Reviews

Open season on MMR

How the Blairs' silence sparked a media storm

   In recent weeks opponents of the triple measles, mumps, and rubella (MMR) vaccine have had rich pickings. In late November the General Medical Council cleared former general practitioner Peter Mansfield of professional misconduct for offering separate vaccines. The Daily Mail heralded this as a victory. Shortly afterwards, the Express picked up an editorial in the British Journal of General Practice, which argued that the Department of Health needed to respond to parental concerns and rethink its policy on single vaccines.

In early December Andrew Wakefield, whose research in the Lancet in February 1998 stoked widespread alarm over possible links between MMR and bowel disease and autism, left the Royal Free Hospital in London. He claimed that he had been forced out for his rebel views. His departure was extensively covered in the Guardian and provoked several angry letters in both the Daily and Sunday Telegraph.

But it was the Blairs' refusal to answer Conservative MPs' questions about whether their youngest son, Leo, had had the triple vaccine that kept MMR firmly on the media agenda.

Many newspapers viewed the Blairs' silence as doing little to quell lingering parental doubts about the safety of the vaccine. This even included papers that supported the prime minister's view that his children's welfare was a private matter, as an article in the Independent on 21 December reflected.

But the refusal to budge vexed the Daily Mail the most. It ran stories on the issue, clamouring for a confession, on 13, 14, 18, 19, 20, and 21 December. The paper continued its campaign in the new year, bringing in television presenter Carol Vorderman to add her voice to the request for the Blairs to break their silence. The Independent had already revealed that Ms Vorderman had not had her son vaccinated with MMR.

The Mail on Sunday chipped in a strand to the conspiracy theory on 16 December. It reported that GPs were paid to meet vaccination targets for MMR, implying that financial concerns took precedence over children's health, a theme that was taken up again a few days later.

Suspicion that a lack of candour must imply something to hide was not dispelled by the less than convincing performance of junior health minister Jaqui Smith on the BBC's influential Today programme on 20 December. The minister was taken by surprise, but wriggled uneasily under relentless questioning about her own children's vaccination. Her defence that their health was a personal matter came across as lame and evasive.

View larger version (71K): [in this window] [in a new window]   Urged to confess: Blair with Leo

Was it the prime ministerial silence that did the most damage to confidence in MMR? After Christmas the Telegraph produced evidence that the Blairs' stance had undermined public confidence by revealing a huge surge in demand for single vaccines. The Independent on Sunday revealed that supplies were running out as parents panicked.

Postings from parents seeking information on doctors willing to offer single vaccines on the Justice Awareness and Basic Support (JABS) website (www.argonet.co.uk/users/jabs/), an anti-MMR organisation campaigning for parental choice, almost tripled during December.

Department of Health figures show that MMR uptake varies considerably across health authorities in England. London is the worst, averaging 79 per cent. Some areas in the capital are as low as 73 per cent, although these figures reflect poor general uptake of childhood vaccines. But in the rest of the country MMR uptake consistently lags behind other childhood immunisations.

A spokesperson for the Public Health Laboratory Service (PHLS) says that trends in MMR uptake, while far from experiencing a vertiginous plummet, have been heading downwards since 1995, when the first of the queries about MMR came to public attention.

The recent downturn after a period of relative stability may have been helped by the introduction last year of meningitis C vaccine in young children, given at the same time as MMR, he said. This may have persuaded parents to defer the latter to stagger the number of injections.

Would it have made any difference to public confidence in MMR if the Blairs had made a public statement about whether or not Leo had had the jab? Only the next set of figures will make that clear.

Caroline White, freelance medical journalist.