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The recommended vaccination schedule in Switzerland and
most of Europe includes shots against measles, mumps,
rubella, diphtheria, tetanus, whooping cough, polio, and
meningitis. And these are administered in the first 18
months of life.
Faced with this rigorous vaccination regime, many Swiss
parents parents have responded by trying to limit the
number of shots given to their children.
Up to 20 per cent of Swiss children are now no longer
vaccinated against measles, mumps and rubella (MMR).
Together with Germany, Switzerland has one of the lowest
take up rates for the MMR vaccine.
What this means is that the measles virus in particular is
still in circulation in Switzerland. This is a source of
frustration to the World Health Organisation, which has
set a target of eliminating measles in Europe by 2007.
“The problem is that here in Europe vaccination has been
the victim of its own success,” said John Clements of the
WHO’s immunisation programme. “Diseases like measles are
not as common as they used to be, and young parents often
don’t have any experience of them, so they don’t know how
serious they are.
“In fact, over 800,000 children a year die from measles.
In Africa you don’t have to convince mothers to go ahead
with vaccination, because they have seen their children
die left, right and centre from the disease.”
But despite the warnings, Swiss parents like Andrea
Muhlherr remain unconvinced that all these vaccinations
are necessary. She has five children, and has had them
vaccinated only against tetanus and polio.
“The first three have already had measles,” said Muhlherr.
“And in autumn all five had whooping cough together. That
was exhausting for me, especially at night.”
But Muhlherr has no regrets about not having her children
vaccinated. “I think these childhood illnesses are good,”
she said. “They strengthen the immune system, and children
also need to learn how to be ill; to know their own
strengths and to trust their own bodies.”
Muhlherr was supported in her decision by her family
doctor, Hans Ueli Albonico. He shares her doubts about the
benefits of the MMR vaccination, and is a founding member
of a working group, which calls for new and more flexible
immunisation programmes.
“Vaccination can be considered a very impressive
achievement,” said Albonico. “But we have started asking
questions about how many vaccinations are good for your
child and where is the optimum level rather than the
maximum.”
Albonico is especially concerned about the effect of so
many vaccinations so early on the development of a child’s
immune system.
“We have seen an explosion in the number of allergies in
children from countries where the vaccination rate is
high,” said Albonico. “Allergies are a disorder of the
immune system, so we have to ask ourselves whether there
is a connection.”
But the Swiss Federal Health Office takes a different
view. Hans Peter Zimmermann of the immunisation programme,
is keen to reassure parents who have concerns about
allergies.
“There may be one or two studies which suggest a link
between allergies and vaccinations,” he said. “But there
are also several studies which suggest vaccination may
have a protective effect against allergies.”
Both Zimmermann and the World Health Organisation also
reject the latest study from Britain, in which research by
one doctor suggested a link between the MMR vaccine and
autism. The finding has caused a dramatic drop off in the
number of vaccinations.
“Autism is a disease which develops in early childhood,”
said the WHO’s John Clements. “It comes on slowly, and
there may have been small signs of it prior to
vaccination. But obviously if recognisable symptoms
develop shortly after vaccination parents will think there
is some connection.
“The problem for us is that we have to go through very
complex epidemiological studies to show that there is no
link between the MMR vaccine and autism. It’s an uphill
struggle for us sometimes.”
But the continuing controversy and the conflicting
evidence simply arouses more concern among many parents,
who believe their best course of action is to reject a
vaccination which may have unknown consequences, and take
the risk of their child contracting a disease which they
believe is easily treatable.
It’s an attitude that paediatrician Daniel deGrandchamps,
a member of Switzerland’s advisory commission on
vaccination, comes across daily.
“What I try to do is address the fears of the parents,”
said deGrandchamps. “And explain to them why, in my
opinion, vaccination makes sense. It’s a question of
assessing the risk factors.”
Degrandchamps points to a recent case in Holland, in which
an outbreak of measles in a religious community of 3,000
people led to the deaths of three children. A further 17
per cent suffered serious long-term complications as a
result of having contracted the disease.
“One in 2000 children contracting measles will suffer
brain damage as a complication,” said deGrandchamps. “It
doesn’t sound like a lot, until we consider that we have
2000 children here in our practice. And in comparison the
risks from having the vaccination, which are so far
unproven anyway, are infinitesimal.”
But the fact remains that 20 per cent of Swiss parents
still do not see the need for the MMR vaccine. Twelve per
cent say no to whooping cough, and eight per cent to polio
immunisation.
Moreover, some parents who decided against vaccination are
among the most educated in Switzerland. Hans Peter
Zimmermann knows that the Swiss Federal Health Office will
have to work hard to convince middle class professional
parents of the benefits of vaccination.
“What they need to know is that by vaccinating we prevent,
every year in Switzerland, 900 cases of polio, 4,000 cases
of diphtheria, or 60,000 cases of measles – and 300
deaths,” said Zimmermann.
“And we don’t recommend vaccines just because they are
available. There is a vaccination against chicken pox now
which we don’t plan to recommend because chicken pox is
not a disease with serious complications for children.
“Before we approve a vaccine we assess all the evidence
and analyse all the risks, and if we find that the
benefits of vaccinating clearly outweigh the risks, then
we go ahead.”
swissinfo, Imogen Foulkes
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