Angry doctors left in the dark over five-in-one jab

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FAMILY doctors have condemned the way the government handled the introduction of the controversial new five-in-one vaccination, with many saying they learned of the move through the media.

A straw poll of Scottish GPs found almost universal support for the vaccine itself, but widespread anger and frustration at mishandling of the announcement. Many said that as a result they were unable to prepare for questions from worried parents about the new jab.

News of the vaccine, and the phasing out of the present whooping cough jab, which contains mercury, was leaked last weekend.

The government had been planning official confirmation just a few days later, with an introduction of the new injection as little as a month away.

Dr Alan McDevitt, assistant medical secretary of the Greater Glasgow local medical council (LMC), said he supported use of the vaccine on the evidence he had received.

However, McDevitt said he had not received the detailed information needed to make an informed decision until days after he first heard the news on the radio last weekend.

He said he only received a report from the Chief Medical Officer, along with electronic updates to the ‘Green Book’, the doctors’ bible to immunisation, four days after the information was made public.

He said: "Normally new developments filter down in a cascade system, and the professionals know about them before the public are made aware. If there is some sudden development or something is leaked, then a fax is sent out to practices.

"However, for something like a new vaccine there is too much information to simply send a fax. Professionals should be fully informed, ideally before something like this is made public. They should not have to give speculative advice to patients based on what they have heard and read in the media."

One Edinburgh-based doctor called it a "national mix-up". He said: "The first I heard was in the Sunday papers. I realised that I had better know something about this for Monday morning, because there would be patients there wanting information."

Some doctors feared the confusion could lead to concern that the public might turn against the quintuple jab, despite universal agreement that it is an improvement on earlier vaccines.

Dr Norman Johnston, from Abelour, Banffshire, said: "I think this will have put the wind up people. I’m not sure how it was supposed to have been released, but we never received any official notification."

Other GPs said the lack of early information was something doctors had started to expect.

One doctor who works in the Borders and asked not to be named, said: "It was badly handled and gave us little warning, but sadly that is little surprise, since these things are almost always handled badly.

"It was said to be a leak, but these things are almost always a ‘leak’. There has been considerable concern from parents over the introduction of previous injections, so it seems odd that the this should be sprung upon the public and doctors in such a sudden style.

"While I do believe that they are safe, I can understand the well-founded concern and confusion amongst parents that that causes. It is ironic, because I imagine the vaccine will be welcomed by almost every health professional."

Of the 40 GPs we spoke to, none opposed the five-in-one jab but almost two-thirds believed the government had in some way mishandled its introduction.

The nurses’ union said last night it had been flooded with approaches from concerned parents looking for guidance on the injection since the bungled announcement.

Shirley-Anne Somerville, spokeswoman for the Royal College of Nursing (RCN) Scotland, said: "Nurses were inundated with queries from concerned parents during the week - a situation which could have been avoided if the announcement had been made in a more orderly and managed manner."

She added: "RCN Scotland is concerned about how this news was made public as it has understandably caused anxiety and confusion for parents across Scotland.

"Given the controversy surrounding child vaccinations in the past, it is imperative that any changes are accompanied with clear information."

David Davidson, MSP, Conservative spokesman for health said: "Quite frankly, the ministers have messed up. The normal procedure for bringing in a new product is that doctors receive data sheets about the product which gives all the information, but that did not happen."

He added: "It will cause a crisis in confidence, just as we had over the MMR, where there is far too much political interference in the normal processes of medicine.

"The whole purpose is to improve the immunisation profile of our young children, and to do that best after the farce of MMR is to make sure that GPs have the information in order to counsel parents so that the parents can make a choice with proper advice."

Parents’ groups added that government had failed to learn despite the concern caused by the MMR jabs.

Jackie Fletcher, founder of the parent support group Jabs (Justice, Awareness and Basic Support), said: "To say that the manner in which this was announced was mishandled is to put it mildly.

"It showed, once again, the problem of having a vaccination policy made behind closed doors and without public consultation.

"On the face of it, this seems to be an improvement on previous vaccines. But if doctors and parents don’t have access to full and transparent information, how can they make their own minds up?"

Others pointed out that GPs received enormous amounts of information every day, and that receiving the news at the same time as the general public posed no serious problems.

Dr Peter Dolan, secretary of the Highland LMC, argued that the announcement of any new vaccine was a difficult thing to get right. He said: "I think the government were on a sticky wicket whatever they did.

"If they had announced it too soon they risked causing a drop off in the number of children that take up the current vaccine, leaving them exposed. As it was, it took some doctors a little by surprise."

However the Scottish Executive argued that a Saturday newspaper had obtained the information ahead of the planned release date.

A spokesperson said: "We had intended to communicate the improved arrangements to the health service and the public at the same time this week and had planned a full factual briefing for the media.

"A CMO (Chief Medical Officer) letter explaining the improvements, accompanied by a factsheet, was issued to the health service, including GPs, through the usual channels.

We took the earliest opportunity to explain the details to the public, health professionals and the media on Monday and ensured public information was made available."

Fears and Assurances

JANUARY 2003 Authorities in the US begin withdrawal of thiomersal from vaccines, warning of ‘biologically plausible’ link to autism. The mercury compound was present in a series of child vaccines available in the UK. The Scottish Executive issues a letter to GPs claiming reports of the link are ‘misleading’.

FEBRUARY Parents told that if they want a mercury-free whooping cough vaccine then they must ask for it.

AUGUST UK health authorities opt for new mercury-free five-in-one jab. Doctors not told about decision. Date for the switch to depend on when supplies are available.

SEPTEMBER Scotland’s Chief Medical Officer issues a letter to Scots GPs insisting vaccines with thiomersal are safe.

MARCH 2004 Study emerges in the United States which links thiomersal to an increased incidence of autism in children.

MAY Leaflets reassuring parents over thiomersal are still being issued to GPs.

JUNE It emerges that researchers at Columbia University in the United States had found autism-like damage in the brains of mice exposed to thiomersal. With supplies of the new vaccine available, the UK health authorities give go-ahead for the switchover to the new five-in-one vaccine.

JULY Launch of new vaccine set for Wednesday, August 11.

AUGUST 6 Details of new vaccine are leaked to newspaper, the formal announcement is brought forward to Monday, August 9.

AUGUST 7 Leaked report on new vaccine published. Critics of vaccine policy react with fury to the prospect of a new combined five-in-one jab. Executive refuses to comment in advance of formal briefing.

AUGUST 9 The new vaccine is launched amid turmoil over its safety and concerns whether a two-month baby’s physiology can cope with a five-in-one injection.

AUGUST 12 Dr Nigel Higson, chair of the Primary Care Virology Group, calls for resignations in the department of health over the bungled announcement.