Vaccinations and nursery schools

[Louise1010]

This is my first post so forgive me if I do anything wrong!

I am just beginning to look at nursery schools for my 15 month old son, and I am a bit surprised that they don't seem to care whether or not he has been vaccinated. I expected it to be a requirement.

It seems incredible to me that I have to provide evidence of my cat's jabs to the cattery but when it comes to children anything goes.

Has anyone come across a nursery school in the UK that does require it?

If you've made your decision not to vaccinate on the basis of medical advice, that's fine. Claiming to be a self proclaimed expert on vaccines and making the decision on that basis is not.

Expert of any type I have never claimed, neither would I. If I were, I'd be advising others. I do not do that.
Incidentally, it interests me that it's ok not to vaccinate if there's a history of vaccine damage in the family. I can see that's sensible.
For the rest of us, we are meant to vaccinate regardless until a child suffers damage? That seems nuts to me.

No it haven't tbaitha. Comment wasn't directed at you.

Because the number of children affected by vaccine damage is tiny. The number of children who would be killed and disabled by disease damage is not.

Come on Elaine - you like science, substantiate these claims.

Incidentally, who is claiming to be a self proclaimed expert on vaccines? I don't see anyone here. Or are you saying that those who decide to read round the subject, weigh up the evidence themselves and decide that for them and their children not to vaccinate or vaccinate selectively is/was the right decision, are the self-proclaimed experts? Why does it bother you so much? No one is telling you how to bring your own children up. You chose to have them vaccinated, that's your business.

You can google it all yourself volcan. Nothing controversial in the slightest in what I wrote.

I don't have a problem with your individual decision. Huge problem with the absolute tosh, misinformation, lack of understanding of basic scientific principles which is posted here. My work is related to public health, I guess I see this as part of my service to the profession.

I hope you don't try getting anything published in a peer reviewed journal Elaine: ' I can't be bothered to give my references' won't get you published. Even below this level - it would get marks knocked off a university student's work if they didn't cite their sources.

One of your beliefs is "Because the number of children affected by vaccine damage is tiny." Many posters would disagree with you and say it was under-reported.

"The number of children who would be killed and disabled by disease damage is not." OK so I took up your challenge and googled 'disease kills more than vaccination' and this was the first reference which came up. www.unicef.org/immunization/index_why.html

First paragraph:
Pneumonia, diarrhoea, malaria, measles, HIV/AIDS and malnutrition are the primary killers of children in the developing world. These children die because they are poor, they do not have access to routine immunization or health services, their diets lack sufficient vitamin A and other essential micronutrients, and they live in circumstances that allow pathogens (disease-causing organisms) to thrive.

Poverty, poor diet, access to health services, insanitary conditions are all listed alongside access to routine immunisation. This is of course, talking about the developing world. Thankfully we now have clean drinking water, good sanitation, babies don't get their cords cut with a rusty pair of scissors.

Just concentrating on the MMR here - why can't there be free single vaccines for the small % of parents who don't want the whole caboodle at once? If the government want a certain % vaccinated, that would increase it I'm sure. Me for one. That way we would see that they actually care and put health above cost.

Leonie
Where did you find the 1-10% figure?
Which reactions does it relate to?

Lee
The available evidence in fact suggests the opposite, that take-up is lower with single jabs, in part because there are 6 jabs instead of 2

www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/MMR/GeneralInformation/

Lee - good question. I wrote to the give in 2000 or 2001 and asked that. They said that the singles were unlicensed because the drugs companies had not requested a renewal of their licence. Apparently if the drugs companies requested a renewal they would consider it.

In the same letter (bearing in mind this was very close to the MMR furure) they said their surveys showed there was no loss of confidence in the MMR, I was quite mistaken to think there was and uptake rates were pretty much back to pre news conference days. So I have no idea why they're still publically blaming Wakefield a decade
later.

I think the figures quoted never include monovalent vaccinations do measles coverage is prob even higher than that quoted.

Jo that's interesting but surely any take up is better than none?

Jo some people will choose one jab and not the other two. Others may immunity check after one dose then choose not to have a booster (I know a few who have done that) so there may be many reasons. I think if people are motivated enough to choose singles they will probably manage to turn up for the jabs they want.

That link also contradicts cochrane who said MMR safety studies were inadequate. And doesn't mention the literature showing better efficacy for some singles (granted the various results are fairly mixed),

Nor, when they are singing the praises of MMR and its protective effect against congenital rubella syndrome, do they bother to say anywhere that the immunity may well have worn off by the time the woman tries to conceive - this could easily be 25-35 years later. Rubella itself is a mild disease.

jimjams
I agree that there are many contributory factors to vaccine uptake, and that extrapolating from past uptake data to a hypothetical future scenario might be misleading, but your view that people will probably turn up could equally be wrong.

I'm very disappointed that you appear to be quoting Cochrane out of context. In the summary, it does indeed say that the design of MMR safety studies is largely inadequate. But if you read the text in the report, they make clear what they mean by this. They say they reviewed 5000-odd papers and found only 31 to be adequately designed. The 'largely inadequate' refers to the papers they did not include. The 31 papers they did include, a pretty substantial body of research, led them to conclude that MMR is safe, and is

'unlikely to be associated with autism, asthma, leukaemia, hay fever, type 1 diabetes, gait disturbance, Crohn's disease, demyelinating diseases, bacterial or viral infections.'

For me, this conclusion is not contradicted on the link I gave up-page.

Rare side effects from vaccines are detected and quantified. For example, vaccine acquired polio from the opv, bowel problems with rotavirus vaccine, guillan barre syndrome with older swine flu vaccine, aseptic meningitis from the urabe strain mumps vaccine. The fact that these rare events (less than 1in 10000) are detected and reported makes me confident.

Secondly, there are other data sources, such as retrospective studies looking for an association between certain conditions and vaccinations, which confirm that vaccine damage is very rare.

The notion that vaccine damage is common and huge is completely made up and has no scientfic evidence whatsoever.

How do the numbers of vaccine-damaged children stack up against children who have died or had serious side effect from measles since the MMR? Just wondered if these figures are available.

Here's the new cochrane conclusions in full:

^Implications for practice
Existing evidence on the safety and effectiveness of MMR vaccine supports current policies of mass immunisation aimed at global measles eradication and in order to reduce morbidity and mortality associated with mumps and rubella.

Implications for research
The design and reporting of safety outcomes in MMR vaccine studies, both pre and post-marketing, need to be improved and standardised definitions of adverse events should be adopted. More evidence assessing whether the protective effect of MMR could wane with the time since immunisation should be addressed.^

You are correct that I quoted out of context (and actually not from the most recent review) for which I apologise. I must admit my main interest lies in autism and I am aware of the limitations of the included studies for someone in my situation. For someone not in my situation, well yes the studies show that the MMR is safe for the majority of children if you want to vaccinate against all 3 diseases.

Lee - the numbers who have died from measles will be very small indeed but available on a govt website somewhere. I remember a few years ago a 14 year old boy with underlying health issues died from measles. You may need to check for separate SSPE figures as well. Although some who died from SSPE have had MMR- i'm not sure it's easy to separate out the cause there (although often assumed to be caused by the virus).

Reports of adverse reactions are notoriously underreported. I have a friend whose child ended up in hospital post MMR and that was not recorded (it should be as 'potential' reactions should be reported). Anyone can now report an adverse reaction themselves - google yellow card UK. It's worth doing IMO.

Oh but Lee before I get jumped on I should say, as with any vaccination, the risk from the vaccination for an average child should be a lot lower than the risk from the disease.

There are measles mortality figures going back many decades.

Thanks for the info. What I was trying to work out (in a twisted sort of way) was that if we have reached a stage where the diseases are under control with the take up as it is, then those of us who are against the MMR shouldn't be made to feel we are putting the rest of the population at risk, and whether now there was a greater risk of illness actually having the vaccine.

Oh I see. Well the magic figure quoted by the dept of health is 95% coverage, although in measles at least outbreaks have been recorded in very highly vaccinated populations - according to the latest jvic minutes coverage is currently high (not sure how much).

Personally I believe if you're not happy with a vaccine you should ask your doctors to reassure you. If they can't you should consider not giving it. But of course also consider how you would feel if your child gets the disease. You just have to bear in mind that if your child is injured by vaccination or disease you will be the one picking up the pieces. No one else will be helping - so the decision is yours alone. You live with any consequences so you take the risk. You should not be guilted into making a decision you are not comfortable with.

Rock and hard place springs to mind!

Asking the doctor reminds me of taking dd1 for her MMR in 1994 before the hoohah. I told the nurse who was giving the jab I was a bit unsure about it and she said 'Well, do you want to be a good mother or bad mother?' I meekly gave in. It's only dd3 that has not been vaxed.

I laughed out loud at that! social pressure much?

I just had ds1 vaccinated without questioning. By the time ds2 was born ds1 had regressed so I turned up to the vaccination appointment with a list of questions - not least regarding the fact ds2 had just been very ill (in hospital) so should I delay. The (locum) GP said ''well he'll probably be ok if you vaccinate and he'll probably ok if you don't so you may as well do it today rather than wait".

I decided to go away and read a bit more!

Leecoakely

Why are you 'against the mmr'? Do you think children should die from measles? Your point of reference should not be how many die today but how may died before there was a vaccine. Because if we stop vaccinating, sure as night is day, measles will return. At the moment you're piggy backing on herd immunity but the primary person at risk is your dd because measles vaccine rates are not high enough to prevent outbreaks, thanks in no small part to misinformation and scaremongering.