Thursday, June 4, 2009

Please Don't Make MMR Compulsory

Yesterday the papers reported that Sir Sandy Macara, the former chairman of the British Medical Association, has called for MMR (Measles, Mumps and Rubella) immunisation to be made compulsory for any child starting school in the UK. Apparently the government has also been seriously looking into this policy as a way of increasing the MMR uptake in the UK.

Here's my take on this. I support vaccination and I plan to have Cave Baby vaccinated against measles, mumps and rubella when she is a year old. She has received all the usual vaccinations thus far. In my judgement, the benefits of vaccination outweight the risks of complications resulting from immunisation. I am fortunate that I do not have to fear my daughter dying from typhoid, tuberculosis or diptheria. These diseases have virtually vanished because of immunisation.

I myself suffered from measles and mumps during childhood: I can remember them, and they were both very unpleasant illnesses, but thankfully nowhere near life threatening. Western medicine is very good at dealing with these illnesses and in this country few people die from them. But serious complications do occur and, particularly in developing countries, people die from measles.

The MMR/autism connection has been discredited. I would urge anybody who still believes that there is a connection, to read the academic literature themselves. Or read this article by Good Enough Mum, who is a GP and a mother of a child with an autistic spectrum disorder. It is easy to be swayed by the testimonials of individual parents whose children are affected by autism, but there is absolutely no evidence to suggest that the autism is related to the MMR vaccination. Autism symptoms have to emerge at some point: by pure coincidence, a certain proportion of parents will notice them soon after the MMR jab. Unfortunately, too many of these parents then conclude that the immunisation was responsible.

It is perhaps easy to take the view that measles and mumps are so rare these days that immunisation is unecessary. If everybody took that view, the diseases would quickly become common again. So I feel my decision to immunise is best for my child but also beneficial for the rest of society. Taking a global perspective, Europe's low MMR vaccination rate means that we are an exporter of measles to the rest of the world: we are responsible for causing outbreaks of measles in other countries. It is all very well if we take measles to a country with good healthcare and nutrition, but by exporting cases of measles to developing countries we bring about deaths.

I would concede that there is perhaps something to be said for delaying vaccinations. It seems intuitively wrong to overload a young baby's immune system with a variety of diseases, even if they have been reduced to weak strains. But that is a separate debate.

Having said all of this in support of the MMR vaccine, I would be strongly opposed to any move by the government to make it compulsory for all schoolchildren (as is the case in the US). In this country the government has historically allowed parents to make their own decisions about their own children's upbringing. Whilst I might disagree with parents who choose not to vaccinate, I recognise their right to make their own decisions based on their own priorities and experience. The government can campaign for us to vaccinate, but forcing us to do it would be one step too far. If they did, I think there would suddenly be a lot of parents choosing to home educate. So please, UK government, invest time and money into educating parents about vaccination but do not - for a moment - think that it is acceptable for you to dictate how we raise our children.


Noble Savage said...

Excellent post, I agree wholeheartedly.

cartside said...

You took the words out of my mouth. Actually, just what I had planned to write for my next blog post. I'll link to it instead.

Anonymous said...

I appreciate your take on this. I also do believe in vaccinating, for the reasons you described (i.e. what if everyone stopped doing it?) I find it interesting though that the UK allows parents to have complete control over their child's health when the gov't is footing the bill, and here in the U.S., we have very LITTLE control, yet our healthcare costs bankrupt many families. Sheer irony, that is.

Based on our woefully archaic system here, many parents simply don't vaccinate, not because they don't believe in it, but because they don't have health coverage and can't afford the doctors visits (like my parents). Those parents who make the purposeful choice not to vaccinate (or to delay them) can do so by claiming that it is against their belief. I believe that works in almost every state (though some states require you to state that it's against your religion.)

But I think our gov't requires this one thing because our country needs preventitive medicine so badly since there's no money to pay for the major illnesses or potential hospitalizations. One may think that getting Mumps is not a big deal, and totally treatable - but it's a very big deal and not at all treatable if you don't have health coverage. Children die all the time here from lack of access to health coverage. I can only hope that Pres Obama changes that.

But in a country where healthcare is free and accessible (I don't know about the accessible part, I can only hope) then it makes more sense to retain your autonomy. It's just a little more complicated than that in the U.S.

Mon said...

Yes, first and foremost I am pro-choice, I believe in the right for every parent to choose what gets pumped into their child. As a person who believes in freedom of choice, then I'm seriously pissed off at more and more Big Brother tactics.

And as one of the parents who is not convinced about the studies and the benefits of vaccinations, who sees it mostly as the pharmaceutical establishment's successful economic campaign, who knows that the various ingredients are more than suspect, then obviously I'm horrified.

Liz said...

Another pro-choice parent here - I am horrified that in a democracy it could even be seriously suggested that any kind of medical treatment should be made compulsory.
I'm neither pro- nor anti-vaccination, I take each vaccination on a case-by-case basis and weigh up the pros and cons of that vaccine, that illness and my individual child. Which is what every parent should have the right and information to do. Sadly, it's very hard to get unbiased information on this topic, and both diseases and vaccines do cause damage and deaths in children (and adults).

The wife of bold said...

Excellent post - i fully agree with all your points made especially regarding autism, however i do think it would be wise to put pressure on parents to immunise school children as in ten years we could end up with an epidemic on our hands. I for one am glad my four year old has had the vaccination as i have seen first hand the devastating effects measles can have on young children. As they say prevention is better than cure.

Cave Mother said...

thefeministbreeder - this is a really interesting analysis of the situation here vs the US. Thanks for posting it. Perhaps having free healthcare does make autonomy more practical, as you say, but it also creates some moral dilemmas in other ways. Obviously healthcare is a limited resource, and allocation of limited resources is tricky. If you have two patients waiting for new lungs, and one is a smoker, it is OK to prioritise the non-smoker? What if one is obese?

Thanks for all comments.