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Scotty, The Naked Time, stardate 1704.3, Episode 7

The Science Museum and MMR

Posted by apgaylard on December 29, 2008

bigstockphoto_doctor_injecting_child_vaccine_26266041I’ve not commented much on the MMR ‘controversy’ manufactured by Andrew Wakefield, his fellow travellers and the media: I’ve left it to better qualified commentators

To date, my only brief foray was on the topic of making decisions in the absence of certainty; a riposte to Dr John Briffa’s apparent instance on being able to be absolutely certain that the vaccine caused no harm before it could be endorsed. 

One of the sources I cited in the piece was the Science Museum’s generally excellent web pages, “The MMR Files“.  Recently bloggers Dr*T , JDC325 and Martin at “The Lay Scientist” pointed out that some of the science museum’s web content is distinctly dodgy.  In particular, it cites the vociferous, bizarre and downright dangerous anti-vaccination campaign group ‘JABS’. 

Aside from giving JABS undeserved credibility the pages also commit the common journalistic sin of ‘balance’.  Giving equal apparent weight (in terms of column inches or air-time) to protagonists is fine where the competing views both have merit.  If, however, one of the views is very much weaker than the other this approach starts to give undue credibility to the weaker view.  In the context of the MMR ‘debate’ this approach has given the impression that concerns which lacked any robust evidential basis were at least as valid (if not more so) than judgements backed up by good (though not perfect) scientific work.

I feel that I must point out, before I go on, that I have tremendous sympathy for those who find themselves, or a loved one, disadvantaged through ASDs (or perhaps a world that doesn’t understand people with ASDs).  This includes those involved with JABS.  However, as will become evident, I don’t think that anyone’s best interests are served by barking (very loudly) up the wrong tree.  Particularly if this involves undermining essential – and life-saving – vaccination programmes.  Neither do I think that being in pain yourself gives you the right to inflict it on others

So, taking (considerable) inspiration from their letters of complaint, I’ve sent one in as well.  [Note: I've disabled the JABS links as I don't really want to poke them with a stick!] 

Dear Science Museum, 

I was browsing your “mmr files” pages and though they have much to commend them I have some serious concerns about the some of the content. 

Given that measles infections are running at alarming levels, and have already resulted in deaths, your giving credibility to the rabid anti-vaccination campaign group “JABS” is as baffling as it is dangerous.  It is also highly irresponsible to be raising the ‘single vaccine’ issue when there is not a jot of evidence that this is either safer or as effective. 

Their claims, that their children have been damaged by the MMR vaccine are absolutely without foundation.  Whilst I have every sympathy for sick children and their parents, choosing to blame vaccines is not merely scientifically baseless (as you should know) but dangerous. 

Please review the JABS website.  This group actively discourages vaccination and perpetuates myths about MMR.  This puts the lives of children at risk.(See hxxp://www.jabs.org.uk/forum/topic.asp?TOPIC_ID=1186 and hxxp://www.jabs.org.uk/forum/topic.asp?TOPIC_ID=3370 for example) 

Please revise the following pages on your website to reflect science, rather than the tragic misapprehension of some understandably angry and upset parents; and your own strange attempt to balance reason with irrationality:

http://www.sciencemuseum.org.uk/antenna/mmr/cip4/128.asp

http://www.sciencemuseum.org.uk/antenna/mmr/cip4/121.asp

http://www.sciencemuseum.org.uk/antenna/mmr/cip4/124.asp

This latter page is also questionable, taken in isolation it could be construed as hinting at a government cover-up: 

“When we spoke to him, the Department of Health’s David Salisbury wasn’t keen to be drawn on single vaccines. He says MMR is protecting the population – even if 10 per cent fewer people are taking it – but is there another reason?” 

It does no one any good to pretend that there is a legitimate ‘debate’ or ‘controversy’ here: there is not.  If you are in any doubt on this matter then may I refer you to the excellent “Austism’s False Prophets” by Dr. Paul Offit. 

Please stop giving the bizarre fringe group JABS credibility: their views have none.  

Please stop adding fuel to the anti-MMR fire yourselves. 

Your “mmr files” have a lot of good information in them.  Please stop contaminating them with irrational anti-scientific content. 

If the science museum does not stand for science and reason, then, what is its purpose? 

Sincerely,

To avoid this being nothing more than a ‘me too’ post, I’d just like to mention where the MMR saga is today, in terms of the evidence.  As I’ve just read Paul Offit’s excellent book “Autism’s False Prophets” I’ll leave it to this humane doctor. 

“The science is largely complete.  Ten epidemiological studies have shown MMR vaccine doesn’t cause autism; six have shown thimerosal doesn’t cause autism; three have shown thimerosal doesn’t cause subtle neurological problems; a growing body of evidence now points to the genes that are linked to autism; and despite the removal of thimerosal from vaccines in 2001, the number of children with autism continues to rise.”

[Offit PA, 2008, Autism's False Prophets. Columbia University Press, p.247]

On page 256 he also lists “Studies exonerating MMR”.  Here are the references, with links to the on-line content where available.  (It’s gratifying to note how many of these studies are not hidden behind pay-walls.)

Taylor B, Miller E, Farrington CP, Petropoulos M-C, Favot-Mayaud I, Li J, Waight PA, (1999) Autism and measles, mumps, and rubella vaccine: no epidemiological evidence for a causal association The Lancet, Vol 353, June 12, 1999, pp. 2026-29.  http://dx.doi.org/10.1016/S0140-6736(99)01239-8 

Peltola H, Patja A, Leinikki P, Valle M, Davidkin I, Paunio M, (1998) No evidence for measles, mumps, and rubella vaccine-associated inflammatory bowel disease or autism in a 14-year prospective study, The Lancet, Vol 351 May 2, 1998, pp. 1327-28.  http://dx.doi.org/10.1016/S0140-6736(98)24018-9

DeStefano F, Chen RT, (1999) Negative association between MMR and autism, The Lancet, Volume 353, Issue 9169, Pages 1987 – 1988, 12 June 1999. http://dx.doi.org/10.1016/S0140-6736(99)00160-9

Fombonne E, (1999) Are measles infections or measles immunizations linked to autism?, Journal of Autism and Developmental Disorders, Vol. 29, No. 4, 1999.  http://dx.doi.org/10.1023/A:1022123822135 

Kaye JA, del Mar Melero-Montes M and Jick H, (2001) Mumps, measles, and rubella vaccine and the incidence of autism recorded by general practitioners: a time trend analysis, British Medical Journal 2001; 322; pp. 460-463.  http://dx.doi.org/10.1136/bmj.322.7284.460

Davis RL, Kramarz P, Bohlke K (2001) Measles-Mumps-Rubella and Other Measles-Containing Vaccines Do Not Increase the Risk for Inflammatory Bowel Disease: A Case-Control Study From the Vaccine Safety Datalink Project, Arch Pediatr Adolesc Med. 2001;155:354-359.  http://archpedi.ama-assn.org/cgi/content/full/155/3/354

Dales L, Hammer SJ, Smith NJ, (2001) Time Trends in Autism and in MMR Immunization Coverage in California. JAMA. 2001;285:1183-1185.  http://dx.doi.org/10.1001/jama.285.9.1183

Farrington CP, Miller E and Taylor B (2001) MMR and autism: further evidence against a causal association. Vaccine, Volume 19, Issue 27, 14 June 2001, Pages 3632-3635.  http://dx.doi.org/10.1016/S0264-410X(01)00097-4

Fombonne E and Chakrabarti S, (2001) No Evidence for A New Variant of Measles-Mumps-Rubella-Induced Autism. Pediatrics 2001; 108; e58 http://dx.doi.org/10.1542/peds.108.4.e58

Halsey NA, Hyman SL et al. (2001) Measles-Mumps-Rubella Vaccine and Autistic Spectrum Disorder: Report From the New Challenges in Childhood Immunizations Conference Convened in Oak Brook, Illinois, June 12-13, 2000 http://dx.doi.org/10.1542/peds.107.5.e84

Taylor B, Miller E, Lingam R, Andrews N, Simmons A, and Stowe J (2002) Measles, mumps, and rubella vaccination and bowel problems or developmental regression in children with autism: population study.  BMJ 2002; 324(7334):393 (16 February), http://dx.doi.org/10.1136/bmj.324.7334.393

Madsen KM, Hviid A, Vestergaard M, Schendel D, Wohlfahrt J, Thorsen P, Olsen J, and Melbye M (2002) A Population-Based Study of Measles, Mumps, and Rubella Vaccination and Autism. The New England Journal of Medicine, Vol. 347, No. 19, November 7, 2002, pp. 1477 – 82.  http://content.nejm.org/cgi/content/full/347/19/1477

Mäkelä A, Nuorti JP and Peltola H (2002) Neurologic Disorders After Measles-Mumps-Rubella Vaccination.  Pediatrics 2002; 110; 957-963. http://dx.doi.org/10.1542/peds.110.5.957

Offit PA and Coffin SE, (2003) Communicating science to the public: MMR vaccine and autism.  Vaccine, Volume 22, Issue 1, 8 December 2003, Pages 1-6 http://dx.doi.org/10.1016/S0264-410X(03)00532-2

DeStefano F, Bhasin TK, Thompson WW, Yeargin-Allsopp M and Coleen Boyle (2004)  Age at First Measles-Mumps-Rubella Vaccination in Children With Autism and School-Matched Control Subjects: A Population-Based Study in Metropolitan Atlanta.  Pediatrics 2004; 113; 259-266.  http://dx.doi.org/10.1542/peds.113.2.259

Fombonne E, Cook EH (2003) MMR and autistic enterocolitis: consistent epidemiological failure to find an association. Mol Psychiatry. 2003 Feb;8(2):133-4 .  http://dx.doi.org/10.1038/sj.mp.4001266

Wilson K, Mills E, Ross C, McGowan J, and Jadad A (2003) Association of Autistic Spectrum Disorder and the Measles, Mumps, and Rubella Vaccine – A Systematic Review of Current Epidemiological Evidence.  Arch Pediatr Adolesc Med. 2003; 157: 628-634.  http://archpedi.ama-assn.org/cgi/content/full/157/7/628

Honda H, Shimizu Y and Rutter M (2005) No effect of MMR withdrawal on the incidence of autism: a total population study.  Journal of Child Psychology and Psychiatry 46:6 (2005), pp 572-579. http://dx.doi.org/10.1111/j.1469-7610.2005.01425.x

And here’s an interesting study from this year, not cited by Offit, but well worth a read:

Hornig M, Briese T, Buie T, Bauman ML, Lauwers G, et al. (2008) Lack of Association between Measles Virus Vaccine and Autism with Enteropathy: A Case-Control Study. PLoS ONE 3(9): e3140. doi:10.1371/journal.pone.0003140

As Offit says, “The science is largely complete.”  As far as it’s possible to tell, MMR does not cause autism.  With a topic as complex as the causation of a diverse disorder, the evidence is as compelling as could be expected. 

The idea that vaccination causes autism is, as the philosopher Imre Lakatos would have it, a degenerate research programme.  It is clearly past time to move on and look at more credible causes; plus what can be done to help people with ASDs and their families. 

Unfortunately it seems that some individuals (see here and here, for example) and advocacy groups have become so invested in this idea that it is going to be incredibly painful for them to back away – even if they are able – from the idea that autism is the result of vaccine damage.  As Offit also mentions, a whole rag-bag of medical practitioners and alternative therapists also have a strong financial interest in perpetuating this failed hypothesis. 

Thanks to a scientifically illiterate (or disinterested) media, some vocal advocacy groups, bad scientists (a.k.a. Andrew Wakefield), self-interested medical practitioners and certain elements in the CAM movement it is going to be very difficult to dislodge this dangerous idea from its place in the popular imagination. 

The science museum – if it really stands for science – should be standing clear of these pressures and telling it how it is; not muddying the waters with misplaced compassion and a bogus notion of ‘balance’.  I hope that they make some sensible revisions. 

Postscript:

20th January 2009.

The Science Museum’s Holly Cave let me know today that the link to JABS is to be removed from their web pages. Also some other tidying up is being done to these rather out of date pages. This good news is covered in more detail by the Thinking is Dangerous Blog.

[Edit: 30/12/2008 Missed reference to the "The Lay Scientist" blog added]

[BPSDB]

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5 Responses to “The Science Museum and MMR”

  1. dvnutrix said

    Thank you for commenting on Offit and so generously providing the online references – very helpful.

    It’s odd isn’t it – I was recently reading WDDTY or some such and I saw a complaint from them that the MMR files at the Science Museum were obviously biased because the original museum exhibit had an interactive game in which children were encouraged to vaccinate babies to prevent them from dying of measles.

  2. apgaylard said

    dvnutrix: Thanks. Just trying to add some value. I really enjoyed Offit’s book. One of the very good things about it is the way it explains why he has got where he is. It’s also very clear on the science and well referenced. The parallels he draws with the arrival of polio in the US are striking as well.

    One of the (many) oddities of the anti-vaccination movement is a denial of the dangers of illnesses like measles. I’ve seen the odd comment along the lines of “I had X when I was a kid and I’m OK”. When, of course, they are here to complain – so they were clearly not the unlucky 1 in 10,000 ish (measles)who are not.

    They also have a very ‘first world’ prespective. For them, the benefits and sucesses of vaccines in the developing world don’t seem to count.

  3. stavros said

    apgaylard, great post once again. Offit’s book is very close to the top of the pile now, so I should be reading it in the next few weeks probably :-)

    a denial of the dangers of illnesses like measles” as always for them epidemiological data just doesn’t count compared to personal experiences…

  4. apgaylard said

    Stavros: Thanks. I appreciate you taking the time to comment. Your point on epidemiology is well made; they just can’t see it as the summation of personal experience (BTW I thought that Ben Goldacre’s 2006 ‘science museum’ debate contribution made a really good fist of linking personal experience to the science; shame that a lot of the audience were not there to listen)

    Perhaps its something to do with the perception of science as cold, technical and divorced from what makes us human – rather than an integral part of the human experience?

    I do have time for those personally affected – when something bad happens to a loved one then it’s natural to feel anger, frustration and to lash out.

    Whilst understanding that, it’s dangerous to be swept along with it; and immoral to exploit it.

    Thanks again.

  5. [...] This will get anyone directly through to my list of studies listed by Offit. It’ll save anyone the bother of working through the rest of the post. [...]

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