliability of the
study.
1 In the
Discussion Section the following statement is made:
“This study provides three strong arguments against
a causal relation between MMR vaccination and
autism.
·
First, the risk of autism was similar in vaccinated and
unvaccinated children, in both age-adjusted and fully adjusted analyses.
·
Second, there was no temporal clustering of cases of
autism at any time after immunization.
·
Third, neither autistic disorder nor other
autistic-spectrum disorders were associated
with MMR vaccination.
Furthermore, the results were derived from a
nationwide cohort study with nearly complete follow-up data.”
Or to put it another
way: no causal relation exists because no disorders were associated. Is that an acceptable
logical conclusion in Medicine? It certainly would not be acceptable logic in
the I.T. field and, given the existence of the term “circular logic”, generally
I suspect.
2. The
conclusion drawn in the study (Conclusions section) states:
“This study
provides strong evidence against thehypothesis that MMR vaccination
causes autism.”
However my attention
was drawn to some of the figures included in the tables (1 and 2). I reproduce
sections of the tables here for reference purposes:
Table 1. Characteristics of the |
|||||
Characteristic |
Vaccinated children (N=440,66) |
unvaccinated children (N=96,648) |
P Value |
||
Number (percent) |
|||||
Age at diagnosis of autistic disorder |
0.87 |
||||
<_ xmlns:yro="urn:x-prefix:yro" _2="_2" yro:p="yro:p"/> |
48 |
(0.01) |
9 |
(0.01) |
|
3 – 5 yr |
187 |
(0.04) |
31 |
(0.03) |
|
>= 6 yr |
34 |
(0.01) |
7 |
(0.01) |
|
|
|
|
|
I have no idea what
the P Value signifies nor how to interpret it but am I correct in reading
|
Vaccinated |
Unvaccinated |
<_ xmlns:yro="urn:x-prefix:yro" _2="_2" yro:p="yro:p"/> |
0.01 |
0.01 |
3 – 5 yr |
0.04 |
0.03 |
>= 6 yr |
0.01 |
0.01 |
Totals |
0.06 |
0.05 |
as showing a higher risk of autistic disorder?
Perhaps more
sinisterly, if the figures are calculated / shown with more accuracy then the
following emerges:
|
Vaccinated |
Unvaccinated |
Comments |
<_ xmlns:yro="urn:x-prefix:yro" _2="_2" yro:p="yro:p"/> |
0.01089 |
0.00931 |
Vaccinated higher than |
3 – 5 yr |
0.04244 |
0.03208 |
Vaccinated higher than |
>= 6 yr |
0.00772 |
0.00724 |
Vaccinated lower than |
Totals |
0.06105 |
0.04863 |
Actually 0.06105 vs |
(all rounded to 5 d.p.)
Does this mean that
this authoritative study is stating that a child is more likely (0.06%) to
develop an Autistic Disorder if vaccinated than if not (0.05%)? Is this
consistent with the conclusion stated?
[The figures for
“another autistic-spectrum disorder” are inaccurate:
|
Vaccinated |
Unvaccinated |
<_ xmlns:yro="urn:x-prefix:yro" _2="_2" yro:p="yro:p"/> |
0.01 |
0.003 |
3 – 5 yr |
0.05 |
0.04 |
>= 6 yr |
0.03 |
0.03 |
Totals |
0.09 |
0.083 |
More accurately:
|
Vaccinated |
Unvaccinated |
Comments |
<_ xmlns:yro="urn:x-prefix:yro" _2="_2" yro:p="yro:p"/> |
0.00726 |
0.00310 |
|
3 – 5 yr |
0.04584 |
0.03828 |
|
>= 6 yr |
0.02678 |
0.03104 |
|
Totals |
0.08988 |
0.07242 |
Again over 24% higher if vaccinated |
(all rounded to 5 d.p.)
Table 2. Adjusted relative risk disorders in |
|||||
Vaccination |
Person-Years |
Autistic |
Other |
||
|
|
No of cases |
Adjusted |
No of cases |
Adjusted |
Total |
2,129,864 |
316 |
|
422 |
|
Vaccination |
|
|
|
|
|
No |
482,360 |
53 |
1.00 |
77 |
1.00 |
Yes |
1,747,504 |
263 |
0.92 (0.68 – 1.24) |
345 |
0.83 (0.65 – 1.07) |
Age at vaccination |
|
|
|
|
|
Not vaccinated |
482,360 |
53 |
1.00 |
77 |
1.00 |
<_ xmlns:moo="urn:x-prefix:moo" _14="_14" moo:p="moo:p"/> |
200,003 |
38 |
1.18 (0.78 – 1.80) |
43 |
0.88 (0.60 – 1.28) |
Given the stated
time for MMR is “around 13 months”
[http://www.mmrthefacts.nhs.uk/basics/schedule.php] does this not mean
that this is more likely to be followed by an autistic disorder (1.18) than if
MMR is not given (1.00)? Should we not be waiting until the 15 – 19 month
period where the comparable figure was 0.86?
3. How can a study so replete
with figures which are then used to justify a conclusion include so many
reference to likelihood without quantifying the figures? Is a likely event
merely one where the probability is over 50% (i.e. somewhere between 50.000001%
and 100%) – hardly precise!
·
all severe cases of autism are likely to
be diagnosed and reported
·
However, itis unlikely that
this misclassification would be associatedwith vaccination status
·
Again, it is highlyunlikely
that a delayed diagnosis was associated with MMR vaccination
4. With apologies to those of you who are not UK residents, the DOH
Green Book[3] states “One vaccine is currently available: MMR II (Merck);
Enders’ Edmonston strain measles, RA 27/3 rubella, Jeryl Lynn mumps.”
What relevance, if any, does the Danish
Study have within the U.K. given that the Danish Study states:
“The MMR vaccine
used in Denmark during the study periodwas
identical to that used in the United States and contained the following vaccine
strains: Moraten (measles), Jeryl Lynn (mumps), and Wistar RA 27/3 (rubella).”?
Is “Enders’ Edmonston” the same
as “Moraten”?Is “RA 27/3” the same
as “Wistar RA 27/3”?
[1] http://content.nejm.org/cgi/content/full/347/19/1477
[2] http://bmj.bmjjournals.com/cgi/eletters/327/7428/1411-a#43391
[3] http://www.doh.gov.uk/greenbook/greenbookpdf/chapter-22-layout.pdf
Competing interests:
None declared
Competing interests: “This study provides three strong arguments againsta
Due to carleless cutting & pasting on my part my previous article
"Re: Re: Epidemiology - Relevance and Usefullness" included 2 erroneous
figures in table 3. The figures 359 and 90 should be deleted.
I apologise for this error.
Competing interests:
None declared
Competing interests: No competing interests
Adam Jacobs responds with "To make an informed decision
about whether to opt for MMR, one would also need to know the probability of
serious consequences through measles, mumps, or rubella following MMR and the
probability of autism without MMR."
Whilst I appreciate the response and, in general, would
agree with the additional factors that would need to be taken into account I
believe, in this instance, they are erroneous.
- Firstly,
in respect of the statement "one would also need to know the
probability of serious consequences through measles, mumps, or rubella
following MMR" - is it not the case that the consequences following
any of the infections is the same and it is simply the likelihood of such
infection that would be the variable? If this is the case then the program
(nearly) provided the answer in the figures they provided in the slides
showing the rates of incidence of the 3 diseases pre and post MMR. So that
information was provided?
- Secondly,
in respect of the statement "the probability of autism without
MMR." - surely, as there has been no causal link accepted by the
medical profession, then the probability of autism without MMR remains
unaffected. The only alternative I can otherwise see is that the
withholding of MMR causes more autism (which without any cause / effect
would be amazing) or less autism (which is surely the point of the
debate). Unless one accepts that MMR PREVENTS autism - has anyone
authoritively suggested that so far? - I have not heard of any such
assertion.
Just to give an idea of how obscure / difficult the
information seems to be: I have extracted from the Green Book [1] and figures
from 3 pages at "MMR The Facts" [2]:
Statistics on countries using MMR
[3],
Statistics on countries not using
MMR [4],
The MMR world map [5]
From these figures it is possible to combine the information
relating to Births and Reported cases of Measles for the countries specified
(except where the information is not available) and convert these to
percentages. Yet this is not given on the DOH's pages - again one is forced to
ask "why not?" as surely one of the factors most significant is the rate
of measles in those countries using MMR and the rate in those not using
it.
(for example:
The Netherlands rate of Measles (using MMR) is 1,109
out of 179,000 births (or 0.57%) whilst the rate for Ethiopia (not using MMR)
is 1,660 out of 2,788,000 (or 0.06%) (DOH figures) and I don’t believe that
Ethiopia's healthcare system is better than the Dutch!
Table 1
Country |
Reported Cases of Measles |
Germany |
N/A |
Italy |
N/A |
Denmark |
14 |
Ireland |
N/A |
United Kingdom |
104 |
Netherlands |
1019 |
(Source: http://www.mmrthefacts.nhs.uk/worldmap/mmr.php)
Yet then proceeds to detail "Recent Outbreaks" (Table
2):
Ref: |
Country |
Region |
Cases |
Dates |
Notes |
1 |
Germany |
Bavaria |
910 |
Nov 2001 to mid-March 2002 |
Most cases occurring in the age band with the highest |
2 |
Leer, Northwest Lower Saxony |
37 |
Nov 2001 to March 2002 |
|
|
3 |
Aachen, Northrhine-Westphalia |
359 |
First three months of 2002 |
|
|
4 |
Italy |
|
981 |
January to May 2002 |
|
5 |
Denmark |
|
19 |
End 2001 to 5 Feb 2002 |
|
6 |
Ireland |
|
844 |
1 January to 28 May 2000 |
So far, 101 children/patients have been admitted to |
7 |
UK |
|
90 |
Late December 2001 to 28th March 2002 |
|
8 |
Netherlands |
|
300 total |
Sept 1999 |
Therefore Sept 1999 to current figure is 2,000 |
|
2,300 total |
Currently |
(Sources: [all at www.MMRTheFacts.NHS.UK/Library]: /germany.php,
/italy.php, /denmark.php, /ireland.php, /uk.php, /netherlands.php)
As can be plainly seen the figures given in Table 1 figures
detailed as N/A are far from Not available or Not applicable as they are both
available and applicable.
All of the above countries are described by the DOH as
“using MMR”. It is therefore interesting to note that in the pages detailing
“Recent Outbrakes” information is sometimes included as to the level of
immunisation that existed at the time of the outbrakes:
Table 3 Immunisation Rates:
Ref: |
Country |
Region |
Vaccination Rate |
Notes |
1 |
Germany |
Bavaria |
4% |
Actually detailed as 96% unvaccinated |
2 |
Leer, Northwest Lower Saxony |
|
|
|
3 |
Aachen, Northrhine-Westphalia |
359 |
|
|
4 |
Italy |
|
60% to 80% |
|
5 |
Denmark |
|
99% for dose 1, 92% for dose 2 |
Dramatically lower in previous years, at 84%. |
6 |
Ireland |
|
|
|
7 |
UK |
|
90 |
|
8 |
Netherlands |
|
|
Cases have occurred throughout the Netherlands but have |
(Sources: [all at www.MMRTheFacts.NHS.UK/Library]: /germany.php,
/italy.php, /denmark.php, /ireland.php, /uk.php, /netherlands.php)
So I am now in the position where the DOH information is:
- Self-contradictory
(Ireland has 844 cases (Table 2) but the figures are N/A (Table 1) - Out-of-date
(All of Table 1 is dated 2000 – yet later figures are available) - Misleading
(All of these countries are listed as using MMR even though the relevant German
figure was 4% and the Dutch figure was (presumable) 0%)
So in summary, whilst I appreciate there may well be more
information that I might find useful, I am having trouble understanding and
validating the information I am being given by the DOH (should that read Dept
of Haziness? [sorry – only ‘H’ I can think of and ‘perplexing’ and ‘unfathomable’
didn’t fit!]) about MMR (More Medical Runaround?)
[1] DOH Immunisation Against Infectious Disease 1996
"The Green Book" (http://www.doh.gov.uk/greenbook/)
[2] http://www.mmrthefacts.nhs.uk/
[3] http://www.mmrthefacts.nhs.uk/worldmap/mmr.php
[4] http://www.mmrthefacts.nhs.uk/worldmap/nommr.php
Competing interests:
None declared
Competing interests: I would like to emphasise a point I made previously - ityou're going to supply figures then make sure they are correct, accurate andconsistent - otherwise people will tend to be suspicious of every piece ofinformation from that source. The DOH website states that the number ofreported cases of Measles (presumed to be 2000) for some countries is:
Re: Re: Unequal standards
As promised, I post the reply received from the UK DOH in relation to
the question regarding the validity of the Danish study to the UK given the
UK MMR vaccine contains different strains of the viruses.
"Thank you for your email. The relevance of the Danish study has to
the UK is that it has followed about 500,000 children and can conclusively
say that there is no link between MMR and autism. The Enders Edmonston
strain of measles is not the same as the Moraten strain. Wistar RA 27/3
strain of rubella is the same as RA 27/3 "
So there we have it - different vaccine but it proves that the (UK)
vaccine is safe.
Anyone still wondering why parents cannot find it in themselves to
trust the DOH?
Competing interests:
None declared
Competing interests: No competing interests