Gift of the jab?

<bold>What is MMR?</bold>

MMR is the combined vaccine against measles, mumps and rubella (German measles) which the Department of Health insists is the safest way to protect children against these common childhood diseases. The vaccine contains live virus particles, which have been modified to stop them causing the disease. The idea is to fool the body's immune system into thinking it is under attack by the viruses so it produces antibodies which will fight off the disease in the future.

<bold>When was MMR introduced and why?</bold>

MMR has been in use for nearly 30 years in the United States. The vaccine was introduced in the UK in 1988. It is given to children at 12-15 months of age and again before they go to school. According to the NHS Health Promotion Service, a single dose of MMR gives 90 per cent protection against measles and mumps and 95 per cent protection against rubella. The second dose increases protection to 99 per cent.

<bold>How serious are measles, mumps and rubella?</bold>

Measles, the most serious of the three illnesses, is usually what health experts call a 'mild disease', but if there are complications it can be dangerous. It causes a high fever and a rash and, in the most severe cases, can go on to cause chest infections, fits and brain damage. About one in every 15 children who develop measles is at risk of complications and in up to one in 2,500 cases, it can be fatal.

Mumps causes headache, fever and painful, swollen glands in the face, neck or under the jaw. It can cause permanent deafness, and viral meningitis and encephalitis. If can also affect male fertility if caught after puberty. German measles causes a mild rash, swollen glands and sore throat in children, but the main risk is to the unborn baby of a woman who contracts the disease during pregnancy.

<bold>Has MMR worked?</bold>

In 1987, the year before MMR was introduced, 86,000 children in England caught measles and 16 died, according to the NHS Health Promotion Service. Now there are fewer than 100 cases of measles a year. Health chiefs are keen to establish what they call 'herd immunity', where a high enough proportion (at least 90 per cent) of the population has been vaccinated to prevent any outbreaks. Health bosses are worried that concerns about the safety of the vaccine are leading to a drop in the numbers of children being inoculated, increasing the risk of new outbreaks of measles.

<bold>What are the concerns about MMR?</bold>

Some parents are worried about a possible link between the MMR vaccine and autism. Parents of some autistic children claim that until they were vaccinated, their children were perfectly normal, but that shortly after being given the MMR jab they began to develop symptoms of autism. One group of British parents whose children developed autism is suing the makers of the MMR vaccine claiming personal injury damages.

<bold>What is autism?</bold>

Autism is a lifelong developmental condition that causes behavioural problems and affects the way a person communicates and relates to other people. Parents often describe their autistic children as living in a strange, detached world of their own.

Classical autism is rare, occurring in 4.5 per 10,000 people, while the related Aspergers Syndrome occurs in approximately 26 per 10,000 people. The cause of autism remain unknown although it is generally agreed it is related to problems with brain development.

<bold>What is the evidence for a link with autism?</bold>

As well as the anecdotal evidence from parents, a paper in medical journal The Lancet by Dr Andrew Wakefield alleged a link between the MMR jab, bowel disease and autism. He argued that injecting three live viruses at once may be seriously compromising children's immune systems. Dr Wakefield was later forced to resign his post.Most scientific evidence suggests no link. Another study published in The Lancet found no increase in autism since the introduction of MMR in 1988. Nevertheless, nearly half of GPs, health visitors and practice nurses have reservations about giving children their second dose of the vaccine.

<bold>What the Government says</bold>

According to the Department of Health "all the experts advise that MMR is the safest and best option for children and that single vaccines are definitely second best. For this fundamental reason the Government does not support the use of separate vaccines." Tony Blair today gave his strongest hint yet that he has had his son Leo inoculated and he is said to be investigating the cost of separate vaccines. Public health minister Yvette Cooper said yesterday: "Our position has not changed."

<bold>What the Opposition says</bold>

Single jabs should be offered while the Government launched a campaign to convince the public that MMR was safe, said Conservative health spokesman Liam Fox. "It is not acceptable to stand back and say we are going to give you MMR or nothing at all, because the nothing at all could lead to a lot of children being damaged."

<bold>What's the problem with single vaccines?</bold>

Health chiefs argue that if vaccines were given separately, it is likely that many children would not complete the course and remain unprotected for longer. Single vaccines are not licensed in this country and have not been tested for potency and toxicity.

<bold>What do other countries do?</bold>

According to the Department of Health: "No country in the world recommends MMR be given as three separate vaccines." The MMR vaccine is used in 90 countries around the world.

However, you can get single measles jabs in France, and single measles and rubella vaccines in Japan. According to parent support group Jabs, since the introduction of the single dose programme the Japanese health authorities have stated that there have been far fewer adverse reactions reported.

<bold>What can parents do now?</bold>

Parents can do one of three things:

1. Decide to have their child inoculated by the MMR vaccine as recommended;

2. Decide against any vaccination, laying their children open to the risk of catching these illnesses; or

3. Go private and find a doctor who will deliver the vaccine in separate injections. This could be expensive and time-consuming: no doctors in this area offer the service. If you want to discuss the issue further, consult your GP or contact NHS Direct: 0845 4647.

Useful websites

www.doh.gov.uk/mmr.htm

www.immunisation.org.uk

www.jabs.org.uk

osiris.sunderland.ac.uk/autism/vaccine.htm

Updated: 10:49 Thursday, February 07, 2002