Doctors Admit 'Reservations' Over Giving Second Dose Of MMR Vaccine

      [By Jeremy Laurance in the Independent, UK.]
http://www.independent.co.uk/news/UK/Health/2001-01/vaccine120101.shtml

      The scare about the controversial triple vaccine against measles,
mumps and rubella (MMR) may have spread to health professionals. A study has
found 48 per cent of family doctors, practice nurses and health visitors
have reservations about giving the second dose of the vaccine to children.
       The news came as the largest study of the vaccination ever undertaken
reportedly ruled out any link to other conditions in children.
      Finnish researchers followed up three million doses of the vaccination
against measles, mumps and rubella and found no link to cases of autism and
serious bowel disorders.
      The Finnish research will be welcomed by campaigners concerned about
falling immunisation levels in the UK and the risk of a measles outbreak,
and will also bolster claims by health officials in the UK that the single
doses are unnecessary and costly.
      MMR, is normally given to children in two doses, with the first at 13
to 15 months and the second between the ages of three and five years. The
vaccine was introduced in 1988 but the second dose was added to the
immunisation programme in October 1996 as part of a World Health
Organisation drive to eliminate indigenous measles from Europe by 2007.
      The first dose of MMR gives a high level of immunity but a second dose
is necessary to eliminate measles from the population. Researchers from
North Wales health authority, where the study was done, say the findings are
worrying because they threaten the WHO target.
      The survey of almost 600 health professionals in Wales was conducted
in May and June 1998, shortly after publication of controversial research at
the Royal Free Hospital in London linking the measles virus with bowel
disease and autism. The research, which has been widely criticised, led to a
sharp fall in uptake of the MMR vaccine .
      The Public Health Laboratory Service warned recently that there was a
risk of measles outbreaks in some areas where immunisation rates had fallen
as low as 74 per cent.
      The Welsh survey, published in the British Medical Journal, found 94
per cent of the 157 GPs who answered the questionnaire agreed with giving a
second dose of MMR but 40 per cent had reservations. Among practice nurses,
95 per cent agreed but 54 per cent had reservations; among health visitors
90 per cent agreed, 41 per cent with reservations.
      Faced with a parent who was unsure about the second dose, 72 per cent
of GPs, but only 42 per cent of practice nurses and 20 per cent of health
visitors, said they would recommend the vaccination. On the claimed link
with autism, 27 per cent of nurses said it was possible or very likely, as
did 13 per cent of GPs and 7 per cent of health visitors.
      Similar percentages considered an association with bowel disease was
possible.
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