http://www.observer.co.uk/comment/story/0,6903,647834,00.html

 

Who can we believe these days?

Our once automatic trust in medical authority has gone, leaving parents in agonies of uncertainty about what is best for their children

Andrew Rawnsley
Sunday February 10, 2002
The Observer

Asked again whether Baby Blair has had the jab, Downing Street is exceptionally needled. 'The attempt to personalise the issue is frankly pathetic.' Frankly, that could not be more wrong. There is virtually nothing more profoundly unpathetic and deeply personal than the fate of your children. I'll be honest where the Prime Minister continues to be opaque. Let me declare what I am going to do about MMR. Here is my candid confession: I don't know.

My wife and I have been arguing about the triple jab for many months. Our agonising - Lord, have we agonised - began well before the present convulsion of panic. Our two eldest daughters have had the multiple inoculation against measles, mumps and rubella, without any ill-effect. Our youngest, Cordelia, has not. This means I am losing the argument. I have been heavily inclined to think that our daughter should be jabbed. A tiny number of researchers using highly questionable methodology have raised only the possibility of a link with autism - and even they make no claim on a definitive answer. The vast majority of scientists around the world declare MMR to be safe. More, it is imperative to keep inoculation levels high if we are to avoid epidemics of some very nasty childhood diseases. Measles can be especially vicious, inflicting, in some cases, brain damage, even death. The outbreak of measles in south London is barely a mile away from where we live. For me, the balance of risks weighs in favour of MMR.

Cordelia will not get the triple jab if my wife prevails. Jane is a rational and highly intelligent woman. She is contemptuous of the frenzy frothed up by some newspapers. She is no less disdainful of Whitehall's efforts to counter press panic with government scaremongering. The Department of Health is spending £3 million on an ad campaign lecturing my wife and the thousands of other mothers who share her anxieties that they are neurotic and selfish idiots. Save the money, Alan Milburn. Patronising bullying isn't going to work. Modern, sophisticated, sceptical citizens are no longer prepared to be spoonfed with cod-liver oil because nanny knows best, not least because nanny has so often been shown to know worst.

Mass vaccination against killer diseases is one of the most brilliant successes in the history of medicine. It was made possible by a triumph of social control. Mothers are asked to take healthy young children and subject their protesting pure bodies to painful injections wriggling with viruses. In the name of the greater good which flows from herd immunity, mothers have submitted to a procedure which runs counter to their most basic instincts. They only do so on the understanding that it is absolutely safe.

Jane first became seriously unnerved when Cordelia had an adverse reaction to the triple vaccine for diphtheria, tetanus and whooping cough. For a month afterwards, our daughter withdrew into herself. The lights were on, but was she still at home? Cordelia is small for her age; a bit slow to progress. Nothing serious, it's just that her clock seems to be running about half an hour late. One paediatrician we have consulted says that everyone lies somewhere on the autistic spectrum from chronic to imperceptible. Cordelia has not been diagnosed as autistic. It's just that she may lie a little further along that spectrum than most people. She may be susceptible to autism. For Jane, the balance of risks weighs heavily against MMR.

I can cite the scientific reassurance, I can quote the British Medical Association, the World Health Organisation, the Royal College of This, the Royal College of That, I can list all those heavy authorities in favour of the triple jab until I sound like a looped recording of Yvette Cooper. Jane counters my impersonations of the Health Minister by listing back the great failures of expert opinion, from mad-cow disease to thalidomide. That last example is a telling argument with me. I could have been one of the victims of that horrific medical blunder, but my mother possessed the unscientific native wisdom not to go near the ghastly drug.

The politicians, knowing how incredible they have become on the subject of health, have handed the propagandising over to the professionals in the hope that the public will find them more believable. That they are, but not that much more. The God of Science is also dead. The Chief Medical Officer's claims to infallibility have gone the way of the Pope's. On the same day that the Government's Top Doc was instructing parents to get jabbing, the High Court was being presented with a confidential memo to Health Ministers from Sir Liam Donaldson urging the Government not to allow public inquiries into medical malpractice because so many might come to light that it would be disastrous for public confidence in the NHS. Jane doesn't want the Medical Research Council to tell her that the chances of a link with autism are extremely weak. She needs categorical reassurance that there is no link, a guarantee that no one can give.

Tony Blair's wriggling about what he and his wife have done with Leo has not had a jot of influence on our debate. Knowing for sure that Baby Blair has had the jab would not make any differ ence to the outcome of our family argument. The Blairs are lawyers, not medics. To be brutally humorous, they are not a couple from whom you would be wise to take advice on safe methods of contraception.

So why look to the Blairs for an unequivocal statement on MMR? Only for this reason. While I have a lot of sympathy with the Blairs' desire to protect the privacy of their children, the Prime Minister has too often invoked 'the kids' in his rhetoric and too frequently used their images to enhance himself. He cannot then turn round and say Leo's treatment is out of bounds in the case of this controversy. Rather characteristically, Mr Blair has tried to have it both ways, refusing to say what he has done while licensing those who spin on his behalf to drip out suggestions that Leo has been jabbed.

The result has been to further inflame this crisis. Not because parents will necessarily follow the Blairs' example, but because they will not trust the Government's advice while its leader is furtive about his own child. My own guess is that Baby Blair did have the jab recently, but only after much agonising by his parents. There is some history of autism on Cherie's side of the family. Instead of being so slippery about it, Mr Blair could have shared his own anguish about the decision. That would have made him a more credible salesman of the Government's advice.

This crisis of confidence is the latest example of the wider crisis of confidence in all the figures to whom society used to look for leadership and judgment. We don't repose much trust in the politi cians and we don't have the faith we once had in the scientists. And we certainly should not be led by the media. The glib solution offered by the self-appointed medical experts in the right-wing press is to offer the option of taking the vaccinations separately. The 'right to choose' is a superficially seductive cry. Little wonder that it has been taken up by a brazenly opportunistic Conservative Party. The worst of this is that it tantalises distraught parents with the possibility of an escape from the dilemma which is actually entirely bogus. If measles can be a prompt for autism, then there's no good evidence I've seen to suggest that taking the vaccine separately makes it any safer than as part of a combination jab.

My mother, sage woman that she is, says that whatever Jane and I choose to do about Cordelia, we must come to the decision together. One of us cannot dump the responsibility on the other. Which means that neither Jane nor I really want to press our argument to a conclusion. If Cordelia has the triple jab and is injected with a catastrophic disability, I will spend the rest of my life racked with guilt. If Cordelia is maimed by measles, Jane will spend the rest of her life torn with guilt.

So there we are, in a limbo of dithering, an agony of prevarication. The past week's media hysterics, government flailing, Tory opportunising and medical bullying brings us no closer to a decision. The greater the clamour from those who claim to have the absolute answer, the more we feel hopelessly unsure.

The MMR debate
10.02.2002: Autism screening for all children to end MMR fears
10.02.2002: Focus: An issue of trust
10.02.2002: MMR: Your questions answered
10.02.2002: Jon Henley: 'This is just not an issue in France...'
10.02.2002: "I'm simply bemused": Observer writers on their MMR decisions
10.02.2002: Andrew Rawnsley: My MMR dilemma - who can we believe?
10.02.2002: Nick Hornby: Why parents are angry about autism
10.02.2002: Leader: Dogma on MMR does not work

Live online: MMR debate, Monday 11 February
The MMR debate: put questions to doctors from both sides
MMR talkboard: have your say here

Useful links
23.12.2001: To jab or not to jab? MMR explained
Downing Street: MMR advice
Department of Health: MMR advice
MMR evidence from Public Health Laboratory Service
How safe is MMR? BMJ debate
JABS: Support group for vaccine damaged children
Guardian Unlimited Weblog:More on MMR

Special reports
Special report: medicine and health
SocietyGuardian.co.uk: Public health special

From the archive: Blair MMR row, round one
23.12.2001: Focus: No 10's fear of needles
23.12.2001: Blair: we have never discussed our children's health
23.12.2001: Mary Riddell: Come clean, Mr Blair
23.12.2001: Rod Liddle: Privacy, or hiding the truth?

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.