Dani Garavelli: Injection of sanity needed

LET'S get one thing straight from the outset. I accept unreservedly that there is no scientific evidence to substantiate fears the MMR jab is unsafe.

I want to clear this up because otherwise I will be lumped with all the "scaremongering" journalists the government blames for causing the backlash against the triple vaccine. (That's the same government whose then Prime Minister refused to reassure the public by confirming his own son had been given the jag, but hey, it's always someone else's fault.)

I guess I believed MMR was pretty much risk-free a decade ago, in the days before Dr Andrew Wakefield – the doctor whose research suggested a link with autism – was discredited, because I allowed each of my children to have both the original jag and the pre-school booster, even though my fear of autism was always far greater than my fear of measles.

I wasn't one of these mothers who agonised over whether or not to take them to France or to a private clinic for single vaccinations, although I do think the government could have done much to head off the backlash by offering those jags on the NHS until public fears were assuaged.

I realise too the fact MMR uptake has fallen below the 95 per cent required to guarantee herd immunity has potentially serious consequences, with measles outbreaks now occurring in several parts of the country. But none of this makes hearing former BMA chairman Dr Sandy Macara calling for the MMR to be compulsory for all children who wish to receive the benefit of a state education any more palatable.

A throwback to a bygone era – where the word of the doctor was law – Macara clearly believes trying to compel an already distrustful section of the population to have an injection they don't want will solve the problem. This being the case, I don't see why he isn't calling for it to be enshrined in legislation. That's what happened with smallpox vaccination in the 19th century – and a very unpopular policy it was too, but at least it applied across the board. There is something inequitable about the suggestion that only those who choose to home-educate or can afford send their children to a private school should be granted immunity (or rather the right to no immunity).

Of course, the debate over compulsory vaccinations isn't really about the safety of MMR, it's about our rights to exert control over our own bodies. If we accept the state should have the power to force us submit to any medical procedure it considers in our best interests, then why stop at vaccinations? Why not fit gastric bands to anyone with a BMI of more than 40 and sterilise drug addicts while we're at it?

The suggestion that making MMR a pre-requirement for entry to school will somehow sway sceptics in its favour betrays a lack of understanding as to why so many turned against it in the first place.

Yes, I know, as we discussed, it was all the press's fault. And I suppose it is true that many newspapers did keep running scare stories after Dr Wakefield's conflicts of interests were exposed. Back in 1998, though, Wakefield was not a pariah, but an esteemed physician and senior lecturer with the Royal Free Medical Hospital in London and his research was published in the prestigious journal The Lancet.

It wasn't so ridiculous, then, that it should have been treated with a degree of credibility, particularly since it was being assessed against of a backdrop of a lack of faith in the medical establishment fuelled by BSE/CjD scare and the Harold Shipman scandal.

Today, very few journalists are still pushing the anti-MMR line, yet websites on the subject continue to attract a large number of anti-vaccine posts. By and large these commentators are basing their opinions on their own experiences. Either their own children or the children of close friends have been diagnosed with autism shortly after having their MMR and no amount of explaining that 12 to 15 months (the age at which the jag is given) is precisely the age you would expect autism to manifest itself can convince them there's no link between the two.

Macara is backing compulsion because he says medical professionals have failed to win such people round, but they never really tried. From the beginning, they adopted a condescending attitude, dismissing those who were trying to make sense of the conflicting reports as neurotics rather than confronting their concerns. Now they are further insulting their intelligence by over-stating the danger of a measles outbreak (according to the Office for National Statistics in 1994, four years before Wakefield published his research, there were 16,375 cases of measles and no deaths, in 2007 there were 3,700 cases and one death).

They also insinuate the drop in the take-up is due solely to worries over the vaccine's safety, but have they asked themselves why it is so much higher in London than elsewhere? Are Londoners really more susceptible to scare stories or could it be that more people in the capital are likely to fall through holes in the healthcare system?

And why is the take-up of the pre-school booster so much lower than the take-up of the original jag? The parents of these children can't be objecting to MMR on principle. Could it not be that the importance of the booster has just not been hammered home? Moreover the attempt to portray refuseniks as selfish people putting the rest of society at risk is only likely to make their hostility more entrenched.

Personally, I suspect the battle to rehabilitate MMR will be won as soon as parents perceive measles as a real threat. In the meantime, I think the government/health authorities should try to stop obsessing about the damage the Wakefield debacle caused; put an end to the moralising, the blame-laying and the exaggerated claims of danger, and finally start talking about MMR in a mature, open and honest manner.