Dr Andrew Wakefield, / safety of the MMR vaccine,/ on patronising parents with spin.

[Guest guest]

http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2004/08/15/ndrug215.xml

 

Ministers have only themselves to blame for the latest

furore

(Filed: 15/08/2004)

 

Dr Andrew Wakefield, who raised fears about the safety

of the MMR vaccine, argues that patronising parents

with spin simply alienates them.

 

Each time the Department of Health announces a change

in the childhood vaccine programme, one minor

consequence is a rash of telephone calls from

concerned parents to the charity Visceral for which I

work.

 

Last week's announcement of the likely introduction of

the new five-in-one combined diphtheria, pertussis

(whooping cough), tetanus, haemophilus influenza (Hib)

and polio vaccine was been no exception. In spite of

assurances from Whitehall officials and ministers

responsible for public health, a large proportion of

the British public is apparently unconvinced of either

the safety of, or the necessity for, this change.

 

Why is it that the Department of Health seems unable

to persuade the public that it is doing the right

thing?

 

First, stop treating the British people like idiots.

They are not; the people to whom we speak at Visceral

have usually conducted their own internet inquiries,

have spoken to friends and colleagues and not only ask

sophisticated questions but are perfectly capable of

understanding a complex answer.

 

Second, don't over-simplify and don't tell lies or

" spin " the facts, however good the motive.

 

The first rule of public relations is to tell the

truth; it seems this has been forgotten. Dr David

Salisbury, the head of immunisation at the Department

of Health, speaking on television on Tuesday, said the

new combination vaccine was completely safe. This was

a mistake. Everyone accepts that no medical

intervention is without some risk. Furthermore, a

summary of the adverse reactions experienced with this

vaccine in Canada is already circulating widely on the

internet.

 

Instead of issuing blanket assurances, public health

officials should explain and quantify the risks within

the context and limitations of the safety studies that

have been performed. Parents understand risk.

Instinctively, they weigh risk every time they send

their children to an adventure playground, or consent

to their participation in a contact sport.

 

Notably, Dr Salisbury was instrumental in the

introduction of the Immravax and Pluserix brands of

MMR in this country in 1988. No doubt he was equally

reassuring about their safety then. The fact that

these vaccines were subsequently withdrawn due to an

unacceptably high rate of meningitis does not inspire

confidence.

 

Alarmingly, Dr Salisbury went on to state in his

television interviews, without any medical or

scientific basis in fact, that children could safely

be given 1,000 vaccines at once. The Times followed up

with the headline on Wednesday, " Experts call for

six-in-one jabs " . Meanwhile, in a sobering article by

Michael Smith of The Daily Telegraph, Professor Simon

Wesseley - previously a sceptic on the existence of a

Gulf War illness - confirmed to the public inquiry on

Gulf War Syndrome that not only were vaccines the

culprit, but also that " the more vaccines you

received, the more likely you were to suffer ill

health " .

 

Dr Salisbury's transparent confusion of fact with

personal opinion reflects a failure to grasp that for

adverse reactions with combination vaccines, the risk

of the whole is likely to be greater than the sum of

the parts. This is particularly the case with live

viral vaccines where interference between viruses has

the potential to alter risk profoundly.

 

Also, during his interviews, Dr Salisbury claimed that

the shift to mercury-free vaccines was almost

irrelevant, as the amount of mercury present was so

small as to present no danger. By contrast, one of Dr

Salisbury's American colleagues, Dr Neal Halsey - upon

the belated realisation of the true quantity of

mercury in many childhood vaccines - was refreshingly

honest, if also alarming in his exposure of

unacceptable regulatory incompetence. " From the

beginning, I saw thimerosal as something different, "

he said in 2002. " It was the first strong evidence of

a causal association with neurological impairment. I

was very concerned. "

 

Dr Halsey, who is one of the architects of US vaccine

policy, then explained the failure to calculate the

total mercury burden to which a baby was exposed as

more vaccines were introduced. " My first reaction was

simply disbelief, which was the reaction of almost

everybody involved in vaccines, " he said. " In most

vaccine containers, thimerosal is listed as a mercury

derivative, a hundredth of a per cent.

 

" And what I believed, and what everybody else

believed, was that it was truly a trace, a

biologically insignificant amount. My honest belief is

that if the labels had had the mercury content in

micrograms, this would have been uncovered years ago.

But the fact is, no one did the calculation. "

 

The next few years are likely to see the introduction

of ever greater numbers of vaccines and the

possibility of using combination vaccines containing

up to 16 different infectious diseases, is already

being discussed in the US. In such a fast-changing

environment, public confidence in public healthcare

policy is crucial. Yet in the eyes of many, the system

is fatally flawed.

 

There is a widespread perception that this policy is

compromised by commercial interests; vaccines are a

multi-billion pound business and drug companies, with

their powerful political connections, are perceived by

many as pursuing vaccine development in the private,

and not the public interest.

 

Unfortunately there is no way of reassuring the public

on this point, since the system of checks and balances

that should operate has failed, and the organs of

vaccine development, safety, licensing and promotion,

are hopelessly intertwined. These functions are

separate responsibilities that should never be

compromised by fuzzy boundaries, overlapping

memberships and close, even financial, relations with

the pharmaceutical companies.

 

Until this situation is corrected, there is a very

grave danger that the Department of Health will

succeed in completely destroying the nation's

confidence in the public health system. The

consequences of this are likely to be grave. Those of

us involved in directly addressing parental concerns

and researching possible vaccine adverse reactions are

affirmed in our resolve by the often dogmatic,

high-handed and alarmingly unscientific response of

those in public health, to genuine issues of safety.

 

Andrew Wakefield is employed by Visceral, the medical

research charity that supports research into autism

and bowel disease.

 

24 February 2004: Dispute over MMR jab 'must stop'

Copyright of Telegraph Group Limited 2004