Measles: the bitter results of a rash panic
When middle-class parents turn their noses up at the MMR vaccine, it increases the risk of disease for everyone's children - especially those in poorer families.
At our medical practice in Hackney, east London, which is at the centre of the capital’s current measles epidemic (150 cases in three months), we have noticed that while our middle-class patients are more inclined to reject the combined measles, mumps and rubella (MMR) vaccine, our more disadvantaged children are more likely to get measles.
As a consequence of the long-running scare connecting the MMR vaccine with an increased risk of autism, some parents, influenced by the promotion of the scare in the media, have refused to have their children immunised. These parents tend to be from the professional and chattering classes, with an outlook that combines scepticism towards mainstream medicine with credulity towards alternative sources of authority. At the same time, there has always been a group of children - in families of newly arriving immigrants, travelling communities or suffering other forms of social exclusion - who have fallen behind in receiving vaccines.
As a result of the convergence of these two groups - active resisters and passive defaulters - the overall level of coverage in our local community dropped from around 80 per cent a decade ago to little more than 70 per cent, though it has recently recovered. (Uptake in inner-city areas, particularly in London, has always lagged around 10 per cent behind the national average.) Because measles is a highly infectious disease, a coverage of 95 per cent is required to guarantee ‘herd immunity’ against regular outbreaks. The only surprises about the current outbreak are that it has not happened sooner and that it is not even larger.
While discussions with privileged parents about the utterly discredited claims of a link between MMR and autism continue in our baby clinics, in our surgeries we are seeing children with measles who come exclusively from poorer families. Though in most cases measles produces several days of high fevers, a hacking cough, sore streaming eyes and a blotchy rash, in a small proportion of children it causes pneumonia and ear and brain infections, occasionally causing lasting disability (there have so far been 10 hospital admissions in Hackney). Of course, measles is more severe and more likely to cause complications in children who have existing health problems. It is a particular threat to children whose immunity is suppressed by disease or treatment, who cannot receive the MMR vaccine (which contains live ‘attenuated’ viruses).
It is worth noting that the measles virus itself does not discriminate. Around half of the deaths in recent outbreaks in Europe have been in children who were previously in good health.
In response to the current outbreak in Hackney, we have renewed our efforts to persuade all parents to give their children the MMR vaccination. Now that the anti-MMR campaign is history, it is a good time to point out to every parent that MMR not only provides the best protection for their own children, but also the best protection for the whole community.
Dr Michael Fitzpatrick is a GP in Hackney, London, and author of MMR and Autism: What Parents Need to Know (buy this book from Amazon UK and The Tyranny of Health: Doctors and the Regulation of Lifestyle (buy this book (buy this book from Amazon UK). This article was first published on Comment Is Free.