To you Mumsnetters who are knowledgeable about vaccines, what about the single measles jab?

[Twinklemegan]

I have been doing some reading up on MMR and I'm not at all convinced I want to take the risk, even though it's apparently very small. I'm not convinced that my DS needs to be vaccinated against mumps or rubella but I do want him vaccinated against measles.

However, according to what I've read, it is the measles part of the vaccine that has been implicated in the autism debate. So what does that mean in relation to the single measles jab? Does that carry a risk as well? I'm aware of the other risks like encephalitis (sp?) etc. but I can just about live with those as I understand that the risks of the disease are still greater. But I just can't bear the thought of anything happening to change my gorgeous bright little boy.

Can anyone advise me please, or point me to reliable sources of unbiased information? Thanks.

The single vaccines are not licensed in this country so you have no evidence of how and where they are manufactured, if the premises have been inspected for cleanliness, sterility or quality control standards, there are no stability studies, no regulations on storage or transport. The product could be fine but there is no written evidence

As the original measles virus used in a single vaccine is basically the same as one used in a triple then on a scientific basis then side effects would be the same (ie the gut problems reported by wakefield etc)

The prices charged are typical of private vaccination (cf holiday vaccination for yellow fever etc) and the actual vaccine has to be obtained from somewhere in smaller quantities so will cost more

On a lighter note the OP doesn't want to change her lovely little boy - you are in for a shock when he reaches 13.

Did a project on MMR for my degree, so I have read just about every paper published on MMR and autism.
I started off with mixed feelings about the issue, but by the end I was convinced that there was no scientific evidence to suggest a link between MMR and autism. Even Wakefield's 1998 paper merely suggested more research was needed. More research was done, and there was no evidence for a link.

Wakefield's speculation was about the measles component of the vaccine, so if you subscribe to his theory then a singles measles vaccine would probably be suspect as well. Anti-vaccine campaigners suggest that combining vaccines may be a bad plan, but there is no scientific basis for that, it's just speculation.

Rates of diagnosed cases of autism have been rising in all developed countries for many years. This is thought probably to be mainly due to changes in diagnostic criteria. In Japan, where MMR was withdrawn due to local safety issues and replaced by single vaccines, the withdrawal of MMR did not effect the incidence of autism www.blackwell-synergy.com/links/doi/10.1111/j.1469-7610.2005.01425.x/abs/.

So I don't think there's any evidence to suggest that single vaccines are safer, but then I also don't think there's any evidence to say that MMR is unsafe.

There's some interesting data on the charity for the deaf and blind Sense about how MMR has resulted in a huge fall in the number of babies born with congenital rubella syndrome who are deaf and blind, and the number of abortions women have because they have had rubella in early pregnancywww.sense.org.uk/NR/rdonlyres/F3ECE241-2E19-4339-8934-E49DE95C10ED/0/SenseMMRbriefing.pdf.

Oh dear, I seem to sound like a salesperson for MMR. Just don't think there's any science behind using single vaccines rather that the combined vaccine.

I posted on another thread about this a day or so ago. DD had singles about 4 years ago - excellent clinic and at the time the vaccines used were licensed over here although not sourced IIRC? It was also only £60 per jab so the prices now are a bit DS hasnt had anything at the moment and nearly 3 yo - The measles issue at the time i think was that the measles live virus stayed in the gut because it was "fighting" the rubella and mumps jab to be absorbed by the body and an immature overloaded immune system couldnt cope with the 3 vaccines in one go in some cases - so giving it as a single jab stopped that happening? This was a few years ago but thats how I remember it at the time..... the problem is getting unbiased information which is really difficult to do

the singles are proven to be more effective I believe.

Totally agree with ThursdayNext. I also work in medical research and went to great lengths over the research.

There is no licence for single Mumps vaccine in this country. I understand many centres import it from Russia. So for me the choice was MMR or nothing.

as mmr is an injection it cannot "stay" in the gut, it would have to pass from the blood into the gut something which nature does not intend to happen apart from digestive enzymes which are secreted from specialized cells, there is also an immunoglobulin in the bowel cells (?IgA) which would normally neutralize the virus

Quite agree that it's difficult to find unbiased information.
I read loads of actual research papers, but it was very time consuming and you need to know a bit of science to understand them.
The NHS information is not factually wrong, but offers heavy criticism of Wakefield's research, which is valid, but doesn't have any corresponding criticism for studies which suggest that MMR is safe. This makes it seem very one sided. Although I think the science is very much in favour of the safety of MMR, if it was presented differently it would perhaps seem a bit more honest.

This is a bit old, but I thought it was quite good and reasonably unbiased www.sciencemuseum.org.uk/antenna/mmr/.

Thursday, your the kind of person I need to convince me I'll be doing right by my daughter when the time comes.

I have to admit, though, that I'm not completely confident that the drug licensing procedures in this country are not partly inluenced by economic and policy concerns. Someone correct me if I am wrong, but from what I have read it appears to me that the UK authorities made a big thing about publicising the fact that the dtap jabs are now free from thiomersal following Sally Clarke's successful appeal against her conviction, because that was a point that came up in the new medical evidence that was put forward on her behalf? So sometimes it may be that other things in the vaccines such as the preservatives can cause a problem.

Generally drug licensing is not based on policy but set research parameters.
However, the fact that single vaccines are not available probably is a political decision. Additionally it would not be profitable for a manufacturer in Europe/US without being availbale on NHS. Vaccines are public health hence promoted by govt.

Oh GRRR bloody Wakefield did a completely biased study of 24 children - he was being paid by a legal team who were investigating claims against MMR manufacturers (so he was looking for something) - he also had patents out on alternatives to MMR and interest in a private company delivering single jabs ....the swedes did a big study thousands and found no proof of a link - GP's don't HAVE to tell you the party line they DO have to be honest with you to the best of their ability - Wakefield wasn't his "research" was flawed and with any luck the GMC will strike him off - single jabs are profiteering of neurotic worried parents so grr grr grr

I agree with Thursday - I haven't done as much research as that, but I was worried and looked into it very carefully. The evidence that there is no link is overwhelming. There are of course people who feel strongly that their child developed ASD after having MMR, but that does not mean MMR was to blame - especially as it's know that it can develop at around that time anyway. For me the Japanese evidence was convincing. That sample is a whole nation and it showed no link. Wakefiled's sample was absolutely tiny - even if it showed a link, the sample was so small as to be inconclusive. For example, you could study 25 kids and find a link between having a tree in your garden and having a birthmark. It wouldn't mean that there was any link in reality - just that with such a small sample, there might falsely appear to be one.

Even if there was a tiny risk, the other risks would still be bigger. One deciding factor for us was when a close friend of DS's got measles - the first case her doctor had seen in 15 years. Measles can kill and cause very unpleasant disabilities.

Lastly, anyone who saw that clip of Wakefield talking about upsetting the kids at his son's party, and chortling along with his audience about it, can surely no longer suppose that he has any child's best interests at heart. I suspect he did what he did for his own commercial interests - which we now know were several. In that clip he seemed to have no love or care for children at all and it made me shudder.

that tv clip where children were queueing up at a party to have a blood sample taken for a fiver, any phlebotomist/paediatrician will tell you that it is very, very difficult to take a blood sample from a child without frightening them so they scream the place down

as for licensing the nhs is a tiny part of the whole european market which itself is dwarfed by the us market

Don't know much about the Sally Clarke / thiomersal story, I have read research till it's coming out of my ears about MMR and autism for Uni but not so much about other vaccination issues
I think the evidence suggests that vaccination may protect against sudden infant death though
GPs do receive incentive payments for reaching immunisation targets. The British Medical Association wants these scrapped, as patients feel this may make GPs biased and it is detrimental to the patient/doctor relationship
A lot of the media reporting is very biased, the Daily Mail has been very anti-MMR, with some factually very innacurate reporting, but the Times ran a bunch of articles 'exposing' Wakefield. I think the Wakefield stuff can be a bit of a red herring, it doesn't really matter what he did or didn't get up to, it's the science that counts and it's pretty clear.

It doesn't matter at all science-wise, but it makes me angry that people see him as a hero and saviour of their children when I don't think that was his agenda at all.

Children may get upset about blood tests, inevitable I suppose, but it was his callousness about it that I didn't like.

I completely agree with whoever said it's the MMR or nothing. The more I've read about single vaccines since starting this thread, the less happy I am to give DS the single measles jab. I'd love to be able to go back to source and look at the actual research papers (I do have some science background) but when I followed link I was pointed to a while ago they were all subscriber only, presumably because they are so in demand. I AM worried about DS having to have all three vaccines in one go, autism risk or not, and I am very angry that I am being forced into doing that or leaving DS unprotected against measles. Grrr!

Just to throw this into the discussion. In the USA the rates of autism are also rising rapidly (currently quoted as 1:150) and people are now starting to point the fingers more seriously towards vaccination. I understand that more research is to be done. So I would say watch this space. I opted for single vaccinations and would do the same again. We have been told too many times that medicines are safe only to be proven wrong (Contraceptive pill and HRT for one). I know how hard it is.

As for unlicensed - maybe in the UK - but not in Switzerland and that's where the vaccinations for my children came from. I used Direct Remedies and they were extremely professional and efficient and brilliant with my boys.

I wrote to the dept of health re the licensing many years ago, had a reply saying basically it was political. The vaccines are not licenced because the drugs companies haven't applied for licences and the ones they had have lapsed. If the drugs companies applied for the licence, they would be licenced. No idea why they don't, but I assume it is for business reasons.

The vaccine strains are the same as in the MMR.

I know Wakefiled's (ex) patients- some of them. I think its unfair to suggest he doesn;t care about children. He treated the children - with him gone andMurch presumably on his way out I have no idea where severely autistic children with colitis will go for treatment (except the States). I think that is revolting. Parents like them because he thinks their children worth treating, and he has the skills to do it. Or rather had. He no longer 'doctors'.

As for Deer? A man who openly gloats on his website about the death of a mother who disagreed with him? Voice of reason? I think not. I wrote to him many years ago as well (he invites people to contact him) asking why he was reporting that the patent application was for a vaccine to rival MMR, when the application made it perfectly clear that it was primarily an application for a potential treatment for autistic enterocolitis. He didn't reply so I'm still stumped as to whether he was wilfully misleading or just didn;t understand the patent application.

Long MMR discussion the other day so am not going to go there again, but the thread explains why to suggest there is no evidence that MMR can cause damage in suscpetible children is wrong. The studies that supposedly prove MMR cannot cause autism do nothing of the sort. They prove that MMR is safe for the majority of children or that it is not temporally assocaited with an autism diagnosis. No-one has ever suggested otherwise.

Gess, my question was though whether the single measles jab could also be implicated in the same way iro a possible link to autism in susceptible children. From what others have said, and what I've read, it seems it could?

OK to clear up licensing once and for all:

From the dept of health; dated 22 May 2001

"... but first I can clarify in a little more depth the licensing position of the monovalent measles and mumps vaccines. Can I assure you that the Govt has not removed any of these licenses. In fact there are 4 extant measles vaccine licenses and one extant mumps vaccine license. The companies who hold these licenses have tols the Dept of Health however that they are not making or marketing to the UK vaccine which matches these extant licenses. Therefore the measles and mumps vaccines currently being imported into the UK are unlicensed. Like any unlicensed medicine the availability of these unlicensed vaccines is restricted under the Medicines Act. If manufacturers of these products wish to apply for these licenses they are free to do so".

Incidentally the dept of health did provide a very detailed reposnse to a letter I sent them. I don't agree with their response. For example I quoted the Taylor paper (pro MMR) where it says "This study does not rule out the possibility of a rare idiosyncratic reponse to the MMR" and suggested that surely that was the point. They replied saying no study could ever rule out a rare idiosyncrsatic response. So not sure where that leaves us as the suggestion is that MMR triggering autism is exactly that.

Interestingly they also disagreed with my suggestion that 'confidence in the MMR is extremely low" abd said thart wasn't true and 88% of children are immunised with MMR by the age of 2. Not quite the same tone as has been trotted out of the BBC over the last 6 years.
But anyway, they did take the time to reply a very detailed reply, so if anyone wants to write to them it would be worthwhile.

There are some recorded cases, but far fewer. No-one is accepting a link to anyone so there certaoinly wont be accruate records to distinguish between the 2. So could wild measles (Wakefields theory is about viruses, not the MMR). Just a case of take your pick really.

A good way to get an idea of vaccine safety (one vaccine versus another) is to find the USA old vaccine damage payment scheme data. They used to get drugs companies to pay a certain amount per shot given into a central fund which was used to compensate victims of vaccine damage. The more dangerous the vaccine the more they paid per shot. DTP was so many dollars, MMR a little less, but still quite high, DT far far less (cents). Somewhere the data will be there, compare the payment per shot for measles with the payment per shot for MMR and you have your answer. It won't relate to autism, but will relate to serious damage so will tell you what you want to know.

Thanks for taking the time to post all that Gess - I'll follow it up.

Twinklemgan, I am a medical librarian and have access to a lot of subscription resources. If you CAT me with the papers you want (as long as it's not dozens ) I'll see what I can do.

By the way, the librarian at your local hospital may well be able to do the same since technically it would be to do with your child's "treatment".

Wow GT, that's really kind of you. I'll look them out and see if I still think they'll be useful (or whether I'll just confuse myself even more).

This might be of interest:
www.guardian.co.uk/comment/story/0,,2128807,00.html

(Afraid I haven't worked out how to do links!)

But science can never rule out a rare idiosyncratic response to anything. That's how it works. The only thing science can ever say, is that on the available evidence there is no evidence of a link. And if there's a lot of evidence to say that a particular treatment or vaccination is beneficial, and no evidence to say that it's harmful, as with MMR, then that's what the NHS offers. Single vaccines are second best to MMR because there is no evidence to suggest they are safer, and quite a lot of evidence to suggest that MMR confers significant benefits over single vaccines.
Single vaccines would either mean 6 jabs instead of 2 if you vaccinated children for all 3 diseases - surely no one would want their children to have 4 extra jabs unless there was a good reason to do so?
Or some people suggest that you only vaccinate children against measles because mumps and rubella are relatively mild. True, rubella is often very mild and although mumps can be unpleasant it is generally a fairly mild disease. But some children will have serious comlications of mumps, such as meningitis, and if there is more mumps in the population because children aren't vaccinated then more men will catch and may become sterile. And with rubella, in the 1970s when teenage girls were vaccinated against rubella there was still a lot of rubella in the population. There were more than 5000 abortions in the 70s because of rubella, and significant numbers of children born with congenital rubella syndrome who were deaf and blind. Post introduction of MMR, in the 90s, there were very few children born with rubella syndrome and only 61 abortions because of rubella.
Now all that business about rubella wouldn't matter a toss if I thought that singles vaccines were safer for my child than MMR. But there's no evidence to suggest that, so I think it does matter.