AUSTRALIA: Vaccines need shot in the arm

In 1998, the respected British medical journal The Lancet published a study linking the measles mumps rubella, or MMR, vaccine to regressive autism. Over the next 12 years, the report and its author Dr Andrew Wakefield (pictured) troubled immunologists around the world who failed to replicate the findings.

Wakefield's claims worried millions of parents who had vaccinated their children - children who later developed autism.

But the Wakefield report has been denounced as fraudulent after investigations by British journalist Brian Deer revealed the data used in the study was falsified and neither the research records nor parental recollection matched the published Lancet study.

Deer's investigation was paid for by London's Sunday Times newspaper and Britain's Channel 4 television network and was published online in the British Medical Journal.

In an accompanying editorial, BMJ editor Fiona Godlee and colleagues called Wakefield's study "an elaborate fraud". They said Wakefield's work in other journals should be examined to see if it should be retracted.

In May last year, Wakefield was stripped of his right to practice medicine in Britain.

Many other published studies have shown no connection between the MMR vaccination and autism, but reports of children suffering measles have surged since Wakefield's paper was published and there are sporadic outbreaks in Europe and the US. In 2008, measles was deemed endemic in England and Wales.

In Australia, a Queensland immunologist based at CQUniversity, Dr John McGrath, said it appeared Wakefield used the fraudulent study to aid a legal claim against the MMR vaccine manufacturers.

"It has been reported that two years before his paper was published Wakefield was hired by a solicitor to help launch a speculative lawsuit against drug companies that manufactured the MMR vaccine," McGrath said.

"He was paid behind the scenes to find a new syndrome of bowel and brain disease caused by the vaccine. Alarm bells should have gone off when they were making the claims even before any of the 12 children identified in the report had been studied."

Numerous studies in the US, Britain and Denmark have failed to find any association between the MMR vaccine and autism, McGrath said. "Since the mid-1960s, hundreds of millions of people worldwide have received measles vaccines without developing behavioural problems. Also, when Japan switched from the combination MMR to a single measles vaccine there was no reduction in autism rates."

Despite the huge amount of evidence that contradicted Wakefield's claims, the report of the study remained in the public domain although it was retracted by The Lancet in February last year.

McGrath believes the damage to the reputation of vaccines, particularly to the MMR vaccine, has been immense. He said that following the report of the study, parents had begun to question the safety of vaccines and anti-vaccine groups had begun to emerge, some radically targeting new parents via online websites.

A number of reports that children were being diagnosed with autism shortly after being vaccinated with MMR fuelled anti-vaccine campaigns. But McGrath believes the timing was purely coincidental.

MMR is given during the second year of life and, according to Autism Spectrum Australia's head researcher Dr Trevor Clark. That is also about the time autism first manifests itself although it may be diagnosed as early as 12 months.

While cases of childhood illnesses such as measles are still low, immunologists are concerned about the impact of the drop in immunisation rates. Since the introduction of the MMR vaccine cases of measles, mumps and rubella have all but been eradicated in western societies.

In 1941, more than 890,000 cases of measles were reported in the US but by 1997 this had been reduced to 135 cases. Mumps dropped from more than 150,000 cases to just 612 while rubella fell from more than 57,000 to 161. Similar rates were found in Australia, which had just 10 reported cases of measles in 2005 although there were 43 cases in the first two months of 2011.

"Vaccines have led to the virtual eradication of some terrible infectious diseases including polio, smallpox, tetanus, diptheria and whooping cough, and have decimated rates of others like meningitis and pneumonia in vaccinated populations," McGrath said.

"But with this enormous success, people are becoming complacent with vaccinations and now we are seeing some diseases making a comeback."

McGrath believes that to prevent major outbreaks of preventable diseases such as measles it is essential to establish a 'herd immunity' - achieved when 95% of the population is vaccinated.

"This means that even if you have not been vaccinated yourself, you can be protected because the virus or the bacteria can't live in a population where high numbers of people are vaccinated and therefore if can't move around and spread," he said.

Governments and health organisations might hope for 100% of the population to be immunised but McGrath believes there will always be those who have side-effects from some vaccines and will not be fully immunised.

"There are people that do have reactions to vaccines and that is not something you can predict or prevent. However, if most of the population is vaccinated, the herd immunity effect will protect those that can't be vaccinated because of health or religious reasons."

* Pricilla Crighton is a journalist with CQUniversity in Queensland.