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.

The doctor is alarmed because vaccinations are only effective in wiping out a disease, or at least limiting its spread, if everyone does it.

It's his job to keep an eye on your health in exactly the same way as in advising you not to smoke or jab yourself in the eye.

In this case he is trying to get his community to follow a health plan which could help to eliminate a disease. Your refusal to vaccinate your children affects others. This alarms him.

YABU.

Just a thought

But I wonder if GPs could just ask is poeple have given a single jab before going all herd immunity / risk of death on many of us.

Might make sense?

Peachy & Pagwatch - really sorry if I've been insensitive: such was not my intention. I freely admit I can be at times, but this wasn't supposed to be one of them.

Peachy I think the concern is that the evidence indicates that single jabs are not as effective as combined. Though as I said to Lancielottie, I don't for a second think a parent with a real cause for concern should feel they have to vaccinate, at all or with a combined, unless they are comfortable doing so.

Beachcomber, the first link was to a study done by Wakefield's new organisation/center which I'm afraid has no real academic credibility; if you notice the fellow researchers are from anti-vax groups with a single exception. (I make no comment on the work the group do with ASD children, because I don't know anything about that and therefore am not in a position to.) It was also hosted online by Generation Rescue, which has less. That isn't a legitimate contribution to the debate.

The second and third are to the Huffington Post. Not only are they known for ridiculous articles on the vaccination scare, they've recently published advice on how to stave off swine flu (via homeopathy), and their "wellness editor" has advocated colonic irrigation as the key to good health. There's been considerable unease at their titling naturopaths and other non-medically qualified people with "Dr", as it's misleading. As blogs discussing medical science issues go, that one's a real turkey. They have been vigorous in campaigning against MMR on autism grounds, and David Kirby has been criticised extremely robustly for being downright dishonest in his statements, when disputing with scientists on their own. It's therefore not especially helpful to your case that even they admit in that article that the NVAC has found the MMR to be safe in the general population.

They misrepresent the opinion of NVAC on potentially susceptible children, and that of the scientific community. There isn't anyone sensible opposed to research that genuinely increases understanding, and that is why so much has already been done since Wakefield. I am at a loss as to why or even how you can think anything else. The actual report is here, and a range of areas are recommended for further research; autism is merely one. NVAC specifically state that the best way to conduct the research is to create a cohort of unvaccinated children, but as they firmly believe the best medical advice is to vaccinate, that would be grossly unethical and all they can do is observe children whose parents choose not to, regardless. The criterion for research is further stated as being: the age/vulnerability, and extent across populations, of a vax programme (MMR clearly falls within that as almost all very tiny children are affected); the severity, treatability and any rising incidence of an alleged adverse health event (clearly within); magnitude of public concern relating to it including refusal rates; the Bradford-Hills causality criteria (whether the concern lends itself to research); and whether further research would increase trust as well as knowledge.

Basically, further research is always to be welcomed unless it's covering such well-trodden ground as to be pointless. I think it's a bit odd that you seem to regard commissioning research as backing any perspective - the whole point of decent research is to go into it with an open mind, without bias as to findings. It isn't evidence there's a problem, it's evidence there's a gap in information that is causing some refusals, and that there needs to be research to determine whether those concerns are legitimate or misplaced. Though the Huffington Post appears to misunderstand that, too. I just find it very strange that you are delighted at the announcement of further, rigorous research (a sensible reaction, I agree entirely with you that it's great news) yet you dismiss the conclusions of previous, equally respected research wholesale because it doesn't support your beliefs. If this research also conclusively finds no link, will you then accept the lack of any? Forgive me, but I have to doubt it, because Generation Rescue and Autism Today won't, and that's where you are getting your information.

Finally I don't know if you're aware, but the most recent study I cited previously, which yet again firmly debunks a link between the MMR and ASD, was actually designed in consultation with anti-vax campaigners, in an effort on the part of the scientists to resolve the dispute. Given the dispute is still going, I can only assume that the failure to achieve the campaigners' desired result has meant the science is suddenly not good enough, after all.

I have to say, it baffles me. Surely, if vaccination is effective and safe, that is a wonderful thing? You don't have to be right to be the catalyst for the creation of excellent science - eliminating information gaps is hugely valuable: science is built on the shoulders of what went before. I just do not understand why people actively want vaccination to be unsafe, to the point they refuse to accept the medical evidence they clamoured for in the first place. Again: a million children die of measles in the developed world every year - in the 1st world, the authorities can name victims. Vaccination achieved this for us. It's a miracle on a par with antibiotics.

Finally, are you aware that some people within the autism community believe that the anti-vax campaign is in itself suspect?

"Like many in the autism community, Seidel feels that the focus on vaccines has been a distraction, and that the only people who have benefited are those who sell "cures" to desperate parents, treatments lacking evidence of either safety or effectiveness. She describes the father-and-son team of Mark and David Geier, one a doctor and the other with a college degree in biology. The elder, Mark, opened a homemade lab in his basement, where, under the patronage of anti-vaccine advocates, he works on his theories. They include prescribing Lupron to autistic children, a drug that several states use to chemically castrate sex offenders. The son, David, runs a medical-legal consulting firm, where he offers up expert witnesses for vaccine-injury trials. The two work hand in hand to make money both selling treatments and testifying as expert witnesses in vaccine-autism cases."

"Again: a million children die of measles in the developed world every year"

Apologies; that should obviously be developing world.

Qally that's great that you have strong opinions on these matters.

However you dismiss everyone and everything posted on this thread which questions those opinions. You justify this dismissal on the basis that, in your opinion, the sources of a view alternative to the one you hold are not good enough for you. You base this subjective judgement on your own personal opinions.

According to you, everyone who disagrees with your opinions or publishes, writes or researches in ways that contradict your opinions is bonkers, cultish, antivax, hysterical, deluded, ridiculous, in it for the money and bizarrely clinging to a dubunked idea for the sake of we don't know quite what.

Your posts are littered with misinformation BTW and you keep linking to studies that fail to back up the opinions that you seem so sure of so it's kind of a shame that you dismiss the work of so many others.

There would be an interesting discussion to be had here about the politics of science that are very much part of all this and that are omnipresent in this thread.

Anyway on a lighter note how do people feel about the fact that the oft quoted Brian Deer has been shown to have some dubious conflict of interest issues of his own?

From The Spectator

Beachcomber - is that short for "I can't respond to your points except by attacking you, and citing conspiracy theorists"?

I'm citing science. You're not. That, I'm afraid, is the crux of the matter.

Okay, that was rude, and I apologise for the discourtesy. But I'm afraid the sentiment remains, because you truly are not quoting any hard science here, and it isn't just me that is telling you so, however much you might like that to be the case. You must know that the scientific consensus is now that MMR is safe for the vast majority, everyone here knows that that is so, so how is denying that obvious fact helping your argument? The Huffington Post may be scientifically hopeless, but the NVAC exists solely to deal in in hard science, and I completely agreed with you that their announcing further investigations into vaccine safety is great news. I also agree with their point that they have a duty to be very careful in mandated vaccination programmes because they remove parental autonomy - interesting that you say the USA is ahead of us, when they make the MMR in effect compulsory in many states, and we don't.

You haven't answered any of the points raised, specific questions posed, or addressed any of the internal contradictions of your position. You seem to have this very post-modernist view that all opinions are equal, and frankly, no, they aren't. muffle spelled out very clearly what our problem with your position is. And when you are trying to spread proven misinformation on a public board, it matters. Vaccination levels are dangerously low, measles is reappearing, so why should you argue unchallenged on a public forum, when what you are saying is misinformed to the point of being disproven? How can I say, oh well, maybe you have a point, when you are arguing a position that is directly contradicted - in fact actively campaigned against - by every single public health body and provider in the world, and arguing that people in our community should risk a preventable, highly infectious and potentially dangerous illness spreading to endemic levels, rather than accept an extremely safe (the WHO's description) vaccination?

Qally, thanks for your posts, I'm really appreciating such a reasoned and thorough argument.

Qally I don't think you were insensitive- it's the ones who won't accept that my concersn, as a Mum to 2 X asd and one with probable dys[raxia, that upset me: scuience is debatable, empathy however is free

Perhaps the measles is less effective but when no MMR is giong to be had then it's me doing the best I can for society whilst trying to protect my child.

I'm not sure there is massive evidence against the MMt - ASD link for the tiny subset of children identified by Wakefield into which my boys all fall, incluidng DS4. however I will agree that as far as I am aware there is no obvious concern for the majority of children (my boys have eczma, psoriasis, dairy intolerances- at least the asd duo and ds4 do)

I beleive thaqt as longa s Wakefield's research is portrayed by the media as having been a blanket causality debate, it will stifle MMr uptake, and put those of us who do know what the studyrbeally suggested off considering it. I#d love to see masses more research into the subgroup, rather than blanket 'no MMR causailty proven' stuff but sadly I think we won't see it coming from the UK. Poeple quote the Japan research- but we'd ned to know about subgroups again.

I do think though that people should read the research before just refusing vaccination. And I think Measles jab should be offered tot hose in the subgroup or like us with a PAediatric confirmed family history

Well said Qally!

i didnt have my 2 immunised till just before they started school,i left it till the eleventh hour becuase i belive a better developed immune system copes with immunisation better

i got several reminders in the post but i just rang the surgery told them my reasons and they were ok (still sent me reminders tho)

its your choice dont let them bully you take a stand and stick to it

good luck

Qally I don't really have much inclination to read and respond to your hectoring, accusing and patronising posts.

You think you have all the answers, great, good for you. You think you know so much about this hugely complex and diverse controversy that you and only those who agree with you can decide what is worthy for discussion and what may be of value in this discussion. Whatever.

I have posted things that to my mind would be interesting to actually discuss and that would go some way to answering some of the interesting questions you pose. You dismiss them and shy from discussing them because you don't give any weight to their source. Fine, good for you.

You have cited two studies in particular that you seem to think give you the right to declare anybody who holds a different point of view as an hysterical, antivax, cultish spreader of misinformation. Neither of those studies stand up to scrutiny and both when reexamined actually contain data which document a concerning assossiation between vaccination rates and ASD rates at population level. Both were authored by people who have serious conflict of interest issues. You have cited Brian Deer and Michael Fitzpatrick both of whom have serious conflicts of interest and who have repeatedly spread misinformation to the public and continued to do so despite this being repeatedly pointed out to them. Neither of these sources carry any more scientific weight than the Huff Post or any other journalisitc source. You rubbish my sources but some of yours do not stand up to close inspection.

You keep repeating that measles cases are on the rise as though this is some sort of trump card. Well there is a simple way to address that which is to listen to the public and bring back single measles vaccine.

Measles being dangerous does not make MMR safe. They are two seperate issues which must, for ethical reasons, be examined independantly.

Qally you are right you are citing science but it is science that has been shown to have serious flaws. If you refuse to consider and address those flaws and just continue repeating that you are right and everybody else is wrong on matters that I doubt you have done much in depth reading on then it makes it a pointless exercise to attempt a grown up discussion with you.

You might notice that I am not addressing the many (many of them rhetorical) questions that you accusingly fire at me for this very reason.

To have a proper understanding of the MMR controversy the context in which it has arisen must be taken into account, you show by your rubbishing of all sources that question the establishment to not be doing that.

You do understand that this is a highly politicaly charged controversy with enormous financial, ethical, medical, social, political and legal implications don't you? You do understand that there are careers, reputations and litigation at stake here?

You do understand that public opinion is being manipulated through the media via the work of people like Deer, Goldacre and Fitzpatrick don't you?

You do understand that the GMC hearing of Drs Wakefield, Murch and Professor Walker Smith is about politics and not science don't you?

Because I imagine that you are as sincere as I am in this discussion I'm going to give it one last bash with you.

The only way I see for us to grapple back some semblence of a discussion (as opposed to a monologue with the odd ad hominen attack thrown in) is to reexamine the studies you are so sure make you 100% right on everything and me a total whacko with no critical thinking abilities whose intention is to spread misinformation on public boards and to bring back measles.

If you don't mind I'll do it in another post as this one is getting a bit long and I don't have time right now.

Just one last thing. In order to discuss these complex issues I am going to set out what my position is in this as opposed to the position that you think I have and that you repeatedly attribute to me which has a basis only in your own personal opinion, predjudices and assumptions.

OK. Can you lsten with an open mind for a second?

I think that there are safety issues with the MMR vaccine. I also think there are ethical ones. I do not believe these issues to be straightforward and black and white nor simple to examine scientifically. I believe that a sub group of the population with underlying susceptiblities does not respond well to the challenge of a triple vaccine as part of an already heavy vaccine schedule. I believe that that population is damaged in ways which include autism, brain damage, intestinal damage, seizures and immune system disorder. I give weight to the science which is examining these children, trying to find ways to help them and trying to develop a screening process to protect other at risk children. I believe that many damaged children are suffering and not being given appropriate treatment because their condition is miunderstood but also hugely controversial.

I also believe that many children deal well with the biological challenge the MMR poses. However a humane society cannot with any conscience turn its back on the countless accounts of children who became unwell following a governemnt endorsed medical intervention simply because it is inconvenient to do otherwise.

There is plenty of science upon which to base these opinions. It is not popular science and as it goes against a mainstream position those who author it have been ruthlessly attacked. Attacking is not, however, the same as discrediting or challenging.

The mainstream position is that these children do not exist and that the distressing biological manifestations of their illnesses do not matter. Paradoxically whilst maintaining that these children do not exist the mainstream position is that whatever is wrong with them it has nothing to do with vaccines. The mainstream does not know what is actually wrong with them nor does it know how to treat them, it just knows what is not wrong with them. A curiously unscientific contradiction.

"How can I say, oh well, maybe you have a point, when you are arguing a position that is directly contradicted - in fact actively campaigned against - by every single public health body and provider in the world, and arguing that people in our community should risk a preventable, highly infectious and potentially dangerous illness spreading to endemic levels, rather than accept an extremely safe (the WHO's description) vaccination?"

See there you go again attributing a position to me that I have not expressed and do not hold. Put down the microphone, step down from the stage and have a little respect for others. Nowhere on this thread have I argued that any community should risk the return of measles. Stop arguing against things that you have made up and try to present as opinions that I hold.

You are rather over egging your pudding by asserting that every health provider in the world is actively campainging against the notion that MMR has safety issues BTW.

I want to add something in here about the scientific truth, reporting of research and what can happen. It isn't relevant to MMR, except that it shows what can happen to a previously well-respected scientist when he publishes something that seriously jeopardises financial interests.
In the field of genetically modified foods, there was a researcher called Arpad Pusztai, well-respected, lots of papers to his credit, working in a prestigious institute. He discovered that the insertion of a snowdrop lectin into potatoes caused problems with rats who were fed these potatoes - not the adults, but the next generation. He published - and suddenly his world collapsed as his paper was rubbished, his science was attacked, and then the attacks on his previous work and reputation started. It ended with him having to leave his prestigious job.

He is not the only example of a scientist who has done this and had the same sort of treatment, but he is the only one I have had personal contact with.

So - this is not a conspiracy theory - it IS the case that research that goes against major financial interest is going to be decried by various high-level Interested Parties and it is naive to believe that this could never happen.

Whether or not this is the case with Dr. Wakefield has yet to be established, but please don't believe it is impossible, because it's not.

By Qually:
'You must know that the scientific consensus is now that MMR is safe for the vast majority'

Er, even Wakefield stated that was the case. So what are you disagreeing with? The press exaggerated Wakefield's claims. Epidemological studies confirm just that, that MMR is safe for the majority. The thinking behind the MMR concern is that less than 10% of all autism may be triggered by MMR. What about the minority then? Are they a lamb sacrifice for the greater god of public health? Fuck 'em? Wakefield's research, as he said himself, was limited. It needed further investigation. Did that happen? No. Does it need to? Well, even the Govt's own Cochrane inquiry concluded research to prove or disprove MMR safety was woefully inadequate.

Asking for more research into MMR safety for a small subset of children with auto immune and gut issues is unacceptable, obviously.

(Sorry ive not read the whole thread)

I think the letter is patronising, fine to send a reminder if they think you have missed/forgotten appointments, but the tone of this letter would anger me too

I can beat that- GP letter to 83 year old housebound occasional smoker informing her of the stop smoking clinics!!!

Feeling sorry for the poor woman who started this thread (she specifically said that she did not want people's opinions on whether she was a good / bad parent for not wanting child to have the MMR).

Anyway, at the end of the day it is not about whether you feel you were wronged against by receiving the letter. It is the purpose of the NHS professional to tick boxes and cover their backs. It is what they do best.

Pagwatch -- really sorry too if I came across as discussing and dismissing your children. It was partly your son I had in mind in my post about trying to work out who might be at higher risk from vaccination than others, but I didn't like to namecheck you on a thread you weren't (then) on.

Sorry.

And thanks Qally for the links and information. I had a feeling you might be coming at this from the 'already ASD risk' angle.

er no....the NHS have a duty to protect the wider society from infection.

Perhaps he is alarmed that you have had appointments and just not turned up? The NHS wastes lots of money that way. Not turning up to routine things can raise alarm bells about how families are functioning well (I'm not suggesting this is what is happening here) and so it is likely that he/she is just doing their job.

More alarming if he/she DIDN'T write.

Qually - I appreciate the apology but it wasn't needed . It is an arguement to raise passions.

Lancelottie - same again . Please don't give it a thought - I know what you were saying.

I just get frustrated when we fight because actually I think ultimately we all wantthe same thing. We want safe vaccines for the majority of children and support and understanding for those who can't or who have genuine, heart felt concerns.

I wish the scientific community spent less time proving and disproving and more time trying to figure out what actually happened to children like mine - WHY a perfectly healthy able NT baby would suddenly loose skills and regress - and develop gut problems at exactlythe same time.

People don't beieve Wakefields theory becasue they are conspiracy theorists but because they wantched this horrible thing happen to their healthy child. And often because the action recommened ( take out gluten and dairy and try to repair the gut gently ) does genuinely result in improvement/reduction in asd behaviours.

Perhaps if we combined our considerable knowledge and occasional rage to insist that this group of children were properly investigated ( and properly supported too) we could help protect children from measles and get a greater understanding of the various manifestations of ASD.

Cheers ladies (and gents)

Beachcomber, thats a lot of belief in your post and not a lot of facts. You assert that there is much scientific basis for your beliefs, but you keep on supplying non-scientific, badly discredited "evidence" for your beliefs.
You may have a basis in fact. You may have very good points to raise. You may have a far reaching understanding and interest in the matter. But if the best sources you can rest on are the Huffington Post and the home-made websites of untrained parents and lawyers of ASD children and groups, you are opening your stance up to ridicule.

Belief counts, though

I beleive my son was harmed by the MMR. The SEN specialist at his unit toldme my belief is shared by a few other parents there.

W are not all dumb, or unable to read a science paper (I may have slept through many of my first year Uni classes in Psychology but I sure as anything didn't get an A and a p[ersonalinvite to continue studying (I wanted a single honours though) for not being able to read a science paper.

I know what happened to ds3, I have another asd child who wasn't affected by MMR and who clearly ahs my genes so not in denial either (I think genes plus leaky gut = more severeasd for ds3, ds1's casein problems were picked up at 3 weeks- so less damage imo)

To me, this is no different to watching your child slip down a muddy bank into a pond only to be told by a dozen health and safety bods that your child didn't slip, they were messing about: I know what happened, i can say for sure I beleive it did, but cannot prove

'homemade websites of untrained parents'

Yes of course, the words of parents whose children have severely regressed following vaccination means nothing, as they are 'untrained'. Should we hope it happens to a few 'trained' parents then?