MMR Vaccination – Why have it?

Issue 11
For the third part of our series of interviews with Dr Annabel Bentley, BUPA’s assistant medical director, we talk about the MMR vaccine and also measles, mumps and rubella (German measles) - the diseases the vaccine aims to protect against.

There has been considerable controversy about the safety of MMR, the combined vaccine against measles, mumps and rubella. But independent experts, the government and the medical profession support the use of MMR. BUPA also supports MMR vaccination but does not discriminate against children who have not received it.

What is MMR?

MMR is a combination vaccine offering protection against three diseases: measles, mumps and rubella (German measles). It is first given, by injection, to children at around 12-15 months with a second dose as a pre-school booster.

Since the MMR vaccine was introduced the number of children catching measles, mumps and rubella has fallen to an all time low. Many parents are aware of the MMR vaccine but as there are no longer many cases of measles, mumps or rubella parents do not have much knowledge about the actual diseases we are protecting our children from and are not aware of the devastating effects these diseases can cause.

Can you tell us more about Measles, Mumps and Rubella (German Measles.)

Measles

Many children are fairly ill with measles but do make a full recovery, however with some children there can be quite serious consequences. Measles can damage the lungs through pneumonia it can cause fits, encephalitis (inflammation of the brain) and brain abnormalities that can lead to long-term mental problems. Occasionally some children can actually die from measles.Mumps

As with measles most children do recover. Again there can be more serious consequences such as meningitis and brain problems. In boys mumps can affect the testicles and can lead to infertility in later life. It can also be a cause of deafness as the mumps virus can affect the ear. These complications are very rare, but this is one of the reasons the vaccination programme was set up, to try and protect our children from these very things.Rubella (German Measles)

Rubella is more of a minor illness and almost all children recover from it. One of the main reasons rubella is given as a vaccine is to protect the population as a whole. If a pregnant woman catches rubella it can damage the unborn baby. It can cause the baby to have heart problems and may make the baby blind, deaf and damage the baby’s brain.

If you are thinking about not giving your daughter the MMR vaccine, one thing to consider is the fact that she will be missing the opportunity to have the rubella vaccine and by the time she is older and pregnant herself she will not be protected against rubella. Therefore if someone were to pass on German measles to her, it would harm her baby.

How effective is the MMR vacine?

The first dose gives 90% protection against measles and mumps and 95% against rubella. This means that out of 100 people given the vaccine 90 will be immune to measles and mumps and 95 to rubella. By adding the second dose as a pre-school booster the protection levels increase to 99%.How long has the MMR vacine been in use?

The MMR vaccination was introduced into the UK in 1988 but it has been used earlier than this in numerous countries across the world. It is now used in over 90 countries and more than 500,000 000 doses have been given. All countries recommend the combined vaccine.

Following the recent media coverage about the link between the MMR vaccine, autism and inflammatory bowel syndrome (Crones disease), many parents will still remain worried even though experts have agreed that there is no proven link. What advice would you give to parents who are still very worried about giving their child the vaccine?

Remember that newspaper headlines are there to highlight a story and headlines are only a tiny part of that story. Parents need more facts and balanced information. If you have specific questions you need answering speak to your health visitor or GP, alternatively you can visit the BUPA website or the MMR facts website.

If a child has autism, parents may start to notice the signs of it in their child’s infancy. As the MMR injection is given at around 15 months of age, it is easy to understand why some people think they may be linked. However, research continues to offer reassurance of the safety of this vaccine.

Although the number of cases of autism appears to have risen in the last 20 years, this is probably due to better diagnosis of the condition. Autism was around before 1988 when the vaccine was introduced.

There really isn’t any evidence suggesting MMR causes autism. It would be a real tragedy if, because of a suggested link between autism and MMR, not enough research was being conducted to find out what actually does cause autism. We could find two simultaneous problems happening - firstly children not being protected and secondly a loss of the opportunity to find out what causes autism.

Anti-immunisation campaigners have tried to claim that a child’s immune system cannot cope with three vaccinations at once, we know that there is no evidence to back up this claim, but can you tell us whether parents can choose to give their children three separate vaccinations and if so what are the disadvantages of choosing this method?

In the UK there is no legislation to say that children have to have MMR, however in America children can only go to school if they have had their vaccinations. In the UK Parents can make their own decisions on whether or not to vaccinate their children.

If parents are considering single vaccines rather than the recommended combined vaccine they are only available from a few private doctors and are not available on the NHS. There really isn’t any scientific justification for choosing the single vaccines for many reasons. A child’s immune system can cope with hundreds and thousands of viruses.

Every day we come into contact with bacteria and viruses and our immune system fights them off. Children can cope with three conditions at once in a vaccine. One of the reasons the vaccine programme was set up as a triple jab is so that parents do not need to take their child to a doctor repeatedly, which is unpleasant for the child. The combined vaccine means that instead of six separate visits to the doctor, children need only go twice. One other disadvantage of separate vaccines is that due to the gaps in-between vaccinations children are at a higher risk to these diseases. Also there is a higher risk of children not completing the course of required vaccines, again increasing the risk of these diseases returning.

Are there any reasons why children should NOT have the vaccine?

Some children should not have the vaccine. These include children who have an illness such as cancer or who are taking medicines that suppress the immune system or high dose steroids. If your child has had a different type of vaccine in the previous three weeks you should discuss this with your GP before taking your child to the nurse for the MMR vaccine. There are also certain types of allergies that may prevent your child from being able to receive the MMR vaccine. If your child has shown allergic reactions to the medicines neomycin or kanamycin it may be a possibility that the MMR vaccine is not an option.

However, it IS safe to give the MMR vaccine to children who have an allergic reaction to eggs.

Visit www.bupa.co.uk and go to the health factsheet section of the website where you can find Free online health information, from BUPA's trusted medical experts