UK General Medical Council Told Docs “Commit Fraud for MMR Vaccine Bonuses”

The UK’s General Medical Council issued formal written advice to UK medical doctors to commit fraud on the UK’s National Health Service for personal financial gain: Target Payments for Preventive Health Measures” which asked and answered the question “Can GPs remove some children from their lists, temporarily, for the purpose of calculating the MMR target payment?” [full quotes below].

If UK doctors met target levels for vaccinations they qualified for bonus payments.  One way of claiming was to make a false return.  The GMC’s advice was for doctors to file false returns of the numbers of patients who had received the MMR vaccine.  Doctors were advised to take unvaccinated child patients off the patient list temporarily to claim the bonuses but also to ensure the parent agreed, [thereby implicating parents in the fraud].

The GMC is the UK statutory body established to protect, promote and maintain the health and safety of the public by ensuring proper standards in the practice of medicine by medical doctors.  Dishonesty, financial impropriety and fraud fall within its purview [in more ways than one it would seem].

This is the same organisation which recently found Professors Walker-Smith, Simon Murch and Dr Andrew Wakefield guilty of numerous charges filed by Sunday Times’ journalist Brian Deer.  No parent complained and the doctors enjoy wide support amongst parents of many autistic children they did their best to help.  Other doctors who have refused to toe the UK’s Department of Health line on medical practice have found themselves facing or threatened with proceedings by the GMC including amongst many others these four cases: UK’s GMC, Dr Jayne Donegan’s Story, Vaccines & MMR – - Dr Sarah Myhill – - Dr Peter Mansfield – -  Dr. Barry Durrant-Peatfield.

So if it concerns getting MMR vaccine uptake up to help the drug industry, fraud is fine.  But make sure you implicate the parents and what better way to do that than to pressure them into agreeing their children become temporary patients possibly for emergency treatment only or else be dumped from the patient roster completely. But if you raise valid concerns about the safety of vaccinations watch out.

What should the GMC have said?  The GMC should have given a clear lead to doctors and should have said [but did not] that temporary removals of child patients from a GP’s roster is never an option because it is neither ethical nor honest  and that such bonus payments created a conflict of interest between the doctor’s financial gain and the welfare of the child patient.

The GMC is independent (allegedly) of the NHS and of Government but in practice is run and controlled by the UK medical heirarchy and paid for by the medical profession.  Where the GMC finds that a doctor is not fit to practise, it has legal power to erase that doctor’s name from the medical register, to suspend the doctor from the register or to place conditions on the doctor’s practice. These restrictions apply to practice in any sector of employment in any part of the UK.

The GMC has a great notoriety in the UK with frequent calls for it to be abolished, suggested legislative threats: “Minister to look again at NHS bill’s threat to GMC” British Medical Journal: 1999 February 20; 318(7182): 482 and has attracted critical analysis of its decisions including in peer reviewed journal papers:

The Intimidation of British Pediatricians” Carole Jenny Pediatrics, Apr 2007; 119: 797 – 799.

United Kingdom General Medical Council Fails Child Protection” Catherine Williams Pediatrics, Apr 2007; 119: 800 – 802;

Meadow, Southall, and the General Medical Council of the United Kingdom” David L. Chadwick, Henry F. Krous, and Desmond K. Runyan Pediatrics, Jun 2006; 117: 2247 – 2251;

It is a criminal offence in England to aid abet, counsel or procure the commission of a criminal offence – such as obtaining pecuniary advantage by deception.

The GMC Formal Advice to Doctors to Commit Fraud

The GMC posed the question “Can GPs remove some children from their lists, temporarily, for the purpose of calculating the MMR target payment?” in an article entitled “Target Payments for Preventive Health Measures” first published in GMC News in June 2003.

And the GMC’s answer was effectively “it’s OK provided you have patient consent“.  It seems it also happens to be OK if it helps to increase the MMR uptake figures.  The advice was not offered for other vaccinations.

The GMC also failed to make mention of the financial and moral impropriety of doing so in their answer to the question they themselves posed:-

This must not be done without the parents’ agreement. Parents must be given a full explanation of what was proposed and why, their child’s rights as an NHS patient, and the implications for their child’s future care. Doctors working within the NHS must treat all patients entitled to NHS services on an equal footing. So temporarily removing a child from a GPs list must not adversely affect their care, for example in accessing secondary care and out-of-hours services, or in providing relevant information to ensure continuity of care and allow effective working with other agencies. Doctors must act honestly in their financial dealings. So GPs must ensure that any arrangement to remove a child from their list and re-register them for ‘immediately necessary treatment’, or on some other basis, would be in line with their contractual obligations to the NHS.

So provided the doctor does what the GMC advises and ensures “that any arrangement … would be in line with their contractual obligations to the NHS” it is fine as “Doctors must act honestly in their financial dealings“.

All this is of course barking mad.

The GMC also advised that if the evidence is available this is not contrary to GMC guidance on good medical practice:-

Are temporary removals from a GPs list acceptable to the GMC? In the absence of evidence that ‘temporary removals’ satisfy the concerns outlined at Q5, we cannot give any reassurance that such arrangements would be seen as consistent with our guidance on good practice.

The conflict with the GMC’s other advice is clear.  The GMC advised UK doctors “must not ask for or accept any inducement, gift or hospitality which may affect or be seen to affect the way you prescribe for, treat or refer patients.“: Conflicts of interest – guidance for doctors

But it seems the GMC do not mind when it comes to MMR, even where the inducement is so strong it encourages fraud on the NHS.  But then, the GMC did not seem to mind about that either.

Ironically  “GMC Today” newsletter carried a story titled “Is the NHS immune to fraud?” [Oct 2005] about reducing and reporting fraud in the National Health Service, stating:-

Most people who work in and use the NHS are honest, but there is a minority that tries to defraud it of its valuable resources. By working to reduce fraud and corruption to an absolute minimum and hold it there permanently, the NHS CFSMS can release these resources for better patient care. In the largest organisation in Europe, even a small proportion of fraudulent staff and patients has a huge impact. Fraud is committed by a range of NHS professionals, who might claim for work not undertaken, alter prescriptions, create ghost patients or make fraudulent claims for out of hours visits, advice not given or treatment not provided. In some areas, claims by NHS professionals fell by between 43% and 54% after processes were fraud-proofed.

It is now accepted that even the NHS is not immune to fraud.

The GMC has an agreement on cooperating and coordinating with the NHS Counter Fraud service.  The story gave a number to call the confidential NHS Fraud and Corruption Reporting Line and an email address too.  It reports:-

If you have a concern about a fraud taking place within the NHS, please call the confidential NHS Fraud and Corruption Reporting Line on 0800 028 40 60. All calls will be dealt with by trained staff and professionally investigated. Lines are open Monday to Friday 8 am–6 pm. You can also email us at nhsfraud@cfsms.nhs.uk at any time.Memorandum of Understanding between the General Medical Council (GMC) and the National Health Service Counter Fraud Service (NHS CFS)

We had not got the heart to tell ‘em.  Would you?

When Was This?

When this news was published by The OneClickGroup in October 2007 the GMC’s response was to claim the advice was withdrawn in 2006.  But the fact the advice was published at all is damning.  Not only that, the advice continued to be published on the GMC website as late as 7th October 2007 with no indication to doctors it had been withdrawn.

After The OneClickGroup’s exposée the GMC removed the page containing the advice from its website and republished the advice but with a banner across it claiming “Withdrawn November 2006″: Target Payments for Preventive Health Measures.

Additionally, the advice was published for over 4 years from June 2003 until October 2007 [just about the time the GMC was ready to attack Wakefield, Walker-Smith and Murch].

Who Ran The GMC Then?

The President when the advice was first published until 2009 was Sir Graeme Catto – also incumbent when the GMC started the proceedings against Walker-Smith, Murch and Wakefield.

So it just goes to show, you cannot trust anyone in “authority” these days.

Anyone wanting to make a complaint to the GMC?  Here is where you do it:-

Making a complaint

But don’t hold your breath waiting.

Sir Graeme’s email address and contact details at The University of Aberdeen are found here:-

http://vcs.abdn.ac.uk/medicine_therapeutics/staff/SirGraemeCatto.shtml

[But probably not for much longer!]

 

UK “Faked” National Autism Data To Declare MMR Vaccine “Safe”

UK children are nearly 5 times more likely to have autistic conditions than adults according to the results of the first ever UK government survey to assess the numbers of adults with the condition: ["Autism Spectrum Disorders in adults living in households throughout England - Report from the Adult Psychiatric Morbidity Survey 2007" The NHS Information Centre.]

But the British public were told instead that the survey shows rates in adults and children have always been the same so that that vaccines like MMR cannot be to blame for the increasing rates in children. The UK National Health Service funded the survey and made these claims.

Survey Authors Couldn’t Find Enough Adult Autistics

There were early rumours in 2008 the authors could not find numbers of adult ASC cases matching numbers in children.

The survey failed to find a single case of an adult with “typical” or “classic” autism, found in approximately 30%  of  ASC children. “Typical” or “classic” autism is a type of ASC controversially claimed in 1998 might be associated with the MMR vaccine.

The authors also failed to find sufficient adult ASC cases overall – just 19 in 7,451 adults, being “higher functioning” ASCs – mainly Asperger’s Syndrome. This represents an overall rate of just under 1 in 300 potential adult cases and not the officially claimed 1 in 100 for children.

The authors say that if they had carried out the survey differently they might have found four times as many adults - a further 46 or 47 ASC cases to come up with the same figure as for children.   Using already estimated data they claimed to be able estimate-on-the-estimate that the adult autism rate for the entire UK is the same as in children [1 in 100].

The survey’s original design meant it was highly unlikely any cases would be “missed” and instead that cases would be over-estimated.   This calls into question the authors’ claims to be able to estimate such a large number of “missed” cases.   The survey design was broadly based.  An unlikely 72% of the adult  participants were selected as potentially having one of four mental illnesses [rather than just ASC]. The study was also designed so that those most likely to have an ASC were interviewed and those unlikely to were excluded.

Whilst designed to estimate the maximum number, the survey as published was also based solely on data for Asperger’s Syndrome from the Adult Psychiatric Morbidity Survey 2007 and not other ASCs.  That is not what the NHS has been telling the media and public. The study authors stated in their prior May 2008 news release that there were to be two surveys in their study, the second to cover other ASCs: University of Leicester to lead audit of adults with autism Eurekalert 9-May-2008. But neither the media nor the public were told by the NHS that the second survey had not been carried out and that no data from it was included in the final survey report.

It is not credible that for none of the other psychiatric conditions in the Adult Psychiatric Morbidity Survey 2007 it seems was it considered necessary to “estimate” “missed” cases – and particularly not an unusually high 3 out of four cases.  The data used is the identical data collected from the identical subjects by the same people at the same time as part of and using the identical study design.

And therefore also the prevalence of ASCs in adults cannot be 1% in any event and also cannot be the same as in children [also contrary to the public claims made by the NHS].

On the basis of the results so far the NHS would have had to claim the prevalence of ASCs in adults is substantially greater than in children and it would have to explain how that could be.

Details of how the missed Aspergers cases were estimated were not provided.  None appear in the survey report to show how the authors calculated this to arrive at an estimated overall adult ASC prevalence figure of 1 in 100.

The NHS also needs to explain of how it came to issue a news release claiming this survey was of the prevalence of adults with ASCs when it is not.  This appears to show that the NHS funded a survey report, assured the Statistics Authority of its validity as “national statistics” when even the title of the report is not accurate and then used it in the media and in public to bolster a policy position when not justified in doing so.

The explanation given of the calculation of “missed cases” appears to be that of all potential cases of adults with ASCs identified by telephone interview only 630 were selected for interview.  The researchers then estimated what they thought they would have found if they interviewed all “potential cases” and multiplied up the 19 cases found to arrive at 73.

Difficulties with this include the remarkably high numbers of adults identified as “potential” ASC cases – more than one in every two adults – or half [ie. 2,854 adults out of a possible 5,329 eligible for consideration].  This demonstrates the inaccuracy of the probabilities the researchers assigned to potential ASC cases and in particular the bias to substantially over estimating the potential numbers of ASC cases.

This is compounded by only 19 cases being found in those deemed most likely to have an ASC and selected for interview.

The estimate of 1 in 100 is also based on what appear  the very same and remarkably inaccurate “probabilities” for selection devised by the researchers.

This does not appear scientific.  It is also compounded by the same researchers claiming wrongfully that their results are for all adults with ASCs when the documented facts  show the data was collected for potential Asperger Syndrome cases only. [Added 16/Feb/2010]

Autism In Children Already Higher Than 1 in 100

A further problem with the survey is that two recent formal peer reviewed journal published studies have found the rate in children is  not 1 in 100 but much higher.  A 2006 study [Baird] found a rate in children of 1 in 85 and a recently published study by Baron-Cohen et al of 2005 data found a  rate of ASC’s in children of 1 in 64 when children not yet diagnosed were taken into account.  This gives a rate of ASC in children 5 times higher than the 1 in 300 indicated by the survey’s results.  Neither of these studies are mentioned in the survey although members of the same team were involved in the Baron-Cohen study, and Professor Baron-Cohen was a consultant to the survey.

Impossible for Adult ASC Rate to Be Same as Childrens’

The authors inexplicably also fail to explain how their estimate of ASC rates in adults is the same as in children when their results show ASC rates in adults and children are significantly different:-

  • Aspergers Syndrome rates in adults on these results are 40% higher than in children;
  • correspondingly Aspergers Syndrome cases in children compared to adults would have to have substantially decreased for this to be so;
  • the rate of “classic” autism has leapt from zero in adults to 30% of ASC cases in children;
  • adults with “classic” autism do not exist.

Identical Figures – A Remarkable Coincidence

The addition of the authors’ hypothetical “estimated” cases provides exactly the same rate of 1 in 100 previously accepted for children.  This is despite the authors themselves warning the results should be approached with caution because of the inaccuracies.  In such circumstances if rates were the same then a similar figure might be expected but not exactly the same one.

The 1% figure for children was stated in pre publicity announcing the start of survey: University of Leicester to lead audit of adults with autism Eurekalert 9-May-2008. “Author bias” in favour of finding a pre-determined figure favourable to the study funder is a well-known phenomenon in formal medical literature.

Breaching the codes of practice prohibiting the release of national statistics for government policy purposes the UK National Health Service’s publicity put out to the media on publication of the survey focussed on claiming ASC rates in adults and children were identical and that therefore the MMR vaccine did not cause ASCs.  This was not the stated purpose of the survey and the authors make no mention of the vaccine-autism issue.  Media stories included: Autism rates back MMR jab safety Michelle Roberts BBC Tuesday, 22 September 2009 and Autism just as common in adults, so MMR is in the clear Sarah Boseley The Guardian Tuesday 22 September 2009.

Survey Does Not Live Up To Its Title

The survey was originally announced to establish the UK adult autism rate for the first time by finding what were then being claimed to be “missed” adult cases of autism.

The publicity claimed “The new prevalence study now underway will give the first ever accurate picture of how many adults have the condition.” [Emphasis added]University of Leicester to lead audit of adults with autism Eurekalert 9-May-2008. The purpose was to inform UK authorities in planning service provision for adults autistics.

The authors used “second-hand” data collected in 2007 which covered only potential adult cases of Asperger’s Syndrome unsuitable for the claimed purpose. The authors planned an additional part of the survey to collect data on adults with other ASCs such as “typical” or “classic” autism but failed to mention this or any resulting data or results in their recently published survey report.  They stated in 2008:-

The prevalence study will make use of new data collected in 2007 by NatCen and Professor Brugha’s team to record the number of adults with Asperger’s syndrome and high functioning autism. There will also be an additional part to the study on the number of people with autism who have more complex needs and learning disabilities. The aim of the combined research will provide good epidemiological information in terms of prevalence and the characteristics and problems of this group.”

University of Leicester to lead audit of adults with autism Eurekalert 9-May-2008.

Many Anomalies

The standard approach under what is called “DSM IV” to diagnose ASC’s was applied but the authors based their assessments on a broader test for ASCs used in a manner neither accepted or relied by other professionals nor scientifically validated. Inexplicably the survey’s results of the DSM IV diagnoses were neither used nor published.

The 1 in 100 figure for children is based on formal diagnoses using accepted methods and published in formal peer reviewed medical literature.  The authors’ survey has not been independently reviewed nor has it been assessed for compliance with accepted statistical standards.

The 19 potential adult ASC cases in 7,451 participants included 17 male and 2 female, a rate of 1 in 8.5 whereas 1 in 5 cases in children are girls.

Other problems with the survey include:-

  • Inclusion in the study was based on the ability of selected members of the public to answer questions on the telephone followed by cooperation with a complex psychiatric assessment. The participants were therefore self-selecting and appear unrepresentative of the general population
  • The 19 cases claimed included no one from an ethnic minority, and a very low rate in females (the ratio of females with ASD is known to be 1 in 5 cases in children, but the survey results indicate it is half that in adults at 1 in 10)
  • Cooperation of more than half the 14,000 households approached is a remarkable and unexplained achievement. The questionnaire screened for psychotic disorder, Asperger syndrome, borderline personality disorder, and anti-social personality disorder.  Were the participants told this and would they have participated had they known?
  • The survey authors give a 95% “confidence interval” to their claim their estimate of adult ASC rate is the same as in children.  A confidence interval is a measure of trust in the reliability of the results but despite being the broadly based the survey failed to find the “missing” cases.

  • The survey results were published despite not having been through peer review nor verified for conformance to accepted standards for government statistics

  • Adults with “typical” autism [associated with the MMR vaccine] remain missing despite being a category claimed in the prior publicity to be part of the survey.

Dr Carol Stott commented on the methodology in Age of Autism:-

Whatever claims are made to the contrary this report tells us very little about the number of adults with ASDs – in England or anywhere else. The main problems with the study are with (a) case-definition, (b) ascertainment (c) diagnostic instruments (d) case identification and (e) statistical power.

There is no clearly stated case-definition anywhere in the report. The cases reported are defined loosely in terms of an initial score on a shortened unstandardised non-peer reviewed version of ascreening tool together with a semi-structured clinical interview – the Autism Diagnostic Observation Schedule (ADOS) – that was not designed to act as a stand-alone diagnostic instrument.

The sample selected is not representative of the ASD population. All participants were verbally fluent, living in ordinary households, and able to complete a self-report questionnaire.

The choice of measurement tools is inadequately justified and badly referenced. No details are provided, nor are any sources referenced, on the psychometric properties of the initial screening instrument (AQ-20). The standardized scoring criteria for the ADOS were not followed (using a total cut-off of 10 for Communication + Social Reciprocity, rather than three cut-offs (respectively) of 3, 6 and 10 for Communication, Social Reciprocity and the two combined). Additionally the authors over state the validity of the ADOS as a tool for use in adult populations. Module Four (used in the study) was standardized on a sample of only 70 adults aged between 16 and 44. Ages in the study sample range from 16 – 75.

The technical appendix, which is intended to provide information about the derivation of the AQ-20 is statistically naïve, unclear and potentially inaccurate. It is not clear for example, what is meant by the phrase on pg 16 of Appendix C “….once the final set of predictors had been selected, a regression equation was available for predicting the prevalence of ADOS.” Neither is it clear whether General Linear Modelling, Linear Regression or both were used to derive final items.

Finally, inferences are made about the lack of a significant association between age-groups and ASD prevalence without reference to statistical power. In a study of this size, with only 19 identified (unweighted) cases, the likelihood is that the study was underpowered to detect such differences.A valid and reliable study of the population frequency of a disorder requires clear and robust case definition, validated instruments, standardized procedures and adequate statistical power. An initial evaluation of this report suggests it fails on all counts.

British & Japanese Data Show Vaccines Cause Autism

We previously published data from Japan showing a clear causal link between changes in the Japanese vaccination schedules and corresponding increases and decreases in rates of children having autistic conditions:- Japanese Data Show Vaccines Cause Autism. The UK’s Joint Committee on Vaccination and Immunisation’s irresponsible and only answer to the Japanese data was it was “not UK data”.

Data from the UK’s General Practice Research Database shows that with each major change in the UK childhood vaccination programme the rates of childhood autism have increased significantly [Full Details Below].

And do vaccines cause autistic conditions?  If you read nothing else we strongly recommend you read this: PDF Download – Text of May 5th 2008 email from US HRSA to Sharyl Attkisson of CBS News].  In it the US Health Resources Services Administration [HRSA] state to CBS News reporter Sharyl Attkisson

We have compensated cases in which children exhibited an encephalopathy, or general brain disease. Encephalopathy may be accompanied by a medical progression of an array of symptoms including autistic behavior, autism, or seizures.

Despite all the lies and deceit by health official worldwide, the question “do vaccines cause autism” was answered after the Hannah  Poling story broke in the USA in February 2008 [see CHS article here].  Hannah developed an autistic condition after 9 vaccines administered the same day.  Under the media spotlight numerous US health officials and agencies conceded on broadcast US nationwide TV news from CBS and CNN. Full details with links to the original sources can be found in this CHS article: Vaccination Causes Autism – Say US Government & Merck’s Director of Vaccines. [Blue Text added 10 April 2011]

Data from the UK’s General Practice Research Database

[Click on graph to enlarge in new window]

The current UK rate of children with autistic conditions is 1 in 64 [or 157 per 10,000 children]: “Prevalence of autism-spectrum conditions: UK school-based population study” Baron-Cohen S, Scott FJ, Allison C, Williams J, Bolton P, Matthews FE and Brayne C (2009) British Journal of Psychiatry, 194: 500-509.

The rate in boys is 1 in 40.  Prior to 1988 which saw the first of several major changes to the UK childhood vaccination programmes the rate of childhood autism was running at between 1 and 4 in 10,000.  Childhood autism is also known as “typical” or “Kanner” autism.

In addition to vaccines being a biologically plausible cause of the worldwide increases in autistic conditions in children we have also seen legal cases in the USA confirming vaccines have caused autism in US children: AUTISM – US Court Decisions and Other Recent Developments – It’s Not Just MMR

The data presented here provides further evidence of the unscientific approach of medical researchers when publishing papers purporting to support the claim there is no association between vaccines and autism.

The graph above is adapted from a 2001 paper by Jick et al.  The authors claimed [emphasis added]:-

“... the data provide evidence that no correlation exists between the prevalence of MMR vaccination and the rapid increase in the risk of autism over time. The explanation for the marked increase in risk of the diagnosis of autism in the past decade remains uncertain. ….. The increase ….. could be due to …… environmental factors not yet identified.

“Mumps, measles, and rubella vaccine and the incidence of autism recorded by general practitioners: a time trend analysis” BMJ 2001;322:460-463 24 February.

The data shows something different and when correlated with major changes in the UK childhood vaccination programme shows what are the most likely “environmental factors not yet identified“.  With each major change to the UK’s childhood vaccination programme cases of childhood autism increased substantially.

The childhood autism risk increased three-fold for children born in 1988 and 1989 from the previous rate of between 1 and 4 in 10,000 to 12 in 10,000. 

The major change: the MMR vaccine was introduced in October 1988.  Routine administration was at around 15 months.

The childhood autism risk increased five-fold for children born in 1990 and 1991 to 20 in 10,000 from the pre 1988 rate of 1 to 4 in 10,000.

The major change: in May 1990 the accelerated DTP vaccine programme was introduced.  British babies were given the DTP vaccine substantially earlier at 2, 3 and 4 months instead of the previous 3, 5 and 10 months: [Persistence of antibody after accelerated immunisation with diphtheria/tetanus/pertussis vaccine: 1489 BMJ VOLUME 302 22 JUNE 1991]

The childhood autism risk increased nearly eight-fold for children born in 1993 to 29 in 10,000 from the pre 1988 rate of 1 to 4 in 10,000.

The major change: the Haemophilus Influenzae b vaccine was introduced in October 1992.  Routine administration was three doses at 2, 3 and 4  months.  [Routine Hib Vaccine: 438 BMJ VOLUME 305 22 AUGUST 1992, Hib immunisation catch up programme in North East Thames: R17 Communicable Disease Report Vol 4 Review Number 2 4 February 1994]

It appears it was only from 1993 that most infants were vaccinated at 2, 3 and 4 months with those born earlier being vaccinated at later ages in “catch-up campaigns”. This data suggests that to reduce the risk of autism from vaccines parents should delay the age at which their children are vaccinated.

One study shows that average vaccine coverage by November 1993 was 34% for 1989 births, 77% for 1990 births, 87% for 1991 births, and 89% for 1992 births: [“Haemophilus influenzae: the efficiency of reporting invasive disease in England and Wales” Communicable Disease Report R13 4:2 4 February 1994].

Japanese Data Show Vaccines Cause Autism

Data from formal peer refereed medical papers show vaccines caused autism in Japanese children.  The number developing autism rose and fell in direct proportion to the number of children vaccinated each year: [click here for full details Japanese Data Show Vaccines Cause Autism]

[Click on graph to enlarge in new window]

[Below is same graph data normalised by annual % of children receiving MMR vaccination - and also showing the same correspondence as above graph.]

[Click on graph to enlarge in new window]

090610 Terada Graph Data - by % Births

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