Alton Street Surgery Patient Information Leaflet
Measles, Mumps & Rubella
(MMR) Vaccine
Controversy over the
MMR vaccine has continued to make headlines in recent weeks. In this article, published in Doctor, 8th
February 2001, vaccine specialist Dr Mike Watson separates fact from fiction.
Only UK parents are
not given the choice of single vaccines.
No country in the world recommends that the MMR vaccine be divided into three separate injections. No country in Europe recommends that parents be given the choice of either the combined MMR vaccine or the three vaccines separately.
In France, parents can
choose single measles, mumps and rubella vaccines.
This is not true.
Measles vaccine: France
recommends that children aged 9 to 12 months attending nursery school have a
single vaccine (approximately 10,000 children per year). All of these children then also receive a
dose of the MMR vaccine six months later and again before going to school (three
to six years of age). All other French
children receive a dose of the MMR vaccine at 12 months and another before
school.
Mumps vaccine:
There is no appropriate single mumps vaccine available in France and there is
no recommendation for it.
Rubella vaccine:
As in the rest of Europe, single rubella vaccines are available for non-immune
women planning to become pregnant.
Parents can obtain
single measles, mumps and rubella vaccines from Europe.
Measles vaccine: As stated above, this is available in some countries, such as France.
Mumps vaccine: There are three different strains of single mumps vaccine in Europe. They are the Urabe, Rubini and Jeryl Lynn® strains.
Urabe: This strain of mumps vaccine was part of the MMR vaccines used in the UK between 1988 and 1992. It was replaced by Jeryl Lynn® strain, which does not cause aseptic meningitis that was rarely associated with the Urabe strain.
Rubini: This strain has never been recommended or licensed in the UK, as it has an efficacy of no better than 12 per cent.
Jeryl Lynn® or Jeryl Lynn derived: These are the preferred strains of mumps vaccine, included in both types of the MMR vaccine used in the UK. Many of the parents who have received single mumps vaccines private in the UK will have received the Urable or Rubini strains. It is these strains that the media have described as ‘banned’ by the Government and, in reality, neither should be used for the reasons given above.
The MMR vaccine has
been banned in Japan.
The MMR vaccine that we use in the UK has never been used in Japan. A Japanese MMR vaccine containing the Urabe strain of mumps vaccine was withdrawn in Japan in 1993, due to unusually high rates of aseptic meningitis following vaccination.
As there is no
alternative MMR vaccine licensed in Japan, they were forced to recommend single
measles and rubella vaccines. These two
vaccines are given simultaneously to Japanese infants.
The consequence of
moving from MMR to single measles and rubella vaccines has been a dramatic rise
in the number of cases of both diseases in Japan. It has also resulted in at least 75 deaths from measles. The Japanese National Institute of Health
recommends combinations vaccines wherever possible.
In the UK the MMR vaccine used
to be given as separate vaccines and these should be ‘reintroduced’.
The MMR vaccine has never been given separately in the UK. Measles vaccine was introduced in 1968 for all children. Rubella vaccine was introduced in 1970 for adolescent girls only. Mumps vaccine was first introduced in the combined MMR vaccine in 1988 and has never been recommended or given as a separate vaccine.
The introduction of the
MMR vaccine reduced the annual number of cases of measles from 100,000 per year
to the current very low levels.
The trials on the MMR
vaccine only lasted four weeks.
The standard period of
follow-up for each child was six to nine weeks. The studies themselves lasted considerably longer. In addition to the clinical trials required
for the licence, many countries, including the UK, perform their own studies to
decide whether the vaccine is right for their children. In the mid-1980s, the UK performed a study
in over 10,000 UK children, which confirmed the safety of the MMR vaccine.
Worldwide, over 500
million doses of MMR vaccine have been used – equivalent to almost ten per cent
of the world’s population. Any
side-effect not detected after so many doses is either infinitesimally rare or
non-existent.
Parents should be
allowed choice for their children.
Parents should be
allowed reasonable choice where it affects only their child. But the experience from Japan has shown that
a vaccination programme based on single measles and rubella vaccines results in
a dramatic resurgence of disease.
This resurgence results
from the fact that if children require six vaccination visits to the doctor
rather than just two, a larger proportion will end up not being vaccinated
fully. Not only are the unvaccinated children
at risk, but also these they come into contact with – this means those who are
too young to be vaccinated, those who cannot be vaccinated because their immune
system is not strong enough and, in the case of rubella, the unborn child of an
unprotected mother.
Giving measles, mumps
and rubella vaccines separately one year apart is safer than the combined MMR
vaccine.
Having single vaccines
separately is more dangerous than the combined MMR vaccine. For this reason, no country in the world that
vaccinates children against measles, mumps and rubella recommends the vaccines
be given separately.
The suggestion that the
single vaccines be given one year apart means it would require six vaccinations
visits over five years, leaving children unprotected for longer and as a result
putting them and others at risk. Many
children would not complete their course of vaccinations, resulting in the
return of these diseases, which were all but forgotten.
MMR vaccine was
introduced as a cheaper alternative to the three vaccines given separately.
The vaccines were never
given separately. Giving the vaccines
separately would be more expensive due to the cost of nurse and doctor
time. Having the vaccines separately
would allow these diseases to reappear and be a drain on NHS resources. This was demonstrated dramatically in
Ireland last year when an outbreak of measles resulted in over 1,500 cases,
with over 100 children hospitalised and two deaths.
MMR vaccine causes
autism.
The World Health
Organisation, the Medical Research Council and the international medical
community have all stated that there is no link between the MMR vaccine and
autism.