Mumps, Measles and Rubella vaccination (MMR)
 No doubt you will have seen and heard much of the publicity surrounding the supposed links between MMR vaccination and autism and certain bowel conditions. Unfortunately, when the press gets hold of an idea the true facts can become distorted, and so this article is an attempt to briefly summarise the evidence about MMR.
1. What is the evidence about MMR?
The idea of a link between MMR and autism or bowel disease was initially raised by one group of researchers at the Royal Free Hospital in London. These concerns were taken very seriously, and numerous studies have been done to see if in fact such a link exists. To date, no researchers have found any evidence of any link at all. Some of the best evidence comes from a group of researchers from the Royal Free who looked at all the children in the North Thames region diagnosed with autism since 1979 (MMR was introduced in 1988). They found that there was no increase in incidence of autism following the introduction of MMR, no time-link between the giving of the MMR vaccine and the onset of autism, and no evidence that more children diagnosed with autism had been vaccinated than those not diagnosed. Further evidence comes from Finland, where they have looked at adverse reactions to MMR in nearly 2 million children. No cases of autism or bowel disease were reported.
Most recently, concerns have been raised about initial safety testing of MMR. This is rather a technical question, but a recent editorial in the British Medical Journal pointed out many flaws in the article that raised these concerns.
2. What about giving the vaccines separately?
It has been proposed that MMR vaccine might be given instead as three separate injections. This suggestion was made by one researcher and is unsupported by any scientific evidence. It would expose children to an increased risk of infection while waiting unnecessarily between immunisations, quite apart from the trauma of having multiple injections. No country in the world recommends MMR as three separate injections. Hundreds of millions of doses of MMR vaccine have been used widely around the world (in 33 European countries at least, plus Canada, Australia, New Zealand) and in the United States for over 25 years.
3. Years ago, most children had mumps, measles and rubella with no long term ill effects, wouldn't it be better to let them develop immunity naturally?
These illnesses are so rare now that it is easy to forget how serious they can be. Although it is true that many children had no ill effects, small numbers went on to develop severe complications, including such things as encephalitis (inflammation of the brain, similar to meningitis) and some children died every year as a result. Probably the best evidence about this come from Ireland, where a few years ago rates of MMR immunisation dropped so far that children started developing the diseases. They had hundreds of children admitted to hospital with complications, and some children died. It is, of course, vital that we keep rubella (German measles) at bay because it can cause severe abnormalities in unborn babies.
4. Where can I get more information?
The department of Health website contains information on this subject, including useful links and summaries of the scientific evidence. Go to http://www.doh.gov.uk/mmr.htm. For those who want more detailed information, read the British Medical Journal editorial on the subject, at http://www.bmj.com/cgi/content/full/322/7280/183.
Overall, there is no good evidence that MMR causes autism or bowel disease. It is vital that we protect our children from what can be very serious illnesses, so we are encouraging everyone to bring their children for vaccination. On a personal note, all the doctors' various children have had all their childhood vaccinations - we practice what we preach! |
