Re: MMR and Japan: a commentary by Wakefield and Stott 15 March 2005
Dr Viera Scheibner,
Principle Research Scientist (Retired)
Blackheath, NSW 2785 Australia
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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