As a scientist (immunologist a long time ago), a nurse, and a mother of four
children, I have been interested to read the "conversation" regarding MMR.
I am an enthusiast of prophylaxis by immunisation, but found it difficult to
understand the justification for MMR. To expose such young children to
three antigens in one vaccine seemed to me unnecessary, and I was not
surprised when reports of problems began to emerge. (Reassurances by the
government fall on very sceptical ears after BSE!)
Like Dave, I am of the generation that had all of these childhood illnesses
as part of growing up and was no worse off for it.
I did not wish my youngest child to have this vaccination, but due to a
"misunderstanding" she was given it without my consent. She has not yet
shown any side effects, but as a strong healthy child I feel that she could
have coped with mumps (which is now rare) and she may have already had
immunity to rubella naturally.
I feel disappointed that the measles vaccine is not available for those of
us who want to have our children immunised.
Another concern I have with the triple vaccine is the effect it may havedoes
on a developing immune system to present it with three antigens at once. Is
there any evidence regarding allergies and the vaccine?
As a mum, scientific queries aside, I want the best for my child and I feel
that I should be allowed to make that decision after considering the
evidence. The emotional element cannot be disregarded by pure scientists or
the government. We cannot start to tell people what to do with their
children's health.
Scientists do not rule the world!
Maggi Thomson
Lecturer in Nursing Studies
Glasgow
> ----------
> From: Dave Monks
> Reply To: Dave Monks
> Sent: Tuesday, January 23, 2001 10:03 am
> To: [log in to unmask]
> Subject: Re: MMR
>
> This is always an emotive subject, so thank you Judi for such sensible
> thoughts. It seems that hard evidence for benefit is difficult to find, so
> most discussion is strongly opinion based and strongly voiced.
> Clinical observation in general practice has shown me that the
> complications
> and severity of these infections are greatest in lower socio-economic
> groups, who may not develop good immunity even with an aggressive
> vaccination programme.
>
> Would Jenner's experience survive a critical appraisal?
> Although we CAN vaccinate children, SHOULD we?
>
> Dave Monks,
> G.P., New Zealand
>
>
> >>It is an intriquing situation when there appears to be a conflict
> between
> logic and evidence. Your initial reaction Andrew was a very logical
> response
> as it is logical to assess the risk before proceeding with an intervention
> and as you say, the risk of catastrophic consequences from childhood
> diseases is remote in healthy children. As a mother of 5 children I have
> taken quite an interest in this issue myself. I like to know what I am
> giving my children, the reason for it being recommended and what the
> evidence says.
>
> Another logical question is why don't we have confidence in the immune
> system of healthy children. I am not aware of any studies that have looked
> at whether there is a better response to the childhood diseases from
> strategies that strengthen the immune system compared to vaccination.
> Reports I have read of children with serious complications of these
> childhood diseases seem to include mainly children who have other diseases
> and conditions, childhood cancers and other conditions that compromise the
> immune system. Even if you argue the herd immunity approach to protect the
> vulnerable, some of the vaccines used are live vaccines and there have
> been
> reports of people contracting the condition from a recently vaccinated
> child. And what about the increasing number of reports of non-specific
> viral
> conditions in adults (that appear very similar to the childhood viruses)
> who
> were vaccinated as children. Could vaccination programmes be responsible
> for
> delaying the exposure and manifestation of these common childhood diseases
> and shifting the problem to a different sector of the community? What
> about
> the differences between natural immunity and immunity from vaccinations? I
> can think of many other such questions that don't appear to have been
> satisfactorily answered yet isn't this what an evidence-based approach
> should do? It seems to me that sometimes the `evidence' is built on to
> enthusiasm, anecdotal experiences and/or flawed assumptions - so although
> the evidence as such appears quite robust - the starting point is a
> problem.
>
> I have found it an interesting exercise to look at the natural history of
> these viruses and their virulence over time, as well as what happened when
> vaccines were introduced. Our Ministry of Health has collected this
> information for over 100years and produces updates in the annual reports
> (as
> do other countries). The graphs often start from when vaccination
> programmes
> commenced and you can clearly see a steady decline in mortality. However,
> when you go back further before vaccines were introduced the same steady
> decline can be seen - with no particular change at the stage vaccines were
> being used (although some plateau out). Although scarlet fever is not a
> problem in NZ I was interested to see that a graph from the UK showing the
> mortality from this disease. The graph revealed a similar downward curve
> to
> the other childhood diseases - yet there is no vaccine for scarlet fever.
> Maybe other factors (eg improved nutrition, sanitation and other public
> health measures) have had a more significant influence in the decline in
> mortality than we have assumed, or maybe the decline in mortality is a
> manifestation of the natural history of a virus - that it becomes less
> virulent in a population over time.
>
> Certainly food for thought!
>
> Unfortunately I have found it difficult to debate these issues and discuss
> my questions as people seem very polarised about such matters and become
> very emotive about vaccination issues. People seem either very pro or very
> anti, but hopefully those of you on the list are neither of these as you
> presumably value discussion and debate about the evidence (and the
> interpretation of it), as well as about the gaps in our knowledge and the
> unanswered questions.
>
> Judi Strid
> Women's Health Action
> Auckland
> New Zealand
>
>
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