Intended for healthcare professionals

Rapid response to:


Measles: Europe sees record number of cases and 37 deaths so far this year

BMJ 2018; 362 doi: (Published 20 August 2018) Cite this as: BMJ 2018;362:k3596

Rapid Response:

Re: Measles: Europe sees record number of cases and 37 deaths so far this year

I apologise for not replying to David Oliver earlier: it was not because I was deliberately with-holding my reply but because of the range of issues he had raised and the present limits of my physical strength. Herewith are some of the points that I intended to go into in more detail, responding also to his latest letter:-

I believe the government’s position has always been that given the high coverage achieved (probably higher than that in the US where they have mandates) there was no point in courting political controversy by making vaccination compulsory. I have seen a letter from a year ago - the DH replying on behalf of the PM - stating this as still the position. Note also - even with Andrew Wakefield who advocated the use of single vaccines spaced out when they were still an NHS option - that there have only been four measles related deaths in the U.K. since 1992. Given how many millions of people will have died over the period (~15m?) I am not quite sure how great the imperative is in relation to so many others within the national health?

Meanwhile, in Italy we have seen the centre left coalition overthrown, because they were being dictatorial, but also through their lack of transparency over deals with the industry (a matter which I have documented). People across the globe will have no idea why Italian people were filling the streets last summer, and you could not even have read it in an Italian mainstream newspaper, such is the industry hold over mainstream journalism.

And here we come to a major issue which is how open we can be about the vagaries of the global vaccine industry. By and large it has been deemed necessary to keep the industries failures out of public view, and keep a muzzle on legitimate concerns because of the alleged pubic good - ie it plays by different rules to normal public debates. It is not I believe often enough false information that the lobby wants to stop circulating on the web (since criticism is already virtually excluded from mainstream sources) but much bona fide information which would be much more damaging to the industry in the long run than things which can simply be shown to be false rumours. For instance, under a normal dispensation the controversy within Cochrane over HPV vaccines would a major public news story, and I am very far from certain that the virtual news blackout is serving the interests of the public rather than just that of the industry.

To put it another way round, how far can the industry/lobby (as the schedule grows and grows at public expense) withstand reasonable public scrutiny?

If I was Secretary of State for Health and Social Care I would certainly be backing off mandates (which would be socially divisive) or compulsion, and I would want greater distance between myself (including all the offices of government and state), and the lobby. Also we can see how the swine flu episode in 2009 (and it’s pre-curser the avian flu episode) distorted public policy: we do not need a repetition.

Competing interests: No competing interests

02 September 2018
John Stone
UK Editor
London N22