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Re: Re: MMR and Japan: a commentary by Wakefield and Stott

http://bmj.bmjjournals.com/cgi/eletters/330/7483/112-d#99926

What does the Japanese study really show?

Firstly, to mention some important relevant points,

Point 1. When Wakefield (and his colleagues) demonstrated the link between the MMR and autism, he recommended that parents give their children all 3 vaccines M, M and R as separate injections, one year apart.

Point 2. Japan is an ideal country to study the causal effect between a variety of vaccines and their reactions because there were many important and profound changes in that country in respect to the timing of vaccination schedules and the push, or lack of it, for high vaccination levels.

Point 3. Japan has no qualms about using the word “cause” when looking at the observed reactions to vaccines.

Now to the main subject matter:

The dynamics of ASD (autistic syndrome disorders) and MMR vaccine-use dynamics in Japan show a perfect fit - the introduction of MMR in 1989 was followed by a high incidence of ASD (85.9) and a fall in the incidence of ASD followed the fall in the use of MMR in 1990-3 (down to 55.8), when MMR use was discontinued (in 1993).

The sharp rise in the ASD incidence after 1994 to 161 (121.8-200.8) is not controversial or unexpected or unexplainable at all. It coincides perfectly with the Japanese public’s and professional restoration of confidence in MMR given as individual vaccines within 4 weeks of each other. It is the individually given measles vaccine that caused that observed rise in ASD.

This highlights the fallacy and dangers of advising UK parents to trust individual M M R vaccines. They are not only useless but also dangerous and no doubt cause autism. Daily Mail (Letters) (3.1.2001) described two cases of UK children developing autism after the single measles jab (see http://www.vaccination.inoz.com/Case%20stories%20-%20autism.html). Wakefield and Stott (as above) admit: “Third, that children that had experienced concurrent natural measles (or single measles vaccine) and natural mumps infection within the same year were at significantly greater risk of later inflammatory bowel disease (3).”

In my opinion, Honda et al. obviously missed this important connection and their analysis was too black and white and limited to only linking MMR and ASD and not M (measles) vaccine when given individually. Nature does not think in concepts like the human species does. For Nature, M (measles) vaccine causes autism whether given individually or together with other vaccines as MMR. That is what the Honda et al. data showed beyond a shadow of a doubt.

I do not share Wakefield and Stott’s opinion that redistribution of Kohoku Ward affected the study data, After all, the dynamics of M M R vaccines given individually were the same in the whole of Japan due to the above-mentioned general acceptance of the individual M M R vaccines.

If vaccination with MMR and M (measles) were both discontinued autism would greatly diminish. It would disappear within a few years if all vaccinations were discontinued. Let’s not forget that Kanner (1943) identified autism at the time when there was no MMR and no individual M M R vaccines) and then it was caused by DPT, DP and later on by polio vaccines, in combination with Hib vaccines….

Other Japanese researchers (Sugiura and Yamada 1991: 211) indirectly provided unequivocal support for this conclusion.

“Incidence of aseptic meningitis among recipients of MMR and monovalent mumps vaccines … was 1 in 2026 and 1 in 6564 vaccinees, respectively… the Infectious Diseases Control Committee of the Ministry of Health and Welfare recommended that the MMR vaccination is done with caution. Thereupon the use of MMR vaccine sharply dropped and so did vaccine-caused meningitis.” I also quote Makoto Yawata (1994) who wrote: “The Japanese Ministry of Health and Welfare (MHW) has released a report on the domestically produced measles-mumps-rubella vaccines that were withdrawn in April 1993, because of vaccine-associated aseptic meningitis. According to the report, an average of 1 in 1044 vaccinations has been complicated by aseptic meningitis. Aseptic meningitis had been reported to be a complication of the MHW measles-mumps-rubella vaccine from the start of its introduction into the national vaccination programme. Originally, the MHW reported that 1 case of aseptic meningitis occurred with every 100 000 to 200 000 injections. 6 months later, the ministry was forced to correct the figure to 1 in several thousand and to urge caution in the use of measles-mumps-rubella vaccines and to compile a manual for doctors on the prescription of these vaccines. When introduced, measles-mumps-rubella vaccination was mandatory, but later, as reports of adverse effects of the vaccine increased, it was reclassified as one being available on request. The measles-mumps-rubella vaccination programme was suspended when vaccines were withdrawn”.

In addition to the above, Sugiura and Yamada (1991) wrote that “Most vaccine-associated aseptic meningitis cases occurred among the recipients of the Urabe Am9 vaccine, partly because the vaccine was used more widely than any of four other subsequently licensed mumps vaccines”. This means that other mumps vaccines also may and did cause meningitis. This is contrary to Wakefield and Stott’s assertion that only Urabe Am9 strain caused meningitis.

Another comment by Sugiura and Yamada (1991) is worth quoting:

“There was a slight but significant delay of the onset of MMR vaccine -induced meningitis in comparison with that induced by monovalent Urabe Am9 mumps vaccine. This was not a result of a different potency of the mumps component contained in the two vaccines, nor was it due to the different age distribution of the recipients of the two vaccines, because there was no age-related delayed onset within the MMR recipients. The difference might have occurred from interference of the measles and/or rubella components with the replication of the mumps component.” In other words, there could have been a delaying effect of measles and rubella viruses on the mumps virus replication in the MMR vaccine. This would explain the often delayed onset of autism after MMR and also means that the individual measles vaccine could speed-up the development of autism. It also means that the Japanese study by Honda et al. showed the causal link between the measles vaccine (both as a component of MMR and individually) and autism.

As usual, there is more: when it transpired that the MMR vaccine containing the Urabe Am9 strain was causing meningitis in the UK babies (Anonymous 1992), it was withdrawn in the UK and sold to Brazil. It was used there, unwisely I may add, within a few days in a mass vaccination programme. This resulted in a substantial upsurge in the cases of meningitis as demonstrated by Dourado et al. (2000).

I just thought that it would be useful to put the above issues into the right perspective.

References.

Wakefield AJ and Stott CM. 2005. Japanese study is the strongest evidence yet for a link between MMR and autism. Redflagsdaily.com.

Sugiura A and Yamada A. 1991. Aseptic meningitis as a complication of mumps vaccination. Ped infect Dis J: 10(3): 209-213.

Anonymous. Two MMR vaccines withdrawn. Lancet; 340 (Sep 19):722.

Makato Yawata. 1994. Japan’s troubles with measles-mumps-rubella vaccine. Lancet;343 (Jan 8) 105-106.

Dourado I, Cunha S, Gloria Teixeira M da. Farrington C.P. et al. 2000. Outbreak of aseptic meningitis associated with mass vaccination with a Urabe-containing Measles-Mumps-Rubella vaccine. Am J Epidemio1ogy: 1512(5): 524-530.

Competing interests: None declared