http://argument.independent.co.uk/leading_articles/story.jsp?story=119040
It is wrong to use the state health system to
obstruct individual choice
09 February 2002
Internal links
Study of
autistic children finds no link to MMR
Steve
Connor: Why parents are ignoring the rational experts
The Prime Minister and his chief
medical adviser, Sir Liam Donaldson, have disastrously mishandled the issue of
vaccination. They have failed to understand the psychology of public
confidence. They simply cannot see that the more they insist that people should
have the triple vaccine, and the more they try to prevent them having separate
doses, the less people believe their assurances that the triple jab is safe.
This error arises out of a more fundamental
philosophical prejudice, which is the denial of choice. The evidence suggests
that the combined measles, mumps and rubella vaccine is safe, in the ordinary
sense of that word, and the hypothesis that the combination contributes to
autism has little evidence to support it and much to disprove it. The number of
children diagnosed with autism was rising before the triple vaccine was brought
in, continued to rise at the same rate during the two years in which it was
introduced, and went on rising afterwards.
Yet, if parents believe that there is a risk, it is
wrong in principle as well as counter-productive in practice to use the state
health system to obstruct their choice.
It is simply no use politicians and the medical
profession complaining that the issue has been misrepresented in parts of the
press. It is true that the theoretical risk from combining the vaccines has
attracted more attention than the known risks from the illnesses themselves,
and from measles in particular. That may have created the impression among some
parents that having the triple vaccine is dangerous whereas not having it is
safe. The measles outbreaks in London over the past week ought to have rebalanced
that perception. We have now been forcefully reminded that measles was not only
a middle-class childhood excuse to have time off school and read a lot of
books, but a serious illness that used to kill an average of 13 children a
year.
It is also true that if there is a risk from the
triple vaccine, it is more likely to come from the measles element of the
combined vaccine than from the fact that it is delivered with two other
vaccines. Andrew Wakefield's discovery of the measles virus in the gut of
children suffering a bowel disorder linked to autism could implicate the
separate measles vaccine – and indeed measles itself – as well as the triple
vaccine. There is, therefore, no risk-free option for the parents of young
children.
Had Tony Blair and Sir Liam not been so
instinctively hostile to the notion that people should be allowed to choose for
themselves even if they make choices that seem unwise, they would not have
ended up with worst of all possible worlds. The result of their giving people a
choice between the triple jab and nothing has been that too many people have
opted for nothing. The Government should have said, and could say now:
"The single vaccines are not as good, but if you want them you may have
them – the important thing is to have your child vaccinated."
It did not, because it feared that such permission
would undermine confidence in the triple vaccine. That allegedly happened in
the scare about the whooping-cough vaccine in the 1970s: it was offered
separately, take-up fell, 70 children died and the scare was subsequently shown
to be unfounded. That argument is unconvincing. Confidence in the MMR vaccine
is already undermined and is more, not less, likely to be restored if the
distracting issue of coercion is removed.
The refusal to license the separate measles
vaccine; the bullying by some GPs of their patients; the posture of aggressive
defiance in the face of parents' sincere concerns – all these are compounding
the problem. If ministers and doctors do not trust people to make their own
decisions, they cannot be surprised if that lack of trust is reciprocated.
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