14 June 2013THE CURRENT measles epidemic in the Swansea area has led to more than fourteen hundred children and adults catching the disease throughout Wales.
A large part of the responsibility for the outbreak rests with Swansea’s local paper, the Evening Post.
In 1997 the paper ran a high-profile series of articles on behalf of a group of parents who believed the combined measles, mumps and rubella vaccine — MMR — had damaged their children.
No medical evidence has ever been found to justify these concerns.
The paper’s campaign led to a dramatic fall in vaccination rates in the area which helped to create a large reserve of unprotected children. This allowed the current outbreak to take hold and spread.
The newspaper refuses to accept its share of the responsibility for the largest measles epidemic in Wales this century.
The current editor says the Evening Post was only doing what any responsible newspaper would have done.
But Rebecca Television has investigated the campaign — and finds the paper guilty of rash journalism.
THE MEASLES VIRUS
Before the introduction of the single measles vaccine in 1968, the disease killed 100 children a year in England and Wales. But the single vaccine failed to eradicate the disease — before MMR was introduced in 1988, there were still between 50,000 and 100,000 cases a year.
ON APRIL 18 this year a young Swansea man called Gareth Colfer-Williams, 25, was found dead at his home.
His mother, Angela Colfer, said the day before he died he went to the doctor complaining of a rash all over his body except his arms.
She added that he had also recently been treated in hospital for asthma.
Post-mortem tests showed he was suffering from measles but the precise cause of death was unclear. Further tests are taking place.
If his death is shown to be due to measles, he will be the first fatality of the disease in Britain since 2008.
By June 10 this year the number of cases in the Swansea health board area — which includes Neath, Port Talbot and Bridgend — had reached 934. The total for Wales stood at 1,413.
The local paper, the South Wales Evening Post, has been reporting the epidemic.
It now supports the campaign to give all children the combined measles, mumps and rubella vaccine — known as MMR.
But in the late 1990s the paper was sending out a different message — and one that led to a massive drop in the number of children getting the jab.
The saga started with a straightforward Evening Post article at the end of July 1997.
The piece highlighted a warning from the local health board urging parents to ignore press reports of a possible link between the MMR jab and cases of autism and the bowel disorder Crohn’s disease.
The warning was issued because, two days earlier, the Daily Mail carried a story about claims that MMR caused autism and Crohn’s disease in a small number of chidren.
The Daily Mail was, in turn, picking up an interview in the doctors’ magazine Pulse with an academic researcher called Dr Andrew Wakefield who was flagging up a piece of research he was undertaking at London’s Royal Free Hospital.
The Daily Mail said the “two illnesses most commonly linked to vaccination problems are Crohn’s disease, which causes ulcers by leading to chronic inflammation of the gut, and autism, the condition in which children are unable to mature socially”.
Wakefield told Pulse the results of his and other studies “clearly confirm our suspicions and take them further. We have not enough published evidence to change policy at the moment, but we have accumulated enough evidence … to conduct an independent review.”
Wakefield was questioning one of the most successful immunisation programmes Britain has ever seen.
MMR — which reduced the number of injections for measles, mumps and rubella from six to two — was introduced in Britain in 1988.
It had already been used in the USA for 25 years and in Sweden for ten.
MMR is given to children on their first birthday with another booster injection just before they go to primary school.
The programme is a spectacular success.
In the Swansea area, in the three years before MMR was introduced, there was an average of more than a thousand cases of measles every year.
By the time of Wakefield’s interview in Pulse in 1997 there had been no cases at all in Swansea in the previous two years.
In its July 1997 article, the Evening Post reported that Dr Peter Donnelly, Director of Public Health for the Iechyd Morgannwg Health authority, insisted there was no medical evidence of any link between the MMR vaccine and the two diseases.
Dr Donnelly — the Public Health Director for the Swansea area in 1997— warned that even discussing alleged links between MMR and autism and bowel disorders risked driving down vaccination levels.
He also laid down an important marker which the Evening Post would later ignore.
Donnelly told reporter Nick Dermody that “merely debating such fears could prompt parents to do the worst thing of all and stop taking their youngsters for their jabs.”
Donnelly warned: “If we were to have an outbreak of measles because people stopped taking their youngsters for their jabs that would be very serious indeed.”
Fifteen years later that’s precisely what happened.
ON 12 August 1997 Evening Post reporter Jo Bailey wrote a front page story — “Mum’s Plea in Vaccine Scare” — about a Swansea mother whose son was given MMR and later developed autism and a serious bowel disorder.
Although the mother believed MMR was responsible for her son’s problems, she wasn’t blaming anyone.
She was simply asking for parents to be given more information about the possible risks involved in taking the MMR jab.
The next day the Evening Post also carried a response from Dr Brendan Mason, then a public health consultant for Iechyd Morgannwg Health.
“Allegations about the MMR vaccine have been around since the early 1990s,” he said, “and there has been a great deal of research into links between the vaccine and conditions such as autism and the bowel ulcer condition Crohn’s disease.”
“However, despite all this research, no evidence has been found of any such link.”
But, two days later, the seeds of the Evening Post campaign were sown.
On August 15 reporter Nick Dermody wrote a piece about Port Talbot mother Jackie Eckton who blamed MMR for turning her three-year-old son Daniel into a “distant and silent recluse”.
She believes to this day that her son’s problems are the result of MMR.
Dermody reported that Jackie Eckton was calling on other parents who believed their children had also been affected by the jab to “team up” and form an action group.
The piece included health officials’ insistence there was no evidence to back up the assertion.
After this article Jackie Eckton was contacted by other mothers concerned that their children’s problems had been caused by the MMR jab.
Three days later this produced a key front page lead story.
Written by Jo Bailey, it was marked “Exclusive” with the headline — “Jab Mums Fear A Rogue Batch” — running across the entire front page.
A much smaller sub-heading added that “Experts say no proof of vaccine link”.
FRONT PAGE EXCLUSIVE
The story that claimed the Post had “discovered that dozens of children in the Neath, Port Talbot and Swansea areas” who were believed to have been damaged by the MMR vaccine in the space of a few months. That claim was false.
The piece reported Jackie Eckton’s fear that a rogue batch of MMR was circulating in the Swansea area.
This article, published on August 18, said ” … the Evening Post has discovered that dozens of children in the Neath, Port Talbot and Swansea areas, who were all given the jab in the period between the end of 1994 and the beginning of 1995, are believed to be suffering problems.”
Rebecca Television can find no evidence to back up this claim.
A later study into 36 alleged victims by the local health board found that only seven had been given the vaccine in the whole of the year from July 1994 and June 1995.
Only two of them had been given vaccine from the same batch.
This was shoddy journalism — the Evening Post was giving massive publicity to alarming claims without making any attempt to substantiate them.
By the time of the article, the Evening Post had only published stories about three alleged victims.
As it did with all its reporting, the paper also included a comment from the public health side.
This time it quoted Singleton Hospital’s consultant paediatrician Dewi Evans who insisted there was no evidence of any link.
BUT BY now the Evening Post had decided it would mount a campaign on behalf of parents with children allegedly damaged by the MMR vaccine.
It began the next day, August 19, with another front page lead story by Jo Bailey, headlined “We’ll Check Jab Batch Numbers”.
This reported the agreement of Iechyd Morgannwg Health to investigate the possibility that a batch of the vaccine had been contaminated.
This piece carried the first use of the logo of a syringe with the words “MMR Parents’ fight for the facts”.
THE CAMPAIGN BEGINS
The paper’s “MMR Parents’ fight for the facts” campaign starts with a distinctive logo featuring a syringe. In the year that follows, vaccination rates in the paper’s circulation area fall dramatically.
In another piece the same day reporter Paul Turner interviewed solicitor Michael Green of Swansea law-firm Smith Llewellyn.
Green told the paper that, if parents could prove that 80 per cent of their children’s health problems was due to the vaccine, they were entitled to compensation under the Vaccine Damage Payments Act.
Inside there was a two page spread, again illustrated by the campaign logo, giving the pros and cons of each side of the argument.
However, the spread was dominated by an article headed “Solicitor takes up the fight for truth”.
Reporter Jo Bailey introduced this piece with the words: “To vaccinate or not to vaccinate is the most pressing issue facing South Wales parents today.”
The article featured the battle by Norfolk solicitor Mike Barr who had been given Legal Aid to assess 903 cases across the UK of alleged damage to see if they could sue the manufacturers of the vaccine.
The feature also detailed four more cases of alleged damage to local children from the MMR jab.
On the same day, there was an editorial entitled “Parents must have jab choice.”
It said the paper’s coverage “should be required reading for every parent. We are not trying to alarm anyone.”
It says that was the reason it was putting the case for and against the vaccine in a special feature.
“What is needed most of all,” it says, “and this must come from Government rather than local level, is a commitment to give parents the right to a truly informed choice when it comes to vaccination.”
It then says that when people are given advice about contraception, they are given an assessment of the effectiveness and possible dangers “in percentage terms”.
“Giving parents the same sort of detailed information and statistics when it comes to vaccinating their child should not be a lot to ask for in a world where science has given us the ability to see the surface of Mars on our television screens.”
The next day, August 20, a story on the front page reported that more than 40 families had now contacted the Evening Post.
In the same edition, Jo Bailey and Paul Turner reported a further seven cases of alleged MMR damage to local children.
Again, the denial of any link from health officials was carried.
By August 21, the Post was reporting health officials’ refusal to give single jabs instead of MMR with an article headlined “Health chiefs stand by jab”.
The piece reported that health officials admitted there was “no medical reason why single vaccines are not offered.”
The Post reported that this view “has incensed parents who claim their youngsters have been permanently affected by the jab”.
When MMR was introduced in 1998 licences for single vaccines were withdrawn.
Another feature the same day reported another batch of five children allegedly adversely affected by the jab. The headline was “Parents’ cry for answers”.
On August 29, health officials reported, as the headline said, “No proof of rogue vaccine batch.”
This article was written by chief reporter Susan Buchanan. It did not make the front page.
By August 29, the Post was reporting that 50 families are forming themselves into an official action group and teaming up with the national anti-MMR organisation JABS.
BUT IN this same edition, there was an indication of unease about the campaign at a senior level.
The Post published its second editorial on the issue entitled “Parents are still waiting for answers”.
Of the cases it had reported, it asks “Can there really have been so many coincidences?”
“Logic would immediately say no, but medical research effectively says yes.”
It repeats the position of the Singleton Hospital paediatrician Dewi Evans — that there was no evidence linking MMR with autism and Crohn’s disease.
“There are few more respected and experienced paediatricians than Dewi Evans,” noted the editorial, “and neither has Dr Evans been afraid to oppose the party line has he felt the need to do so.”
“Yet Dr Evans says he is not aware of any scientific research which links MMR injections with subsequent learning difficulties or chronic health problems.”
If any research existed, “Dr Evans would know about it.”
“As things stand there is no answer …”
The editorial ends with the advice that parents should talk to their doctor or health visitor.
But, whatever the misgivings, the Evening Post campaign continued.
On September 3 the paper reported on “calls to withdraw MMR jab” from the action group.
By September 9, the Post reported that Michael Green of local solicitors Smith Llewellyn was preparing an application for Legal Aid for some of the families.
On September 22, in an article which reported the health board’s detailed research dismissing the “rogue” batch of MMR theory, the Post increased the number of children allegedly affected by the vaccine to 60.
By this point, the paper had carried reports of only 21 of these 60 alleged cases.
Before the paper’s campaign, the uptake of MMR in the Swansea area had been higher than the rest of Wales.
After the campaign got under way, vaccination rates began to fall.
In February 1998 Andrew Wakefield finally published his research in The Lancet, one of the world’s most prestigious medical journals.
Even though it stated categorically that the article “did not prove a link between MMR vaccine and the syndrome described”, the article sparked a massive controversy which lasted several years.
It even reached No 10 in 2002 when Tony Blair refused to say if his young son Leo had been given the jab.
Vaccination rates fell throughout the UK.
But a study carried out by the Iechyd Morgannwg Health officials, Peter Donnelly and Brendan Mason, and published early in 2000, showed that the decline was much sharper in Swansea.
The two experts compared the uptake rates of MMR in the period July to September in 1997, when the Post campaign was at its height, with the rates in the same quarter a year later.
They found that the rate of vaccination in the Swansea area dropped by more than 13 per cent compared with a fall of less than three percent in Wales.
The two doctors concluded the data “suggests that the [Evening Post] campaign has had a measurable and unhelpful impact over and above any adverse national publicity.”
The Post continued its campaign.
In September 1998, it published an editorial in which the unease of a year before had vanished.
The line was now uncompromising.
“Parents are making it abundantly clear they want separate vaccinations,” it stated.
“Any further debate on why and how that feeling is so strong is pointless and, increasingly, dangerous.”
“It is a fact of life and blithely repeating ad infinitum that ‘MMR is safe’ is not going to change that.”
And it defended the Evening Post campaign.
“If the uptake rate on MMR falls any further there will only be one place to point the finger of blame — and that is not at the drug companies or the press.”
IT TURNED out that Dr Andrew Wakefield, the man who started the MMR scare, was a charlatan.
An inquiry by the investigative journalist Brian Deer, commissioned by the Sunday Times and Channel 4’s Dispatches programme, revealed that Wakefield was already working for the Norfolk solicitor Mike Barr in 1996.
Barr was the lawyer, as the Evening Post reported on August 19, who was trying to put together a “class action” to sue the manufacturers of the MMR vaccine.
The case was initially funded by the Legal Services Commission until barristers decided in 2003 that there was no hope of the action succeeding — the medical evidence didn’t stack up.
By that time, the legal aid bill had reached £18 million.
A substantial chunk of that money went into Wakefield’s pocket — he amassed £435,000 in fees.
When his infamous paper was published in The Lancet, in February 1998, Wakefield did not inform the editors that he was working with Barr. This was unethical practice.
Deer also discovered that Wakefield had patented single vaccines for measles — and formed companies apparently created to market them.
Deer’s campaign eventually led to the General Medical Council charging Wakefield with unethical practice.
He was struck off in January 2010 for performing unnecessary invasive procedures on some of the twelve children who formed the basis of his 1998 article in The Lancet.
The GMC branded Wakefield “dishonest”, “unethical” and “callous”.
The Lancet article was partially retracted in 2004 and fully retracted in 2010 after Brian Deer showed that the data had been manipulated to fit Wakefield’s thesis.
The full story can be found on Brian Deer’s website — see the notes below for the link.
None of this was known to the Evening Post in 1997.
WHEN THE current epidemic began in November last year, the Evening Post was silent about its conduct in 1997.
Four months after the measles epidemic began, the BBC Radio 4 programme Today carried a report about the role of the paper’s “MMR Parents’ fight for the facts” campaign in the outbreak.
The current Evening Post editor Jonathan Roberts declined to appear on the programme.
He said the campaign “pre-dated their entire newsroom”.
One of the paper’s current reporters is called Paul Turner.
As we have already seen, there was a Paul Turner among the team of Evening Post reporters who worked on the story in 1997.
We asked the Paul Turner who works for the paper today if he’s the same Paul Turner who wrote MMR stories back in 1997.
He emailed to say “you will have to deal with the editor on this I’m afraid”.
We asked Jonathan Roberts. There was no answer by the time this article went online.
Five days after his refusal to appear on Today, Roberts finally wrote about the issue in his own paper.
The piece appeared on April 12 under the headline “South Wales Evening Post campaign was hard-hitting but reflected parents’ concerns at the time”.
The core of Roberts’ defence of the 1997 campaign is that “It is dangerous to judge this campaign outside of its time.”
“The evidence of a link between the MMR and autism has since been discredited, but in 1997 that was not the case.”
This is a travesty of the facts.
In August and September 1997 the medical evidence was overwhelming — MMR was safe and effective and no medical evidence had ever been published demonstrating a link between MMR and autism and Crohn’s disease.
Study after study had shown no connection between MMR and autism and Crohn’s disease.
For example, a Swedish study of autism rates in the five years before and the five years after MMR was introduced showed no increase in autism.
At the time the Post mounted its campaign all that existed was Wakefield’s press interview in Pulse which was given additional credibility in the Daily Mail.
Right at the beginning — and more than a week before the Post campaign began — local public health chief Dr Peter Donnelly warned that even debating the issue was dangerous because it risked driving down vaccination rates.
No journalist would accept Donnelly’s point that the issue shouldn’t be debated — but he clearly put the paper on notice that it had to do so responsibly.
A week later the health board’s public health consultant Dr Brendan Mason told the paper there was no evidence of a link between MMR and autism and Crohn’s disease.
The paper’s first piece of rash journalism was Jo Bailey’s shoddy front page story of August 18 about an alleged “rogue” batch of vaccine.
Her claim was that the Post had “discovered dozens of children” believed to be suffering problems “were all given the jab in the period between the end of 1994 and early 1995.”
As we have seen, the local health board’s study of 36 of these children found only 7 had been immunised in the entire year covering the year from July 1994.
Only two had received the same vaccine.
But the damage had been done.
Parents were getting the message that there were question marks over MMR generally — and the disturbing idea had been floated of a “rogue” batch of vaccine circulating in the Swansea region.
The day after this disastrous article, the Post mounted its “MMR Parents’ Fight For The Facts” campaign.
This implied that, somehow, important “facts” were being deliberately with-held.
And yet — even though Jo Bailey was commended for her investigative work at the 1998 BT Press Awards — she and the Post seemed uninterested in uncovering the “facts”.
Instead they rushed into print with the flimsiest of evidence.
Throughout August and September 1997, the Evening Post coverage concentrated on simplistic reports of parents’ claims that their children had been damaged.
No attempt was made to investigate the circumstances behind each case.
For example, when the parents of 36 children with alleged problems came forward so that their children’s vaccination records could be checked in August and September, health officials found many of them had not been diagnosed with autism at all.
For this article, a spokesman for Public Health Wales said that most of these children “did not have autism. The usual diagnosis was learning difficulties.”
“In many (perhaps the majority) the diagnosis was clearly documented in the records before the MMR was given.”
Public Health Wales also told Rebecca Television there was no significant change in the rates of autism or Crohn’s disease in the Swansea area at the time.
Nor did the Post seem to grasp that the average age of a mother’s perceived sense that her child might have learning difficulties was around 14 months (for experienced mothers who already had at least one child) and 18 months (for first time mothers).
With the first MMR jab coming after a child’s first birthday and with more than 90 per cent of all such children at that time receiving MMR, the chances of parents reading the Evening Post at the time, putting two and two together and coming up with five were extremely high.
When Jonathan Roberts says there was “genuine concern, even fear, among parents that they could be putting their children at risk”, he’s talking about “concern, even fear” that was being generated by the Evening Post campaign…
THE MOST likely explanation for the editorial position of the Evening Post in 1997 is that the paper was taking a gamble.
It was banking on Dr Andrew Wakefield producing hard evidence of problems with MMR — and, with its clutch of local victims, it would be shown to be in the vanguard of journalists exposing the scandal.
Awards and kudos would come to the team who led British journalism with their hard-hitting “MMR Parents’ Fight For The Facts” campaign.
So, what should have happened?
In the days after Jackie Eckton brought cases of alleged damage following the article about her son’s problems, the paper should not have published anything.
Instead, it should have organised a systematic piece of investigative journalism.
Reporters should have started to compile detailed medical profiles of each alleged victim.
They should have obtained parents’ permission to talk to their children’s GPs and obtained their medical histories.
Reporters should have started to research the general medical background to see if the rates of autism, Crohn’s disease and other related problems had been rising in the Swansea area.
It should have sought the co-operation of health officials in this investigation, especially in the suggestion that a rogue batch of vaccine was responsible for the alleged Swansea victims.
It should have waited until it knew what the score was.
In the end, it would still have had a story — perhaps not as sensational as the “MMR Parents’ fight for the facts” — but the one that had the merit of being accurate.
It would have responsibly investigated the concerns of parents with damaged children — and shown there was no evidence that the vaccine was responsible for their children’s problems.
At the same time it would have reassured parents that MMR was safe.
And, last but not least, it would almost certainly have prevented Wales’ worst measles epidemic this century.
The paper’s journalists can’t argue that they weren’t warned about the consequences of backing the wrong horse.
Tens of thousands of children were not vaccinated — and the rate in the Swansea area was so much greater than elsewhere in Wales that the only possible culprit is the Evening Post.
The paper made the wrong call.
It was rash journalism.
WE WROTE to current Evening Post editor Jonathan Roberts and the four named reporters who contributed to the campaign and spelt out these criticisms.
There was no reply from Roberts — who edits the largest circulation newspaper in Wales — by the time we went online.
Susan Buchanan, the chief reporter at the time, is now ironically, the communications chief at the Abertawe Bro Morgannwg health board, under her married name of Susan Bailey.
She had not commented by the time this piece was published.
As we have already seen, the current Post reporter Paul Turner won’t say if he is the same journalist who worked on the story in 1997.
Jo Bailey, now Jo Doek, is a press officer for Swansea City Council. She did not reply to emails.
Nick Dermody now works for the BBC in Cardiff. He too, did not answer emails.
The Evening Post editor in 1997 was George Edwards.
He has not responded to our criticisms.
However, he told the BBC programme The Wales Report in April that the newspaper was not responsible for the fall in vaccination rates in Swansea.
He said the paper never told people not to get their children vaccinated — and was providing a service for its readers.
“As I saw it, their concerns were totally genuine.”
“Newspapers listen to their readers, report what they say, and then go to the relevant people and say ‘what have got to say about this?’ And then publish that response.”
“It’s impossible to have regrets. I’m certain that if we wound the clock back and started again, I can’t imagine any reason why we wouldn’t do it the same way.”
1 This article is based on a detailed survey of Evening Post articles in July, August and most of September 1997. It is not exhaustive and there remains scope for a major piece of academic research on what remains an important story about the interplay between the media and public health.
2 The only parent mentioned in this article is Jackie Eckton and she only features because she played a central role in the 1997 campaign. She continues to insist that MMR damaged her son. We do not believe the parents featured in the “MMR Parents fight for the facts” campaign can be criticised for their part in the saga.
3 The articles by Brian Deer can be found on his website, click here.
4 The full defence of the Evening Post by current editor Jonathan Robers can be found here.
5 The BBC online report of then Evening Post editor George Edwards’ justification of the 1997 campaign can be found here.
6 The National Autism Society can be found here
7 The campaign group JABS, headed by Jackie Fletcher, can be found here.
8 More information on the current measles outbreak can be found on the Public Health Wales website, here.
© Rebecca Television 2013
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