Promoting Vaccination, Fear, Hate & Discrimination

The discrimination begins, always, with the majority in a society pointing the finger at a minority for somehow endangering the public health and welfare. Individuals in the minority group are singled out as different - ethnically, biologically, spiritually, morally - from the majority. The human impulse to fear, judge, marginalize or eliminate those different from the rest has left a blood soaked trail winding throughout the entire history of man from the Great Inquisition to the Holocaust; from the killing fields of Cambodia to Rwanda, Serbia and Tibet; while the persecution of those with leprosy, TB, AIDS, mental illness, and handicaps continues in every society.

It was with a heavy heart that I read the March 21 New York Times article, "Public Health Risk Seen as Parents Reject Vaccines." Then I waded through the venomous comments posted on the NY Times website attacking parents of vaccine injured autistic children and those supporting informed consent to vaccination, specifically legal exemptions.

Some New York Times readers simply engaged in adolescent name-calling, angrily accusing parents of being "stupid" for questioning the wisdom of doctors in positions of authority and "selfish" for wanting to make informed vaccine choices:

"I'm so tired of these morons who refuse to vaccinate their children. It's stupid and selfish and, as usual, the kid suffers because of an hysterical, paranoid mother. What we need is a vaccine against paranoid conspiracy theory nuts. Oh, yeah....and by all means, let's trust a primary care doc from Arizona rather than the AAP and CDC. After all, what does some pinhead in private practice know that the best trained, most informed academic docs at some backwater like Johns Hopkins or CHOP or Children's Boston know, anyhow."

Others ridiculed parents for having faith in God but not in medical science, doctors and the safety of vaccines:

"The irrational decisions of adults, including parents and even physicians, supported by superstition, faith and magical beliefs, rather than data, evidence and proof, cannot stand in the way of science's obligation to create new knowledge to protect the members of a society, especially its most vulnerable members."

"Western religion's relationship with God requires a scapegoat. Since the Satan bit is worn a little thin they have once again decided that science and technology are to blame for all man's evils. As a civilized society we have given far too much deference to religion. Those not wishing to participate should simply not be included in schools, hospitals, etc. Not allowing their children to participate is the cruelist of abuse and should be removed from their "care."

"The parents whose personal beliefs cause them to fail to vaccinate their children should be seen clearly for what they are - child abusers. They are as monstrous as people that allow their children to die because they are convinced that if their god wants their children to live, he'll take care of it."

"Science is not infallible but it works. No one doubts that savagely beating a kid and offering "religious beliefs" as a pretext is a crime. These parents are doing the same thing. They should be prosecuted for endangering the health of their children - and ours."


The idea that the unvaccinated should be made "outcasts" in society and kept in isolation or even banned from being able to go out in public was a popular one:

"To those who demand an exemption, the choice should be clear and simple. No vaccine, no attendance at any public venue, schools in particular. Let these leaches live up in the woods as hermits."

" Parents of immunized children should not allow their children to play with [unvaccinated children]. Being an outcast is a powerful tool to use against these very selfish people."

Doctors defending their belief in vaccination weighed in, too, calling for elimination of the unvaccinated from society:

"As an epidemiologist who believes in the power and strength of herd immunity, I would like to ask these people who forgo vaccination to politely leave the herd."

Several more suggested the unvaccinated be publicly branded and forced to reveal their vaccination history to all who come in contact with them:

"Those making this decision [to not vaccinate their children] should be ineligible for access to public schooling. They should also be mandated to inform any and all people with whom they come into contact of their lack of vaccinations. They should also sign a waiver to any public or insurance pool funding for treatment of avoidable disease and/or long term damage caused by contraction of that disease."

"Should parents get to decide what happens to their child, even when that decision flies in the face of all evidence? Yes. But then should I have a right to know who these children are, so that I can keep my own child away from them? Indeed, I think I should......"

Another went further, calling for hospital and medical care to be denied to the unvaccinated:

"They should not be permitted in clinics and hospitals, where immunocompromised children and adults have the right to safety. No exception, whether based on religious faith or just garden-variety ignorance and superstition."

Several others believe mothers and fathers with unvaccinated children should be not only be charged with a crime but have their children taken from them:

"This should be a reason to notify CPS so that they can remove these children from parents who endanger their lives. This should be a crime."

There was a call for legislators who vote for vaccine exemptions to be punished:

"The parents who unilaterally decide to withhold immunization from their children should be sent to jail. The legislators who voted to condone this behavior should be identified and subjected to recall."

And some wanted to see parents and their unvaccinated children physically harmed:

.....Fine, so long as these parents are forcibly exposed to the illnesses themselves. And if their children either die, or are permanently injured, criminal charges should be laid. Then we'll see how much they still believe in their voodoo- science......"

Like sharks in a feeding frenzy, they gave public witness to their fear and loathing of fellow human beings who do not believe, think or act as they do.

I could not help but think of the children and parents forced to line up last November at a Maryland County Courthouse patrolled by armed police with dogs, a stark reminder that the parents were under threat of imprisonment and fines for failing to show schools proof that their children got chicken pox and hepatitis B shots.

I remembered the news report out of Belgium last month describing how a State court had sentenced mothers and fathers to five months in prison and a $4,000 fine because their children had not gotten vaccinated.

I thought of the persecution of Andrew Wakefield, M.D., who is being punished by his British colleagues for daring to report an association between the MMR (measles-mumps-rubella) vaccine and neuroimmune dysfunction, including inflammatory bowel disease and autism. Like when the heads of heretics were impaled upon stakes on the Tower of London as a warning for all to see, the Wakefield inquisition is a spectacle designed to persuade all doctors contemplating questioning the safety of current mass vaccination policies to remain silent.

And then I thought of the Jewish orphan from Philadelphia, whose DNA I inherited from several generations back, and whose lineage in my mid-west Protestant family was not known to me for many years. Her blood is my blood, her genes belong to me just as the Norwegian and Scottish-Irish genes that predispose me and my children to autoimmunity and vaccine reactions are part of who I am.

I wondered how many of the readers of that New York Times article, who spewed fear, prejudice and hate into cyberspace and urged discrimination against and punishment of the unvaccinated, remembered that we are who we are because of the genetic strengths and vulnerabilities inherited from our mothers and fathers, grandmothers and grandfathers going back generations and generations.

I come from a family of doctors and nurses, physical therapists and social workers, historians and soldiers, artists and writers, pastors and farmers, public administrators and builders; feminists and teachers, who have made the world a little better because they were allowed to live. And all through our family there is a history of autoimmunity, including rheumatoid arthritis, thyroid disease, diabetes, asthma, inflammatory bowel disease, severe allergies to foods, prescription drugs and pollen, and vaccine reactions.

My mother died of lupus two years ago this week, her body unable to protect itself from self. A nurse who once took care of polio victims at Mayo Clinic, she left three children and 11 grandchildren, all of whom carry her genes.

We do not choose the genes we inherit that make us the unique individuals we each are, as different from one another as we are similar within the human species.

My mother would have gladly laid down her life for any one of her children or grandchildren in order to protect them from harm, as I and countless other mothers around the world would do. The biological imperative, which prompts mothers and fathers to willingly sacrifice their lives to ensure their children survive, dictates we do that in order to ensure the survival of the human race.

For what is the human race but a collection of individuals from individual families living in different communities, all joined together to make up the whole of humanity? When any one life is devalued and deemed expendable, by extension, the well being and integrity of the whole is compromised.

Individual health IS public health.

Vaccine policies issued by the Centers for Disease Control (CDC) and the American Academy of Pediatrics (AAP) do not recognize the potential biological vulnerability of my family and many other families to be harmed by vaccination. It does not matter if we have a vaccine injured child: CDC and AAP policies turned into law by state legislators do not provide for vaccine injured children or the siblings of vaccine injured children to be medically exempt from vaccination. Children, who have had seizures and other health deterioration after vaccination, often do not qualify for medical exemptions.

In the past quarter century, the numbers of vaccines the CDC and AAP insist that children must get has increased from 23 doses of 7 vaccines to 48 doses of 14 vaccines by age six without any large, credible studies proving it is safe for all children. How many of those genetically vulnerable to repeated atypical manipulation of the immune system through forced multiple vaccine use are among the highly vaccinated American children who are chronically ill and disabled today: 1 in 6 learning disabled; 1 in 9 asthmatic; 1 in 150 developing autism?

The doctors in charge at the CDC and AAP have refused, for more than a quarter century, to acknowledge the existence of a growing number of vaccine injured children and so they have refused to identify and screen out children biologically vulnerable to vaccine-induced brain and immune system dysfunction. One-size-fits-all vaccine policies and state laws have become a de facto selection of the genetically vulnerable for sacrifice. It is a very small step from that kind of societal thinking to the prisons, concentration camps and killing fields that stand as chilling testimony to the human impulse to dehumanize others in order to control, exploit or eliminate them.

Holocaust survivor Elie Weisel has said "When you take an idea or a concept and turn it into an abstraction, that opens the way to take human beings and turn them, also, into abstractions."

Individuals harmed by vaccines are not abstractions. They are human beings who deserve to be spared a lifetime of suffering rather than being thrown under the bus to prop up forced mass vaccination policies that fail to acknowledge biodiversity within the family of man.

In the face of a medical community committed to the utilitarian rationale that a minority of human beings can be sacrificed in service to the majority, the only way parents can protect children from being injured or killed by vaccines is by the free exercise of non- medical legal exemptions for deeply held religious or conscientious beliefs.

Doctors inside and outside of government, who have instilled fear of and discrimination against parents with vaccine injured children, bear responsibility for the hate and prejudice expressed on the New York Times website last week. It is a wake-up call for all Americans who cherish freedom and the human right to make informed, voluntary medical decisions that involve a risk of injury or death.


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"The very success of immunizations has turned out to be an Achilles' heel," said Dr. Mark Sawyer, a pediatrician and infectious disease specialist at Rady Children's Hospital in San Diego. "Most of these parents have never seen measles, and don't realize it could be a bad disease so they turn their concerns to unfounded risks. They do not perceive risk of the disease but perceive risk of the vaccine." Dr. Sawyer and the vast majority of pediatricians believe strongly that vaccinations are the cornerstone of sound public health. Many doctors view the so-called exempters as parasites, of a sort, benefiting from the otherwise inoculated majority.....While the picture of an unvaccinated child was once that of the offspring of poor and uneducated parents, "exempters" are often well educated and financially stable, and hold a host of like-minded child-rearing beliefs. Vaccine skeptics provide differing explanations for their belief that vaccines may cause various illnesses and disorders, including autism. Recent news that a federal vaccine court agreed to pay the family of an autistic child in Georgia who had an underlying mitochondrial disorder has led some skeptics to speculate that vaccines may worsen such conditions. Again, researchers say there is no evidence to support this thesis. Alexandra Stewart, director of the Epidemiology of U.S. Immunization Law project at George Washington University, said many of these parents are influenced by misinformation obtained from Web sites that oppose vaccination. "The autism debate has convinced these parents to refuse vaccines to the detriment of their own children as well as the community," Ms. Stewart said." - Jennifer Steinhauer, The New York Times (March 21, 2008) http://www.nytimes.com/2008/0 3/21/us/21vaccine.html?hp

"Two sets of parents in Belgium were recently handed five month prison terms for failing to vaccinate their children against polio. Each parent was also fined 4,100 euros ($8,000)....The parents can still avoid prison - their sentences were delayed to give them a chance to vaccinate their children. But if that deadline also passes without their children receiving the injections, the parents could be put behind bars.....The polio vaccine is the only one required by Belgian law. Exceptions are granted only if parents can prove their children might have a bad physical reaction to the vaccine.....Aside from Belgium, only France makes polio vaccinations mandatory by law. In the United States, children must be vaccinated against many diseases including polio, but most states allow children to opt out if their parents have religious or "philosophical" objections. In the U.S. state of Maryland, prosecutors and school officials in one county threatened truancy charges against parents who failed to vaccinate their children.....People who refuse to be vaccinated are "free riders," Harris said. "They can only afford to refuse the vaccine because they are surrounded by people who have fulfilled their obligations to the community." - Maria Cheng, Associated Press (March 12, 2008) http://news.yahoo.com/s/a p/20080312/ap_on_he_me/polio_vaccine_prison

"One of the most reprehensible weapons being wielded in the witch-hunt against Wakefield is the claim that anyone who gives any credence whatever to his concerns is responsible for the incidence of measles amongst children whose parents are as a result too frightened to give them the MMR vaccination. There are two obvious points to make in response to this piece of moral blackmail: 1) the whole panic could have been avoided by offering single measles, mumps and rubella jabs rather than the triple MMR, and 2) it is surely just as important as avoiding cases of measles mumps and rubella to avoid causing the kind of catastrophic damage to the brain and gut displayed by the children at the heart of this controversy. And there is a further and quite appalling point to note. This whole saga started because parents of such children found that their family doctors were dismissing out of hand their children's gut and brain problems, accordingly refusing to alleviate their suffering. Now, as a direct result of the animosity towards Wakefield that has been whipped up - and the fear that any doctor who suggests he might be right will similarly find him or herself at the receiving end of the medical establishment's fist - children exhibiting this combination of gut and brain damage are finding it difficult to obtain treatment." - Melanie Phillips, The Spectator (March 21, 2008) http://www.spectator.co.uk/melanieph illips/568226/the-wakefield-witchhunt.thtml

Public Health Risk Seen as Parents Reject Vaccines New York Times March 21, 2008 by Jennifer Steinhauer Click here for the URL: SAN DIEGO - In a highly unusual outbreak of measles here last month, 12 children fell ill; nine of them had not been inoculated against the virus because their parents objected, and the other three were too young to receive vaccines. The parents who objected to their children being inoculated are among a small but growing number of vaccine skeptics in California and other states who take advantage of exemptions to laws requiring vaccinations for school-age children. The exemptions have been growing since the early 1990s at a rate that many epidemiologists, public health officials and physicians find disturbing. Children who are not vaccinated are unnecessarily susceptible to serious illnesses, they say, but also present a danger to children who have had their shots - the measles vaccine, for instance, is only 95 percent effective - and to those children too young to receive certain vaccines. Measles, almost wholly eradicated in the United States through vaccines, can cause pneumonia and brain swelling, which in rare cases can lead to death. The measles outbreak here alarmed public health officials, sickened babies and sent one child to the hospital. Every state allows medical exemptions, and most permit exemptions based on religious practices. But an increasing number of the vaccine skeptics belong to a different group - those who object to the inoculations because of their personal beliefs, often related to an unproven notion that vaccines are linked to autism and other disorders. Twenty states, including California, Ohio and Texas, allow some kind of personal exemption, according to a tally by the Johns Hopkins University. "I refuse to sacrifice my children for the greater good," said Sybil Carlson, whose 6-year-old son goes to school with several of the children hit by the measles outbreak here. The boy is immunized against some diseases but not measles, Ms. Carlson said, while his 3-year-old brother has had just one shot, protecting him against meningitis. "When I began to read about vaccines and how they work," she said, "I saw medical studies, not given to use by the mainstream media, connecting them with neurological disorders, asthma and immunology." Ms. Carlson said she understood what was at stake. "I cannot deny that my child can put someone else at risk," she said. In 1991, less than 1 percent of children in the states with personal-belief exemptions went without vaccines based on the exemption; by 2004, the most recent year for which data are available, the percentage had increased to 2.54 percent, said Saad B. Omer, an assistant scientist at the Johns Hopkins Bloomberg School of Public Health. While nationwide over 90 percent of children old enough to receive vaccines get them, the number of exemptions worries many health officials and experts. They say that vaccines have saved countless lives, and that personal-belief exemptions are potentially dangerous and bad public policy because they are not based on sound science. "If you have clusters of exemptions, you increase the risk of exposing everyone in the community," said Dr. Omer, who has extensively studied disease outbreaks and vaccines. It is the absence, or close to it, of some illnesses in the United States that keep some parents from opting for the shots. Worldwide, 242,000 children a year die from measles, but it used to be near one million. The deaths have dropped because of vaccination, a 68 percent decrease from 2000 to 2006. "The very success of immunizations has turned out to be an Achilles' heel," said Dr. Mark Sawyer, a pediatrician and infectious disease specialist at Rady Children's Hospital in San Diego. "Most of these parents have never seen measles, and don't realize it could be a bad disease so they turn their concerns to unfounded risks. They do not perceive risk of the disease but perceive risk of the vaccine." Dr. Sawyer and the vast majority of pediatricians believe strongly that vaccinations are the cornerstone of sound public health. Many doctors view the so- called exempters as parasites, of a sort, benefiting from the otherwise inoculated majority. Most children get immunized to measles from a combined measles, mumps and rubella vaccine, a live virus. While the picture of an unvaccinated child was once that of the offspring of poor and uneducated parents, "exempters" are often well educated and financially stable, and hold a host of like-minded child- rearing beliefs. Vaccine skeptics provide differing explanations for their belief that vaccines may cause various illnesses and disorders, including autism. Recent news that a federal vaccine court agreed to pay the family of an autistic child in Georgia who had an underlying mitochondrial disorder has led some skeptics to speculate that vaccines may worsen such conditions. Again, researchers say there is no evidence to support this thesis. Alexandra Stewart, director of the Epidemiology of U.S. Immunization Law project at George Washington University, said many of these parents are influenced by misinformation obtained from Web sites that oppose vaccination. "The autism debate has convinced these parents to refuse vaccines to the detriment of their own children as well as the community," Ms. Stewart said. While many parents meet deep resistance and even hostility from pediatricians when they choose to delay, space or reject vaccines, they are often able to find doctors who support their choice. "I do think vaccines help with the public health and helping prevent the occasional fatality," said Dr. Bob Sears, the son of the well-known child-care author by the same name, who practices pediatrics in San Clemente. Roughly 20 percent of his patients do not vaccinate, Dr. Sears said, and another 20 percent partially vaccinate. "I don't think it is such a critical public health issue that we should force parents into it," Dr. Sears said. "I don't lecture the parents or try to change their mind; if they flat out tell me they understand the risks I feel that I should be very respectful of their decision." Some parents of unvaccinated children go to great lengths to expose their children to childhood diseases to help them build natural immunities. In the wake of last month's outbreak, Linda Palmer considered sending her son to a measles party to contract the virus. Several years ago, the boy, now 12, contracted chicken pox when Ms. Palmer had him attend a gathering of children with that virus. "It is a very common thing in the natural-health oriented world," Ms. Palmer said of the parties. She ultimately decided against the measles party for fear of having her son ostracized if he became ill. In the late 1960s and 1970s, measles outbreaks in Alaska and California triggered strong enforcement of vaccine mandates by states, and exemption laws followed. While the laws vary from state to state, most allow children to attend school if their parents agree to keep them home during any outbreak of illnesses prevented by vaccines. The easier it is to get an exemption - some states require barely any paperwork - the more people opt for them, according to Dr. Omer's research, supported by other vaccine experts. There are differences within states, too. There tend to be geographic clusters of "exempters" in certain counties or even neighborhoods or schools. According to a 2006 article in The Journal of The American Medical Association, exemption rates of 15 percent to 18 percent have been found in Ashland, Ore., and Vashon, Wash. In California, where the statewide rate is about 1.5 percent, some counties were as high as 10 percent to 19 percent of kindergartners. In the San Diego measles outbreak, four of the cases, including the first one, came from a single charter school, and 17 children stayed home during the outbreak to avoid contracting the illness. There is substantial evidence that communities with pools of unvaccinated clusters risk infecting a broad community that includes people who have been inoculated. For instance, in a 2006 mumps outbreak in Iowa that infected 219 people, the majority of those sickened had been vaccinated. In a 2005 measles outbreak in Indiana, there were 34 cases, including six people who had been vaccinated. Here in California, six pertussis outbreaks infected 24 people in 2007; only 2 of 24 were documented as having been appropriately immunized. A surveillance program in the mid '90s in Canada of infants and preschoolers found that cases of Hib fell to between 8 and 10 cases a year from 550 a year after a vaccine program was begun, and roughly half of those cases were among children whose vaccine failed. Gardiner Harris contributed reporting from Washington.

Parents may be jailed over vaccinations Associated Press March 12, 2008 by Maria Cheng Click here for the URL: As doctors struggle to eradicate polio worldwide, one of their biggest problems is persuading parents to vaccinate their children. In Belgium, authorities are resorting to an extreme measure: prison sentences. Two sets of parents in Belgium were recently handed five month prison terms for failing to vaccinate their children against polio. Each parent was also fined 4,100 euros ($8,000). "It's a pretty extraordinary case," said Dr. Ross Upshur, director of the Joint Centre for Bioethics at the University of Toronto. "The Belgians have a right to take some action against the parents, given the seriousness of polio, but the question is, is a prison sentence disproportionate?" The parents can still avoid prison - their sentences were delayed to give them a chance to vaccinate their children. But if that deadline also passes without their children receiving the injections, the parents could be put behind bars. Because of privacy laws, Belgian officials would not talk specifically about the case, such as why the parents refused the vaccine or how much longer they have to vaccinate their children. The polio vaccine is the only one required by Belgian law. Exceptions are granted only if parents can prove their children might have a bad physical reaction to the vaccine. "Polio is a very serious disease and has caused great suffering in the past," said Dr. Victor Lusayu, head of Belgium's international vaccine centre. "The discovery of the vaccine has eliminated polio from Europe and it is simply the law in Belgium that you have to be vaccinated. .....At the end of the day, the law must be respected." Some ethicists back the hardline Belgian stance. "Nobody has the right to unfettered liberty, and people do not have a right to endanger their kids," said John Harris, a professor of bioethics at the University of Manchester. "The parents in this case do not have any rights they can appeal to. They have obligations they are not fulfilling." Aside from Belgium, only France makes polio vaccinations mandatory by law. In the United States, children must be vaccinated against many diseases including polio, but most states allow children to opt out if their parents have religious or "philosophical" objections. In the U.S. state of Maryland, prosecutors and school officials in one county threatened truancy charges against parents who failed to vaccinate their children. The measure sharply reduced the number of unvaccinated children although nobody has been charged. The only other case of mandatory polio vaccines is during the Muslim yearly Hajj pilgrimage in Saudi Arabia. Pilgrims from polio-endemic countries - Afghanistan, India, Nigeria and Pakistan - must prove they have been vaccinated. Saudi officials even give them an extra dose upon arrival at the airport. Since the polio virus can live in the human body for weeks, it jumps borders easily. That makes health officials even in developed countries nervous, since the threat of an outbreak remains as long as the virus is circulating anywhere. Polio is a highly infectious disease spread through water that mainly strikes children under five. Initial symptoms include fever, headaches, vomiting, stiffness in the neck and fatigue. The polio virus invades the body's nervous system and can lead to irreversible paralysis within hours. In extreme cases, children can die when their breathing muscles are immobilized. Incidence has dropped by 99 percent since the World Health Organization and partners began their eradication effort in 1988. But the virus is still entrenched in Afghanistan, India, Nigeria and Pakistan, and occasionally pops up elsewhere. For developed countries, imported polio cases could cause chaos in the health system, warned Dr. Steve Cochi, an immunization expert at the United States' Centers for Disease Control and Prevention. He said that unlike other medical problems, in which rejecting treatment only affects the individual, refusing a vaccine for a transmissible disease like polio puts others at risk as well. "Most of the time, polio outbreaks do spill into the general population," Cochi said. Ethicists argue that people who refuse vaccinations are taking advantage of everyone else who has been vaccinated. Once the majority of a population is vaccinated, there are few susceptible people the disease can infect, thus lowering the odds of an outbreak. People who refuse to be vaccinated are "free riders," Harris said. "They can only afford to refuse the vaccine because they are surrounded by people who have fulfilled their obligations to the community." Health officials doubt that Belgium's strategy will be useful to countries still battling polio. "It is up to individual countries to decide their own policies, but we do not feel that imprisonment would help," said Dr. David Heymann, WHO's top polio official.

The Wakefield witch-hunt The Spectator (UK) March 21, 2008 by Melanie Phillips Click here for the URL: A couple of days ago, yet another story appeared claiming that fresh research had shown that there was no link between the MMR vaccination and autism. This new research was said to have shown that, contrary to the claims made by Dr Andrew Wakefield, the surgeon at the centre of the MMR scare, there was no relationship between gut problems and autism, the core of his concerns. It also claimed that the discovery furthermore damaged the related theory that a gluten- free diet could help children with autism. Dr Hilary Cass, from Great Ormond Street, said: 'It is very distressing to have a diagnosis of autism, a lifelong condition.Many families are driven to try out interventions which currently have no scientific basis. For example, advocates of the leaky gut hypothesis offer children a casein and gluten-free diet which as yet lacks an evidence base.' This particular observation is a telling indication that this study bears little relation to reality. For there are countless families whose autistic children's suffering from gut problems has only been eased, and their autistic symptoms improved, by the introduction of precisely such a diet. 'No evidence base'? Tell that to those families. It is their lived experience. Second, despite the way this was presented in the media this is not a new piece of research at all. It is instead a recycled version of a study by Baird G. et al, published in the Archive of Diseases in Childhood on February 5 and reported in the press around that time. The study drew the following response from Andrew Wakefield: ....The study is severely limited by case definition in the context of the crucial 'possible enterocolitis' group. For inclusion in this group they required the presence of two or more of the following five current gastrointestinal symptoms: current persistent diarrhea (defined as watery/loose stools three or more times per day >14 days), current persistent vomiting (occurring at least once per day, or more than five times per week), current weight loss, current persistent abdominal pain (3 or more episodes [frequency not specified by authors] severe enough to interfere with activity); current blood in stool; plus: past persistent diarrhea >14 days' duration, and excluding current constipation. We have over the last 10 years evaluated several thousand children on the autistic spectrum who have significant gastrointestinal symptoms. Upper and lower endoscopy and surgical histology have identified mucosal inflammation in excess of 80% of these children. Almost none of these children with biopsy-proven enterocolitis would fit the criteria set out above. Firstly, these children rarely have vomiting, current weight loss (as opposed to failure to gain weight in an age-appropriate manner), or passage of blood per rectum. The requirement is thus narrowed to a child having two of two relevant symptoms - current persistent diarrhea and current abdominal pain according to their criteria, plus a past history of persistent diarrhea excluding current constipation. The requirement for the current presence of these symptoms, for 14 or more days continuously, shows a singular lack of understanding of the episodic, fluctuating, and alternating (e.g. diarrhea/constipation) symptom profile experienced by these children. In our experience, ASD children with histologic enterocolitis typically have 1 to 2 unformed stools per day that are very malodorous and usually contain a variety of undigested foodstuffs. This pattern alternates with that of "constipation" in which the unformed stool is passed after many days of no bowel movements at all, and with excessive straining. This group is entirely overlooked by the arbitrary criteria set forth in their paper. With respect to diarrhea and constipation, a detailed discussion of stool pattern in these children is available1 which further highlights the shortcomings of the above criteria. Moreover, the interpretation of pain as a symptom in non-verbal children, as it often manifests as self injury, aggressive outbursts, sleep disturbances, and abnormal posturing, is notoriously difficult. This interpretation requires an insight based upon the correlation of symptoms, histological findings, and response of symptoms to anti-inflammatory treatment. There is no evidence in the Baird et al. paper that these crucial factors were taken into account. This study's inappropriate symptom criteria would explain the discordance with other reports that have revealed a high prevalence of significant gastrointestinal symptoms in general autism populations 2,3. It is surprising that Dr Peter Sullivan, a co-author on the paper, who presumably provided the above gastroenterological criteria, was not aware of the aforementioned limitations. In his role as a Defendant's expert in the UK MMR litigation, he will have had access to the clinical records of autistic children with the relevant intestinal symptoms and biopsy-proven intestinal inflammation. We suggest that the authors might wish to reflect on the ethical implications of setting the bar too high for the investigation of such children by ileo- colonoscopy, with the attendant risk of missing symptomatic, treatable inflammation. Since the relevant MMR/autism children are considered to be those with regression and significant gastrointestinal symptoms, the appropriate stratification for between-group analyses of measles virus antibody levels has not been conducted; therefore the paper is difficult to interpret, adding little if anything to the issue of causation. Moreover, it is a major error to have presumed that peripheral blood mononuclear cells are a valid 'proxy' for gut mucosal lymphoid tissues when searching for persistent viral genetic material. A further major problem in this study is the number of children who dropped out or who were unable to provide adequate blood samples. We know nothing about either the 735 children who were lost at stage two, or the 100 children for whom blood samples were not available. At the very least, we should be told whether the children who dropped out were likely to be representative of those who stayed in, with regard to the key issues of interest. For reasons that will emerge in the near future, it would be of interest to know whether siblings of autistic children were included in either of the two control groups. This information is not provided. As a general observation, this paper contributes nothing to the issue of causation, one way or another. Case definition alone is likely to have obscured the relevant group of autistic children. The study tells us nothing about what actually happened to the children at the time of exposure. We are increasingly persuaded that measuring things in blood many years down the line tells us very little about the initiating events in what is, in effect, a static (non-progressive) encephalopathy unlike, for example, subacute sclerosing panencephalitis, which is a progressive measles encephalopathy. The gut is a different matter, and analysis of mucosal tissues has been very informative, since here, in the relevant children, active ongoing, possibly progressive [AV1]4, inflammation has been identified. None of Wakefield's pointers to the irrelevance of or inadequacies in the Baird research was included in the news stories. Nor do these stories refer to other research studies which show a higher rate of gastro- intestinal problems among children with autistic- spectrum symptoms. The recycling of the Baird study was but the latest in a steady drip-feed of such items which appear to be part of a concerted campaign to ensure that the General Medical Council hearing into the conduct of Wakefield's research, which is shortly due to resume, takes place in as prejudiced an atmosphere as possible. No stone is being left unturned by the medico-political establishment and its creatures in the media to ensure that this doctor is destroyed. As I have repeatedly said, I have no idea whether Wakefield is correct or not in his concerns about the possible adverse effects of the MMR vaccine on a small sub-set of vaccinated children. Nor do I know whether any of the charges being levelled against him at the GMC has any legs. But I do believe - as I wrote in my series of articles on the subject for the Daily Mail in 2003 - that many of the statements made by the Department of Health and medical establishment about the 'proof' of the vaccine's unchallengeable safety are deeply misleading. And I also believe, having spoken to many parents of such children, that their experiences simply cannot be dismissed as they have been by the medical establishment. No-one has ever suggested that the MMR vaccine causes all or most of the incidence of autism. If Wakefield is correct, it is only a small proportion of children whose immune systems may be unable to cope, for whatever reason, which makes them particularly vulnerable to such ill-effects. And contrary to the message being pumped out by the medical establishment that the vaccine has been proved to be safe - by studies which are all either flawed, inadequate or irrelevant - the fairest and most accurate thing to say is that the jury is still out. One of the most reprehensible weapons being wielded in the witch-hunt against Wakefield is the claim that anyone who gives any credence whatever to his concerns is responsible for the incidence of measles amongst children whose parents are as a result too frightened to give them the MMR vaccination. There are two obvious points to make in response to this piece of moral blackmail: 1) the whole panic could have been avoided by offering single measles, mumps and rubella jabs rather than the triple MMR, and 2) it is surely just as important as avoiding cases of measles mumps and rubella to avoid causing the kind of catastrophic damage to the brain and gut displayed by the children at the heart of this controversy. And there is a further and quite appalling point to note. This whole saga started because parents of such children found that their family doctors were dismissing out of hand their children's gut and brain problems, accordingly refusing to alleviate their suffering. Now, as a direct result of the animosity towards Wakefield that has been whipped up - and the fear that any doctor who suggests he might be right will similarly find him or herself at the receiving end of the medical establishment's fist - children exhibiting this combination of gut and brain damage are finding it difficult to obtain treatment. Another letter to the Archive of Diseases in Childhood from John Stone, the parent of an autistic child, makes terrifying and distressing reading: In this regard it is worth noting the recent warning of the National Autistic Society (NAS): 'The National Autistic Society is keenly aware of the concerns of parents surrounding suggested links between autism and the MMR vaccine. The charity is concerned that the GMC hearing, and surrounding media coverage, will create further confusion and make it even more difficult for parents to access appropriate medical advice for their children. It is particularly important that this case is not allowed to increase the lack of sympathy that some parents of children with autism have encountered from health professionals, particularly on suspected gut and bowel problems. Parents have reported to the NAS that in some cases their concerns have been dismissed as hysteria following previous publicity around the MMR vaccine. It is crucial that health professionals listen to parents' concerns and respect their views as the experts on their individual children....' The NAS warning relates to the GMC hearing involving doctors Wakefield, Walker-Smith and Murch which is set to resume on 25 March approaching. I do not think it is being unduly cynical to query the publication of this study at the present time as a media event, bearing in mind that it seems to have been carried out five or six years ago. Moreover, the study has once again been promoted as refuting the Wakefield hypothesis when it in fact tests for a possibility that had not been proposed. Meanwhile, the plight of autistic children with gastro- intestinal symptoms is excluded both from the study and public attention, as if they did not exist. The NAS statement warned of 'creating further confusion' and this is precisely what this study and its media exposure has done. As the resumption of the GMC hearing draws nearer, one has to ask whether this will serve the cause of truth and justice and the relief of suffering - or is it instead merely a show trial which will bring about the precise opposite?