British doctor in crucial row over MMR

Dr Peter Mansfield is going to win on Wednesday, he says

Dr Peter Mansfield is going to win on Wednesday, he says. If he does, his victory will be seen as a significant coup for the thousands of doctors, scientists and parents who believe there may be a link between the MMR (measles, mumps, rubella) vaccine and autism, and who are demanding more research into the issue before they will be convinced children should be given the triple vaccine.

Dr Mansfield is a family GP who practises in the north-east English town of Louth in Lincolnshire. On Wednesday, in a case which has caught enormous public attention in Britain, he appears before the General Medical Council's disciplinary body accused of putting "children at risk".

This is because he is offering an alternative to the MMR combined vaccine, which Prof Brian McCloskey, director of public health in Worcestershire, says is "at variance with normal clinical practise". The GMC has the power to ban him from practising.

"It won't be a matter of luck," he said last week. "I have the public and the media on my side. The control freakery of the civil service in the Ministry of Health and by the medical establishment will simply have to be overridden by the politicians."

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Since January, he has offered parents the option of having their children vaccinated against measles, mumps and rubella with separate shots, rather than all at once in the MMR vaccine. His clinics in Louth and in nearby Worcester are "booked solid" until Christmas.

"The reality is that a sizeable number of parents, who are not happy to have the MMR vaccine for their children, are withholding their children from having it.

"They are being accused of civic irresponsibility by health authorities which are standing over them with a syringe waiting for any hesitation. The medical civil service is not in close contact with the people and displaying a cast of mind that looks at people as statistics.

"They want a 95 per cent take-up of vaccination and I think one might say that they see a small percentage of casualties as a justifiable risk. The MMR is, they say, more efficient and cost effective."

Though Dr Mansfield stresses his case "does not rest on science but on giving people real choice in their healthcare", the alarm bells of many were set ringing in 1998 by Dr Andrew Wakefield of the Royal Free Hospital in London.

The gastroenterologist claimed in the Lancet that he had found the measles virus in the bowels of children who, after the triple vaccine, developed a form of autism, or a serious bowel condition called Crohn's disease.

His argument is that administering three vaccines at once is dangerous because the three may interfere with one another, mutating and possibly becoming toxic.

The theory, supported by, among others, Dr Paul Shattock, director of the autism research unit at Sunderland University, is that these toxins pass through the gut to the brain.

Children whose immune systems are weak would be particularly at risk, though the regressive symptoms of autism may not become evident for a number of months or even years after the vaccination was administered.

An alarming escalation in the incidence of autism appears to coincide with the introduction of the MMR vaccine in 1988. Since then, autism has increased more than tenfold in Britain.

The British Ministry of Health has dismissed any link between MMR and autism, while the World Health Organisation says "all results from vaccine trials published reaffirm the high safety and efficacy of the MMR vaccine".

The WHO also points out that measles accounts for about 875,000 deaths in the developing world; congenital rubella syndrome is an important cause of deafness, blindness and mental retardation; and mumps is an acute infectious disease from which 10 per cent of patients can develop aseptic meningitis or, less commonly, encephalitis.

Dr Mansfield believes that another reason the medical establishment is so against him and other doctors offering the three single jabs lies in the fact that a large-scale "control group" is emerging. The effects of the MMR vaccine could in coming years be compared against this group.

If the non-MMR cohort has a significantly smaller incidence of autism, he says, the government could face an enormous scandal and legal costs if a class action were taken on behalf of those children who did develop autism as a result of MMR.

If a link is proved by these means "heads must roll", said Dr Mansfield.

"I am not an expert on MMR. I can offer no scientific view on whether or not it is safe. But nowhere in nature does the human body have to cope with three viruses at once. On first scientific principles it is perfectly reasonable for parents to ask for separate vaccinations. And if the GMC decides differently it will be a national disgrace."