Andrew Wakefield's legacy

I hadn't been planning on doing any serious pieces to intersperse within the reruns of old posts while on vacation. Despite the impression some have gotten from my Random Observations posts about London and Britain, we've had an absolutely wonderful time the last week and are sorry to see it end. (Although I understand that I might have ruffled a few feathers when I complained about restaurant service, who would have thought that a post about how polite and friendly Londoners seem to us or an intentionally silly post about our failure to have seen any squirrels in London would have ruffled a few feathers? I'm particularly puzzled at some of the reaction to the latter post, although I will point out that we have still not seen any squirrels. Perhaps we should go to Hyde Park and hang out a while as suggested. Over the three day holiday weekend, perhaps I'll describe some of the great things we saw and did while in London. But I digress)

Then what should show up in front of me Friday morning at the news stand? Plastered on the front page of The Times underneath a banner advertising a special commemorative issue for the tenth anniversary of the death of Princess Diana, I found the headline: Vaccine warning as measles cases triple. I had thought that the damage done to the vaccine program by Andrew Wakefield's bogus science and hysterical scaremongering had been starting to abate, but apparently I was wrong:

Parents are being urged to give their children the measles, mumps and rubella jab before the start of the new school year after an unprecedented surge of measles cases was recorded over the summer holidays.

Experts fear that hundreds of thousands of children returning to school as early as next week may cause the highly infectious disease to spread. Despite this the Government has ordered no extra stocks of the MMR vaccine and doctors may run out if they face a sudden rise in demand, The Times has learnt.

The Health Protection Agency (HPA) said that the number of confirmed cases of measles in children had more than trebled over recent months and was far higher than would normally be expected for this time of year.

By June 10 only 136 cases of measles had been confirmed. But just over 11 weeks later this number has risen to 480, with new cases being detected every day, the HPA said. This compares with 756 cases recorded during the whole of 2006 - the highest year on record.

Measles, which can be life threatening or cause severe disabilities, is most common among children aged 1 to 4 who have not been immunised, but can strike older children and adults, too.

It was difficult to explain the large increase this year, the HPA said, but parents not vaccinating their children and a lower uptake of a second MMR "booster" dose are thought to be key factors. The triple vaccine has proved highly controversial in recent years over unfounded concerns that it may be linked to autism. The study that first sparked fears about its safety is currently being scrutinised in a hearing by the General Medical Council, the medical watchdog. Andrew Wakefield and two co-authors of his research are currently appearing before the GMC on charges of serious professional misconduct.

MMR coverage began to drop in the late 1990s, though uptake is rising slowly again. The latest figures show that 88 per cent of British children begin school having had one dose of MMR.

This is Andrew Wakefield's legacy. I do find some hopeful things in this reporting, however. The Times, at least, seems to be getting it. Note how Mr. Rose describes the concerns that the MMR might cause autism as "unfounded." Compare this to previous credulous coverage by some papers and it it heartening to see, as is the accompanying editorial, which describes Wakefield's ideas as "widely discredited." What is disturbing about this report, which got wide play on BBC news, is that the number of cases rose during the summer holiday and have been remaining elevated:

The latest data, for January to March 2007, showed particularly high numbers of measles cases in London and southeast England, East Anglia and Yorkshire and Humberside.

Mary Ramsay, a consultant epidemiologist at the HPA, said yesterday: "We've been very worried because the cases have stayed up over the summer holidays. This means it is crucial that children are fully immunised with two doses of MMR before they return to school."

In previous decades, measles could cause an average of 20 deaths a year. Officials are nervous that the numbers could creep up again after gaps in vaccination coverage. "Although the numbers are still small, compared to the history of measles, we're always worried about measles because very rarely it can kill," Dr Ramsay added. "We hadn't had any deaths from measles since the early 1990s, but unfortunately we had one death last year and we don't want any more.

"Measles is a highly infectious and dangerous illness and, as there is increased close contact in schools, it can spread easily."

But here's the money quote:

Michael Fitzpatrick, a GP in the borough, said that he was disappointed but not surprised by the latest figures: "Scepticism about the MMR vaccine results in outbreaks of measles like this," he said. "This was inevitable and I think the only surprise is this hasn't happened earlier, and on a bigger scale."

Nine years after his trial lawyer-subsidized and shoddy study, Andrew Wakefield's legacy to British children lives on--much to their detriment.

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This is truely sad.

I live in the UK and I am beginning to detect signs of a backlash against Wakefield and parents who refuse to have their children vaccinated. I rather suspect this in part is because the public, especially those currently having children have forgotten just how serious measles can be.

By Matt Penfold (not verified) on 01 Sep 2007 #permalink

The great irony of it all is that because MMR vaccination rates dropped in the UK and the US due to this antivax nonsense, I had to go out and GET a vaccination that I wouldn't have to otherwise. (IIRC, a visitor from the UK was infected with mumps and thus the vector for the US cases.) Because I work in secondary schools and a college, I'm exposed to a lot of students. I am also old enough to predate the MMR, and likely had not been naturally infected, so had no measurable titer and therefore no protection.

In a more reasonable world, measles, mumps and rubella would have been nearly as extinct as smallpox!

Why not just let the kids get sick and see if they survive? That'll just help weed out the weak. I remember when I was a kid the mumps got into my group of playmates and we all got sick and - so what? We felt like crap for a while and got better. End of story.

PS - smallpox is not extinct. There's plenty of it (including new strains) in bioweapons labs and at CDC in Atlanta as well as ATCC in Virginia. It's just a nice evil genie sitting in its bottle waiting for someone to let it out into a populace that has no immunity against it.

Don't you just love governments, human aggressiveness and short-sightedness?

Marcus Ranum said: "Why not just let the kids get sick and see if they survive? That'll just help weed out the weak. I remember when I was a kid the mumps got into my group of playmates and we all got sick and - so what? We felt like crap for a while and got better. End of story."

Because the vaccine is not given until a child is a year old. This is why some of the children in Ireland who died from measles were still infants.

Also, it effects those who have medical conditions that preclude them from getting vaccinations:

Read that article, and please please tell us why those two boys deserved the outcome they had from the actual disease.

Also, how do you know that everyone who had mumps around the time you did came out completely unscathed? How big is your group of playmates? Was it a good sized sample? Did you personally know every child in your county or country who had mumps that year? Once upon a time mumps was the largest cause of post-lingual deafness. The risk of deafness is actually 1 in 10000... but in the American Midwest with only about 2600 infections last summer, FOUR people became deaf.

... "Parotitis was reported in 870 (66%) of the 1,327 patients for whom such data were available. Data regarding mumps complications and hospitalizations are incomplete. However, complications have included 27 reports of orchitis, 11 meningitis, four encephalitis, four deafness, and one each of oophoritis, mastitis, pancreatitis, and unspecified complications. A total of 25 hospitalizations were reported, but insufficient data were provided to determine whether mumps caused all the hospitalizations. No deaths have been reported."

So please explain with great detail why the two boys in the Times Online article deserved encephalis, why the infants in Ireland deserved to die before they were old enough for the MMR and why those Americans last summer deserved meningitis, encephalitis and deafness (along with the other complications).

In a small town in Germany, an unvaccinated preteen infected 9 children in his doctor's practise with measles (at the time, the index case just had a fever). In 2005, one of the infected, Micha, came down with SSPE - you can see Micha here (click on the real video link):…

Earlier this year, another of the 9 infected, a girl, also came down with SSPE. The concious decision of one couple not to vaccinate their own child has effectively killed two children (both babies at the time of infection). That's why it is so important that everyone who can be vaccinated is vaccinated.

By catherina (not verified) on 01 Sep 2007 #permalink

Just to let you know this retort comes out of the absolute indignation I experienced while reading your rather callous comment (I have a health impaired child who did depend on herd immunity for pertussis, at a time when our county was having a pertussis epidemic... just about the time the USA had over 120 measles deaths).

Since you said: "Why not just let the kids get sick and see if they survive? That'll just help weed out the weak."...

Does this mean that you will never vaccinate your children? That if they become ill you will not let them get any kind of medical treatment? Then if they do become permanently disabled or die it will be fine with you, and you will then be satisfied with your remaining children?

I don't know about you, but none of my children are replaceable commodities. Even though Roald Dahl had five children, he was deeply affected by the death of his eldest daugther when she was 8 years old (he dedicated the book _The BFG_ to her after her death). Do you know how his daughter died? It is explained here:

Marcus Ranum said: "Why not just let the kids get sick and see if they survive? That'll just help weed out the weak."

Good heavens! Doesn't anyone recognize sarcasm anymore??

Sorry, #1 Dino... but no, I did not and I still don't.

If someone's infant died from measles contracted from exposure to an unvaccinated child with the disease, could the unvaccinated child's parents be tried for negligent homicide?