Intended for healthcare professionals

Education And Debate

Communication and miscommunication of risk: understanding UK parents' attitudes to combined MMR vaccination

BMJ 2003; 327 doi: (Published 25 September 2003) Cite this as: BMJ 2003;327:725
  1. Paul Bellaby, director (
  1. Institute for Public Health Research and Policy, University of Salford, Greater Manchester M5 4QA

    In this article on the public perception of risks Paul Bellaby considers three examples of risks to children in the UK–an insignificant risk (autism caused by MMR vaccine), a real but probably small risk (vCJD from BSE), and a real and demonstrably larger risk (injuries from road crashes) and contrasts the perceptions of the risks by parents

    Science cannot prove a negative, but, where their children are concerned, parents want to be assured that risk is zero. Would establishing a comprehensive “Richter scale” of risks remove that misunderstanding? If not, then what accounts for miscommunication of risk and how might it be overcome? In this article I try to provide answers by considering public perception of three risks, each of a different order, all involving children:

    • Autism linked to the combined measles, mumps, and rubella (MMR) vaccination

    • Variant Creutzfeldt-Jakob disease (vCJD) arising from food containing the causative agent for bovine spongiform encephalopathy (BSE)

    • Injury and death in road transport crashes.


    In 1998 Wakefield was the first to make the claim that autism and the MMR vaccine are linked.1 It is based on a dozen clinical cases of gastrointestinal disorders with which developmental regression seemed to be linked. They arose in previously normal children. His team found that eight of the 12 parents attributed the onset to the MMR vaccination. On a population level, diagnoses of autism increased rapidly from 1988, when MMR was introduced, and through the 1990s, not only in Britain but also in North America. Yet epidemiological studies have found no link between increasing numbers of diagnoses of autism and the introduction of MMR vaccine.2 3 The weight of scientific opinion is that the risk is insignificant.

    By contrast, there is both laboratory and epidemiological evidence for the transmission of BSE from cattle to humans. Consumption …

    View Full Text

    Log in

    Log in through your institution


    * For online subscription