| MMR: The zombie controversy that lurches on The MMR vaccine makes an unwelcome return to the headlinesI thought it was over. I thought it was finished. But then I flicked on the TV and saw that Ultimate Big Brother was on, some monstrous new zombie version of the interminable celebration of mediocrity, and now I'm too traumatised even to glance at a TV Guide until probably around December time, when I have my annual "oh dear God is this really what they're putting on the telly for Christmas" moment. But even that doesn't compare to the nausea-inducing sight of the letters "MMR" plastered across the front of the Mail on Sunday like an immigrant who made house prices go up. Once again the MMR vaccine has hit the headlines, and once again the journalism involved has been less than stellar.Having apologised to the shopkeeper for all the swearing, I hurried back home to pour a stiff brandy and take a look at the article. The facts of the case are fairly straightforward. Some 18 years ago Robert, the then 13-month old son of Jackie Fletcher, was given an MMR vaccination. Ten days later he began suffering seizures that left him "epileptic and severely retarded". Fletcher believes that the MMR vaccine was responsible and has fought a long campaign for compensation, which she was eventually awarded last week by the government's Vaccine Damage Payment Scheme. Previous applications failed on the grounds that it was impossible to prove that the vaccine was responsible, but on appeal a new expert panel (consisting of a barrister and two doctors) agreed - though not unanimously - that the "temporal association" was enough to pay out on. That means Jackie Fletcher now has £90,000, which she's apparently going to spend on home improvements that will benefit her severely disabled son. On balance, I think that's a good thing, and I hope the money goes some way towards reducing the burden Fletcher faces as a full-time carer.The problems start when people try to make this story into something it isn't, for example by splashing it across the front page of the Sunday edition of their newspaper with a headline like "Family win 18 year fight over MMR damage to son: £90,000 payout is first since concerns over vaccine surfaced". There is a real danger that a decision like this will end up being used by anti-vaccination activists in the way that the case of Hannah Poling was in the United States. The first and most important point to make is that this case tells us nothing new about the safety of MMR, for two broad reasons. Firstly, it's a legal verdict, not a scientific one, which was reached by a panel of one barrister and two doctors, and where one of the doctors disagreed with a verdict that was at best tenuous. Correlation in time isn't proof of causation, any more than hearing a car drive past the window as my WiFi dies is evidence that nearby traffic affects my internet connection (although it still feels good to shout at them). A great weakness of the human mind is that we tend to be good at finding patterns and relationships where none actually exist. Secondly, the fact is that vaccines do have risks and side-effects. Although research has failed to find any general link between MMR and brain damage, it's plausible that some rare reaction to the vaccine resulted in Fletcher's predicament; but that shouldn't be seen as evidence of a wider problem, as the panel's judgement makes clear:"We would stress that this decision is fact-specific and it should not be seen as a precedent for any other case. In particular, it has no relevance to the issue... as to whether there is a link between the MMR vaccine and autism."Even if this was a reaction to the vaccine, we know from decades of using it that the chances of it happening are so rare as to be insignificant compared to the risk of contracting the diseases the vaccine protects from. Millions of doses of MMR have been dished out with only a handful of cases like Fletcher's; but measles is far more dangerous, with 1 in 1000 cases in the UK causing inflammation of the brain - 40% of those leading to permanent brain damage. In short then, this is a one-off legal decision, and yet the Mail on Sunday's headline tries to conflate this with the wider, long-since discredited concerns about MMR and autism. While the Mail accepts that the link between MMR and autism has been discredited, it seems to do so grudgingly, and the article is a great example of "false balance", with sensible contributions placed against the likes of MP Nadine Dorries and Dr Marcel Kinsbourne.Kinsbourne was brought in as an "expert witness" for the appeal, where apparently "he explained the biological changes which had occurred in Robert's brain following the vaccination." His presence in this story is quite disturbing, given that Brian Deer's investigations revealed through a Freedom of Information request to the Legal Services Commission that he pocketed over £400,000 working as an expert witness for a solicitor trying to build a case against MMR. Needless to say this isn't mentioned in the Mail piece, but one wonders why such a controversial figure was called to give evidence at all. Nadine Dorries has somehow managed to grab a place on the Health Select Committee for this parliament, and blunders into the debate with a gem of a quote which neatly ignores the panel's warning that the verdict isn't applicable more widely:"If an independent panel has reached the conclusion that there has been a link between the MMR vaccine and the brain damage suffered by this boy in this case, then it is fair to assume that there could be as many as thousands of children and parents in the same position."Dorries is needlessly fanning the flames, but of course her comment feeds nicely into the Mail's narrative, which seems to be based on the story of hundreds of plucky parents, fighting to get justice for damage caused by a jab that the (Labour) government insisted was safe. It's a view that's reinforced by the inclusion of a highly sympathetic comment piece by journalist Sally Beck (underneath the main article on the same page), which portrays the struggle of parents seeking compensation without any real attempt at scrutiny of their claims. It's a bloody good narrative too. There are many parents out there with children they sincerely believe to have been damaged by vaccines. A few of them might actually be right, but in any case I wouldn't begrudge all of them receiving compensation like Jackie Fletcher has - there are far worse ways to spend public money. But MMR is a safe vaccine, it's been in use for 22 years now, and it's time that journalists at the Daily Mail and elsewhere started putting science ahead of a good story. But for many of these hacks, the MMR controversy isn't over. Like the tales of Japanese soldiers found deep in jungles unaware that the war has ended, they seem to exist in a sort of jungle of misunderstanding, still debating an issue which has long since been resolved, and thus producing journalism which is almost as bad as this jungle metaphor. The problem is that this creates a kind of feedback loop. Readers commenting in the Daily Mail claim there's been "too much controversy" surrounding it, the irony being that the controversy has been generated by papers like the Mail itself. With vaccination rates struggling to reach pre-Wakefield levels, their reporting could yet have serious consequences for public health.MMRMedical researchControversies in scienceHealthMail on SundayMartin Robbinsguardian.co.uk © Guardian News & Media Limited 2010 | Use of this content is subject to our Terms & Conditions | More Feeds guardian.co.uk |
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