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Wednesday, May 01, 2013

Swansea, the history of the MMR scare and a measles epidemic

As the Western Mail notes Public Health Wales says that there has now been 1,011 cases of measles since the outbreak, centred in the ABMU, Powys and Hywel Dda health board areas, began in November. It is worth reflecting on why the epidemic has been so centred on Swansea.

The media and others have already speculated that the campaign run by the South Wales Evening Post ten years or more ago was a major factor in the decision of many parents not to give their child the MMR jab.

Indeed the scare started by Dr. Wakefield still resonates today, with a call to my office just a few days ago by somebody convinced that there is a link between MMR and autism and even stating at one point that autism could be caught in the same way as a contagious disease. For the record there is no link and it cannot be caught in that way.

I had a conversation with a journalist on Friday who questioned why Swansea should be so different from any other part of the country, that take-up rates of MMR should be so low there. They could not bring themselves to believe that the distinguishing factor was the campaign run by the Evening Post.

The Evening Post themselves say that they were only doing their job, that their reporting was balanced and that they had a duty to state both sides of the story. That may well be the case. However, when 95% of scientific opinion is saying that a vaccine is safe and only 5% is questioning its side-effects, a 50-50 balance is not always appropriate.

What cannot be underestimated is how enormously influential the Evening Post was over a decade ago. Its circulation was most probably around 50,000 and it was read and discussed by virtually everybody in the City and the surrounding area. How it reported the news therefore, and the emphasis it placed on the facts at its disposal were key factors in informing people's decision-making processes.

In that context a selection of articles passed to me by a constituent from 2002 are particularly disturbing. The stand-out article is the front page exclusive from Paul Lewis and Peter Slee on Monday 11th February 2002 that announces in inch-high type 'I don't believe MMR jab is safe.'

The article continues: 'A leading health authority member says he believes MMR left his grandson with autism. Noel Crowley, a member of Iechyd Morgannwg Health and Leader of Neath Port Talbot Council, has decided to speak out after his personal experience, His 11 year-old grandson was diagnosed with autism after having the triple measles, mumps and rubella vaccine. Now he wants parents to be given the choice of single jabs.'

The article continues: 'His decision is even more surprising because Iechyd Morgannwg Health has always insisted that the MMR jab is safe. And his warning has come the same day as news of a multi-million pound Government publicity campaign to promote MMR.'

The Evening Post makes it clear that Mr. Crowley disagrees with his own health authority and then reports without comment or qualification the following: 'He said his grandson Sam Parry, aged 11, was given the combined injection when he was 16 months old and the effects were catastrophic. He has since been diagnosed as autistic. "He was a perfectly normal child but immediately after he had the MMR injection he started having a temperature," said Mr. Crowley today. "Within a week he was a completely different child who could not speak and still cannot, and could not do anything for himself."

It is worth noting that Mr. Crowley is not and was not a medical professional, he offered no evidence of any link between his grandson's condition and the MMR jab other than conjecture and no reference is made to any attempt to get a medical opinion on the cause of Sam Parry's illness. However, the fact that Noel Crowley was a public figure and a member of the health board gave his view particular resonance with many readers.

On the front page of the same paper, there is a prominent box headlined 'What you think' which reports on the outcome of a telephone poll in which 82% of Evening Post readers say parents should be offered the single jab, 18% demurring.

An article from 5 February 2002 headed 'MMR fighter praises TV poll' reports that a local campaigner has welcomed a television poll showing 85% of parents questioned agreed with her that there should be an alternative to the MMR vaccine. The reference is to the programme Tonight with Trevor MacDonald.  The item goes on to say:

'The Evening Post has been running a campaign highlighting the issue for the past four years. More than 70 families in Swansea, Neath  and Port Talbot claim their babies developed autism, deafness and bowel disorders after receiving MMR.'

Of course if that causal link actually existed then the paper would still be reporting cases on that scale today. It is not.

On 8 February 2002 the Evening Post published an editorial in which they noted the furious debate that was going on over the MMR vaccine.  They pointed out that politicians were sticking to their position that the jab is safe but went onto say:

'That would all be very well were it not for the fact that a substantial group of parents prefer to believe the evidence of their own eyes. And that evidence is that the behaviour of their children changed after they received the innoculation. Coincidence say the medical experts...come off it reply mum and dad.'

They go on to say that the Evening Post's position is that it is better for children to have the MMR jab than not but then go on to conclude: 'Truth is the Government has backed itself into a corner. Had it been less dogmatic, more understanding and provided separate injections for those who felt unhappy about MMR, the whole problem would have gone away. They can do it in France, so why not in the UK?'

To be fair to the Evening Post on Wednesday 6th Februray 2002 they run two big stories in which a local GP warns that Swansea could be next to suffer a measles outbreak because the immunisation rate is falling for MMR and also a story in which Welsh Government health officials state that MMR remains the safest way for parents to protect their children.

Two days later there is a big story about a mum taking her MMR battle to the Assembly, demanding single jabs be made available, but that is balanced by a full page supporting the case for MMR in a question and answer format. It is worth noting that it is this edition of the paper that contains the editorial referred to above.

Finally, there is the role of politicians. On February 6th 2002 we find a story headed 'Tories want choice on MMR vaccines' in which Shadow Health Secretary, Dr. Liam Fox is quoted as saying that although MMR is the safest method of protecting children, the crisis in public confidence over the triple vaccine means that it is 'reluctantly time to offer parents the choice'.

It is most probably impossible to say why Swansea stands out as it does. Certainly the Evening Post was not the only paper running these campaigns. However, it is my view that their coverage unintentionally impacted on parents' decisions and that the current measles outbreak in South West Wales can be traced back in part to that.
All this could have been avoided if The Lancet had not published Wakefield's lousy piece of 'research' in the first place (involving a tiny self-selecting group of children with autism etc. and no controls whatsoever checking the millions of children who HAD had the MMR jabs without developing problems such as autism).
Um, didn't Jonathan Roberts, the new editor at the evening Post, claim that no-one working in the newsroom these days was involved in the MMR safety campaign? You've just named two people who are still most definitely on the staff.
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