http://bmj.com/cgi/content/full/324/7335/492

 

BMJ 2002;324:492 ( 23 February )

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How parents decide on MMR

A radio journalist describes giving one family a unique perspective on the triple vaccine story

Early in the new year I was asked to work on an in-depth piece about MMR. I "adopted" the Warburton family, who had emailed the BBC saying that they were in a quandary over whether or not to vaccinate their 14 month old first-born, Phillip. It seemed the simplest way to illustrate how parents are thinking, and the effect that the polarised arguments for and against MMR are having on them.

I took the Warburtons to see some of the people who have had a role in the debate: Dr Peter Mansfield, who was referred to the General Medical Council for offering single vaccines and whose case was dropped; Dr Elizabeth Miller at the Public Health Laboratory Service; and the charity Sense, which represents people who are deaf and blind, which is often the result of rubella. They spoke to the deputy chief medical officer, Dr Pat Troop; and they conducted the only interview with Dr Andrew Wakefield during the week of his most recently published material.

Darren and Carol Warburton had read on the internet about possible links with autism and bowel disorders and they were hungry for as much information as they could get. They were ready to be convinced either way, but the BSE (bovine spongiform encephalopathy) scandal had left them distrustful of government policy. Perhaps most interesting was the fact that they really couldn't decide where to draw the lines between government and medical professionals' advice. They wanted to trust their doctor and health visitor, but they felt they were being spun a political line.

I'd love to say the journey---which was broadcast on BBC Radio Five Live every morning from 4 to 8 February---helped them, but it pulled them from pillar to post. Dr Mansfield told them that most advisers sang from an official hymn sheet and that healthy children had nothing to fear from the three viruses. Dr Miller took them through the scientific evidence and the potentially horrible consequences of measles. The director of Sense said he felt that MMR was the best option but that if they were really opposed to it they should at least have single vaccinations. Dr Troop assured them that the government's scientists knew best. And Dr Wakefield said that he would need some time yet to prove any links, but he admitted it was theoretically possible that the measles in a single vaccine might have affected the intestines of children just as he believes that measles in MMR might have done.

What really swayed the Warburtons the most was the personal touch. When Peter Mansfield said that they were right to question the official line, they felt vindicated. Elizabeth Miller's science talk impressed them, but it was when she talked of her own children that they warmed to her advice the most. Pat Troop's comments about truly wanting what was best for Phillip stick in the mind. And it was the conviction in Andrew Wakefield's voice when he talked about listening to parents' worst fears that impressed Darren and Carol, and not the results of his research.


(Credit: BBC RADIO FIVE LIVE)



The Warburtons: swayed by the personal touch

The Warburtons have decided to opt for single vaccines, after toying with the idea of no vaccine at all. If single vaccines had been available on the NHS, I don't think they would have thought twice---it would have endorsed their concerns over MMR.

I've not publicly said whether my children have had the vaccine because I have a responsibility not to influence listeners' medical decisions. I'm a journalist, not a doctor. But I've watched the Department of Health box itself into a corner over this vaccine. It has huge amounts of scientific evidence to back up its policy. Anyone who cares to read it all can see that it is overwhelming. Parents know that. They've been told. But the decisions we make about our children's health are, in the end, a lot to do with individual emotions---confidence, trust, fear. If Tony Blair had been able to talk personally of his and Cherie's dilemmas over vaccination, it probably would have held much more sway with undecided parents than any medical research.

Halfway through their journey, Darren and Carol said that the more insistent the government became, the more they distrusted its advice. So when Professor Liam Donaldson called a press conference to endorse MMR, flanked by the great and the good of the medical world, it was the last straw. If more measles outbreaks are to be avoided, parents have to feel as though the medical profession isn't pulling rank and dismissing their concerns.

Footnotes

You can hear the Warburtons questioning Andrew Wakefield at www.bbc.co.uk/fivelive/audio/mmr.ram and you can read about the Warburtons' week in full at www.bbc.co.uk/fivelive/breaking_news/20020204_mmr.shtml

Sharon Alcock, health specialist. 

BBC Radio Five Live

© BMJ 2002

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ALL INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR LEGAL ADVICE.  THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.