Josie Bate is angry that parents won't trust the MMR vaccine. Judith Woods meets her

LOUISE BATE is gazing listlessly from her mother's arms, showing little interest in her toys or her three-year-old brother, William, playing on the floor. Aged nine months, she is just recovering from a dose of measles that has left her drained of energy.

Her mother, Josie, points out the blotches on her daughter's face and chest, where the spots are fading. She is indignant that Louise has fallen ill.

She lays the blame at the door of other parents who are refusing to let their children have the three-in-one measles, mumps and rubella (MMR) vaccination, in the wake of scare stories over its safety. Louise is too young to have the triple vaccine, which is administered between 12 and 15 months.

"I feel very frustrated and sad that she got an illness that could have been avoided," says Josie, 32. "Louise went from being a totally contented, happy, sleeping, well-feeding baby to the most miserable, distressed, sick child - and I know from my GP that she didn't have it badly. Measles can cause complications, such as brain damage and hearing loss."

Parental concern over suggested links between the MMR and autism in particular, has caused a dramatic downturn in the number of children receiving the triple vaccine. According to the most recent figures from the Public Health Laboratory Service, 88 per cent of babies are being given the jab, 2.5 per cent down on the previous year's figures. For children community-wide to be protected, 95 per cent of babies must be vaccinated. The current rate is at a low enough level to spark a nationwide epidemic, which is predicted for 2001.

Josie, a former medical press officer, and her husband Richard, 35, weighed up the pros and cons of MMR before deciding to have their son, William, vaccinated. They were determined to look at the issues as objectively as possible.

"It wasn't a decision we took lightly," she says. "I remember taking William to the doctor and feeling ill because of the concerns I had about it."

The couple talked to their GP and the health visitor and did extensive reading on the subject.

"We knew there was controversy, and the autism link was what frightened us most. But, on balancing the evidence, we decided it was better for him to have the MMR than not."

Josie says the wider implications were also a factor in their decision. She felt there was an onus on them to act for the general good.

"You have a responsibility to help other children, too," she says. "There are some who can't have the vaccine for medical reasons - such as leukaemia, where their immune system is depressed - or they are allergic to the neomycin antibiotic. I totally accept that, but I would hope that if everyone else has their vaccination, then everyone's children are at less risk."

Fears over the safety of MMR arose early in 1998. Reports emerged from the Royal Free hospital in north London of a possible link between the vaccine, bowel disease and autism.

The evidence suggested that the rising incidence in autism - which doctors say may now be falling - was connected to the introduction of the MMR vaccine in 1988. This link was dismissed in June 1999, after research commissioned by the Department of Health. One explanation for the earlier suspicion about autism is that the MMR vaccine is given shortly before the time when signs of autism are, typically, first picked up.

A single measles vaccine is available, but is not supplied on the NHS and there is evidence that it is not as effective as its triple-dose counterpart. The single vaccine can be obtained through private practitioners and is also available in France, where some British parents have taken their children to be vaccinated.

Although immunisation programmes in developed countries have virtually eradicated measles, the illness remains the world's sixth most deadly infectious disease. About one child in every thousand who catches it will die or suffer brain damage.

Poor nutrition and primitive healthcare invariably exacerbate the effects of the illness in developing countries. A British epidemic wouldn't cause the same number of widespread fatalities; nevertheless, in the 1940s, measles killed 1,000 people in Britain annually. In the 1960s, when the first measles vaccine was introduced, that figure fell to 90.

Ann Coote is a founder member of Jabs - Justice Awareness Basic Support - which campaigns on behalf of parents who feel their children have been adversely affected by the MMR vaccine. She says the single vaccine ought to be more widely available.

Ann believes her daughter Rachel, now 12, was permanently disabled after receiving MMR. Rachel went into convulsions and stopped breathing, with the result that she is severely epileptic and has a mental age of six.

"We are not an anti-vaccine organisation," says Ann, "but we do have children who have been affected by MMR. Other parents are losing confidence, but they do want their children protected, and would like them to have the single vaccine."

According to Josie, however, information is the key. Parents need more facts at their disposal, she says, to prevent them rejecting the MMR vaccine in a "knee-jerk reaction".

"I do feel strongly that there needs to be a new public health campaign, telling people the facts about MMR, so they can make an educated decision."

8 September 1999: [UK News] New fear over autism link to triple vaccine