The MMR Story/Wakefield

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Wakefield & MMR

In the mid-nineties a group of children were

brought to the attention of Dr Wakefield

and others by their parents. The children

appeared to be suffering from a combination of

gastro-intestinal symptoms and a developmental

disorder. The developmental disorder was

characteristic of a pervasive developmental (or

'autistic spectrum') disorder. In many cases,

either parents or professionals had noted a close

temporal relationship between exposure to a

polyvalent (i.e. not single) measles-containing

vaccine (pMCV) and an autistic-like behavioural

regression. Prior to this behavioural regression,

the children, in the majority of cases, were

reported to have met age-appropriate milestones

and had generally been considered to be developmentally normal.

A subsequent study, published in the Lancet in

1998 reported the characteristics of the

presentation of 12 such children with

developmental disorder consecutively referred to the Royal Free Hospital.

A number of misunderstandings about the

background, content and conclusions of this study

have resulted from misleading treatment of the

issue in both the scientific and non-scientific

press. The misunderstanding stems from a

misconception, planted in what appears to be an

intentional manner by irresponsible and ill

informed ‘journalists’. Specifically, the

misconception is that the Lancet paper reported

on a study that was set up to elucidate the role

of MRR in the causation of autism. This

interpretation is either hopelessly naïve or

intentionally misleading. Either way it is incorrect.

The Lancet paper simply reported on the clinical

presentation of a series of 12 cases. On taking a

routine history, 8 of the children’s parents

noted the temporal association between onset of

behavioural regression and exposure to a measles

containing vaccine. The paper makes it clear that

onset of GI symptoms was difficult to ascertain

but generally appeared to occur prior to the

behavioural regression. At no stage does the

paper claim a causal association between MMR

vaccine and autism, which is the rather ill

informed and naïve interpretation that both the

lay population, several ill informed journalists

and, rather surprisingly, various members of the

scientific community have made. On the contrary

the paper makes explicit the fact that ‘We did

not prove an association between measles, mumps

and rubella vaccine and the syndrome described’.

It really couldn’t be stated more clearly than

this and leads one to question how many of the

paper’s critics understand the first thing about

study design. Apparently very few.

Whilst such inaccurate interpretations pervade

science this one is of particular importance

because the folk myth that surrounds the paper

forms the basis of an orchestrated offensive

against the doctors who were involved in the

original investigations. The view that the paper

was in some way flawed has been ruthlessly

propogated by those who wish to promote the

supposed safety of the MMR vaccine and deny its

potential role in the causation of developmental

regression and GI problems in hundreds of

thousands of children worldwide. The imminent GMC

hearing holds the paper central to its

allegations against the doctors involved and

several misinformed bloggers and web-based writers perpetuate the myth daily.

The misunderstandings surrounding this work are

no longer limited just to the Lancet paper. There

is also a total failure by almost all

commentators on the subject, to understand the

basic hypotheses surrounding the MMR/MR – autism

issue. There is a common misconception that the

original theory, developed from early clinical

observations – states that ‘MMR causes autism’.

Period. If the situation were not so tragic it

would be comical. The theory, unsurprisingly, is

rather more sophisticated than that.

It is perhaps timely to restate what has

subsequently been referred to as the 'Wakefield

Hypothesis' and to direct readers towards

subsequent (and earlier) scientific publications

whose accreditation in scientific peer-reviewed

journals is a matter of undisputed public record.

The Wakefield Hypothesis: There exists a subset

of children who are vulnerable, for immunological

reasons, to developing a particular form of

developmental regression following previously

normal development, in combination with a novel

form of inflammatory bowel disease. Onset, which

may be acute or insidious, may be triggered by

exposure to a measles containing vaccine,

predominantly the measles-mumps-rubella vaccine

(MMR). Exposure leads to long-term infection with

measles virus within key sites, including the

intestine, where it is associated with lymphoid

hyperplasia and acute and chronic mucosal inflammation.

Despite the focus of the popular press on one

article, Dr. Wakefield has himself published

around 132 scientific papers, many of which

directly address the issues originally outlined

in this hypothesis. Additionally, a number of

studies have been completed whose findings are

currently the subject of peer review in the

scientific press. Current evidence is clearly

available to support every aspect of this

hypothesis. Specifically, ongoing, published and

presented work provides strong and irrefutable evidence of:

* immunological differences present in children with ASD

* a particular form of developmental regression

* a novel form of inflammatory bowel disease

* onset contemporaneous with MMR exposure

* long-term infection with measles virus in key sites

* presence of lymphoid hyperplasia and acute

and chronic mucosal inflammation.

The story is by no means over.

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Sheri Nakken, former R.N., MA, Hahnemannian Homeopath

Vaccination Information & Choice Network, Nevada City CA & Wales UK

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