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BMJ. Sep 14, 2002; 325(7364): 597.
PMCID: PMC1124112

Aspects of MMR

Survey shows that some homoeopaths and chiropractors advise against MMR
K Schmidt, Pilkington research fellow
E Ernst, director

Editor—Vaccination for measles, mumps, and rubella (MMR) is highly controversial.1 One of us (EE) found that some providers of complementary medicine have a negative attitude towards immunisation.2 We therefore evaluated and compared the response of professional homoeopaths, chiropractors, and general practitioners to an inquiry about MMR vaccination.

We obtained the email addresses of the three health professions from these websites: www.homeopath.co.uk/directory, www.chiro-online.com/interadcom, www.internetgp.com/gpsites/alphabet.htm. We also visited the private homepages of homoeopaths and chiropractors on the internet. We sent a letter in which a mother asked for advice about the MMR vaccination for her 1 year old child to all the addresses. We explained to all those who responded that the query was, in fact, part of a research project, giving them opportunity to withdraw their answers. The study was approved by the local ethics committee.

We contacted 168 homoeopaths, of whom 104 (72%) responded, 27 (26%) withdrawing their answers. We contacted 63 chiropractors, of whom 22 (44%) responded, six (27%) withdrawing their responses. No general practitioners responded. The table shows that only a few professional homoeopaths and a quarter of the chiropractors advised in favour of the MMR vaccination. Almost half of the homoeopaths and nearly a fifth of the chiropractors advised against it.

These data suggest that some providers of complementary medicine are advising people against government policy. General practitioners, on the other hand, seem not respond at all to patients' emails on this delicate matter.

Responses of three health professional groups to letter from mother asking for advice about vaccinating 1 year old child against measles, mumps, and rubella


1. Ferriman A. London mayor attacked for doing “irreparable damage”on MMR. BMJ. 2002;325:66. . (13 July.)
2. Ernst E. Rise in popularity of complementary and alternative medicine: reasons and consequences for vaccination. Vaccine. 2002;20:S90–S93. [PubMed]
Sep 14, 2002; 325(7364): 597.

Trying to find biological cause for autism does not make sense

David N Andrews, psychologist in training

Editor—Can vaccines cause autism?1-1 Not really. Autism has no actual physical form; it is identified and diagnosed behaviourally, and most medical practitioners do not possess psychological competence. I am therefore not sure that something like autism is entirely contained in the medical sphere. I am a social psychologist and therefore interested in human interaction and its effects on behaviour. I am autistic myself and was not immunised with the measles, mumps, and rubella (MMR) vaccine.

Kurt Lewin, founder of group dynamics in social psychology, found that there are systems based around any individual that give rise to tensions between individuals.1-2 These tensions operate like electrostatic fields and interact, resulting in behaviour (as people sense and perceive, and then construe1-3) that reorganises the tension system. The occurrence of “problem behaviours” might be seen as the end result of a system reorganising in such a way as to “force” a “leak” of behaviour at the point of least resistance.

The Finnish neuropsychologist Timo Järvilehto seems to support this idea from a social neuropsychological viewpoint.1-4 His work accentuates the existing neurobiological substrate that can be said to underlie any person's behaviour but that none the less cannot possibly be the sole cause of that behaviour.

We cannot assume that autism is an “illness” with the same types of aetiological factors seen in, for example, haemorrhoids. Autism is best seen as a continual set of possible response states by the individual, concerned with inhospitable situational factors with which he or she has to deal. It is the best possible defensive response by the autistic person to the expectations and attitudes of the society into which he or she has been born. An autistic person may behave totally differently in any two different situations, which seems to support the notion of tension systems in that person's system that encompass organism and environment.1-5

I believe that biological causes for autism cannot be found, regardless of contributory factors. For this reason, I find the whole vaccine debate tiresome. The research should be oriented to discovering the types of interactions between the person and his or her environment are that bring about autistic states. Trying to find a biological cause for autism is akin to attempting to find a psychological basis for piles.


1-1. Dyer O. Experts question latest MMR research. BMJ. 2002;325:354. . (17 August.)
1-2. Fontana D. Personality in the workplace. New York: Palgrave Macmillan; 2000.
1-3. Boeree CG. Shippensburg, PA: Shippensburg University; 1997. Personality theories: George Kelly 1905-1967.www.ship.edu/~cgboeree/kelly.html (accessed 13 August 2002).
1-4. Järvilehto T. The theory of organism-environment system, parts I to IV. wwwedu.oulu.fi/homepage/tjarvile/indexe.htm (accessed 13 August 2002). (English adaptation of the author's earlier book Ihminen ja Ihmisen Ympäristö, 1994.)
1-5. Andrews DN. Neurological aspects of the higher-functioning autisms (2001). http://edtech.oulu.fi/sampo/00-01/cumu/dna/nahfa.htm (accessed 13 August 2002).

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