Mumps vaccine: swollen concerns

The government’s latest response to the scare over the measles, mumps and rubella (MMR) vaccine is to launch a counter-scare – over the safety of one of the single mumps vaccines that have been imported to meet the demand from anxious parents who have chosen this alternative to the triple jab.

But experience shows that counter-scares are likely to be counterproductive.

‘Please activate the cascade.’ This is the red alert heading on the ‘urgent message’ faxed from Dr Pat Troop, the deputy chief medical officer, to GPs and other frontline health service staff last week. The fax announced the government’s decision to suspend the import of Pavivac, a mumps vaccine produced in the Czech Republic, because of concerns over the ‘manufacture, testing and storage’ of the vaccine.

The message did not specify what these concerns are, though after explaining the necessity of storing the vaccine at temperatures between minus 20 degrees and minus 10 degrees Celsius, it indicates that ‘current information suggests that the vaccines have been stored correctly’.

So what is all the fuss about? It is only in the lengthy ‘Q&A’ supplement that the real object of this exercise becomes apparent, as Dr Troop, with scarcely concealed glee, sets about turning the prejudices of the anti-MMR campaign against the single mumps vaccine.

Moving rapidly on from the non-issue of cold storage (with a quick reminder that ‘it is not too late to have MMR’), the supplement slyly notes that ‘concerns have been raised about ‘TSE’ (transmissible spongiform encephalopathy, aka mad cow disease); ‘do the same concerns exist with this vaccine?’.

In fact, the only concerns that have arisen about mad cow disease relate to one brand of the polio vaccine (not MMR) that may have used indigenous rather than imported beef products (as required under the new precautionary regulations).

But, as Dr Troop is well aware, concerns about mad cow disease run high in the same middle-class, environmentally-aware, constituency that is worried about the risks of MMR. So this seemed a good opportunity to raise the spectre that the single mumps vaccine might be contaminated with some form of a transmissible, untreatable and rapidly lethal, neurodegenerative disorder.

In the true spirit of the Phillips Report into the mad cow crisis, which criticised the old Tory government for issuing categorical assurances that beef was safe, the New Labour Department of Health carefully avoids any assertion that the mumps vaccine could be considered safe. The best that it can offer parents for whom fears of autism are now joined by fears of Creutzfeldt-Jakob disease is the bland statement that ‘the Medicines Control Agency is urgently seeking additional information on this issue’.

Some people have objected to the MMR vaccine because its rubella component is grown in a cell culture using a line of human cells originally derived from an aborted fetus; others object to the use of chicken embryos in preparing the measles and mumps component. But the government has trumped these concerns in its revelation to the great British dog-loving public that the imported mumps vaccine contains canine proteins.

‘Is there a safety issue for children who are hypersensitive to dog antigens?’, Dr Troop enquires, with puppy-like innocence. ‘Yes’ comes the terse reply. She continues, observing that the data sheet warns of ‘the possibility of allergic reactions in individuals who are hypersensitive to dog protein (dog hair)’. What? Dog hair in vaccine from a former communist regime of which we know little? Can we be sure it doesn’t also contain anthrax spores or bubonic plague bacilli?

‘How come I wasn’t advised about the presence of dog protein in Pavivac?’ is the next question, eagerly put into the mouths of the sort of parents who are not reluctant to assert their rights as consumers to full product information. The answer is that ‘the doctor giving the vaccine is responsible for talking you through these issues’. On behalf of all those doctors who have spent hours talking anxious parents through the issues of MMR, Dr Troop seems to be determined to make sure that the private clinic doctors who have been doing a brisk business in giving single vaccines for cash are now called to account.

This is all good fun, and the anti-MMR campaigners richly deserve this dose of their own medicine. The squeals of outrage from Direct Health 2000, one of the private clinics that has profited from the MMR scare, confirm that the Department of Health’s barbs have hit their target.

Having been the beneficiaries of all the scaremongering over MMR, they are aggrieved to find themselves at the receiving end of what they call ‘appalling scaremongering’ over the mumps vaccine.

The real casualties of this war of scares are parents whose children are due for vaccination. The government has already tried a campaign of reassurance over MMR, and it has also hyped up the risk of new epidemics of measles if parents fail to get their children immunised. Neither approach has succeeded in reversing the decline in uptake of MMR as parents have become paralysed by rival sets of fears.

The lessons that might have been learned from this experience are that people who are in a state of anxiety are not susceptible to reassurance – and they are even less responsive to counter-scares.

Dr Michael Fitzpatrick is the author of MMR and Autism, Routledge, 2004 (buy this book from Amazon (UK) or Amazon (USA)); and The Tyranny of Health: Doctors and the Regulation of Lifestyle, Routledge, 2000 (buy this book from Amazon UK or Amazon USA). He is also a contributor to Alternative Medicine: Should We Swallow It? Hodder Murray, 2002 (buy this book from Amazon (UK) or Amazon (USA)).

Read on:

spiked-issue: MMR