Separate vaccines could endanger children

BMJ 2001; 323 doi: (Published 29 September 2001) Cite this as: BMJ 2001;323:711
  1. Zosia Kmietowicz
  1. London

    Experts have declared that the current fad among some parents to give their children single injections against measles, mumps, and rubella rather than the triple MMR vaccine is a “backward step” that could endanger their children's health.

    There is no evidence that using separate vaccines to immunise children against these childhood diseases is either safe or effective, because this type of regimen has never been used anywhere in the world, write Professor David Elliman of St George's Hospital, London, and Dr Helen Bedford of the Institute of Child Health, London, in a review of all the evidence on MMR to date (Archives of Disease in Childhood 2001;85:271-4).

    None of the single mumps or measles vaccines is licensed in the United Kingdom, and of the separate mumps vaccines one is ineffective and another increases the risk of meningitis slightly.

    The reviewers reiterate that research carried out by Dr Andrew Wakefield and colleagues at the Inflammatory Bowel Disease Study Group at the Royal Free Hospital in London, which linked measles vaccination to bowel problems and autism, has been quashed by subsequent work, including some from the group itself.

    Dr Wakefield is criticised for his remarks in 1998 that he believed the combined vaccine overloaded the immune system and that separate vaccines were preferable. “He has yet to produce any sound evidence to support this view,” say Professor Elliman and Dr Bedford, adding that other team members emphatically endorsed the use of the triple vaccine and that many other scientists were unable to reproduce Dr Wakefield's findings.

    They add that a review by Dr Wakefield and a colleague, published earlier this year, which claimed to show that the MMR vaccine was inadequately tested for safety, was deeply flawed, with “many errors” and a “highly selective” choice of studies. In particular, it overlooked an important Finnish study which found a very low rate of side effects and no increase in bowel problems after MMR vaccination.

    In a commentary on the article, Dr Elizabeth Miller of the Public Health Laboratory Service attacked the Lancet for publishing some of Dr Wakefield's most controversial work, even though it was badly designed and poorly conducted.

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