Q:Three years ago our son Christopher was given a BCG vaccination (against tuberculosis) and a few days later contracted what was later diagnosed as ME.
He was given the Heaf test a test to find past or present tuberculosis infection or sensitivity to tuberculin, a purified protein derivative of tubercle bacteria, using a small disposable disk with multiple prongs to puncture the skin and insert the tuberculin].The result was, we felt, almost a Grade 2 [see below]; the area was very swollen, with the six dots relating to the needle points palpable, reddened and almost joined together. However, instead of further investigations being carried out the injection was given.
We are convinced that Chris's illness was as a direct result of the BCG and have heard of a few more cases where this particular vaccination has caused similar problems.
As a consequence we have been forced to take legal action and are now carrying out our own research, in conjunction with our solicitor, to find evidence which will help us prove our claim.
We already have in our possession a report from a consultant physician who considers that, on the balance of probabilities, Christopher did react positively to the Heaf test and that, at very least, further tests should have been carried out.
He also states: "The development of ME after BCG vaccinations is not specifically recognized as a complication, but given the slow emergence of explanations for ME, it may well be that something which specifically sets out to alter immunity such as BCG could, in some susceptible individuals, cause this type of reaction."
We also have a letter from Professor John Dwyer of the University of New South Wales who says the following: "We have seen chronic fatigue syndrome stimulated by vaccination in the past. . . both with vaccines, such as those used for influenza, and the use of material which is not alive, such as that in a tetanus toxoid shot.
". . .we believe that if you have a genetic predisposition towards the development of an organic fatigue syndrome, then by stimulating your immune system it is possible that the long term sequelae could be triggered off by such an experience."
Christopher has a past history of bacterial infections, treated of course with antibiotics. Subsequent tests at Great Ormond Street showed evidence of immunodeficiency C P, Hoddesden.
A:Thank you for your heartfelt letter. This vaccine was administered to all children in the 1950s and 1960s, in the UK and the US; after a continuing decline in the overall incidence of tuberculosis (except among special groups) the Joint Committee on Vaccination and Immunization in the UK intended to put a halt to the schools programme, which offers automatic immunization of children aged 10 to 14 through the schools by 1990. However, the number of reported cases has slightly increased (in 1989 there about 500 cases of childhood TB in England and Wales, half occurring among children of Asians and other immigrants and a high percentage in inner cities such as Leeds or the East End of London). So, erring on the side of caution, the committee recommended that the schools BCG programme be continued for another five years.
Besides school children, the Department of Health recommends that BCG be given at birth to Asian and other immigrant families with high TB rates; those who live in or travel to areas of high risk; those in contact with active TB; those with a family history of TB in the past five years; and children living in crowded conditions in inner cities.
In other words, to protect a minority at high risk (who would mostly be protected by the jab at birth), the department is needlessly exposing to the vaccine a majority which has almost no chance of contracting the disease. A recent study in the British Medical Journal (29 August 1992) showed that 92 per cent of districts were carrying out routine BCG immunization.
The Heaf test is used by 95 per cent of the school districts interviewed to measure tuberculin sensitivity. Unlike most sensitivity tests, a negative result is supposed to mean that the child does not carry antibodies to the tubercle bacillus. However, the test is notoriously inaccurate; even the American Academy of Pediatrics warns its members that the test carries the possibility of false negatives and false positives. Furthermore, no one is really sure any more what a positive test really means. (An article in the Lancet on 16 May 1952 confirmed this attitude among the medical profession.) It could mean that someone is immune to tuberculosis, had prior infection, or it could mean that someone is simply allergic or sensitive to the test.
In the BMJ study, most districts agreed on what to do with a 0 grade, which showed very little reaction (recommend immunization) or a grade 3 or 4, which indicated a pronounced reaction (refer to a chest clinic for special evaluation before going ahead with the jab). The disparity occurred with those scoring grade 2, the same reaction as your son. Around one third of the districts recommended no immunization and approximately two thirds, referral to a chest clinic for special examination before going ahead with the jab. Only a single district recommended immunization at this level of sensitivity to the test. In other words, the doctor who ordered that your son be given the jab acted contrary to many of his peers. This study will be particularly useful to you if you go ahead with your legal claims, which we urge you to do.
On top of all this, the vaccine may not even work. Medical Monitor (5 June 1992) reported that: "In 10 randomized controlled trials from around the world since the 1930s, the protective efficacy of BCG vaccination has ranged from 0 to 80 per cent, although higher rates are reported with use [among newborns]." On average, it concludes, the jab only protects about 65 per cent of exposed children against pulmonary disease.
Medical Monitor goes as far as to label the tuberculin tests "inaccurate". A positive tuberculin test, it says, doesn't always imply protection against the disease.
The article also admits that BCG vaccination can only limit the multiplication and spread of the tubercle bacteria; it cannot prevent infection in people exposed to the germ. "It can cause disseminated TB in immunosuppressed individuals, including children, and local ulceration and osteitis [inflammation and wasting away of bone] appear to be more common with its use in [babies]."
Other side effects include lymphadenitis and generalized lymphadenopathy (that is, inflammation or disease of the lymphatic system, the complex network in the body that maintains the fluid environment and is vital to the immune system). The complication rate is 0.3-0.6 per cent.
To add to the damning evidence, The Lancet (March 14 1992) carried a study of 83,000 individuals in Malawi who'd been vaccinated with BCG and found that about half were protected against leprosy but could find "no statistically significant protection by BCG against tuberculosis. These findings add to the evidence that BCG vaccines afford greater protection against leprosy than against tuberculosis."
There is ample evidence that this vaccine, as many others, particularly those administered live, may harm the immune system, particularly in a child whose immunity is already weakened. Increasingly, many doctors believe that ME could be caused by drugs that interfere with the immune system. Christopher's repeated infections and courses of antibiotics may have placed him in that position.
We would urge you to pursue the legal route with Action for Victims of Medical Accidents (Bank Chambers, 1 London Road, Forest Hill, London SE23 3TP). Finally, we would suggest that you find a good nutritional doctor with a good deal of experience in helping patients with ME to strengthen your son's immune system and possibly overcome the damage done to him by modern medicine.