GIVE THEM A CHANCE... GIVE THEM THEIR JAB

MMR myths and on­line scare sto­ries have seen chil­dren’ s vac­ci­na­tions plum­met—and in­fec­tions soar. It’s why to­day the Mail is­sues this plea:

Daily Mail - - Front Page - By So­phie Bor­land, Ben Spencer and Eleanor Hay­ward

AN UR­GENT cam­paign to raise the take-up of child­hood vac­ci­na­tions is launched by the Mail to­day.

We are urg­ing min­is­ters to start a mas­sive pub­lic­ity drive to re­as­sure par­ents that vac­cines, par­tic­u­larly MMR, are safe and vi­tal.

Measles cases have soared, with the dis­ease strik­ing 991 chil­dren last year – tre­ble the 2017 to­tal.

of­fi­cial fig­ures an­a­lysed by the Mail re­veal that across Europe only France has more chil­dren with­out pro­tec­tion against the dis­ease.

nearly 62,000 UK ba­bies missed their measles, mumps and rubella jab last year. and more than half a mil­lion chil­dren have not had the vac­ci­na­tion since 2010. Health ex­perts fear par­ents are be­ing turned against in­oc­u­la­tion by fake sci­ence put on so­cial me­dia by the ‘anti-vaxx’ lobby.

Busy mod­ern life­styles and pub­lic com­pla­cency have also been cited for the cri­sis, with many adults for­get­ting that measles is a killer.

two weeks ago a govern­ment re­port re­vealed up­take had fallen for all ten child­hood jabs, in­clud­ing measles, po­lio, menin­gi­tis and whoop­ing cough.

But health of­fi­cials are par­tic­u­larly wor­ried about MMR vac­ci­na­tion rates, which have slipped to their

WHAT IS THE MMR VAC­CINE?

THE MMR jab is a com­bined vac­ci­na­tion that pro­tects against measles, mumps and rubella, all po­ten­tially ex­tremely se­ri­ous dis­eases. Be­fore the in­tro­duc­tion of measles vac­cines in the 1960s there were, on av­er­age, 85 deaths from the dis­ease each year in England and Wales. MMR was in­tro­duced in 1988 and has proved so ef­fec­tive that be­tween 1999 and 2019 there were only four deaths.

Mumps can cause deaf­ness, brain swelling and menin­gi­tis. Rubella gen­er­ally presents as a mild rash in chil­dren, but if it’s caught early in preg­nancy, a woman has a 90 per cent chance of pass­ing the virus on to her foe­tus which can cause se­vere birth de­fects or death.

The MMR jab is given as part of a NHS child­hood vac­ci­na­tion sched­ule that starts from the age of eight weeks and goes up to 14 years. The age at which chil­dren have each vac­ci­na­tion varies, but as well as MMR, the sched­ule in­cludes ro­tavirus (a com­mon cause of di­ar­rhoea and sick­ness), whoop­ing cough, menin­gi­tis B, diph­the­ria, tetanus, po­lio and HPV (hu­man pa­pil­lo­mavirus, linked to cer­vi­cal can­cer).

MMR is given in two stages, first at one year old and then a booster jab at three years and four months. The vac­cine con­tains weak­ened ver­sions of measles, mumps and rubella viruses, along with wa­ter and preser­va­tives for bet­ter storage and to hold the com­po­nents to­gether. Two brands of MMR are avail­able on the NHS – Pri­orix and MMRVaxPro (which con­tains porcine gela­tine).

‘Once you’ve been vac­ci­nated, your immune sys­tem de­vel­ops mem­ory an­ti­body cells,’ ex­plains Dr Nicky Longley, a con­sul­tant in travel medicine and in­fec­tious dis­eases at Uni­ver­sity Col­lege Lon­don. ‘Next time it comes into con­tact with the in­fec­tion, those mem­ory cells are ready to di­vide and pro­duce an army of immune cells fight­ing the in­fec­tion and pre­vent­ing it from in­vad­ing your body and mak­ing you ill.’

HOW EF­FEC­TIVE IS MMR?

A sin­gle dose pro­tects 93 per cent of peo­ple against measles, 78 per cent against mumps and 97 per cent against rubella. The rec­om­mended two doses of the vac­cine in­crease the rate of pro­tec­tion to 97 per cent for measles and rubella, and 88 per cent for mumps. You may still catch one of these dis­eases af­ter be­ing vac­ci­nated but it’s very un­likely and, if you do, it will be a much milder ver­sion.

Pro­tec­tion against measles and rubella lasts for many decades; pro­tec­tion from mumps grad­u­ally de­clines (last­ing on av­er­age 27 years) so many adults may not be immune.

WHY DO EX­PERTS SAY IT’S SAFE?

Anti-vaxxers claim the triple vac­cine is too much of an as­sault on a young child’s immune sys­tem. But, ac­cord­ing to Dr Doug Brown, chief ex­ec­u­tive of the British So­ci­ety for im­munol­ogy, it works be­cause if the vac­cines were spread out, chil­dren would be vul­ner­a­ble for longer.

‘A child’s immune sys­tem is de­signed to fight off lots of germs ev­ery day,’ he says. ‘The amount of chal­lenge that it faces from the com­bined vac­cine is very small in com­par­i­son and puts no ex­tra strain on it.’ Jon­athan Ball, a pro­fes­sor of molec­u­lar vi­rol­ogy at the Uni­ver­sity of Not­ting­ham, says there is no ev­i­dence the triple vac­cine is too much

for a child’s body. ‘You can­not over­load your immune sys­tem,’ he adds. ‘And the MMR in­volves just two vis­its (rather than six if each vac­cine was given sep­a­rately) – fewer nee­dles for your chil­dren.’

WHY DOES IT MAT­TER IF MMR IM­MU­NI­SA­TION RATES DROP?

In­fec­tious dis­eases are eas­ily passed from per­son to per­son and en­tire com­mu­ni­ties can rapidly be­come in­fected. If a high enough pro­por­tion of a com­mu­nity is pro­tected by im­mu­ni­sa­tion, it stops the dis­ease cir­cu­lat­ing be­cause the num­ber of peo­ple who can be in­fected is so small. this is called herd im­mu­nity. Herd im­mu­nity is im­por­tant be­cause it pro­tects peo­ple who can­not be vac­ci­nated - some of the most vul­ner­a­ble peo­ple in so­ci­ety, in­clud­ing chil­dren who are too young to be vac­ci­nated and peo­ple with a com­pro­mised immune sys­tem. By vac­ci­nat­ing your child, you’re not only pro­tect­ing them but also pro­tect­ing the most vul­ner­a­ble in your com­mu­nity.

the World Health or­gan­i­sa­tion ad­vises that 95 per cent of chil­dren need to re­ceive the MMR jab in or­der to stop the dis­eases spread­ing. ‘this is par­tic­u­larly im­por­tant for measles as it is so con­ta­gious,’ says Dr Brown. ‘In an un­vac­ci­nated com­mu­nity, each per­son with measles would on av­er­age pass the dis­ease on to 12 oth­ers. that’s why en­sur­ing a high vac­ci­na­tion rate is crit­i­cal to stop­ping the spread of this dis­ease.’

HOW MANY CHIL­DREN HAVE IT?

The up­take of MMR in the Uk is well be­low the rec­om­mended level of 95 per cent to achieve herd im­mu­nity – with an up­take of 90.3 per cent in 2018/19. this is lower than in many other euro­pean coun­tries. Re­cent NHS vac­cine statis­tics for england showed that last year only 86.4 per cent of chil­dren re­ceive two doses of MMR by the age of five.

In the past few years, measles and mumps rates have risen rapidly in the UK – and all over the world. the num­ber of cases across europe soared from about 5,000 in 2016 to 84,000 in 2018. the us is suf­fer­ing its worst measles out­break for 27 years. the who lists vac­cine hes­i­tancy – de­lay­ing or avoid­ing jabs – as one of its top ten global health threats.

WHY ARE SOME PAR­ENTS SHUN­NING THE VAC­CINE?

A Ma­jor is­sue is not be­ing able to get a GP ap­point­ment at a con­ve­nient time, says Dr jon­athan Kennedy, a global pub­lic health ex­pert at Queen Mary uni­ver­sity of Lon­don. ‘In a re­cent sur­vey by the Royal so­ci­ety of Pub­lic Health, the “tim­ing, avail­abil­ity and lo­ca­tion of ap­point­ments were iden­ti­fied as bar­ri­ers to vac­ci­na­tion”,’ he says.

‘there’s also a prob­lem with de­mand for vac­cines as a re­sult of con­cerns about safety,’ he adds. ‘In the same sur­vey, one in five par­ents thought MMR was likely to cause un­wanted side- ef­fects and one in ten de­cided not to vac­ci­nate their child with MMR, the ma­jor­ity due to con­cerns over safety.’ MMR can po­ten­tially cause red­ness, pain or swelling at the site of the in­jec­tion, a fever (about one in 15 chil­dren) or a short­lived rash (around one in ten). ex­tremely un­com­mon side-ef­fects in­clude se­vere al­ler­gic re­ac­tions and seizures.

WHAT ABOUT MMR AND AUTISM?

Some par­ents be­lieve the triple jab can cause autism. the root of this lies in a pa­per pub­lished in 1998 in the Lancet med­i­cal journal by Dr An­drew Wakefield. the British gas­troen­terol­o­gist had looked at 12 chil­dren with autism, iden­ti­fy­ing eight whose par­ents said their chil­dren’s be­havioural symptoms had de­vel­oped within two weeks fol­low­ing the MMR jab. the pa­per had a ma­jor im­pact but Wakefield was struck off in 2010 by the Gen­eral Med­i­cal coun­cil for act­ing dis­hon­estly and ir­re­spon­si­bly in the way he con­ducted his re­search. His pa­per was re­tracted by the Lancet.

HOW DO WE KNOW THE MMR DOESN’T CAUSE AUTISM?

At least ten ma­jor stud­ies have shown there is no link be­tween the MMR and autism. the most re­cent, pub­lished ear­lier this year, in­volved over 650,000 chil­dren and found not only no ev­i­dence of a con­nec­tion, but that this was true even among chil­dren con­sid­ered at height­ened risk of autism.

SHOULD MMR BE MANDA­TORY?

Health sec­re­tary Matt Han­cock says there is a ‘very strong ar­gu­ment’ for mak­ing vac­ci­na­tions for chil­dren com­pul­sory.

Ac­cord­ing to Dr Kennedy, the uk would not be the first coun­try to con­sider this. ‘In 2017, the Ital­ian govern­ment an­nounced that un­vac­ci­nated chil­dren would not be al­lowed to at­tend school,’ he says. ‘the fol­low­ing year, france in­creased the num­ber of manda­tory vac­cines from three to 11.

‘In the us, where par­ents can claim ex­emp­tions from com­pul­sory vac­ci­na­tion for med­i­cal, philo­soph­i­cal or re­li­gious rea­sons, some states have moved to limit or elim­i­nate non-med­i­cal ex­emp­tions.

‘Data sug­gests that manda­tory vac­ci­na­tion leg­is­la­tion is ef­fec­tive,’ he adds, point­ing to Italy and france, where vac­cine up­take has in­creased up­take.

But Dr Brown says com­pul­sory vac­ci­na­tion is a blunt tool and there is no ev­i­dence that it would in­crease im­mu­ni­sa­tion rates. ‘there are con­cerns that it could in­crease cur­rent health in­equal­i­ties and alien­ate par­ents with ques­tions on vac­ci­na­tion,’ he warns.

WHAT IF MY CHILD MISSED OUT ON THE MMR JAB?

It’s never too late to catch up. older chil­dren and adults who missed out can get the jab free on the NHS.

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