MMR Science and Fiction

The MMR crisis continues to risk lives and cause confusion, guilt and distress to many parents. It's high time that a scientist emerged who could give the public a clear, unbiased overview of the whole issue. Unfortunately Richard Horton isn't the man to do it, no matter the quality of his writing. As the editor of The Lancet and the person who first allowed Andrew Wakefield's controversial paper to be published, he is very much an insider on this issue. His reputation is at stake as much as anyone's, so it's hard to accept what he says without some degree of cynicism.

In the first chapter the author discusses the evidence for the safety of the MMR vaccine. A few more facts and figures would be welcome in this section, but otherwise it's a good summary of the research on MMR to date. Horton also writes about what the research can't tell us: a correlation between MMR and autism can't logically be ruled out as being a cause and effect relationship, no matter how unlikely.

However this is less a book about science than a book about the politics of science. In the subsequent chapters Horton points out Andrew Wakefield's funding sources and lack of neutrality. He also exposes the venality and bias of scientific conferences sponsored by pharmaceutical companies. The media is blamed for sensationalising and misrepresenting this issue, and the public is criticised for failing to understand risk.

In fact nobody gets off lightly, as Richard Horton criticises just about everyone involved in this matter, except of course The Lancet. He does concede that publishing the original paper was a mistake, and describes how the paper was partially retracted later on.

On autism Horton is brief, dealing with issues such as the lack of research funding for this condition, how little we know about its causes, and the economic and social cost of it. He also writes about measles, which is a far more serious disease than many people realise, potentially disabling and even fatal. Yet without vaccine scares and political apathy it might be possible to eradicate this infection altogether.

The author is concerned with where scientific debate is going, and who is in a position to mediate on scientific issues that concern the public. MMR Science and Fiction illustrates what a bad state this debate is currently in, and points up some of the obstacles to research integrity and trustworthy, accesible science. It isn't simply an exploration of the truth behind the MMR vaccine and its biological effects. Instead this is a wider-ranging discussion of the social and political implications of this topic, and it may be a little lighter on facts and figures than some may expect. This is an informative book which would be more illuminating if only Richard Horton were less defensive about his position.