Meet the Other Phone. Protection built in.

Meet the Other Phone.
Protection built in.

Buy now

Please or to access all these features

AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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

286 replies

evilplaguerat · 27/06/2009 11:15

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.

OP posts:
JoPie · 30/06/2009 18:01

*"Dan Olmstead and Dr Wakefield are collegues and friends, not sure why that bothers you. They work in the same highly specialised field along with many other researchers, scientists and journalists.

Also don't quite understand why you put Dr in inverted commas, would you care to explain? Are you suggesting that Dr Wakefield is not a qualified doctor? That would be a pretty ridiculous, indeed, libellous claim to make."
Qualified doctor he may be. Qualified doctor charged with serious professional misconduct charges and data fixing allegations definitely. "Dr" Wakefield published a study on 12 (!) cases, found no causal connection to be shown, yet still called a press conference advocating the withdrawal of the MMR. After seeking a patent for single vaccines. His study was so badly flawed he should have been struck off, hence the "Dr", IMO. He performed painful diagnostic tests on children, without proper consent and arguably against their best interests. He misrepresented results. He neglected to mention conflicts of interest and where his funding came from. He paid for blood samples at his own childs birthday party!

In mine, and in many peoples opinion, he is single handedly responsible for the large scale drop in immunisation rates, and the resulting fatalities that occurred.

I wouldn't look at any article written by a good friend and colleague of "Dr" Wakefield. You may find interest in the writings of "The age of autism" and the friends of Dr Wakefield, but I prefer to believe in the CDC, the IoM, CPS, APA, the NHS, The EU, the Cochrane Library, and the many many large scale peer reviewed scientific studies that have never found any evidence, however remote, of any link, despite 10 years and millions of dollars spent.

daftpunk · 30/06/2009 19:38

totally agree jopie

Qally · 30/06/2009 20:17

Sorry - posted rather than previewed! Sleep deprivation kicks in again.

The study link against the Amish claim.

The final link was meant to read, From where I'm standing measles is back, and it's because your kids aren't vaccinated.

Qally · 30/06/2009 20:19

Old Lady Knows Nothing - if only the gullible could restrict their inability to grasp their own limitations to medical issues that don't affect other people's kids, huh?

OldLadyKnowsNothing · 30/06/2009 20:44

nods in agreement

Qally · 30/06/2009 20:50

Oh good Lord, I need sleep! Thank God for back buttons.

Beachcomber - the study in question found that a condition combining epilepsy with autistic features was more common in the Amish population, not less. Levels of ASD depend, critically, upon definitions - excluding those that don't fit your hypothesis is poor science.

You haven't answered my question as to why a fringe group of oddities are worth listening to, when the WHO, NIC and CDC are not. You haven't explained why you sneer at Goldacre yet trust Wakefield, when he personally benefited, prior to conducting the famous study (which 10 of the 13 scientists involved later renounced), from almost half a million pounds he was paid from legal aid funds to argue that vaccinations were unsafe. You haven't explained why you can on the one hand acknowledge that a version of the MMR that has even very tentative question marks on safety is being being withdrawn swiftly pending further examination, and not grasp that that doesn't support your own insistence that the powers that be don't withdraw vaccinations if there are any concerns whatsoever. You haven't explained why, if vaccinations are about money for pharma or adult convenience, the NIH decided against universal varicella coverage in this country on public health grounds. Nor why, given there's been blanket coverage of the MMR for almost two decades now so increase of any linked conditions should have plateaued (or even fallen, given the drop in coverage), yet the diagnosed incidences of autism still inexorably keep on rising. You've not explained why the goal posts of concern keep shifting, either: previously it was thimerosol. Since the Danish government moved solely to thimerosol-free vaccines and autism kept rising; the MMR never contained thimerosol, and the US Court of Federal Claims comprehensively dismissed the issue (an article discussing that decision states that "Bustin?s revelations follow a series of studies, using the most rigorous analysis techniques, which have failed to replicate O?Leary?s results, while other researchers have disputed the existence of ?autistic enterocolitis? as a distinctive disease entity (see footnotes 1-3). All these results are reassuring to parents of autistic children, whose anxieties have been needlessly provoked by the Wakefield campaign. Parents facing decisions about immunisation can also be reassured that the MMR-autism scare has been shown to have no basis in science."). Now the anti-vax focus has moved to the mumps component. You've not explained why the Cochrane review on vaccination - the most focused, detailed and comprehensive survey of data imaginable - concluded that there was no risk of autism, and the millions of pounds of NHS funding should be dedicated to vaccination. You've not dealt with the fact that not only has identification of ASD massively improved, the diagnostic criteria has altered out of all recognition - if a child has to meet 6/6 criteria, you'll get a smaller number of diagnoses compared to an 8/16 range, no? You've not explained why you think Wakefield et al was unflawed and unmistaken when the majority of the researchers involved have themselves said it was; yet you simultaneously arguing that the Japanese research (which should be of evident usefulness given that you couldn't intentionally create such conditions, ethically speaking, by refusing coverage to huge numbers of children), is flawed. Flawed? It's a total population study in a first world country where MMR coverage was abruptly withdrawn. How much more useful a contribution to the debate can there possibly be? Yet that's somehow less valuable than Wakefield conducting a tiny, observational study on 12 kids? How on this earth can that be so? And what of the Danish cohort study, showing no greater levels of autism amongst children who had the MMR than those who did not? 537,303 is a pretty respectable sample size.

It's a bizarre double standard. Anyone who supports the position you do not (and let's face it, that's almost everyone in a position to understand the science) is in some way compromised or acting less than honestly - yet those you agree with are not subjected to the same scrutiny. Why? Why isn't it relevant that Halversen runs a private clinic selling single vaccines? That Wakefield was paid a great deal of money by lawyers seeking to win damages for parents who believed vaccine damage had occurred? That he was also censured by a High Court judge for trying to use the libel laws to shut off criticism of his scientific methodology?

For vaccination to be dangerous and the information on this to be readily available to anyone who can google, there would have to be a huge, ruthless and blatant conspiracy at every level, internationally, involving every public heath body in existence and many levels of health care research and provision. Because to argue as you do, that is what you must, genuinely, swallow. Do you honestly think that the overwhelming majority of epidemiologists involved are that venal, dishonest and self-seeking? That Bill Gates wants to dedicate his billions to propping up big pharma, and doesn't give a damn about the developing world? Or is it that measles kills a million children worldwide each and every year, and he wants to extend the protection our children are freely offered to those less blessed by an accident of birth? Isn't it more probable that epidemiologists enter a career in science because the subject fascinates them and they actually want to help people? There are far more lucrative areas for money-motivated scientists, after all.

The most recent study, entitled "Lack of Association between Measles Virus Vaccine and Autism with Enteropathy: A Case-Control Study" was conducted by researchers from Columbia University, Harvard Medical School, the Departments of Neurology and Pediatrics and Learning and Developmental Disabilities Evaluation and Rehabilitation Services at the Department of Pathology of Harvard Medical School and Massachusetts General Hospital, the Measles, Mumps, Rubella, and Herpesvirus Laboratory Branch at the CDC; the Department of Histopathology, Trinity College Dublin; the American Academy of Pediatrics; and the National Center for Immunization and Respiratory Diseases at the CDC. Yet you prefer to trust Olmsted.

You can of course prefer to trust the writers of Autism Matters, and believe all those research bodies are in some way corrupt, compromised, and trying to create false data to ensure the vaccination industry keeps on rolling. If you prefer to believe batshit conspiracy theories rather than the science, that's absolutely your prerogative. But for most of us, the message is quite simple: Measles is back, and it's because your kids aren't vaccinated.

OldLadyKnowsNothing · 30/06/2009 20:51

applauds

wilderduck · 30/06/2009 20:57

evilplaguerat - He can't strong-arm you. From your first post you seem to be still undecided, you've deferred the decision, not made it. Perhaps you're intending to do some more research in order to make that decision.

Alarmed is strong language, I agree. GPs shouldn't be alarming their patients in this way. You need to tell your practice that their letter has if anything put you off your GP and or immunisation. In fact you could put in an official complaint to ensure such a letter is not sent to anyone else.

Its worth remembering that GPs get in a state about this for financial reasons. While they may well agree that immunisation is on balance beneficial, the main motive behind the letter is to achieve targets, for which they get paid. Generally this has probably led to better immunisation rates and reduced illness, but particularly after media scares or in localities with lots of woo (Hebden Bridge, Totnes etc) they may well feel resentful that their salary is cut.

However this in no way excuses the letter you received. Not all GPs are good communicators! Hope you point this out constructively and resume your normal lovelier posting name.

Oldyellow · 30/06/2009 21:26

More applause for Qally. Brilliant post.

JoPie · 30/06/2009 21:36

Most sensible post on MN ever. Brava, Qally.

zookeeper · 30/06/2009 21:42

I think the doctor's note is a well-meaning if clumsy attempt to encourage you to do what he feels is best - it must be so frustrating for healthcare professionals to watch their patients do something they disagree with.

Agree Qally's post was really excellent

muffle · 30/06/2009 21:49

Thank you Qally for nailing this issue down with a round-up of the solid research once and for all (well it won't be once and for all, of course, but should be).

I do think some people have understandable reasons to worry about vaccinations, and there are some children for whom they may not be a great idea - and believe it or not the medical profession is aware of that IME. But the way in which those who support an MMR/autism link evade and deny the facts in front of them, and apply a vastly unscientific bias in favour of tiny, patently dodgy studies and unsubtantiated theories while binning huge, massively respectable studies, is mindbogglingly frustrating. Can't they see that even if they do have a point - and anything is possible as any good scientist knows - to take such an unscientific approach to their argument does them no favours?

To answer the OP, the GP doesn't have any power to make you vaccinate, but I do think it's his absolute right to tell you that in his medical opinion you would be wise to - in fact that's his job. If GPs are alarmed by non-vaccination that's perhaps because of the rise in potentially very dangerous measles they are seeing, and that is alarming (notwithstanding the fact that the rise in ASD may also be alarming). And I think it's also his right to say "I'm alarmed". It's fair enough and not as if he said "I'm cross with you" or "I order you".

daftpunk · 30/06/2009 21:49

good post Qually...but wont sway some people unfortunately...i will never understand people who are still doubting the MMR..crazy!

Qally · 30/06/2009 21:56

"I do think some people have understandable reasons to worry about vaccinations, and there are some children for whom they may not be a great idea - and believe it or not the medical profession is aware of that IME."

Totally agree. In fact that IMO strengthens to argument to vaccinate the rest - because it offers protection where a family history, or an allergy to a component, or a compromised immune system makes vaccination inadvisable. I also delayed my ds' vaccination last week because he had a fever - I asked the nurse to take his temp and she promptly said "too high". We rescheduled for this week. But my ds is a strong, healthy little boy, and plenty of parents who cannot vaccinate rely on those who can doing so, to offer their kids herd protection. Obviously I wouldn't sacrifice my son for the greater good - I want him protected, too. But the fact remains that, if unvaccinated, he could infect someone with a preventable disease who doesn't benefit from his robust good health. Not on, IMO.

ravenAK · 30/06/2009 22:10
carocaro · 30/06/2009 22:11

I got one of these too. Although I had told my doc and she said as long as you get him done I'm fine with it. I have send three letters with all the single injection details in it. They eventually update their files.

It's not the law to have MMR and you don't have to explain to anyone your reasoning.

They should send letters to people who smoke telling them that they should stop as they are going to die. Same sort of thing really!

daftpunk · 30/06/2009 22:11

qally...i've been on so many of these threads....the pro-MMR posters get nowhere tbh....it's quite worrying.

mrspooh · 30/06/2009 22:30

at least he is bothered about your childs health and wants to highlight that there are some age related jabs your child hasnt had. its up to you wether they have them but id rather have a lette like that than a dr who wasnt interested.

muffle · 30/06/2009 22:31

I don't know - until someone can logically answer the very clear challenges in qally's long post I think she has had the last word.

Beachcomber · 30/06/2009 23:44

Qally the study you link to re the Amish is actually the Madsden study, nothing to do with the Amish. I'm guessing this is an error.

Your post is very long so I'm going to put my response in list form for clarity.

  1. You seem to be swimming in misinformation re Wakefield.

Please take a look at the formal complaint made by Dr Wakefield against Brian Deer and the Sunday Times linked to here

  1. On what the Cochrane review actually said and the context in which it said it.
  1. An analysis of the Madsden Danish study you and many others think answers the question on autism rates in the US and the UK.
  1. Thoughtful House's response to the Japanese study you cite.

An interesting analysis of the Japanese study which suggests that it is in fact evidence at a population level of a link between vaccination rates and ASD rates

  1. The first four studies on the page examine how the rise in ASD rates cannot be explained by changes in diagnostic criteria alone.
  1. Thoughtful House's response to the recent study you mention and how it calls into question Bustin's testimony
  1. If measles cases are increasing that that is a direct result of the government refusing to provide single measles vaccine to a general public which quite rightly is not convinced by the safety of MMR.
  1. An impressive collation of the relevant science. Warning it is 480 pages long but not a difficult read and gives a good idea of the complexity of the issue at hand here. A highly recommended read.
Beachcomber · 01/07/2009 00:01

Forgot to say that if you scroll down to page 321, section 223 of the Briefing Note linked to in point number 8 then you will find some interesting information re the Danish Cohort Study of 537,303 children.

JoPie · 01/07/2009 00:10

Are you serious with number 8? Never mind number one....

You really need to read some actual evidence instead of these conspiracy theories by autism campaigners.

Qally · 01/07/2009 00:19

No, it is not an excellent overview of the available science - it's a pile of disingenous hokum by JABs, which is not a respected research organisation but an hysterical anti-vax campaigning pressure group. I'm sure you're right that it's awfully long, but that alone is not a criterion for clinical excellence, I fear. And links alone are not a reasoned answer to the questions I asked, especially when they come from such wholly unconvincing and non-reputable sources. You are seriously countering major medical journals and the CDC overview of them with "A friend of Wakefield complains and demands an apology"?! - funny, Wakefield was pretty litigious in the past, why is he not suing for libel given the accusations are now so devastating?

You link to a string of obscure pressure group statements, and try to imply that they equate on any level with reputable, minutely scrutinised, published peer-reviewed scientific research from the leading universities and research institutes across the world. That's not logical. Indeed it's the absolute opposite. Frankly, there's no point debating with you, because you aren't engaging at any intellectually respectable level; just making a great deal of noise. Just as one small example - you say mumps is the problem, you say synergestic reactions are the problem. But you then say that when many in Japan removed the mumps component by refusing it and single vaxing only the others over a (non-MMR) health scare, thus also reducing any synergestic effects, it's perfectly logical that ASD increased. Uh, no, it isn't. You can argue that the effects are not much different, that rates shouldn't have fallen sharply, but it is quite bonkers to say that singe vax for rubella and measles would cause greatly increased levels of autism over the MMR when you are simultaneously arguing that the MMR is unsafe. The position is so patently self-contradictory as to be ludicrous.

Allow me to explain to you: not all online links are equal. Not all analyses of data are equal. You are countering peer reviewed scholarly research stringently conducted by all the leading research organisations in the world with cranks, quacks and zealots and trying to imply parity. That is laughable.

Of course you can believe that your views are correct, just as you could that Diana was murdered, Elvis lives, and the World Trade Center was demolished by the CIA. I, in turn, can think you must be wilfully blind to the overwhelming weight of genuine evidence. Look, I'm sorry, but I have said my piece, it's supported wholly by all current scientific thinking of any repute, and you are, quite frankly, adhering to what is increasingly looking like some sort of bonkers cult. I really have no interest in debating until you can pull together some genuinely respectable research to support your position - though I do naturally understand your difficulty on that score, and appreciate there may be an exceedingly lengthy wait.

OldLadyKnowsNothing · 01/07/2009 00:28

I tried reading number 8, I really did. But I'm confused - is it MMR, thiomersal, measles vaccine alone or what, that causes regression days, weeks or even many months after it's received?

[roll eyes emoticon]

Should have trusted the bullshit detector that went off on page one.

1dilemma · 01/07/2009 00:32

Comes back to say to Qally you really are doing some excellent posts on this wanted to say it last night but think I forgot.

BTW I looked at 1,2 and 3 in case there was anything there but seem to have major VI in the whole thing couldn't really use the word impartial

Swipe left for the next trending thread