MMR study dismisses fears as groundless

A MAJOR study of children who had the triple MMR vaccine against measles mumps and rubella has found no evidence of a link with bowel disease and autism.

Public confidence in the MMR vaccine was severely dented two months ago when researchers at the Royal Free Hospital, London, published a study of 12 children with bowel disease and autism in the Lancet which suggested there might be a connection with the vaccine.

In some areas of the country, up to 25 per cent of parents refused permission for their children to have the triple vaccine, which is normally given in the second year of life, after one of the researchers, Dr Andrew Wakefield, recommended that it should be split into its component parts and given separately to reduce the shock to the developing immune system.

A subsequent meeting of 37 scientists brought together by the Medical Research Council at the request of Sir Kenneth Calman, the Government's Chief Medical Officer concluded there was no reason to change current vaccination practice. However, parents have continued to refuse MMR and the health department is considering an advertising campaign to restore public confidence.

Now scientists in Finland have found further evidence for the safety of the vaccine. Researchers from Helsinki University traced children who received the vaccine over 14 years between 1982 and 1996. Around 3 million doses of vaccine were given but there were no cases of autism or any similar syndrome.

The researchers, who publish their findings in tomorrow's Lancet, found 31 children developed symptoms such as fever, diarrhoea and vomiting within 15 days of the vaccination but most recovered within a week. A one-year- old boy had diarrhoea for six weeks but he recovered and was healthy six years later.

The researchers conclude that "over a decade's effort to detect all severe adverse events associated with MMR vaccine could find no data supporting the hypothesis that it would cause pervasive developmental disorder [autism] or inflammatory bowel disease."

The Royal Free study is challenged in a second series of letters in the Lancet. Dr David Walker, of the department of public health medicine at Durham health authority, describes the association between the vaccine and the diseases as "anecdotal reporting of a biased sample". He says it is "poor science which has no place in a peer-reviewed journal".

Defending his decision to publish, Dr Richard Horton, editor of the Lancet, said: "The description of what seems to be a new syndrome and its relation to possible environmental triggers was original. Peer review confirmed that the paper merited publication." He added that "other investigators must urgently seek to confirm or refute" the findings. The Finnish researchers are the first to do so.

Sir Kenneth Calman has ruled out making the three vaccines available separately to parents who requested them on the grounds that it would be "bad medicine." It would mean children having three injections instead of one and exposed them to the risk of going for two years without at least one vaccine during a critical period.