Paul Vallely: We need an outbreak of common sense

It was an unhappy juxtaposition, from the Government's point of view at any rate. First came the report that hormone replacement therapy can double women's chance of developing breast cancer. Then, immediately following it on the radio news yesterday, was another medical story. It predicted that a nationwide epidemic of measles was now inevitable because so many parents were refusing to give their children the combined measles-mumps-rubella jab.

You didn't have to be a brain surgeon to spot the link. Nor did you have to be, as I am, one those parents who have refused the MMR for their toddler and opted for three separate vaccines. Every time medical research revises the conventional wisdom on something, another tiny incremental change occurs in the public attitude to science. Sometimes it's an occasion for exasperated expostulation, as when red wine or whatever, which used to be bad for you, suddenly becomes good. Sometimes it's a time for a chortle, as when masturbation, instead of making you blind, turns out to stop you from getting cancer. But sometimes it's serious - as when yesterday's HRT wonder drug turns into tomorrow's potential carcinoma. Yet each time our embrace of the scientific miracle becomes more provisional.

Of course it is worrying that only 79 per cent of children are now vaccinated against measles compared with 92 per cent in 1996. In London, where most of the recent measles outbreaks have occurred (largely from strains imported from abroad) coverage has fallen to just 70 per cent. The population is losing its herd immunity. The fear is that an outbreak may soon become self-sustaining, infecting everyone who has not had the disease and is not vaccinated.

So what is the Government's response? To assert, badly and ever more forcefully, that the MMR is the answer. And to insist that parents' fears of a link, in rare cases, to autism or the bowel disorder Crohn's disease are unfounded and based on bad science. Parents who demand single jabs are irrational and should be ignored.

The trouble is that this strategy is clearly failing. Faced with the Government's intransigent "MMR or Nothing" stance, parents are unfortunately opting for Nothing. The reaction of the Government is to shout louder and wield a big stick, by making it more difficult for parents to get hold of single vaccines even where they are prepared to pay privately for them.

There were two other striking factors about the debate on the Today programme yesterday. The chap from the Royal College of GPs trotted out the usual establishment line about the problems in Japan, where single jabs were available, and where measles outbreaks were killing children. Unusually the expert was faced by a politician, Julie Kirkbride, who was well informed on parents' reservations. The so-called expert suddenly didn't sound so expert.

In fact, the Japan experience suggests the opposite of what many MMR advocates maintain. What happened there was that a crisis of confidence occurred after an MMR containing a dodgy mumps component (not the one used in the UK) produced serious side effects. Japan's secretive and high-handed bureaucrats refused to accept this and a wide-scale parents' boycott began. Eventually the authorities admitted that more than 1,000 people had suffered side effects, mostly meningitis. Three died before the triple vaccine was withdrawn in 1993. Eventually single vaccines were introduced, but the damage had been done. Deaths from measles are mainly among children under the age of 12 months, who would be accounted too young to vaccinate under UK practice, and who are the victims of falling herd immunity precisely because the government was so tardy in responding to the crisis - much as the medical establishment here is now.

The reason I know all this is because I got clued up when we had to decide whether to give the MMR to our toddler, who has Crohn's disease in his immediate family tree. Which brings me to my second point. The parents who have given their children single jabs - around 72,000 - are mainly well-educated middle-class types who know far more than the interviewers asking the questions when the subject comes up on air. The number of untrue or half-true statements they hear from experts anxious to "sex up" the case for MMR - and the fact that these often go unchallenged - only compounds their mistrust.

Let me give you just one example. We routinely hear the line that single jabs involve giving children six separate vaccines, each a year apart, which exposes them to illness for too long. In fact the main worry about the MMR is that the three live vaccines taken together might produce an interactive "cocktail". To get round this you need leave only six weeks between jabs, which is what we did. Since, after single shots, boosters are necessary only in 5 per cent of cases, all that remains for our three-year-old is a blood test in two or three years to ensure he has the necessary antibodies. If not, the separate jabs can be repeated.

Parents like me know that from an epidemiological point of view the MMR is overwhelmingly safe. We just don't want to take the risk that it is our child who might be the exceptional victim. Which is why reintroducing single jabs is the sensible option. It's no good the Government being in favour of patient choice and then objecting when patients make one.

p.vallely@independent.co.uk