BRIAN DEER:
THE VANISHING VICTIMS Page 1
The
Sunday Times Magazine (London) November 1 1998
Can
whooping cough jabs cause brain damage in children?
BRIAN
DEER INVESTIGATES
On
Friday, October 26, 1973, Dr John Wilson, paediatric
neurologist, stepped to the front of the London
lecture theatre of the Royal Society of Medicine. For
the past couple of hours he had been crammed among 50
professors, consultants and other specialists,
listening to research and discussion papers about
children's convulsive disorders. Now it was his turn
to address the gathering. He slipped a typescript on
the lectern and began to read.
The
topic of his contribution was brain damage caused by
whooping cough, or pertussis, vaccination. Wilson was
a consultant at the Hospital for Sick Children in
Great Ormond Street, and he planned to use the event
to highlight what he believed were the dangers of the
vaccine. Then, as now, it was routinely given with
diphtheria and tetanus shots as the three-in-one
"DTP" injection.
"Findings
are presented in 36 children seen in the past 11
years who are believed to have suffered from
neurological complications of pertussis
inoculation," ran his paper's opening abstract.
"The clustering of complications in the first 24
hours after inoculation suggests a causal rather than
a coincidental relation."
Wilson,
42, was the son of teachers, and since joining Great
Ormond Street in 1965 had polished a fastidious
demeanour. He was a doctor of philosophy as well as
of medicine and a fellow of the Royal College of
Physicians. He wore a dark suit and gold cufflinks.
His black hair was immaculately combed. He read his
paper slowly in the voice of a bishop, with
cultivated, drawn-out vowels.
"Between
January 1961 and December 1972 approximately 50
children have been seen at the Hospital for Sick
Children, London, because of neurological illness
thought to be due to DTP inoculation," he said.
"Several children with screaming and fever
during the first 24 hours have been excluded from the
study because of their benign outcome. The majority
of the remainder, whose ages ranged from three months
to seven years, were referred months or years after
the acute episode."
He
was by no means the first doctor, or even the most
prominent, to suggest a link between the vaccine and
brain damage. But few in the lecture theatre's
steeply-ranked pews missed the dynamite in his
presentation. Previous reports, dating as far back as
1933, had mostly been isolated anecdotes: a couple of
cases here or there. They were also short on crucial
facts, such as the time between the jab and the
damage. Yet here was a consultant from the world's
most famous paediatric centre with three dozen
dramatic examples.
"One
child was exceptional in that she had transient
blindness after recovering from a fit; she was later
discovered to be suffering from a progressive
cerebral degeneration," his gruesome narrative
continued. "The four children who did not
convulse include the identical twin of the infant
above. She vomited four days after her second DTP
inoculation at 15 months, and developed severe
cortical blindness and optic atrophy. She died in status
epilepticus."
It
was a bravura performance, based on a remarkable feat
in connecting these cases together. Despite worries
about the vaccine, there was no agreed description in
medical literature of exactly what harm it could do.
"Brain damage" is a catch-all term, and
there was nothing to distinguish injuries following
vaccination from many of the 2000 causes of brain
damage - including genetics, infections, birth
problems, and traumas - that often reveal themselves
at exactly the age at which DTP is given. In Britain,
about 200 babies and infants develop such disorders
every week, and by chance 6% will start within seven
days of a jab. And because its pertussis component
can trigger a fierce immune response, this particular
vaccine can cause screaming, fevers and other upsets,
making parents recall it if something serious should
go wrong later on.
Wilson's
route through this maze produced whispers in the
theatre and then murmurs throughout medicine. Three
months later, his four-page paper, co-authored by two
junior doctors, was published by the British Medical
Association in Volume 49, issue 1 of the Archives of
Disease in Childhood. With both numbers and detail,
it became an instant classic, as often quoted a
quarter of a century later as it was when it first
appeared.
Not
surprisingly, journalists pounced on his claims as
worthy of public concern. In April 1974, ITV
broadcast a half-hour, prime-time This Week
documentary, focusing on one of Wilson's patients. It
unequivocally blamed the vaccine, with numbing images
and terrifying calculations. "Every year about
100 brain damaged," was one caption that filled
the screen. Six minutes into the programme, Wilson
appeared and, when asked if he thought whether the
link was established, he took his crusade to millions
of viewers. "I personally am," he declared,
in his bishop's voice. "Because now I've seen
too many children in whom there has been a very close
association between a severe illness, with fits,
unconsciousness, often focal neurological signs, and
inoculation."
"What
do you mean, you've seen a lot?" the television
reporter pressed him.
"Well,
in my time here, the last eight and a half
years," he said of his Great Ormond Street
experience, "I personally have seen somewhere in
the region of 80 patients."
The
national furore that followed these remarks was the
prototype for modern health scares. Before the
broadcast, 80% of British children were inoculated
against whooping cough. By 1978, after newspaper
campaigns, the number had slumped to 31%. Cases of
whooping cough soared. In 1974 there were about
12,000 notifications. In 1978 there were nearly
67,000. And in an epidemic towards the end of the
decade, 36 infants died and at least 17 were left
brain damaged by spasms of choking and retching
While
Wilson's alarming remarks had this devastating
effect, he none the less believed that the dangers of
whooping cough were greater than those of
vaccination. He supported routine inoculation. But
his crusade to warn the world about the potential
dangers of vaccination gathered pace. He became
adviser to the National Association of Parents of
Vaccine Damaged Children, launched by Rosemary Fox, a
46-year-old social work administrator. He backed
lawsuits against DTP manufacturers, and pressed for a
government compensation scheme for all vaccine
victims. And when a scheme was launched, in 1978, he
became the chief assessor for making awards.
His
message, meanwhile, spread from country to country. A
global panic ensued. After a frightening television
broadcast in the United States in April 1982,
American vaccine makers were hit with lawsuit claims
worth $10 billion. Wilson's paper was repeatedly
cited. And under pressure from parents and industry
alike, Congress launched a compensation scheme in
1986 like the one he helped to run in Britain.
Wilson
was not alone in his campaign; other doctors became
equally vociferous. But the chain of events led back,
link by link, to that Royal Society of Medicine
paper. From it have sprung bureaucracies that in
Britain alone have paid out more than £9m and
probably cost as much again to administer. Using its
authority, lawsuits have been brought that have run
into billions in costs worldwide. And the scare that
followed it has caused parents to agonise whenever a
child has a vaccination.
But
at the heart of this scare lay a disturbing truth,
hidden for a quarter of a century. Wilson's original
three dozen vaccine victims were not as conclusive as
he led people to believe. While he may have seen 80
children where he thought that there was a "very
close association between a severe illness... and
inoculation", as he claimed on television, by
1988 he was having to admit that in eight of his
original 36 cases there was no link whatever between
the vaccine and subsequent brain damage, in 15 cases
there was a reasonable alternative cause, and in only
12 cases did he stand by his original report.
Of
these remaining 12, only three were cases where there
was no alternative explanation and on which
information was reliable. Even those three could not
be shown as having been injured by DTP.
Studied
today, the cases reveal how wide of the mark Wilson
was. One child had a bang on the head. Another
recovered fully. Two had genetic conditions: tuberous
sclerosis and gangliosidosis. At least three were
suspected of suffering from infections, including
isolated Coxsackie virus. And most of the remainder
were patients who were diagnosed as epileptic - a
generic term embracing a host of different symptoms,
causes and possible outcomes. One child's father,
sister, uncle and grandfather all had histories of
fits.
Surprisingly,
some of the children on whom Wilson reported suffered
their first neurological symptoms before their
DTP jabs. But the most striking feature of the series
that he presented concerned the identical twins. Both
were diagnosed with an inherited condition called
Seitelberger's disease. And although their cases
helped to trigger one of the century's great health
panics, neither child ever had a whooping cough jab.
*****
