Professor Stanley, MMR, Measles and C4 Dispatches Publicity

Jane Moore has been publicising the C4 Dispatches programme about the UK human papilloma virus (HPV) vaccination programme and illustrating the issue with the story of her own decision for her (then) 14-year-old daughter: Gardasil: a cancer jab I don’t regret. Moore also provides an overview of the contents of the programme that is scheduled for broadcast 20:00 this evening. She reports that Cervarix (GSK’s HPV vaccine) has been selected as cheaper and better value for money by the UK Government, in preference to Merck’s Gardasil. Moore reveals that Cervarix been trialled in Manchester for a year but parental consent issues mean that only seven out of 10 girls were vaccinated.

However, Moore then acknowledges parental apprehension grounded in previous vaccine alarums but misguidedly seeks to reassure about the safety of HPV vaccines by seeming to deprecate that of MMR.

First and foremost, though, many were understandably reticent to sign up for the jab until they had a cast-iron guarantee that it was safe. The controversy over the MMR vaccine has put paid to the days when parents unquestioningly followed public health advice.

However, Margaret Stanley, a leading cervical cancer expert based at Cambridge University, assured me that unlike MMR the HPV vaccine is not live and is therefore biologically safe. However, it stops only two strains of HPV – so her main concern is that girls who are vaccinated should be given the strong message that they must still go to the doctor’s for smear tests from the age of 25. [My emphasis.]

The difficulty here is that although we have no quarrel with the first part of that message that emphasises Professor Stanley highlighting the importance of continued screening, inadvertently, Moore seems to imply that the attenuated MMR is biologically ‘live and dangerous’ in comparison. Professor Stanley’s views on public health and the benefits of vaccination for preventable childhood diseases are well known so it seemed plausible to assume that a researcher or reporter had misconstrued her remarks on this issue or that there was misunderstanding relating to context[a]. HolfordWatch contacted Professor Stanley and she was kind enough to email the following response.

Gardasil is a subunit vaccine[b] comprised only of 1 protein: there is no nucleic acid (DNA or RNA) and therefore no possibility of infection. It is therefore theoretically a very safe vaccine. In addition, after the delivery of more than 23 million doses worldwide, it has been shown to be a very safe vaccine.

MMR is a live but inactivated virus vaccine. There is no association with autism at all and the safety profile of the MMR vaccine is as good as any other live viral vaccine: e.g., the polio vaccine or the smallpox vaccine both of which have been crucial in preventing these serious diseases. Measles is a dangerous disease: there were 2 measles related deaths last year in the UK and in the Lambeth area of London in May/June more than 120 children were in intensive care as a consequence of complications from measles. These children had not been vaccinated and therefore not protected. [My emphasis.]

HolfordWatch is grateful to Professor Stanley for her elegant clarification of this important issue. We are also surprised that there has not been wider coverage of the consequences of the measles outbreak in Lambeth. However, in several recent talks, Dr Ben Goldacre has referred to the complicity of the british press in the MMR hoax and argued that they are deflecting responsibility for their part in it by:

  • laying the entire blame on Dr Andrew Wakefield, whose influence would not have been so great if a credulous press been more willing to examine his work in a timely fashion and report those findings accurately
  • failing to recover the adverse effects of falling vaccination rates and of the return of measles – such that measles is again endemic in the UK.

Anna Pearce and her colleagues recently reported on the results of their analysis of the factors affecting the take up of MMR vaccine in the UK.[1] One of the most surprising and unsettling findings was that:

[n]early three quarters (74.4%, 1110) of parents who did not immunise with MMR made a “conscious decision” not to immunise.

Measles and the MMR vaccine are such important public health issues that there is no room for even the slightest misunderstanding of their relative safety profiles: we are very grateful to Professor Stanley for her clarification.

References

[1] Pearce A, Law C, Elliman D, Cole TJ, Bedford H; Millennium Cohort Study Child Health Group. Factors associated with uptake of measles, mumps, and rubella vaccine (MMR) and use of single antigen vaccines in a contemporary UK cohort: prospective cohort study. BMJ. 2008 Apr 5;336(7647):754-7.

Notes

[a] To be fair, it is possible that the mistake was introduced by a sub-editor of The Times. However, it shows the importance of having better access to the source material than journalists typically provide.
[b] A subunit vaccine is a vaccine that has been through chemical extraction so that it is free of viral nucleic acid and now contains only specific protein subunits of a specific virus rather than the complete virion: nonetheless, it stimulates the formation of antibodies that protect against infection.

Related Reading

1 in 58 have autism redux: I blame the Observer
JQH on A letter that should be sent and Getting the measles message.

Update

jdc wrote about the media scapegoating of Wakefield to displace their own responsibility.
Anthony Cox highlights the media attempt to dissociate themselves from blame.
Ben Goldacre points out that 80% of MMR stories were written by ‘non-specialist’ journalists. This is why it is such dismal news that a newspaper such as The Telegraph has [whatever the current euphemism] the Science Editor and Science Correspondent.

Update 22 July: we’ve just noticed that The Sun also carries a version of the MMR canard part of this story.

[A]fter the controversy surrounding MMR, [parents] understandably question [Cervarix’s] safety. But medical experts say that the HPV jab is a non-live vaccine and, therefore, biologically safe.

We can’t improve on Professor Stanley’s clarification.

Update 9 August: What Came First? The Chicken or the Gardasil?

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8 Comments

Filed under vaccination, vaccines

8 responses to “Professor Stanley, MMR, Measles and C4 Dispatches Publicity

  1. Thanks – it’s good to clarify this. Hopefully, this might restrain the inevitable quoting of Moore on anti-vax sites…

  2. Ben

    “Hopefully, this might restrain the inevitable quoting of Moore on anti-vax sites”

    Don’t count on it, quote mining is their speciality

  3. Glad you contacted Prof Stanley and even more gladdened by her response. I imagine the anti-vax sites will still quote Moore qouting Stanley and ignore Stanley’s clarification. Ben is right and quote-mining is a speciality of the anti-vaccinationists.

    PS: Re the media’s MMR hoax – I posted a little piece about the media’s role [here] and suggested Wakefield was being scapegoated and I was pointed to a piece by Anthony Cox [Black Triangle] and a piece by Ben Goldacre pointing out that 80% of MMR stories were written by ‘non-specialist’ journalists [here].

    Admin Edit: we’ll put those links in an update. We knew that you had written some relevant items but the BSblogs search wasn’t cooperating and the only ones that we could find were jqh’s.

  4. Robert Carnegie

    On the badscience.net forum I suggested “therefore even more certainly biologically safe”. Even theoretically, there’s less to go wrong in this vaccine than in MMR. Then again, any puncturing of the skin is inviting trouble that may not even be connected to the vaccine, but is a consequence of the vaccination. Even psychological. Then again again, children in particular are liable to meet with greater accidents to their skin, and less hygienic, in everyday life, particularly in hard-paved play areas – although the adolescent target group for HPV vaccine may be a bit past that, unless the powers that be are successful in encouraging more cycling.

  5. @RC, it is annoying that scientists and researchers have to pick their words so carefully but that is the reality.

  6. “…I have tried throughout to keep close to the original authorities, wherever that has been possible; and, where conjecture is inevitable, to summarise the best modern criticism.”

    Written in the preface to “A history of Rome” by J.L. Myres in 1902.

    If only the press and the likes of Holford would do the same in 2008.

  7. Irim, thank you – I’ve come across versions of that quotation but never an attribution!

    Yes. It’s interesting that Dr Richard Smith recently deplored what he believes to be over-done excitement about a prostate cancer treament. He gave this insight into his own thought processes in such over-eager promotions:

    Years ago I used to be the BBC Breakfast Time doctor, and I had to struggle every week with how to present the results of these sorts of studies to an audience only half awake. My conclusion was that I did much more harm by hyping treatments than I did by being over cautious – because new treatments famously go through phases of being “a major breakthrough” to being “terrible poison” to ending up as “a treatment of limited effectiveness that has some use in some patients”.

    As several commenters point out, there seems to be a drive towards attracting reader attention at the expense of accuracy for readers.

    It’s difficult for newspapers to make a decent call when they are shedding specialist journalists. A Healthy Distrust has an interesting piece of this topic: The biggish picture or why this blog exists.

    I couldn’t agree more with fidelity to sources and an appropriate overview.

  8. Pingback: Why Medscape Should Have Issued A Correction « Holford Watch: Patrick Holford, nutritionism and bad science

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