To think my doctor has overstepped the mark by sending me this letter?

[evilplaguerat]

I am a regular but I'm afraid I have namechanged because there WILL be hostility on this thread

Basically my ds2 hasn't had all his preschool immunisations, because when we received his initial appointment we deferred it because we really weren't sure we wanted him to have the MMR booster (I KNOW what many people think of this attitude, I really do)

I've just had a letter from our GP which starts

"Dear Mum and Dad

It is with some alarm that I've heard from our practice nurse that XXX has not attended multiple appointments for his preschool immunisations"

whatever you think about children not being immunised - does my GP have the right to order me to immunise him? Or am I right in feeling that it's legally our decision and the letter is inappropriate?

To be clear - I'm not asking for views on parents deciding not to immunise (although I realise I am going to get them anyway), I'm asking about the legal position of the parents and the GP and whether he can in fact strong-arm us into having them if we don't want to.

Wow, you guys sure read quick.

Qally what is your problem with me exactly?

Why are you being so rude and engaging in personal attack? Your above post implying that I am not in full possession of all my marbles is just plain weird. Trying to make out that people who question vaccine safety do so because they are loons who will believe anything is a common tactic used in underhand and dishonest debate.

It's a shame if you can't bring yourself to actually read what I have linked to before attacking it but it does strongly suggest that as you say we have little to say to each other on this issue.

That's cool by me. I only really posted the above links because they just might be of interest to other people.

I would, however, appreciate if you could stop lying about what I have actually said on this thread.

I skimmed/speed read/concentrated on conclusion discussion looked at sources and checked/cross referenced/googled some of the authors.

Your comment about the 480 page one being long put me off a bit!

Who's lying? Where?

By the way Qally JABS is not 'an hysterical anti-vax campaigning pressure group', it is a support group for the parents of vaccine damaged children (remember them in all this posturing and debating. This is not about scoring points but about children's health be they vaccinated and damaged by vaccines or damaged by infectious disease).

Your blasé personal attack on this support group is crass and in poor taste.

"Qally what is your problem with me exactly?"

You as a person? None. I don't recall other posts of yours, but I would imagine you're probably very kind. In fact in other contexts I would imagine we'd get on very well, as it happens. After all, the MMR hysteria comes from anxiety about children, not a desire to start Armageddon or torture puppies. But I have a major issue with wholesale misrepresentation of science when it means people are not getting the protection we all need against disease. You are misrepresenting the science badly, and that is almost certainly unintentional, but it's also disturbing when immunisation rates have been as low as 85% for no genuine reason. You're arguing about scientific data, and yet you are trying to weigh a feather against a leaden anchor and insisting that one counters the other perfectly effectively. I'm afraid the only conclusion is you genuinely don't understand the weight of the competing evidence, because at this stage in the debate the evidence is overwhelmingly on one side. You haven't any convincing response to the questions I asked because quite frankly there IS none.

Can you really not see that you are yourself linking to places that say mercury causes autism (not in MMR) thimerosol (never in UK MMR) mumps (high refusal rate for that component in Japan after the viral men. furore) - one of the weirdest thing about this whole mess is that the anti-vax campaigners aren't even arguing the same causal factors, internationally. You are not supplying any decent evidence and yet you seem to think, okay, someone's written this, it's nicely annotated and there are research references, it must be every bit as legit as respected peer reviewed studies by a team of leading scientists who are expert in the related fields. No, no and no again. It just doesn't work that way - this isn't scientific links snap.

This is why people's failure to trust epidemiologists is so very worrying - you can't read competing research and understand which is more valuable by guesswork, and you may well misunderstand minor caveats and believe your position vindicated. Cochrane's only concern about the MMR was a (systemic, NHS general) failure to properly and adequately report side effects. That needs to be rigorous, sure, and isn't good enough. But it's hardly unusual in the NHS, which is so incredibly bureaucratic, and that is light years away from saying Cochrane supports the anti-vax case when it most explicitly does not. You are patently not able to evaluate the competing evidence, frankly you're arguing in the manner of someone who has spent a long time in places where everyone agrees with each other and echoes mutual misapprehensions with increasing confidence.

I'm frustrated because this is all so pointless, and people will get unwell and some will actually die, and all for sod all. Do I hold you personally responsible? No, of course not, I'm quite certain your heart is determinedly in the right place and you genuinely think you are saving a generation from an easily preventable condition. Do I find credulous misinterpretation and blind trust of the essentially poorly qualified and/or self-interested frustrating? You bet.

I'm afraid I really am going to bow out from this thread now, because I've said my piece, it's comprehensively supported by all reputable research in the area, you won't ever listen with anything approaching an open mind so more is pointless, and I have a little boy who is hot, teethy, and needs me. I repeat: I have no beef with you personally, but I find the preventable and entirely unnecessary spread of potentially serious disease very worrying indeed.

Thanks, but I don't really need patronising homilies on consideration for SN people. You have absolutely no idea of my personal circumstances, so I'd appreciate it if you didn't make assumptions.

Blimey Qally. Fantastic posts.

"Trying to make out that people who question vaccine safety do so because they are loons who will believe anything is a common tactic used in underhand and dishonest debate."

And beachcomer the above is a disingenuous, slippery and dishonest point of argument.

In fact, neither qally nor any official body nor research centre have any problem with the concept of questioning the safety of vaccines. In fact, it happens all the time, as public health programs, their efficacy and safety are constantly reviewed and trialled, and programmes are started and stopped on the basis of the evidence found. Vaccines have been found to be unsafe or unnecessary and thusly not used.

That is indeed one reason why there are so very many studies into the safety of MMR and possible links with autism. Because despite the tininess and conflict of interest of the Wakefield study, the science community went into overdrive to see if there was any truth to the suggestion of an MMR/autism link.

It is not your questioning vaccine safety that makes people have a problem with your posts. It's that you don't see to be able to apply scientific rigour to that process, or indeed even understand basic scientific processes and logic and how experiments and statistics lead to conclusions. So you seem to genuinely think that some evidence-free accusations by a pressure group or friend of Wakefield with a vested interest stand as some kind of argument against vast scientific studies carried out according to rigorous scientific principles by people with no vested interest. Can you not see that vested interests and self-contradictory statements and constant goalpost-moving do not make a convincing argument?

I think the truth is you want there to be a link and you will cling to the tiniest suggestions of evidence for that in the face of massive evidence against that. But once you let desire for a certain result influence your assessment of the available evidence, science has gone out the window I'm afraid. So at least don't pretend that you are arguing on a scientific basis, because you aren't.

"It's a shame if you can't bring yourself to actually read what I have linked to before attacking it but it does strongly suggest that as you say we have little to say to each other on this issue."

Its not necessary to read all the stuff you linked to. The first thing to do is see who wrote it and who published it/sponsered it. Your link no 8 was written by the campaigning parent of an autistic child, a parent with a clear agenda and bias and little to no credentials whatsoever. It was published by a anti-vax group again with a clear agenda and bias. No credible sources or information, just conjecture and misrepresentation.

Why on earth would anyone read the whole thing?

Qally,
I'm appreciating your posts. I'm scientifically literate, but still wrestling with the decision to give my daughter the MMR booster, given that she has an autistic brother.

The figures you give for the cohort studdy are large, yes, but the argument that still bugs me is the suggestion that only a small subset of autism cases might be triggered in this way, in already susceptible children. With autism rates of roughly 1% of the population, and the suggested subset being 6 to 7% of these (probably misquoting MrsTurnip's half-remembered posts here), I make that a difference of 300 to 400 children. Would that show up in whole-cohort statistics? Maybe it would, but I think you'd expect a variation of several hundred either way in any case.

My concern is not that vaccination causes autism, but that genetically autistic children (for want of a better term) may respond very badly to some vaccinations, and that the statistics on this reactions of, specifically, children in autism-prone families are not necessarily being collected.

(After all, we accept that some people react idiosyncratically to all sorts of things egg, milk, bee stings regardless of whether the statistics for the population as a whole bear this out.)

If these data ARE being collected and still show no increase, that's great.

"Providing treatment to a patient that is not clinically needed and misleading patients as to the clinical need for a treatment so as to vitiate their consent can mean the administration of the treatment is a criminal offence: Appleton v Garrett (1995) 34 BMLR 23."

Mumps Vaccine "Unnecessary" Says BMA
According to The British Medical Association ('BMA') and The Royal Pharmaceutical Society of Great Britain (RPSGB):-

"Since mumps and its complications are very rarely serious there is little indication for the routine use of mumps vaccine": British National Formulary ('BNF') 1985 and 1986
That's from the following website which makes for interesting reading:
homepage.ntlworld.com/clifford.g.miller/risks.html

Oh puhlease! Your link says both that mumps isn't serious enough to warrent vaccination, and then that it makes yer balls shrivel up and die. Which is it?

the 1986 bnf quote is 20 years (and about 40 editions) out of date. They are updated every 6 months and the current edition (march 2009 - no. 57) says nothing of the sort.

I can't help wondering if you would be as upset about it if they hadn't bothered to get in touch at all regarding your childs immunisations.
The doctor only put "with some alarm" not really a disparaging remark is it? he clearly just wanted to get the point across that childhood diseases can be avoided and are in fact quite nasty if they are caught.
The problem with letters is they are sent to various people from all different backgrounds and every one puts a different slant on how they read it, surely the simplest thing to do would have been to make an appointment and talk to your doctor before having a huff about it?

Mumps and its complications are rarely serious?
Could it be because mumps is now quite rare due to widescale immunisation???

Mumps can cause orchitis and testicular atrophy, are you happy for your sons to suffer from that? Mumps when caught in the 1st trimester of pregnancy can cause a miscarriage. Mumps can cause deafness, inflammation of the brain, and even fatal meningitis. Before we had the mumps vax, there were on average 5 deaths a year in the UK from mumps, well into the 1970s.

It is grossly negligent to suggest that mumps is not something to worry about. Its not something we worry about anymore because most of us are immunised. However if the anti-vax campaigners get their way there will be a lot more mumps to worry about, as well as measles, rubella and more.

Ah, but all boys should get mumps before puberty, y'see.

taps nose

Then there would be no problem at all.

Oh and the bizarre conspiracy theory website you link to contains some of the most unscientific rubbish I have ever had the misfortune to read.
Nuggets such as "By 2007 the chance of anyone in England and Wales dying of measles if no one were vaccinated was less than 1 in 55 million"
You tell that to the parents of the infants who died from measles in the last fatal measles outbreak in Dublin. I'm sure they can put you straight on that statistic.

Lancielottie - my brother and my uncle were both diagnosed with ASD. As a result I shared your concerns - had done ever since I started thinking about having children. But my son's godfather works at the MRC and was able to put me in touch with researchers who said, hand on heart, as far as they can know (scientists' usual caveat in case anyone else thinks that is worrying!) it's fine. There really isn't any evidence indicating that a child who is genetically predisposed to ASD is going to have that triggered by the MMR - and people have been looking for that evidence for a fair time now. I do remember a scientist commenting in an interview that younger siblings of children with ASD almost never get the MMR, precisely because parents in your position are very reasonably concerned, yet still have a statistically significant increased rate of ASD themselves, and while you could of course argue that the number would be even higher if they were MMR vaxed, there's no evidence to support that, either. Afair the sole example where a the MMR was believed to have triggered autism was when a child with a very rare mitochondrial disorder had a febrile reaction to the MMR, and that caused damage, and in turn autism. But my understanding is that that febrile reaction could have occurred with a range of other illnesses as well - it wasn't in any way MMR specific. And measles is many, many times more likely to cause a range of severe complications, including febrile seizures, than the MMR.

Maybe try emailing someone who's done research that impressed you, and asking them to talk about it with you in more detail? IME scientists love an interested audience, as we all do, and they may also be in a position from conference attendance etc. to tell you if research of the kind you're talking is being conducted (seems quite likely). But in essence, there's no convincing evidence I've ever encountered that actually supports the idea of the genetically loaded gun. It's a suggestion without an evidential basis.

The problem is that so many people have become emotionally committed to the anti side, and whenever yet another piece of evidence shows no causal connection they wait till one of their group rubbishes it, however unscientifically, and then somehow feel that cancels out the new research. It isn't about finding the truth at this point, it's about a self-perpetuating campaign.

Having said all that, I don't think a parent in your position, with an autistic older child, could be blamed in the slightest for opting out, even though the evidence isn't really there on why you need to, because your first concern has to be to your child. It's not dissimilar to people who can't vax for reasons of allergy or family history or serious immune system deficiencies. But the vast majority are not in your position, and arguably owe it to parents like you to vax, so your children aren't likely to be exposed to infection.

All I can say is my 8 month old will be vaxed, despite having close relations with ASDs, and I'm genuinely not worried about it.

Haven't got time to read the latest posts on this illuminating thread so won't be answering any that might have been addressed to me, will look in later to catch up properly.

Just thought I would post this as it addresses quite a number of interesting points and makes references to the fact that the Institute of Medicine held a conference in 2007 in which it included vaccines in a number of environmental triggers that need to be researched in relation to ASD.

Here is an article on what they have come up with. Pretty incredible stuff, I had heard that the US was working towards this sort of thing, it is becoming increasingly difficult for the UK government to maintain their official position as things move forward in the US.

And more on the US situation with regards to official research into ASD, vaccines and a whole bunch of other stuff.

Similar situation here qally - DP's brother has Asperger's, and I suspect his dad might also be diagnosed ASD these days. So were were worried about DS and I asked all the doctors and scientists I could what they thought and read up on the evidence (and the counter-arguments). The lack of a link became fairly clear, but another tipping point for me was when one of DS's friends caught measles at 10 months. That did scare me.

Fark. Wish I hadn't clicked on this now but as I have...

YABU.
I told my GP I had no intention of vaccinating and discussed it with him.
he has no problem with my decision and has never bothered me since. He does need to check that people have no just forgotten or not bothered although he could have tried to reach for something a little less patronizing.

(the only time I am is at hospital where passing tosser feel obliged to try and discuss with you when a) you are obviously busy with said child and b)vaccination has nothing to do with why you are there.)

I can't (honestly can't) read through this stuff but having tried to skim could people try and wind down the yah boo sucks stuff. My son is one of those involved and whilst that gives me no greater right to an opinion than anyone else, it is very hard to see it beingtreated like a discussion on y-front or boxers.

I know too that tis an open forum and you can of course all post as you like . But thought I would ask anyway

I've missed 3 appointments for the MMR. not because I forgot but becuase he was booked for Measles 2 weeks ago as a separate (was too ill that day but would have been for MMR anyway so rebooked for next month)

I'd resent the letter as it would make me feel I didn't care- rather than made it my responsibility to find an alternative I am happy with.

I'd also feel a little bit less likely to seek his advice in the future so wouldn be counterproductive really

not being stronga rmed perhaps- guilted?