Blaming mummy for MMR

When did the heat move from Wakefeld and the media, to parents?

On Thursday I saw a tweet asking “what kind of C*** stops their child having the MMR anyway?” I have to say, this kind of switch in dialogue around where blame lies sets my teeth on edge. And there’s a good reason for that.

I don’t have children, yet. I hope to have a few some day but I have worked with them in my role as an ABA tutor (Applied Behaviour Analysis – used in this case for children diagnosed with Autism Spectrum Disorder), helping frazzled parents cope with the bureaucracy of the Local Education Authority, their child’s education establishment and the demands (which I recognise are many) of running a successful ABA programme. Not to mention the normal stressors parents face and the additional difficulties of having a child who needs extra care, education, help and attention.

Ask any parent of a neurotypical child and they’ll tell you sometimes they struggle to have enough time to go to the toilet in peace.

So when I see someone decrying parents’ fears over the MMR I get pretty angry. I can well understand, based on my affection for my tiny dog (I know, I know – it’s not the same – but it’s what I’ve got!) that parents spend their time worrying constantly about their kids. At the height of the scandal, in 2001, Cherie and Tony Blair were widely criticised for asserting MMR was safe whilst at the same time avoiding confirming their infant son Leo had been vaccinated. This also is nonsensical. My medical records, your medical records and Leo Blair’s medical records are no one else’s damn business. Cherie later confirmed, in her autobiography ‘Speaking for myself’, in 2008, that he was vaccinated, but many children have health reasons that preclude them from immunisation.

Given we’re now reaping what Wakefield first sowed in 1997 – 808+ infections of teenagers (as of reports on the 18th April 2013) and the death of 25 year old Gareth Williams in Swansea – it’s time to really think about health information and how it’s disseminated.

Much light is made of the Daily Mail’s list of what will kill or cure you of Cancer but unfortunately I’m going to give them a break and side with them. A bit. Last week, on my way to work, I heard about new research stating that women who drink one glass of wine when pregnant could, instead of damaging their baby, end up with a more intelligent child. The radio report ended with a confirmation that Department of Health advice to avoid all alcohol during pregnancy remains unchanged. Health advice, from the point of view of the layman, seems to just keep bloody changing (changing, note; not developing). It was the same when I was born in the mid-80s – advice on whether to lay your child on her front or back when sleeping had just changed. My mum sleeps on her front, I sleep on my side. “Scientists can’t make their bloody minds up!” comes the cry. You can hardly blame sleep-deprived parents of one year olds for being reticent.

So what’s an expectant mother – or a new parent of a 12 month old, a month away from getting the MMR, in 1998-2001 to think? Should I give my precious child the MMR injection and risk him developing Autism or should I take the risk he’ll develop measles? An illness most people have never seen the full effects of? Herd immunity has been so high, historically, most people had never met or remembered someone with a bad case of measles, mumps or rubella. “Anyway, it’s unlikely just this one kid is going to have that much of an effect on herd immunity.” Or so they think.

Anti-vaccination arguments are powerful and emotive . Powerful and emotive is, to me, just another way of saying ‘damn convincing’. The trouble with Scientists, despite their perceived air of authority, is that they just don’t talk the same language campaigners do. They don’t come out with things that seem plausible and obvious to the ill-educated on the subject of vaccinations – “a child can’t cope with three vaccines at once!”

I don’t blame parents for being frightened- especially those with little to no real knowledge of how vaccines work or are developed and tested. They simply don’t have time to do all the research and when your daily newspaper, talking to you in language written for you, tells you there’s a debate and a controversy to hear about vaccines I think you could be forgiven for making what seems a logical risk-benefit analysis to make. Risk measles – that few people suffer from (they thought) or risk a developmental disability that will affect my child’s, and my life forever. Seemingly no contest.

Health information does change and develop and there is, rightly or wrongly, suspicion around Big Pharma and a perceived authoritarian government. I think if skeptics really want to get their point across about vaccines they have to do the following (and it involves a lot of work!)

– go to meetings of anti-vaxxers (like my friend Simon Clare did) and find out what their actual arguments are. Some are misunderstandings, some are twisted facts. They are many and they are fickle.
– Actually learn how vaccines are made and developed. Find out about their history – it’s more complicated and involved than you may first imagine
– Learn to speak the language of emotion and rhetoric – stories are powerful but numbers are not.
– Rebut specific claims rather than boldly asserting vaccines are safe. Realise some vaccines have been improved and ingredients removed (not because of the danger – because of public perceptions surrounding safety)

– Find really good, hard hitting evidence that’s easy to demonstrate where specific claims are incorrect. This graph is an excellent example (from http://www.medicine.ox.ac.uk/bandolier/booth/vaccines/nommr.html, accessed 21/04/2013)

Graph showing, persuasively that ASD diagnoses continued to rise after MMR was withdrawn in Japan in 1992

Cumulative incidence to age 7 years

NO EFFECT OF MMR WITHDRAWAL ON THE INCIDENCE OF AUTISM: A TOTAL POPULATION STUDY

As I prepare to write a forthcoming Skeptics in the Pub talk on the history and development of vaccines I hope to write and learn more and do some activism around public awareness. Stay tuned.