They must be thinking about making it compulsory, thats their next move.
The times is the voice of the establishment.

john

February 08, 2002

A sad case of Media Meddling not Reason
SIMON JENKINS



The Health Minister, Yvette Cooper, told the nation this week on radio that
the triple vaccine against measles, mumps and rubella was safe as safe could
be. The medical advice was clear. Of course all drugs were kept under
review, but parents should use MMR. Well said, Yvette, I thought, and
returned to the Corn Flakes.
But Britain is now open house to psychoterrorism. Any troublemaker can
reduce the populace to gibbering panic by a simple strategem. It involves
finding a dead or damaged child, splashing it across the media as "human
interest" and drumming up a scientist to blame the Government. Then off we
all go.

Since anything called a row must have two sides, Ms Cooper's advice had, for
some reason, to be balanced by a rebuttal. The BBC could not find a
reputable expert so it dragged in her Conservative opponent, Liam Fox. His
performance was as irresponsible as it was opportunistic. Of course he was
in favour of the MMR vaccine but he felt that any "public disquiet" needed
an airing. The political pot had to be stirred. It was Ms Cooper's fault
that MMR use was declining.

Parents were right to be worried. Vote Tory, he almost cried, vote measles.

When I made my own MMR decision, I regarded it as just another item of
parental riskmanagement. It sat in the pantheon of terror, with
amniocentesis, post-natal jaundice, whooping cough vaccine, cot death,
babyfood salmonella and chewed Hong Kong toy. It remains a wonder that any
child reaches 12 months. But until Tony Blair turned fatherhood into a
battle between regal privacy and leadership by example, I never regarded the
MMR decision as an Abraham-and-Isaac crisis.

Panic attacks caused by Britain's scientific inadequacy have become absurd.
The latest scare arose from a return to some four-year-old research by a
doctor, Andrew Wakefield. He had found a coincidence of child bowel disorder
and autism. He "suggested" that this might be triggered by the MMR vaccine.
Drug safety agencies worldwide understandably crawled all over his
suggestion, but signally failed to confirm it. Apart from other problems,
the symptoms of autism tend to emerge at 16 months, which happens to
coincide with the time when the MMR jab is normally given.

The media and Tory party are now demanding "single" vaccines for measles,
mumps and rubella. These are not banned and are available privately. But
they are regarded by public health authorities worldwide as unnecessary and
less effective because they require six separate treatments. MMR is better,
a phenomenally successful vaccine that has all but wiped out these diseases
in Britain, France, Germany, Italy, Spain, Sweden and most states in
America. In some countries the triple vaccine is even compulsory.

Of course no parent can see television footage of an autistic child without
feeling the stab of fear. It is pure terror, inducing the protective
instinct, however irrational, in all of us. Hence newspapers love to exploit
it. Small wonder 1,000 parents of autistic children are planning a class
action against the five vaccine manufacturers.

In 1988 a similar case was fought on behalf of children suffering brain
damage after taking the whooping cough vaccine. Scientists representing
drugs companies and research institutes came to blows in television studios.
The case before Lord Justice Stuart-Smith was instructive. He agreed that
"at first sight to the untutored and inexperienced eye" the brain-damaged
children made an impact. But his job was to weigh "the balance of
probabilities".

He sifted the evidence and decided that any causal link between whooping
cough jabs and brain damage remained hypothetical. Despite the fog of
research, a sensible person could not say that the vaccine was dangerous or
that its maker, Wellcome, was negligent. The advantage to public health was
clearly in its favour. As a result, parents continue to vaccinate against
whooping cough. Children who would once have died of it no longer do so.

From everything I have heard and read, the same applies to MMR. Yet the
publicity given to Dr Wakefield's research has had a stark effect. It has
led to MMR cover in Britain falling from 92 per cent to 84 per cent. Before
MMR was introduced in 1988, there were between 10 and 30 child deaths a year
from measles. There has been none for the past decade. Now measles is back,
in the North East and in two separate areas of London. The odds must be on
children dying once more. Already one unvaccinated child has been admitted
to intensive care.

The campaign to encourage parental choice for a single vaccine is the
classic scare twist, the proffering of a safe alternative. Single vaccines
are not free on the NHS for the good reason that there is no public health
case for them. Indeed, if Dr Wakefield's hypothesis held and autism did
result from a measles virus induced in the bowel, I cannot see why a single
measles jab is appreciably less risky than an MMR one.

No right is as treasured by the British as the right to be scared witless by
the press. Long may that freedom last. But I cannot see why the State should
subsidise the consequence. I cannot see why it should encourage more costly
and less effective MMR prevention than in the past, merely because the press
and Opposition are inducing the public to demand it.

Britain seems likely to find itself isolated in Europe in the paucity of its
cover against epidemics once thought obsolete. The prospect is bizarre. When
I was a child, bouts of measles, mumps and scarlet fever visited communities
as regularly as swallows in summer. Many died and thousands were scarred or
disabled for life. Advances in public health have stopped this. Children may
be pumped full of vaccines, but the price is surely worth it. We are better
and live longer as a result.

I am happy to blame the Government for anything, but this panic is in no way
of the Government's making. Apart from Mr Blair's attention-grabbing refusal
to say whether or not he has given his son an MMR jab, I cannot see any
ministerial fault. The Lancet has not thundered. The Medical Research
Council is solid. The evidence has not altered and expert advice has not
changed. A thousand parents may be suing a drugs company for millions of
pounds, but that is their business. I am sorry for their plight but I hope
the judge sends them packing.

Scientific convention should always be questioned, especially when its
practitioners are in the pay of drugs companies or government. There are
plenty of wonder drugs that have not worked. The shroud of thalidomide still
hovers over this debate. But in matters of epidemic control, I would rather
trust the Chief Medical Officer than the ranting tribunes of the mob. It is
his job to assess risk. He must punch out the statistics and sustain the
general good above a flurry of individual misfortunes.

The campaign against the MMR vaccine plainly endangers public health. It is
using easily publicised personal tragedies to fuel public fear and distort
policy. I believe any parent has the right to choose what, if any, vaccine
to adopt. They have that choice in Britain. Although I sympathise with
nations that make vaccination compulsory and ban unvaccinated children from
school, I admire the fact that it is still voluntary in this country.

There is a price. What no country does is centralise its health service as
ruthlessly as does Britain. The result is that, when confidence starts to
collapse, in a matter as simple as a vaccination programme, it collapses
nationwide. When every facet of the service, from a Thai chicken dinner to a
washing routine in the Whittington Hospital, is ordained from Whitehall and
becomes a matter for ministerial accountability in Parliament, chaos is
bound to ensue. If the Government insists on nationalising every bedpan,
small wonder it falls victim to nationalised hysteria.

At the same time, the State has a clear obligation to prescribe the vaccine
which it has decided is the safest and most effective in warding off
epidemic. In the present state of knowledge, that vaccine is plainly MMR.
There can be no public interest in undermining its use.




Contribute to the new Debate page via comment@thetimes.co.uk