Dr Simon Atkins 

At last – the end of the MMR myth

Dr Simon Atkins on why it's safe to give jabs.
  
  


It's official, the MMR jab is safe. Forget all the cobblers that has been written about it over the past few years. A report published yesterday by the Cochrane Library (the most authoritative source of evidence-based medicine) has shot holes through the flimsy evidence linking the controversial vaccine with autism and provided vindication for all of us doctors who stuck by it, subjected our own kids to a dose of it and insisted everyone else was right to do the same for theirs.

Forgive me if I sound a little cock-a-hoop about the announcement, but it is as though a huge weight has been lifted. It's hard to believe that a three-letter acronym such as MMR could have caused doctors as much bother as the three letters WMD have caused Bush and Blair. But it's an issue that unnecessarily destroyed the public's trust in members of the medical profession - whom they saw as uncritical servants of a dangerous government policy - and ruined many previously close relationships between doctors and their patients.

Though it's now seven years since the whole thing blew up, I'm still having flashbacks of the days when my surgery was besieged by angry mothers yelling at me about the jab as they brandished the latest download from alldoctorsareevil.com as justification for their rage.

And it was all down to one small study by Dr Andrew Wakefield, who, with a handful of colleagues, published his research in the Lancet medical journal in 1998 under the rather jazzy title, "Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children". The paper featured just 12 youngsters who had a syndrome consisting of autism and bowel symptoms, eight of whose parents believed their problems began with their first dose of MMR.

But despite the fact that the report included the quietly telling sentence, "we did not prove an association between measles, mumps and rubella vaccine and the syndrome described", Wakefield went further when announcing his findings at a press conference. He made the unsubstantiated suggestion that people should shun the triple vaccine in favour of three separate jabs meant that parents would be scared out of their wits the minute anyone approached their toddlers armed with a syringe of the stuff.

After that things really kicked off. Hundreds refused to have their children immunised while others fought the government for the right to follow the suggestion of giving their children three separate vaccines.

As a consequence, MMR uptake - which needs to stick at around 95% to ensure effective protection for the UK population - dipped to a low of 82% in 2002 and has only recently started climbing again. It's no surprise, then, that there have been subsequent outbreaks of both measles and mumps, with Health Protection Agency figures for the number of mumps cases rocketing from 180 in 1997 to 33,531 so far this year.

So, despite a number of the original research group issuing a retraction of their evidence in 2004, the damage has been done.

Hopefully the Cochrane review will begin to turn things around and restore public confidence. It has the reassuring clout of including all of the current evidence that is available on the effectiveness and safety of the vaccine from around the world. And it has been produced independently, so that it avoids claims of bias. So, unlike the concerns expressed in 1998, Cochrane's conclusion - that there is no credible evidence for a link between MMR and autism - can be trusted as sound.

It's understandable that parents would not want to risk their child developing autism, and equally understandable why this particular government wasn't trusted on the matter. But on this issue it was right: right to stick to its guns and right to remind anxious parents that with half a million deaths worldwide from measles alone every year, they can't afford to risk not vaccinating their children

· To ask Simon a question email health@theguardian.com. He cannot enter into correspondence.

 

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