Wary parents have proved the experts wrong before. They will do so again

The case against MMR

One of the fundamental rules of medicine is to listen to your patients because the clues to their disease lie in their story. If you forget that rule, it is time to leave the ward.

One of the fundamental rules of medicine is to listen to your patients because the clues to their disease lie in their story. If you forget that rule, it is time to leave the ward.

In 1995 I was approached by parents - articulate, well-educated and concerned - who told to me the stories of their children's deterioration into autism. The children had developed normally for the first 15 to 18 months of life when they received the MMR vaccination. But after a variable period the children regressed, losing speech, language, social skills and imaginative play, and descending into autism.

The parents described developmental regression in a normally developing child, bowel symptoms the severity of which appeared to parallel the behavioural problems, and an association with the MMR vaccination.

The parents said their children had a bowel disease underling their autism. They were right. The pain, diarrhoea and abdominal bloating suffered by their children, often for many years, reflected a novel and characteristic inflammatory bowel disease. The initial findings, published in the Lancet, were so consistent and so unexpected they merited publication in their own right.

A detailed follow up study was published last October in the American Journal of Gastroenterology confirming the presence of a new bowel disease in these children.

The number of autistic children investigated stands at more than 170; our waiting list grows by the day.

Parents who had raised concerns with their child's paediatrician or vaccine experts at the Department of Health were told it was "coincidence". MMR is given in the second year of life when the symptoms of autism are often first noticed by parents. Doctors had not listened. What the parents described was not classical autism but regression in a previously normal child accompanied by symptoms of systemic disease.

Since 1995 my colleagues and I have reviewed all of the available studies of measles and MMR vaccine safety. Our analysis of pre-licensing trials of MMR shows they were inadequate.

The success of vaccination programmes depends upon trust and the loss of trust has the potential to compromise vaccination strategies. The DoH's decision to withdraw the license for importation of monovalent measles vaccine was wrong. If protection against measles is a principal concern, surely it is important to allow parents to use the monovalent vaccines when they are concerned - rightly or wrongly - about the safety of MMR. The public must be offered a choice. For MMR, autism, and inflammatory bowel disease, suspicion exists without adequate evidence of safety. While doubts remain - give parents a choice. They have proven our profession wrong before; they will again.