http://www.independent.co.uk/story.jsp?story=110964
At first, I just didn't get the whole furore about
the measles, mumps and rubella vaccine. I wondered if the parents who were
scared of the jab weren't just ignoramuses, the kind of people who would have
shied away from the smallpox vaccine in the 19th century. I even wondered if
those who thought their children had developed autism after the vaccine were
just looking for somebody to blame for their children's difficult behaviour.
But I feel rather differently about it now.
That's partly, of course, because I've had no
choice but to start following the debate in more detail. My daughter celebrated
her first birthday last weekend, an event that is now marked not just by
balloons and a cake boasting a solitary candle, but also by a little blue slip
fluttering through the door, requesting that you make an appointment for the
triple jab as soon as possible.
But it's also because I can't help feeling that the
Government is conducting this debate in the most absurd way. Why does it feel
that the best way to put the kerfuffle to rest is just to shrug off parents'
concerns? In so many other areas of policy, the Government has learnt that it
doesn't pay to dismiss the mainstream concerns of the electorate.
Yes, politicians are happy to ignore what you say
if you seem in any way on the fringes – too liberal, say, or too green, to
represent their target voters. But the concerns of the centre ground usually
finds a willing ear. That's why it's so bizarre that there has been so little
attempt to meet the demands of the MMR lobby, since it's a centre ground lobby
if ever there was one. It's composed of worried parents who prefer to make
their views known by personal choice rather than public protest, and their
concerns have been aired throughout the media, from Private Eye to the Daily
Mail. But when it comes to the MMR vaccine, the Government and the medical
establishment have chosen to display a withering disregard for these pockets of
popular dissent.
This dismissive spirit surfaced again yesterday
when Tony Blair was challenged in the Commons to say whether his baby, Leo, had
received the MMR vaccine. We can all sympathise with his desire to keep his son
out of politics – but why does he feel that on this issue he can't talk freely?
Unless he does, there will be continued speculation, however unlikely, that he
or Cherie has decided not to go with the vaccine and that they are now
terrified of putting a spanner in the Government's propaganda machine.
Of course, if the Government was relying wholly on
research rather than spin to damp down the debate, then it wouldn't matter a bit
what any individual politician or public figure had decided to do. But rather
than launching the massive research projects that some respected doctors say
are necessary to put the fears to rest for good, the Government has chosen to
support rather less conclusive studies and then to pour its resources into
promoting the vaccine. It launched a £3m campaign to increase uptake earlier
this year, in which, for instance, not giving your child the vaccine was
compared to leaving a baby in the path of a tiger.
But there is a very obvious drawback to relying on
propaganda rather than research when it comes to health. It doesn't work. Too
many people have become too sceptical about the establishment's record on
public health to shut up just because the Government launches a smart video.
And this scepticism isn't just confined to the
chattering classes of England's south-east. Today it was announced that
Lanarkshire health authority has sent out letters to all parents in its area
whose children haven't had the jab. It's understandable that the authority is
getting worried: uptake in the area is just below 87 per cent, the lowest since
the vaccine was first offered, which makes a serious outbreak of measles a real
risk. The letter's message is, above all, fear: it tells parents they may have
forgotten how serious such diseases can be.
But I don't think parents have forgotten. Those who
choose not to take up the vaccine are well aware of the dangers of measles and
mumps, but they are also now unnerved by the vaccine itself. In such a climate,
where fear lurks on either side, scaremongering cannot possibly be the right
approach. If the medical establishment really wants to increase the uptake of
the vaccine, they will eventually have to try the only other tack. They will have
to engage with the dissenters.
Why is this so very difficult for the establishment
to contemplate? The dissenters are not mavericks or madmen. They are respected
professionals working in various fields, from general practice to specialist
clinics to epidemiological research. None of them, it is worth noting, are
saying they are absolutely sure there is a link between autism and the vaccine
for measles, mumps and rubella. No, they are suggesting only that a link might
be possible and they are stating that more research should be done.
Even Dr Andrew Wakefield, who started the whole
controversy in 1998 when he published a study that connected Crohn's disease
and autism with the MMR vaccine, put it forward only as a hypothesis. His study
concluded: "We did not prove a link between measles, mumps and rubella
vaccine and the syndrome described. Virological studies are under way that may
help to resolve this issue." But even such reasoned dissent is impossible
in the present climate, and earlier this month Dr Wakefield felt obliged to
leave his job at the Royal Free and University College Medical School, due to
"political pressure" on himself and his colleagues.
Similarly, the GP who was called to the General
Medical Council's disciplinary body earlier this year for offering separate
vaccines, Dr Peter Mansfield, never claimed to be privy to some superior
knowledge about the triple jab's safety. "I offer no view on whether or
not it is safe," he told anIndependent journalist who visited him.
"But it is perfectly reasonable for parents to ask for separate
vaccines."
And Professor Walter Spitzer, who has now become
one of the great heroes of the dissenters, has described himself only as a
"worried agnostic". His opinion, as an internationally acclaimed
epidemiologist, is that "there has not been a single properly designed,
properly executed, properly analysed epidemiological study published since this
controversy became visible. A proper study needs to be done."
More research! More information! That is the cry of
the dissenters. It's hardly going to bring the establishment crashing down, is
it? So why can't the Government go for it, and announce a large-scale
international study along the lines that Professor Spitzer has recommended, in
which literally thousands of children's records should be retrospectively
examined, each coupled with its relevant controls, and the possible links
finally ruled in or out?
Sure, even in the absence of such studies, most
parents, myself included, will conclude that the evidence still tends more to
the Government's side, and we will trot along to our doctors for the maligned
vaccine. But that won't stop us doing it with a heavy heart. And it won't stop
us wishing that we could be treated like adults, and given rather better
research, and rather less scare-mongering.
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