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By now, several tired minds were stoking their paranoia that these interventions might, just might, have been orchestrated to delay delivery of the samples, allowing them to spoil. So when the virologist in the party, Colin Fink, got them back to his private lab, Micropathology, in Coventry, he took the unusual precaution of placing an armed guard outside overnight.
The next day the CSF samples were couriered to their final destination: Professor John O'Leary's laboratory at Trinity College in Dublin, a facility whose viral-testing kit had previously identified the DNA of measles in the guts of autistic children. Rather disconcertingly, the package appeared to have been opened en route, but with the war in Iraq only two days old, customs everywhere were on high alert.
The analysis proceeded: three of the six samples tested positive for the vaccine strain of measles virus, but only in minuscule genetic fragments — and not enough to count as a valid research sample. According to medical-research protocol, that result had now to be compared to the CSFs of a "control" group of non-autistic patients. Acquiring these took several months, during which the claimants missed the LSC's July deadline and had their funding temporarily suspended awaiting an appeal on September 30.
When the doctors finally assembled their evidence, the children's lawyers felt confident. Only 1 in 20 of the control group — all leukaemia sufferers, specifically chosen for their high susceptibility to random viral infections — was found to be carrying measles virus in their CSF.
The defendants' analysis of the same samples, carried out by Dr Peter Simmonds at Edinburgh University, had found no trace of measles in the children's CSF. But Simmonds had chosen to use a different viral tracker, Nested, rather than the claimants' TaqMan process. Given the accepted centrality of findings in this area, they felt that their case against MMR looked strong enough to take to court in April 2004. But the four adjudicators on the LSC's funding-review committee disagreed with them. Justifying the £15m already spent as having served the "wider public interest", the committee stated that the £10m needed to see the action through "would not prove a link between MMR vaccine and Autistic Spectrum Disorder".
The claimants' lawyers suspected that the committee had made up their minds before considering the CSF test results, as these offered fresh evidence of just such a link. At the hearing, they were told to await a decision at the end of the day, and written reasons for it two days later. But if the answer was yes, they wondered, why would the reasons not be immediately forthcoming?
Continued on page 2
()MMR RIP? (continued)
They were not reassured to discover, when they looked more closely, that the LSC's e-mailed press release dropping the case had been originated the day before the hearing.In a footnote to editors, the LSC admitted that its decision reflected a change of policy rather than an assessment of evidence. "In retrospect it was not appropriate for the LSC to fund research. The courts are not the place to prove new medical truths." That judgment is itself up for judicial review in the new year — though the LSC is not bound to accept its recommendations.
Paranoia is currently the default mood on all sides of the MMR debate. The British government is so scared of it that health ministers will not be interviewed on it. The drug companies are on the defensive against damages claims that, if proven, could seriously undermine their credibility and their business. And the anti-MMR lobby is convinced a coalition of government agencies, the medical Establishment and big pharma are against them, X-Files style.
In a leafy southwest-London suburb, the man whose 1998 paper in The Lancet kicked off the fracas, Dr Andrew Wakefield, would prefer not to talk on the phone. He believes his line was tapped about three years ago, and now conducts regular "sweeps" to check it for bugs.
Visiting the house whose garage has served as his office since he resigned his post at London's Royal Free hospital in 2001, it strikes you that Wakefield can't be doing this for the money. From the outside, his house looks as if it might be the only squat in an otherwise tidy, middle-class road, its overgrown front garden dominated by a tree stump curiously carved into a V-sign (a message to the former chief medical officer, Sir Kenneth Calman, he later tells me). Unlike many of the activists in the anti-MMR camp, Wakefield is a man unscarred by family tragedy. His four children, the eldest of whom is 13, are as fit as fleas, tearing around the house and back garden. All have had vaccinations, he says, though not the MMR jab. As he first said in public in 1998, he's a one-at-a-time man where vaccination is concerned.
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