government office block above
the Elephant and Castle shopping centre, 15 health officials
and experts settled down for the meeting eight months before the MMR programme
was rolled out nationwide in the UK in 1988.
Sir John Badenoch, chairman of the “working party on the introduction of measles, mumps and rubella vaccine”, called the meeting to order. “The chairman reminded those present that the proceedings of the working party were confidential,” record the minutes of the meeting.
But we are able to reveal what happened at that crucial meeting on 11 February 1988 – and the minutes of other meetings of Whitehall committees dealing with the triple-vaccine – thanks to the freedom of information act (FOIA).
And these minutes provide a unique insight into how officials came to introduce a nationwide MMR programme in the UK despite receiving a series of alerts from overseas authorities that raised questions about the safety of the triple-vaccine.
For all the controversy about whether MMR causes autism, the minutes reveal that there was real concern that the triple-vaccine would trigger several other devastating conditions among some children. The concern was not about autism, but encephalitis-type conditions, including meningitis, with symptoms such as swelling of the brain, swelling of the lining of the brain or spinal chord, or swelling of the brain and the lining of either the brain or spinal chord.
Back at Room 63 of Hannibal House, the meeting had reached item number 5 on the agenda, “MMR vaccination in Canada”.
“Members read a report of cases of mumps encephalitis which had been associated with MMR vaccine containing the Urabe strain of the mumps virus. The Canadian authorities had suspended the licences of MMR vaccines containing the Urabe strain,” record the minutes.
In light of this, could officials go ahead with using the Urabe MMR in Britain?
One attendee, whose identity has been redacted (ie withheld), dismissed the data on which Canada’s decision was based as “slender”.
However, officials were anxious about what the British public might think if it also became aware of the concerns. The minutes say: “A statement would be prepared in anticipation of any adverse publicity which might arise.”
There was confusion in Whitehall over the action taken by the Canadian authorities. They had not in fact, at that stage, withdrawn the licences for Urabe MMR; but, as a precaution, they had decided to stop using it.
And this was not the first time that the alarm had been raised within Whitehall about MMR. An early sign of trouble came back in May 1987 following “adverse reactions” in America. This was a month after ministers had decided that a UK MMR programme should be an “option”.
Although Whitehall minutes are infamous for presenting as anodyne an accounts of events as possible, the sense of unease remains clear in the records of the meeting on 1 May 1987 of the “Joint Committee on Vaccination and Immunisation” (JCVI), which advised ministers to introduce MMR.
The minutes record: “The meeting questioned the dedication and commitment of appointed officers and [identity withheld] expressed his reservations concerning reported adverse reactions to MMR in the USA.”
Sweden’s Central Microbiological Laboratory said in a letter to British counterparts four months later that it had 52 cases of “febrile convulsions probably associated with MMR vaccination”, including several with encephalitis symptoms. These were out of 360,000 doses, and Sweden continued to vaccinate even children with a previous history of convulsion.
And a month after that, a JCVI meeting received a report from the MMR working party that five cases of convulsions had been reported in an MMR trial in Somerset, although only three of these appeared to be related to the triple-vaccine.
“This gave a rate of three convulsions per thousand doses of MMR,” the minutes say. The working party “expressed concern” about giving the triple-vaccine to children with personal or family history of convulsions.
We have established that the data from Canada related specifically to Urabe MMR, while the figures from America and Sweden concerned the form of MMR that replaced it in the UK in 1992.
This was the background in which the MMR working party received news in February 1988 about cases of mumps encephalitis linked with the triple-vaccine in Canada and how these had led the authorities there to stop using Urabe MMR.
Despite this, the UK began injecting hundreds of thousands of children with Urabe MMR from October 1988.
And the warnings from overseas continued. In May 1990, the JCVI recorded that its sub-committee on “adverse reactions” had “especial concern” after receiving “reports from Japan of a high level of meningo-encephalitis associated with the administration of MMR.” Japan was using a Urabe MMR.
However, the adverse reactions committee “con-cluded that the Japanese experience may be due to different reporting/investigating criteria or other local factors.” Officials “also felt that the methods of surveillance in the UK would detect problems were they occurring on that scale.”
One unidentified JCVI member “was concerned about the possibility of the Japanese experience being widely published in the UK.”
And another “highlighted concern” about Canada’s decision not to use Urabe MMR, as well as the “neurological complications” in Japan.
Canada, having stopped using Urabe MMR in 1988, took the further step of withdrawing licences for Urabe MMR in May 1990. Malaysia, the Philippines and Singapore followed suit.
However, not until September 1992, did the UK finally stop injecting children with Urabe MMR. It used MMR II instead, which has a different mumps component from Urabe.
And it was the manufacturers that forced the UK into doing this because, as later recorded in JCVI minutes, they told health officials at a meeting in August 1992 that they had decided to stop producing Urabe MMR and were informing licensing authorities worldwide of its decision.
Even so, health officials “agreed on 4 September that no action would be taken to revoke the manufacturer’s licence as a change of purchasing policy was to be made by the department; revoking the licence would have caused a world-wide vaccine crisis.”
It would also have revealed an astonishing secret from the bowels of Whitehall: the UK had injected hundreds of thousands of children with a specific type of MMR even though it was known to risk encephalitis-type adverse reactions on a greater scale than an alternative version of the triple-vaccine.
Another version of this article first appeared in The Daily Telegraph. The minutes were obtained by the FOIA Centre acting on behalf of one of the parents of a child in a group bringing litigation at the high court against various pharmaceutical companies over MMR.
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