The Lancet has finally withdrawn the paper on MMR and autism that it published 12 years ago. The study: “Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children” consisted of a series of 12 children all of whom had been referred in to a paediatric gastroenterology unit with a triad of autism-like symptoms, abdominal pain and diarrhoea. Note that this study is little more than a series of linked case studies with a very strong pre-selection bias towards gastroenterology (they were referred in to the gastroenterology unit).
The study was seized upon by the anti-vaccination groups, despite its deep inadequacies, and used to promote unreasonable fear of the vaccination process. Long-time readers of this blog will know that I am not a fan of the drive to indiscriminately vaccinate children against every known disease. It seems to me that this is likely to be a counterproductive policy in the long run because each addition to the armamentarium of needle-weilding nurses meets with more and more parental resistance. After all, it is a traumatic experience having your child vaccinated. At some point (which we may have already reached) parents are just going to say “forget it” and ignore vaccination entirely. Of course articles like the above study simply reinforce this tendency.
I can’t see that the belated withdrawal of the study is really going to make any difference to this situation. At this stage, the withdrawal merely intensifies the suspicions of parents (look, they’re suppressing the truth) who increasingly tend to see the myriad of vaccines as just a ploy of vaccine manufacturers to make money. Given the combination of trauma and fear-driven conspiracy theory, it is a wonder that any parent has their child vaccinated!
I see a fair number of parents who opt out of the vaccination program. I usually try to (gently) persuade them to have the DTP, Polio and HiB courses. All of these diseases (Diphtheria, Tetanus, Pertussis, Polio and Haemophilus Influenza B) have appreciable mortality and are worthwhile having your child protected against. Thereafter, the benefit of vaccines compared to their cost becomes more and more dubious. Judging by the almost hysterical reaction of the public health department, one would have thought the recent measles “epidemic” – that did not actually happen – was an outbreak of ebola virus. Families who had not vaccinated their kids were being treated like some sort of plague factory. Measles is very unpleasant but not really a great deal more dangerous than seasonal flu, so some sense of proportion would have been helpful.
While the Lancet’s response to a poorly written article was “too little, too late”, the vaccination program could well be characterised as “too much, too soon”.