MEASLES fever has again struck Britain. It’s not the disease itself that’s
raising temperatures—though there have been a few minor
outbreaks—but a resurgence of a row over the safety of MMR, the combined
measles, mumps and rubella vaccine. At the heart of events is the hypothetical
link between MMR and autism. More and more worried parents are abandoning
vaccination, or opting for three single vaccines. Health officials, eager to
stave off a measles epidemic, have accused these parents of playing Russian
roulette with their children’s health
(see “Tough choices”).
Health ministers must take the blame for this tragicomedy. The official
campaign to get parents to vaccinate their children has been negative and
reactionary. The central message that “there’s nothing to worry about” is
patronising and lacks candour. Even though all the evidence shows that MMR is
the best option for the country as a whole, ministers have failed to address
parents’ concerns.
Though government epidemiologists have ruled out any significant association
between MMR and autism, there could be a link in very rare cases. Instead of
dogmatically sticking to its message, the government could, if it had a mind to,
call the odds on just how rare any putative link would be. Such a move would
help parents make up their minds. After all, they already have to consider other
rare side effects of vaccination, such as seizures and anaphylactic shock.
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The absolutist line in Britain is in sharp contrast to that of the Institute
of Medicine in the US. Last year the IOM conceded that there may be rare cases
in which MMR could contribute to autism. Epidemiology is a blunt instrument and
it could miss children with rare genetic susceptibilities. British health
officials may be taking this possibility seriously. If so, there’s nothing to
show for it. Where, for instance, is the research programme into the causes of
autism or the shared genetic characteristics of sufferers? Such a programme
would signal an intention to solve the puzzle.
But that’s not the impression the public is getting. Last week, the chief
medical officer for England responded to a paper by a team including Andrew
Wakefield—the researcher who first proposed MMR’s link with
autism—by saying that it was “riddled with flaws”. There was no discussion
of the science or significance of the findings. He simply dismissed it out of
hand.
People can tell when they’re being fobbed off with half truths. The
Department of Health seems to have returned to the bad old days, when the public
were supposed to do what officials told them. Contrast this with the Food
Standards Agency announcement last year that there is a small chance that sheep
harbour BSE. Until it had more evidence, said the FSA, it would not advise
people to stop eating lamb. It then convened a committee, including lay people,
to investigate the issue.
This is an upfront, commonsense approach. When people have all the facts,
they can deal with risk. That was the central lesson from the influential
inquiry into the government’s handling of the BSE crisis. What will it take to
get health officials to learn it?
