Intended for healthcare professionals

Rapid response to:

Letters Case for mandatory vaccination

Debating the future of mandatory vaccination

BMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j4100 (Published 07 September 2017) Cite this as: BMJ 2017;358:j4100

Rapid Response:

Re: Debating the future of mandatory vaccination

After two weeks, Anand’s request for a reasonable debate on this subject has seen a disappointing response. Thus far it has been a completely one sided debate.

No one has spoken up for the safety and effectiveness of the current UK vaccine schedule, which is an essential prerequisite before the idea of mandatory vaccination can be put on the agenda.

No one has questioned the many responses which have detailed concerns, fears and experiences around vaccine safety, and about the difficulty in engaging government and NHS agencies in reliable discussions of those experiences.

In particular, no one has responded to Hinks’ remarks about HPV problems, nor to Wendy Stephens’ comments on the record of the UK Vaccine Injury Compensation Scheme. (1)

No one has dissented from my suggestion that GPs are often not fully aware of the safety concerns around vaccination, and that GPs are often unaware that they may have serious gaps in their knowledge, which prevent them fulfilling their duty to obtain valid informed consent, prior to vaccination. (1)

The MDU has made it clear how the process of gaining consent has changed, since the Montgomery case.
“ At the heart of the Supreme Court's judgment is a repudiation of medical paternalism, which is replaced with the value of self-determination. The patient is no longer a passive recipient of medical treatment, but a partner in the provision of that treatment.” (2)

Is this happening, and are adults and parents made aware of possible risks prior to any vaccination procedure ?

The payment that GPs receive from the NHS for childhood vaccinations is usually reduced if the practice vaccination rate falls below 90%.

The MDU advice, above, indicates that doctors should explain in detail the safety concerns around vaccines. Concerns which moved the US Supreme Court to describe vaccines as “unavoidably unsafe products “ in 2011. (3)
The NHS payment scheme for vaccination appears to have a contrary motivation -to ensure children, through their parents, are pressured towards vaccination, keeping the practice rate above 90%, or lose income.

Has the Royal College of General Practitioners any advice for it’s members who may be perplexed, how they should respond to these conflicting messages ?

It may be bad enough that informed consent to vaccination is not presently taking account of the Montgomery decision, but if even some of the safety concerns re vaccines (detailed and referenced by previous responders) are soundly based, and correct, then the implications for the health and well being of children being vaccinated without proper consent, are potentially horrendous.

For the peace of mind of parents, and the well being of children, present and future, will someone please explain if this is not so ?

We are often reminded that it is important that whistle blowers are listened to, whenever and where ever they are. Especially so in the NHS.
The concerns about safety of vaccines, and the necessity for fully informed consent before vaccination, have come from many quarters, for many years. More akin to a trumpet, than a whistle.

It is an interesting coincidence that this debate occurs soon after the BMJ decided to disenfranchise readers, and visitors to this website, by removing their use of a tick box.
Despite the current fashion to offer more involvement to consumers and patients, in decision making, perhaps there are limits to the amount of anti-establishment sentiment, that can be allowed to surface ?

1 http://www.bmj.com/content/358/bmj.j4100/rapid-responses

2 https://mdujournal.themdu.com/issue-archive/issue-4/informed-consent-a-y...

3 http://www.nejm.org/doi/full/10.1056/NEJMp1102182?viewType=Print

Competing interests: No competing interests

29 September 2017
Noel Thomas
retd/ part time GP
BronyGarn, Maesteg, Wales CF34 9AL