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EDITIONS
Thursday, 7 February, 2002, 13:32 GMT
Six Forum: The MMR vaccine
Dr Vas Novelli, a consultant in paediatric infectious diseases, answered questions on the issue of the controversial measles, mumps and rubella jab versus a separate vaccine, in a live forum for the BBC's Six O'clock news, presented by Manisha Tank.

To watch coverage of the forum, select the link below:

  56k  


The topics discussed in this forum were:

  • Single vaccine
  • Booster vaccine
  • Autism
  • Rubella vaccine
  • Measles vaccine
  • Mercury in MMR
  • Allergies and epilepsy
  • Reactions to the vaccine
  • General

    Single vaccine


    Newshost:

    Hello and welcome to the 6 o'clock News Forum. We're talking about the MMR vaccine and joining us to address your questions is Dr Vas Novelli. He is a consultant in infectious diseases at the Great Ormond Street Hospital in London.

    We've have a couple of e-mails here of the same genre from parents. Donna Collins says she has a nine month old son and she's decided not to let him have the MMR vaccine. She says, I'm trying to find out where I can go to get the jab separately and this is turning into a nightmare. I think we should be given the choice and then maybe we wouldn't be having this panic at the moment. Also a similar one from Julie Shackman in Scotland: Our little boy is 15 months old and is due to have his MMR vaccine on Friday morning. Me and my husband are frightened. Why won't the Government sanction single vaccinations?


    Dr Vas Novelli:

    I would like to reassure those parents that all the paediatric community, in terms of paediatric consultants throughout Great Britain, are firm believers of the vaccine and that the MMR vaccine is safe. I talk to parents individually to try and convince them of the safety. I am not part of the Government. This is part of my own speciality - infectious diseases - I've looked through all the data and I can reassure them that the MMR vaccine is safe. It's the best vaccine for children. Both my three children have had MMR - I've got no problems with that. All my colleagues - that's all the paediatricians in this country - are backing the vaccine. We are about to put out a statement from the Royal College of Paediatrics and I would try and reassure parents to go ahead and have the best for their children. The single vaccine is not the best vaccine. The appropriate approach for parents is to listen to their doctor.


    Newshost:

    On that point, we've had an e-mail from Toby Stevens in the UK: I'm very keen to protect my nine month old son from the disease but also wish to minimise the risk of any MMR side-effects - real or otherwise. If he has the three separate immunisations at the correct intervals will that prove to be as effective intervals, will that prove to be as effective as the MMR jab?


    Dr Vas Novelli:

    I actually work with the MMR and yes, the answer is that if you give a child the single vaccine, the response will be the same as if you give the triple vaccine together as compared to the single vaccine. But again you are talking about a delay between the vaccines when the child is not protected. That particular parent may have the financial clout to go and have the vaccine from a private practitioner. But if the Government were to switch and offer the single vaccine, the whole MMR vaccine programme would fall in disrepute, the MMR vaccine would not be given at all.

    This has been a major advance the fact that we're able to give three vaccines in one. The immune system of a child is able to tolerate this - there is no question about it. There is scientific evidence - there is nothing to suggest this is too much for the immune system. Every reputable scientist throughout the world at the moment - in America, in Sweden - all over the place - back the vaccine. This association with autism and inflammatory bowel disease is really bunkum. All the data has been shown not to exist anywhere else except in this country. What is so special about this country?

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    Booster vaccine


    Newshost:

    People are perceiving it to be more risky. Samantha Robinson, Camberley, Surrey: Both my sons (aged 5 and 3) have had the MMR vaccine with no ill-effects. My 5 year-old (6 in April) has not, however received the booster. I understand that his first vaccine will give him 90% protection. With all the current controversy does he really need to have the booster or will it be to his detriment not to do so.


    Dr Vas Novelli:

    He should have a booster. The reason why the booster was introduced was because about 5% of patients receiving MMR vaccines don't mount a response so they're left unprotected. We haven't got the availability to be able to take blood samples from every child to see which ones have responded and which ones haven't responded. So in most countries what they've introduced is a booster programme. There shouldn't be any problem with this child having a booster and I would urge this mother to let this child have the booster.

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    Autism


    Newshost:

    A text message: My wife's brother has a form of autism. Will my future son be more at risk and would he be a high risk if he the MMR?


    Dr Vas Novelli:

    Again, I don't think there is any connection between the MMR and autism. In some families there is some genetic susceptibility for this disorder. We don't know what causes autism but certainly I do not believe that there is any connection between the MMR and autism. I would say to that family for them to go ahead and have the MMR and I wouldn't have any problems with that. The problem with autism is that it tends to present in exactly the same period when we give the MMR - between 1 and 2 years of age - so this where the association has occurred. But talk to your doctor - this is not the Government talking - get advice from your doctor because after all we are trying to do the best for our patients and the best for our patients is to have MMR.

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    Rubella vaccine


    Newshost:

    Jules May, Scotland: The health problems seem to be associated with mumps and rubella given together. But Mumps is only dangerous to boys and rubella is only dangerous to girls. What is wrong with a MM vaccine for boys and a MR for girls - that way everyone only needs one vaccine and the health worries are avoided?


    Dr Vas Novelli:

    The problem with rubella is that we used to give the rubella vaccine to teenage girls to protect them before they were pregnant. The problem with adopting that strategy what was happening was that we were still seeing children with congenital rubella. The reason why that was happening was because the rubella virus circulates in young children at pre-school, kindergarten etc. when they have a mother who may be onto her second or third pregnancy. The idea of giving rubella vaccine is to stop the transmission of virus in 1 to 4 year-olds so the virus is not transmitted to the mother who may be pregnant and who may then have a congenital rubella syndrome. Since we have introduced that, congenital rubella has come right down. So that would be a disaster to just give the vaccine to half the children - we have to prevent the transmission of the virus amongst all children in that age group.


    Newshost:

    A text message: I'm 16 and I was wondering if it is safe for me to have MMR because I don't want to be in danger? Can I just have the rubella vaccine?


    Dr Vas Novelli:

    Yes absolutely. The appropriate thing for that person would be for her to go to her doctor and he would take blood from her to see whether she may have been exposed to rubella and may not need the rubella vaccine. But usually that happens also when somebody wants to become pregnant - it's part of the screening. She should go and have a blood test and see whether she is or is not immune and then she could have the rubella vaccine.

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    Measles vaccine


    Newshost:

    Sylvia Willcocks: What is the downside of the single vaccine if the measles vaccine is given first at the same time in a child's life when the MMR would have been given and the two other jabs are subsequently given? Obviously there is a risk that the child contracts either Mumps or Rubella, but I understand that these diseases are not life threatening. Is that the case?


    Dr Vas Novelli:

    We're talking about public health policy and also individual parents' concerns. If the Government were to say - we will let people have single jabs, what would happen - in an ideal world 80% of the people would still go for MMR because that's what's happening at the moment. Twenty per cent would go for the single jabs and we'd continue trying to sort out the 20% who would have to have six or so more visits than normal. In the real world, if you offered the single vaccine, everybody would opt for the single vaccine. The MMR, which is the best vaccine available for these diseases - there is no doubt about it - it is better than the single vaccine, that would fall in disrepute and we'd be in a situation where we would be trying to catch up with children's immunisation with extra visits etc - the whole immunisation programme would be chaotic. This does not exist anywhere in the world - what makes us so different? I don't understand what the difference is. This vaccine is safe - MMR is safe, there is no need for a single jab.

    The original reason why people wanted a single jab was because they thought that the three vaccines would totally overwhelm the immune system. But there's been recent studies to show a child can actually cope with 11,000 vaccines given at once - the immune system could cope with that. If you give 11 vaccines to a child at once, you're only basically using up .1% of your immune system. If you're not worried about overloading the immune system and are still worried about autism and inflammatory bowel disease - I tell my patients there is no link, I've looked at the data and there's no link.

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    Mercury in MMR


    Newshost:

    Stewart: Over Christmas there was an article in the Times saying that the MMR contained mercury which could cause autism - they went on to mention that most other countries had immediately stopped the use of this mercury vaccine, but the UK had decided to use up their stocks. How true is this? Does the mercury cause autism?


    Dr Vas Novelli:

    Mercury doesn't cause autism - it can cause neurological problems, it can cause behavioural problems. In the United States they have withdrawn vaccines that contain mercury. It is not clear - I'm unaware at the moment of the long-term effects of having mercury in a particular vaccine. The main vaccine where mercury is contained is in the hepatitis B vaccine. I don't know how much mercury is in the MMR - I suspect that there's very little in it. But yes there is a situation in this country where we are trying to use up stocks. I have not looked at the policy and what the Government have said about this but we will be moving to mercury-free vaccines because that's the next stage. But it does not cause autism.

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    Allergies and epilepsy


    Newshost:

    Louise Frampton, Scotland: My 14month old son has a dairy allergy. Is the MMR safe for him?

    Also, Dawn Lovejoy: My son has West's Syndrome (also known as infantile spasms - a mild form of epilepsy). He's 14mths, and so far, hasn't had his MMR - we're looking at single vaccines as I've read that the triple vaccine should be avoided if there's any history of epilepsy. His consultant said we should go ahead with the MMR (but then she would whatever) - what should we do?


    Dr Vas Novelli:

    An allergy is not a contraindication to MMR - so dairy allergy, no problem. I would go with the MMR, this is the best vaccine available. You are doing your duty to your children, you are protecting them and this is the way to go. I would totally ignore all the bunkum about this business with autism and inflammatory bowel disease.

    With West's Syndrome - that is a neurological problem. In that situation I would still go ahead with MMR but I would certainly make sure to try and control any fevers that may be associated with MMR - you may get a low-grade fever which could precipitate increased seizures. But there is no contraindication to giving the MMR and I would go with the MMR.

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    Reactions to the vaccine


    Newshost:

    Two text messages: I'm worried about my 4 year-old he has a severe rash all over - temperature, vomiting and a bad appetite. He's been on and off since his MMR. The GP says it's a virus. Please advise.

    My son has only received the first MMR jab. Due to a bad reaction we decided against the second. Approximately how much immunity is he likely to have?


    Dr Vas Novelli:

    With the first mother who is concerned that her child's symptoms may be related to the MMR. Certainly about 5 to 7 days after the MMR some children may get like a measles-type rash and you may get a slight fever, you may get an upset tummy. Unless I was able to see this child, I really can't say whether this maybe related to the MMR. It sounds like the child may have acquired a different virus - a virus causing a winter vomiting sickness that has been going around the country.

    The second questioner who is worried about a reaction. If you look at the reaction the child had to the first dose - if it's just a bit of rash and fever, I would not worry about giving the second dose and I would go ahead with the second dose.

    Return to the top of the page


    General


    Newshost:

    Fabbi: As a mother of a four year old due for her second MMR jab I cannot help but worry. If it were true that there is a link between the jab and autism/irritable bowl, would children who already have the first jab be less at risk?

    David: My son is due his final injection soon. Can I assume that he is not at risk as he has not suffered any problems from the earlier injections.


    Dr Vas Novelli:

    There is no risk - that's all I can say. Both these parents should have their child have the second vaccine - there is no risk there.


    Newshost:

    Rosheen Brown, Northern Ireland: No one has asked or answered the question about any side effects of the single jabs if any. Also if you opt for the single vaccinations how long do you wait in between the jabs?


    Dr Vas Novelli:

    I don't agree with giving single jabs. The side effects are same as the combination MMR. The main side effects of the measles vaccine is a slight fever between day five and day seven and to perhaps a mild rash - sometime with conjunctivitis - so it's like a mini-measles. With rubella, again it's a rash. With the mumps it's sometimes a bit of swollen glands and really that is it. These are the same side-effects as if the vaccine is given as MMR.


    Newshost:

    Text message: If I were going to a country and I needed a vaccine, I'd tell my GP and it would be ordered and I'd pay for it. Why can't I do that?


    Dr Vas Novelli:

    Because there is no licence for a single vaccine at the moment in this country - it's been phased out. If somebody wants the single vaccine, it has to be imported from abroad. Possibly, the only appropriate place for a single vaccine is if there's a large measles outbreak and we're trying to protect children from getting measles in the environment - e.g. in a kindergarten. That would be a situation where you may consider giving a measles vaccine in that particular situation. But even then these days we would probably use MMR - but that's the only situation. It is not available in this country because there's no licence - it is an unlicensed product.


    Newshost:

    Ms Alexander, Scotland: My daughter now 14 having missed for various reasons her MMR vaccine when she was an infant, should she receive it now? What are the risks advantages and/or disadvantages?


    Dr Vas Novelli:

    She should go to her doctor and possibly have a blood test to see whether she's been exposed and has mounted an immune response. If she's got immune response she doesn't need the vaccine.


    Newshost:

    Nasheena Jaffar: What are your views on the alternative approach e.g. chiropractic holistic care that has been shown to enhance your immune system thereby avoiding the need for MMR?


    Dr Vas Novelli:

    I have no great problem with alternative therapy as long as it doesn't block what we've been speaking about. We have very good vaccines. This country has been at the forefront of vaccine development. Edward Jenner developed the first vaccine against smallpox. We have a duty to protect our children. Parents don't see the vaccine-preventable diseases because everybody is vaccinated. They forget what whooping cough is like, they forget what diphtheria is like. We have a duty to give them the vaccine. Holistic treatment may be appropriate but as well as your vaccine to improve your immune system. But the children need their vaccines.

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    06 Feb 02 | UK Politics
    05 Feb 02 | Health
    03 Feb 02 | Health
    06 Feb 02 | Health
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