The MMR children’s vaccine is about more than scientific certainty. The decade-long boycott by parents over the link between childhood inoculations and autism stymied essential public health programmes, such as the eradication of measles, and left tens of thousands of children vulnerable.
Health officials sought to prevent the spread of contagious diseases by sterilising pregnant women, and doctors offered fever-reducing medicines to lessen the risk of infection in the community. Those groups that responded to these measures put their own health at risk.
Health officials should aim to close the loop on measles from the marginalised children who become mumps-stricken to the risk from more vulnerable people of preventable life-threatening diseases.
An analysis by the British Medical Journal (BMJ) last year concluded that the MMR vaccination may have contributed to about 5,000 to 10,000 childhood deaths in the 1990s, when uptake of the vaccine dropped and vaccine coverage levels fell.
There is still no “disinclination” to vaccinate in certain communities in the UK. In some areas, vaccination rates are now as low as 40%. Had we used an alternative method for screening children for measles, we could have vaccinated and prevented the death of up to 30,000 young children in Britain today.
Those who continue to refuse vaccination fear only that vaccines may not be 100% effective – to which they have been proven true. The termination of research into the MMR vaccine’s safety may have led some parents and communities to worry that the MMR vaccine poses greater risk than all the measles medicated against and diseases in herded populations that have years of immunity. These families also prevent the spread of deadly diseases in hospitals by refusing to send their children to healthcare providers.
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David Halpern’s history, Vaccination: A History of a Dangerous Hurdle, notes that Germany was the “first industrialized nation in the world to ban children from vaccination in 1967. As a result, measles swept through the country, killing more than 130 people in that period”.
One can imagine children being autistic today as it did for many years before MMR. It took a landmark US court decision – thimerosal v Merck in 2008 – to remove the mercury-containing preservative from thimerosal-containing vaccines in the US.
This triggered the largest outbreak of measles since 1991, with 28,000 cases in the US and upwards of 80,000 cases worldwide. More than 90% of measles infections occur in people who are unvaccinated and, indeed, measles is still a serious risk to those who do not have access to immunisation.
And why do people resist the vaccination that could save their children’s lives? For some, the anxiety over a rare neurological problem means they want to avoid it at all costs, even when there is clear proof that it is relatively harmless.
Another reason why people choose not to vaccinate is that they have attended medical school and assumed that they have sufficient information to make informed decisions about the safety of vaccines. However, the scientific discussion about the safety of the MMR vaccine has been heated and confusing. Scientifically informed decisions about the safety of a vaccine are difficult and difficult decisions.
We must take measures to close the loop between the marginalised children who become mumps-stricken and the risk from more vulnerable people of preventable life-threatening diseases.
Other countries in the developing world have made better use of vaccine-preventable diseases by involving women of childbearing age in routine immunisation programmes. I found this very disappointing when I recently returned from working in India and Zimbabwe. In countries where mothers are better educated about the use of vaccines and in poor areas where child labour is widespread, these diseases have become less prevalent. The use of vaccine-preventable diseases has not dropped. For all of the tragic consequences of the earlier childhood measles epidemic, we must learn from our mistakes and ensure that a similar tragedy is avoided in the future.
• Julia Powles is a journalist and director of Abortion Rights