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Julia Manning: Vaccinating for the greater good

Julia_manning Julia Manning, Director of, says that discrediting new vaccines such as the MMR risks the lives of more than those who don't take them.

Last week, held a seminar on the crucial role that modern vaccines have to play in the delivery of Public Health in the UK. We heard a story from a Consultant Paediatrician working in South East London about two children who had previously received kidney transplants at the age of two. They had had their first MMR jab but not the booster which is contra-indicated following organ transplants. The children came into contact with the measles virus and caught the disease. Both of them suffered permanent brain damage.

This week, the General Medical Council hearing begins into serious professional misconduct by Dr Andrew Wakefield and two other doctors who published their damaging theory of a link between the MMR vaccination jab and autism in 1998. One of the accusations is that Dr Wakefield did not declare to his hospital Ethics Committee that he was getting money from the Legal Aid Board for advising the parents of autistic children who wanted to pursue compensation in the courts. Only 3 years before in 1995, the uptake rate of the vaccine had reached 95%, the target rate to achieve ‘herd immunity’. This is where the immunity of a sufficient number of individuals in a population is such that infection of one individual will not result in an epidemic. Every parent who declines the MMR jab increases the risk not only to their child of serious disease, but also the risk to many others. It is precisely this herd immunity that is vital to protect people who are immunocompromised, which includes all organ transplant recipients.

Despite both numerous publications since finding no link between MMR and autism, and the fact that in 2004 the 10 co-authors of the 1998 paper issued a retraction, the take–up has still not recovered. Nearly 10 years after publication of the paper, the vaccination rate is still barely 50% in some London boroughs, and the first six months of last year saw the biggest outbreak of measles in 20 years. The consequences of Dr Wakefield’s unfounded ideas are devastating.

There are two facts we need to remember when we think about immunisations. Firstly, we must not forget history - the suffering, disability and in many cases death that arose before the introduction of universal vaccination for diseases such as polio, measles, smallpox and whooping cough. It is all too easy to forget how much good health most of us enjoy as a result of those childhood jabs. We need as well to be open to new vaccines that will protect future generations from disease. New vaccines emerging such as those for hepatitis B, cervical cancer and chicken pox, not to mention the search for a vaccine against HIV, could prevent much devastating illness amongst significant numbers of the population.

And not just the UK population. As secondly we must remember the global benefits to developing countries of the vaccines that have been developed in the West. Not only do vaccination programmes dramatically improve mortality rates, but the consequential improvement in people’s educational attainment, average income and productivity through disease avoidance is measurable. The current work on vaccinations against Malaria and HIV could transform the prospects of many African countries.

Despite the evidence, there will still be campaigners outside the GMC in the coming weeks who claim Dr Wakefield is a ‘hero’. It behoves us all to remember that there is no such thing as risk-free medicine, and it is good science to try and minimise those risks. However, it is patently true that the benefits of vaccination vastly outweigh the risks. 1000 mothers still bury their children who have died from measles every day in the developing world. This is an unnecessary tragedy, and we should not make matters worse by discrediting life-saving Public Health measures.


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