Three cheers for the five-in-one jab

Now that I have a baby, naturally only one news story has made it into my head in the past six weeks – the plan to introduce in the UK a new five-in-one vaccine for infants (1).

The new combined vaccination will protect children against diphtheria, tetanus, whooping cough, Hib and, for the first time, polio in a single shot. And as my daughter comes up for her first round of jabs against these strange and serious diseases, forcing me to register their existence for the first time, I find myself more bewildered than ever by the UK’s increasingly vocal anti-vaccination lobby. Surely anything that reduces your child’s chance of getting a disease, the number of needles stuck in her arm, and the number of trips you have to make to the doctors to get the jabs is a good thing? Or am I missing something here?

Well, sleep deprivation makes you a bit slow, but in the case of the five-in-one vaccine it’s the scare stories that are stupid. The arguments ranged against the five-in-one jab are utterly unconvincing from a health point of view – all they seem to do is to build supposition on to superstition, leading to a mystical condemnation of the new vaccination, the old vaccination, and any other vaccination.

So the alleged problems with this new jab have been raised by those leading the claims that the triple MMR vaccine causes autism (which it clearly does not). Yet because of these unfounded claims about the triple MMR vaccine, this different five-in-one jab is labelled problematic – even though infants are currently given a quadruple jab, which has never been raised as a problem before. And because the new jab does not contain mercury, apparently making it a bit safer than the old jab, the old jab is suddenly labelled dangerous – even though the evidence provided by all those babies who survived the quadruple jab without ill effect clearly indicates that it is not.

Parents who swallow this stuff are then left with the choice not to vaccinate at all (as all jabs are apparently as bad as each other) – until officials from the Department of Health wade in and start threatening their children with whooping cough. What a fuss about nothing.

Unfortunately, though, it’s not nothing. The reaction against the five-in-one vaccine has no scientific basis, but so potent is today’s climate of irrationalism and mistrust that it does not really need one. What the anti-vaccine lobby is expressing is not a well-considered problem with a particular medical intervention, but the neurosis of our pathetic, pampered risk society. The fact that some unfounded superstition that a new vaccine might be a bit dodgy simply because it’s new gets elevated to the status of a problem with the national childhood immunisation programme indicates how short our memories have become, and how individuated our concerns.

As Dr Michael Fitzpatrick explains in his new book MMR and Autism, today’s parents are a generation for whom the reality of serious childhood diseases is simply unknown. Parents come into his surgery accompanied by a cheerful child with a few spots and ask if the child has measles and are shocked if their child’s illness is likely to last longer than a couple of days. The characteristic features of measles, ‘the racking cough, the sunken, inflamed eyes and the peeling skin’, barely feature in Britain today; nor do the ‘two weeks of unremitting toil, caring for an often-inconsolable toddler who is likely to demand attention day and night for the duration of the illness’.

That such devastating illnesses as measles, polio and whooping cough have been virtually eradicated from countries like Britain is a remarkable achievement, and shows the debt that we, as a society, owe to mass childhood immunisation programmes. But the very success of immunisation has allowed the anti-vaccination lobby to take what looks like a cavalier approach to children’s health, by encouraging concerned parents to opt out of the schemes.

It’s all very well for the Department of Health to warn of the dangers of whooping cough facing children who forgo the five-in-one jab, but when parents do not really know what whooping cough is, this is not going to mean very much. Furthermore, when most children are immunised against whooping cough, the chances of your own, non-immunised child contracting the disease do seem pretty small. It’s not hard to see why parents who are suspicious of a vaccine prefer to take their chances – after all, you definitely inflict a vaccination upon your child, whereas there is always the possibility that they won’t get the disease, and even if they do you can put it down to bad luck. To reject giving a child a jab in favour of chancing it with the disease is to absolve oneself of responsibility – both for your own child’s resistance to illness and the fate of other children.

In today’s fragmented society, this kind of thinking is understandable – but that doesn’t make it right. Far from it. That the question of childhood immunisation can be presented as some kind of pick’n’mix option indicates the collapse of a broader, social understanding of what vaccinations are about, and how they work. There seems to be a mystical view that whooping cough, Hib and the rest have simply been magicked away, rather than a recognition that they are kept at bay by mass immunisation, and should immunisation drop off, there is no reason why they shouldn’t come back. Protecting society against these diseases is not simply a matter of your own child’s health, but of the health of children generally; and once people start opting out of mass programmes, the programmes stop working and all children are put at needless risk.

Which is why all this nonsense about the five-in-one jab needs to be stopped in its tracks before it gains credibility. Through vaccination programmes, science and medicine have saved many children from horrible, often fatal diseases; through irrational scaremongering, the anti-vaccination lobby is jeopardising one of society’s biggest public health achievements. Take your pick.

Read on:

spiked-issue: MMR

(1) Five-in-one baby jab plan unveiled, BBC News, 9 August 2004