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1 Measles is a serious disease.
2 The measles vaccine is effective. (http://www.phls.co.uk/facts/Immunisation/Measles/meas.htm)
3 High levels of vaccine uptake create "herd immunity"
which can create the conditions where the measles virus cannot
survive and reproduce in the vaccinated population.
4 If we achieve herd immunity in the UK, this does not mean that
we can then cease vaccination, because that would leave our population
with no natural immunity, vulnerable to measles imported into
the UK from areas where measles virus still exists in the wild.
5 Measles vaccination will therefore have to continue in the UK
for the indefinite future, into a time when the actual condition
of measles will be a historical note in the medical textbooks.
The vaccination can only stop when the measles virus will have
been eradicated through a programme of global vaccination.
6 In contemplating a vaccination programme on this scale, we must
be certain that the measles vaccine that we are using is as safe
as possible.
7 Combined vaccines require less injections, so population uptake
is better than with single vaccines; but compliance must not override
safety.
8 Since combination vaccines (up to six antigens are routinely
given to infants at vaccination sessions) present a more complex
challenge to the immune system, and since there is some evidence
that wild measles and mumps virus may interact to produce adverse
results in the body, the onus is on the vaccination policy makers
to give clear evidence that combined vaccines are as safe as single
vaccines. The experts discount this possibility, but i remain
uneasy about it.
9 All effective treatments have side effects, and vaccines are
no exception to this rule.
10 Since measles vaccine is a live attenuated (weakened) virus,
it is right to look for evidence that it could produce some of
the same effects in the body as wild measles virus.
Dr Wakefield said he had found anecdotal evidence of autism and
bowel disorder following measles vaccination. (Ileal-lymphoid-nodular
hyperplasia, non-specific colitis, and pervasive developmental
disorder in children, A J Wakefield, et al. Lancet 1998; 351:
637-41; search www.lancet.com) However, it emerged in 2004 that
Dr Wakefield had a financial interest in developing an alternative
vaccine, and his team found no evidence of measles virus in their
gut samples.
Epidemiological surveys have not confirmed Wakefield's observations,
but they have shown that bowel disorder is more common in children
with autism. (Measles, mumps, and rubella vaccination and bowel
problems or developmental regression in children with autism:
population study Brent Taylor, Elizabeth Miller, et. al., BMJ
2002; 324: 393-396. Search at www.bmj.com)
11 It is noteworthy that the condition of some autistic children
improves when they exclude certain foods from their diet.
12 It now seems to me pretty unlikely that a sensitivity to the
MMR vaccine triggers cases of autism.
13 Autism is a serious disease, and its incidence has roughly
doubled in Western countries in the last 20 years. It is probable
that this increase is not due to increased use of the diagnostic
category, but is the result of some environmental factor or factors.
They must be identified.
14 No hypothesis is ever "proven" in science; only "not
yet disproven" .
15 The hypothesis that the MMR (or the measles vaccine) is involved
in autism has been weakened by the epidemiological work, and I
now do not believe it.
16 After BSE and FMD, Government scientists have to long way to
go to regain the trust of the people. They need to learn to engage
in serious and detailed dialogue with scientifically literate
people who take a different view to the Government line. The use
of vigorous denial of any problem is a political and not a scientific
tool.
17 It is possible that a vaccination programme might be beneficial
in preventing a disease that kills say 100 people a year, but
that adverse reactions to the vaccine might kill or disable say
1 person a year. In that case it would be ethical to continue
with the vaccination programme, but only if the family of the
victim of the programme were to receive compensation for what
could be a sacrifice pro bono publico. Instead of this, people
who have reason to believe that their children have been damaged
by vaccination tend to meet with a wall of official denial.
18 In conclusion, far more systematic studies need to be made
on the effects, both wanted and unwanted, of vaccination.
Richard Lawson
19.11.04
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