http://bmj.com/cgi/content/full/324/7329/120
BMJ 2002;324:120 ( 12 January )
Reviews
Press
Open season on MMR
In recent weeks
opponents of the triple measles, mumps, and rubella (MMR) vaccine have had rich
pickings. In late November the General Medical Council cleared
former general practitioner Peter Mansfield of professional
misconduct for offering separate vaccines. The Daily Mail
heralded this as a victory. Shortly afterwards, the Express
picked up an editorial in the British Journal of General Practice,
which argued that the Department of Health needed to respond to
parental concerns and rethink its policy on single vaccines.
In early December Andrew Wakefield,
whose research in the Lancet in February 1998 stoked widespread
alarm over possible links between MMR and bowel disease and autism,
left the Royal Free Hospital in London. He claimed that he had been
forced out for his rebel views. His departure was extensively
covered in the Guardian and provoked several angry letters in
both the Daily and Sunday Telegraph.
But it was the Blairs' refusal to
answer Conservative MPs' questions about whether their youngest son, Leo, had
had the triple vaccine that kept MMR firmly on the media agenda.
Many newspapers viewed the Blairs'
silence as doing little to quell lingering parental doubts about the safety of
the vaccine. This even included papers that supported the prime
minister's view that his children's welfare was a private matter, as
an article in the Independent on 21 December reflected.
But the refusal to budge vexed the
Daily Mail the most. It ran stories on the issue, clamouring for a
confession, on 13, 14, 18, 19, 20, and
21 December. The paper continued its campaign in the new year,
bringing in television presenter Carol Vorderman to add her voice to
the request for the Blairs to break their silence. The Independent
had already revealed that Ms Vorderman had not had her son
vaccinated with MMR.
The Mail on Sunday chipped
in a strand to the conspiracy theory on 16 December. It reported that GPs
were paid to meet vaccination targets for MMR, implying that
financial concerns took precedence over children's health, a theme
that was taken up again a few days later.
Suspicion that a lack of candour
must imply something to hide was not dispelled by the less than convincing
performance of junior health minister Jaqui Smith on the BBC's
influential Today programme on 20 December. The minister
was taken by surprise, but wriggled uneasily under relentless
questioning about her own children's vaccination. Her defence that
their health was a personal matter came across as lame and evasive.
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Was it the prime
ministerial silence that did the most damage to confidence in MMR? After
Christmas the Telegraph produced evidence that the Blairs'
stance had undermined public confidence by revealing a huge surge in
demand for single vaccines. The Independent on Sunday
revealed that supplies were running out as parents panicked.
Postings from parents seeking
information on doctors willing to offer single vaccines on the Justice
Awareness and Basic Support (JABS) website (www.argonet.co.uk/users/jabs/),
an anti-MMR organisation campaigning for parental choice, almost
tripled during December.
Department of Health figures show
that MMR uptake varies considerably across health authorities in England.
London is the worst, averaging 79 per cent. Some areas in the
capital are as low as 73 per cent, although these figures
reflect poor general uptake of childhood vaccines. But in the rest
of the country MMR uptake consistently lags behind other childhood
immunisations.
A spokesperson for the Public
Health Laboratory Service (PHLS) says that trends in MMR uptake, while far from
experiencing a vertiginous plummet, have been heading downwards
since 1995, when the first of the queries about MMR came to
public attention.
The recent downturn after a period
of relative stability may have been helped by the introduction last year of
meningitis C vaccine in young children, given at the same time as
MMR, he said. This may have persuaded parents to defer the latter to
stagger the number of injections.
Would it have made any difference
to public confidence in MMR if the Blairs had made a public statement about
whether or not Leo had had the jab? Only the next set of figures
will make that clear.
Caroline White
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