Category: Od tego kiedy rozmawiamy o niepozostanie na skrzynię, skrzynię chciwie kieruję po dwóch spolu. Science

Here I am in Edinburgh on 22nd August 2012

Blaming mummy for MMR

April 21, 2013

When did the heat move from Wakefeld and the media, to parents?

On Thursday I saw a tweet asking “what kind of C*** stops their child having the MMR anyway?” I have to say, this kind of switch in dialogue around where blame lies sets my teeth on edge. And there’s a good reason for that.

I don’t have children, yet. I hope to have a few some day but I have worked with them in my role as an ABA tutor (Applied Behaviour Analysis – used in this case for children diagnosed with Autism Spectrum Disorder), helping frazzled parents cope with the bureaucracy of the Local Education Authority, their child’s education establishment and the demands (which I recognise are many) of running a successful ABA programme. Not to mention the normal stressors parents face and the additional difficulties of having a child who needs extra care, education, help and attention.

Ask any parent of a neurotypical child and they’ll tell you sometimes they struggle to have enough time to go to the toilet in peace.

So when I see someone decrying parents’ fears over the MMR I get pretty angry. I can well understand, based on my affection for my tiny dog (I know, I know – it’s not the same – but it’s what I’ve got!) that parents spend their time worrying constantly about their kids. At the height of the scandal, in 2001, Cherie and Tony Blair were widely criticised for asserting MMR was safe whilst at the same time avoiding confirming their infant son Leo had been vaccinated. This also is nonsensical. My medical records, your medical records and Leo Blair’s medical records are no one else’s damn business. Cherie later confirmed, in her autobiography ‘Speaking for myself’, in 2008, that he was vaccinated, but many children have health reasons that preclude them from immunisation.

Given we’re now reaping what Wakefield first sowed in 1997 – 808+ infections of teenagers (as of reports on the 18th April 2013) and the death of 25 year old Gareth Williams in Swansea – it’s time to really think about health information and how it’s disseminated.

Much light is made of the Daily Mail’s list of what will kill or cure you of Cancer but unfortunately I’m going to give them a break and side with them. A bit. Last week, on my way to work, I heard about new research stating that women who drink one glass of wine when pregnant could, instead of damaging their baby, end up with a more intelligent child. The radio report ended with a confirmation that Department of Health advice to avoid all alcohol during pregnancy remains unchanged. Health advice, from the point of view of the layman, seems to just keep bloody changing (changing, note; not developing). It was the same when I was born in the mid-80s – advice on whether to lay your child on her front or back when sleeping had just changed. My mum sleeps on her front, I sleep on my side. “Scientists can’t make their bloody minds up!” comes the cry. You can hardly blame sleep-deprived parents of one year olds for being reticent.

So what’s an expectant mother – or a new parent of a 12 month old, a month away from getting the MMR, in 1998-2001 to think? Should I give my precious child the MMR injection and risk him developing Autism or should I take the risk he’ll develop measles? An illness most people have never seen the full effects of? Herd immunity has been so high, historically, most people had never met or remembered someone with a bad case of measles, mumps or rubella. “Anyway, it’s unlikely just this one kid is going to have that much of an effect on herd immunity.” Or so they think.

Anti-vaccination arguments are powerful and emotive . Powerful and emotive is, to me, just another way of saying ‘damn convincing’. The trouble with Scientists, despite their perceived air of authority, is that they just don’t talk the same language campaigners do. They don’t come out with things that seem plausible and obvious to the ill-educated on the subject of vaccinations – “a child can’t cope with three vaccines at once!”

I don’t blame parents for being frightened- especially those with little to no real knowledge of how vaccines work or are developed and tested. They simply don’t have time to do all the research and when your daily newspaper, talking to you in language written for you, tells you there’s a debate and a controversy to hear about vaccines I think you could be forgiven for making what seems a logical risk-benefit analysis to make. Risk measles – that few people suffer from (they thought) or risk a developmental disability that will affect my child’s, and my life forever. Seemingly no contest.

Health information does change and develop and there is, rightly or wrongly, suspicion around Big Pharma and a perceived authoritarian government. I think if skeptics really want to get their point across about vaccines they have to do the following (and it involves a lot of work!)

– go to meetings of anti-vaxxers (like my friend Simon Clare did) and find out what their actual arguments are. Some are misunderstandings, some are twisted facts. They are many and they are fickle.
– Actually learn how vaccines are made and developed. Find out about their history – it’s more complicated and involved than you may first imagine
– Learn to speak the language of emotion and rhetoric – stories are powerful but numbers are not.
– Rebut specific claims rather than boldly asserting vaccines are safe. Realise some vaccines have been improved and ingredients removed (not because of the danger – because of public perceptions surrounding safety)

– Find really good, hard hitting evidence that’s easy to demonstrate where specific claims are incorrect. This graph is an excellent example (from http://www.medicine.ox.ac.uk/bandolier/booth/vaccines/nommr.html, accessed 21/04/2013)

Graph showing, persuasively that ASD diagnoses continued to rise after MMR was withdrawn in Japan in 1992

Cumulative incidence to age 7 years

NO EFFECT OF MMR WITHDRAWAL ON THE INCIDENCE OF AUTISM: A TOTAL POPULATION STUDY

As I prepare to write a forthcoming Skeptics in the Pub talk on the history and development of vaccines I hope to write and learn more and do some activism around public awareness. Stay tuned.

Pod Delusion Live at QEDcon 2013

April 17, 2013

On Saturday I was privileged to not only appear on the Skeptics in the Pub Panel with Sid Rodrigues of London SitP and Michael Marshall of the Merseyside Skeptics society at QEDcon but I was also on a live recording of the Pod Delusion – I think my 4th appearance.

Here’s what I said:

I do a talk about Autism and quack therapies for it and within that talk I mention vaccinations as a purported cause for Autism. Of course, we know that’s not the case and, historically, in order to fit my talk into 45 minutes to an hour my slide on the MMR vaccine has been curt. It simply reads ‘MMR – I’m sick of MMR’. I then go into a short rant about how MMR should not and should never have been part of the dialogue when it comes to talking about the aetiology of Autism.

However, I may have to alter my talk since MMR is, again, a blisteringly hot topic.

MMR is a vaccine intended to prevent Measles, Mumps and Rubella. I could rehash the story of discredited former doctor Andrew Wakefield and his unethical studies on children in order to peddle his own single vaccinations, but if you’re unaware of this then can I recommend Darryl Cunningham’s comprehensive comic on the subject, available as a link on the show notes. This will give you the background you need if you don’t already know.

The media frenzy surrounding Wakefield’s study results has, without a doubt, clearly influenced the conversation around Autism and vaccines in general. Unfortunately, the British propaganda slogan ‘careless talk costs lives’ is true in cases where journalists take a story like this and run with it. For years and years and years. Even in January this year, we had a story in the Daily Mail with the headline ‘American parents awarded £600,000 in compensation after their son developed autism as a result of MMR vaccine’ – an article by David Gardner – an exceedingly misleading headline given the article itself acknowledges that the decision doesn’t apportion blame or lay fault for the child’s condition with the actual vaccine.

What many parents don’t realise is that measles is highly infectious and can lead to blindness and death. Most people, since the measles vaccination was introduced in the UK in 1968 (63 in the US) haven’t seen a child really suffer with the illness as herd immunity quickly strengthened.

Whooping cough is another deadly illness, with 5 children dying in 2012 – children too young to be vaccinated (under 13 months old) are suffering from the reduction in herd immunity. Between January and June 2012, there were 2,466 confirmed cases.

12 years http://janrebel.eu/100jaar/nggallery/album-19/huizen-in-huizen (correction – should be 15!) since Wakefield’s study was first published, we’re now seeing the deadly and injurious results – an increase of measles cases can be clearly seen since then. In Swansea, at the time of writing on Thursday 11th April, 693 children have been infected.

As Sarah Ditum wrote in the Guardian on Monday April 8th, “with measles cases so low, it was easy to forget what the vaccines were protecting us from.. the illnesses sounded almost picturesque – vintage diseases from the 50s. It was as difficult to imagine as the taste of Spam.”

But now Wakefield is on the offensive. He claims, on Age of Autism dot com, which has, this morning, been republished on the Independent website, that the British Government is culpable for the Measles outbreak, since they have denied parents the single vaccines he was championing. The trouble with single vaccines is that there’s little evidence of a benefit for them. He claims they are not in use solely because the government is trying to cover up the dangers of the combined vaccine and this is motivated by money. However, single vaccines involve delaying protection for children, risking missing the doses and attrition and injecting them three times instead of just once. Adam Finn, quoted in the Independent today, said “his proposal for single vaccines … came straight out of his head…. single vaccines are used in poorer countries that cannot afford MMR. No country in the world has switched from MMR to single vaccines.” What’s most interesting in this statement, for me, is that Autism is in fact found in every culture and every country in the world and chrildren are diagnosed with autism whether they’ve been given a vaccination or not. MMR is given at 13 months old but autism can now be diagnosed as early as 6 months and most parents notice some kind of developmental delay before their child reaches 12 months of age. 

In February 2012 The Cochrane Library published a systematic review called ‘Vaccines for Measles, Mumps and Rubella in children, with the “To assess the effectiveness and adverse effects associated with the MMR vaccine in children up to 15 years of age.”

They searched the Cochrane Central Register of Controlled Trials and used five randomised controlled trials, a controlled clinical trial (CCT), 27 cohort studies, 17 case-control studies, five time-series trials, one case cross-over trial, two ecological studies, and six self controlled case series, concluding “exposure to the MMR vaccine was unlikely to be associated with autism”

Only last week the centre for disease control in the US released a new study that confirmed what we already have enough evidence to assert with good confidence levels – those with autistic spectrum disorders are no more likely to have had more jabs than the other – Frank Stefano, the lead author, stated his study of one thousand children simply found no relationship between vaccine antigens and ASD.

So why does this continue? Why must children suffer from ignorance? Conspiracy theories are attractive and grieving parents who haven’t yet come to terms with their child’s differences – differences they never anticipated – will grab on to anything to take away the blame. It’s cathartic to suggest an outside agent – the government – pharmaceutical companies – are to blame. To put this into context, these are the same people who told the National Autistic Society in May 2012 that 74% of people caring for someone with ASD get no support and only 28% say they receive good info where to go for support and help. The 72% who get no help and information are often the ones sucked in to alternative medicines that are often harmful and very expensive and end up with an ill, frightened and traumatized child.

 If you can, tell just one parent about the vaccine scare and the truth behind it- tell them vaccines are rigorously tested and if they want to really know about vaccines they should read a book on the history of vaccines and not just do bit of Googling and call it research. The websites about vaccines seem so plausible and are pseudoscientific enough to give them a real air of credibility. A little knowledge is a dangerous thing.

 

This has been Tannice Pendegrass, reporting live at QED for the Pod Delusion.

References:

http://www.guardian.co.uk/uk/2012/jul/27/infant-deaths-whooping-cough-epidemic

http://www.dailymail.co.uk/news/article-2262534/American-parents-awarded-600-000-compensation-son-developed-autism-result-MMR-vaccine.html

http://www.guardian.co.uk/commentisfree/2013/apr/08/measles-mmr-andrew-wakefield?INTCMP=SRCH

http://www.guardian.co.uk/society/2013/apr/06/what-happened-man-mmr-panic?INTCMP=SRCH

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004407.pub3/abstract;jsessionid=C6FEF218407B0196EEDC3F533115A40B.d04t04

Demicheli V, Rivetti A, Debalini MG, Di Pietrantonj C. Vaccines for measles, mumps and rubella in children. Cochrane Database of Systematic Reviews 2012, Issue 2. Art. No.: CD004407. DOI: 10.1002/14651858.CD004407.pub3.

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