MMR single vaccines just a bit of info please.

[leander]

I feel a bit nervous posting this as i dont want to start anymore arguments,but we got our app through for ds's mmr.We would prefer to give him the single vaccines but people keep saying they are not licensed and some say they are.I will go and talk to my hv about it but I thought the combined wisdom of mumsnet may be able to tell me more.

When I say older, I mean during puberty or older. There's no sperm in babies to affect. And when I say rare in men or teenage boys, I mean vanishingly rare or possibly non-existent. Sterility is not a risk you run by waiting for single vaccines to arrive. And if the DoH was less obstructive, there wouldn't even be a delay!

My dh's grandfather was left sterile after catching mumps which then progressed to orchitis (inflammation of the testicles). They couldn't have further children which caused a great deal of sadness. Maybe nowadays there is a better chance of reducing the risk of infertility by treating the orchitis but it would be a shame for any man (and his partner) to miss the chance of having a family. Probably the case for herd immunity isn't quite as strong as that for rubella but I would still feel guilty if my child caused infertility in young man.

It may have been a coincidence that your grandparents didn't have further children. Even the government admit there's no firm evidence of a link between orchidis and infertility. Anyway, all illness carry some risks - even colds can kill if they cause respiratory infections. I still think it's rather over the top to call colds 'killer diseases'. The severity of mumps is being talked up to quite an extreme degree in some sources, primarily, I believe, to terrify people who have chosen single vaccines who now cannot vaccinate their babies against mumps purely because of the DoH policy to prevent parents having a choice. The 'terrifying' certainly seems to work.

Frieda last week I met a woman my age (30s) who is totally deaf, since birth because her mother had rubella while pregnant. I guess this MMR debate must make her quite angry. Its not her fault or her mother's that she is deaf. You can't expect all mothers to be to plan jabs. Plenty of women get pregnant without planning, many don't know if they have already had rubella (do you?). Its up to us all in society to protect 'the herd!'

Why did the teenage girl rubella programme stop anyone know? I was given rubella at 13- seems more sensible to me that immunising baby boys (and probably more likely to last the girls until their childbearning years). Also why can't a woman's rubella status be checked when they go for their first smear as a routine. OK so it would miss people- but it would catch a lot (including those who thought they were immune but weren't becuase the vaccination didn't work). More publicity for getting your status checked would make sense as well. Again it won't get everyone but I only got mine checked before getting pregnant as a friend did. A few leaflets a GP's surgery's may encourage more??

Of course I don't want rubella babies to be born but I don't want loads more autism either (see below for evidence of possible link).

Aloha makes a good point. Because of a very strange reaction to an upper respiratory infection (ie a cold) a friend's dd is currently in hospital with kidney failure. However I don't think her mother would describe a cold as a killer and insit of vaccinating us all or keeping her daughter away from colds. Extreme reactions do happen- both to naturally caught illnesses and to vaccinations. If your child happens to be the one with a reaction to a vaccintation I'm afraid you stop seeing them as pure and simple lifesavers and see them more as one side in a balance of risks. As the GP said to me when I was trying to decide whether to vaccinate DS2 with dtp etc "you want me to tell you it's perfectly safe but I can't- everything carries a risk". Of course he was right and for him the risk of the vaccinations was greater than the risk of the diseases (exscept tetanus which he will get a saome stage- preferable when they've removed mercury from it or his brain is big enough not to worry about a bit of mercury). The whole thing is a balance of risks, but you can't say "oh it doesn't matter if a few children (collateral) are being damaged and given autism - at least we haven't got any rubella baies/mumps menigitis/sspe (except the vaccination cases of sspe) or wahtever. The risks have to be taken in the round and the greatest risk to each indiviaula guessed at". Fo course it's just a guess and could go wrong- but we could at leats make some attempt to individualise risk surely rather than just jab everyone and to hell with the ones it doesn't suit.

I'm not saying that mumps is a killer disease, I'm just surprised that the link between mumps and sterility has been totally discounted. Campbell's Urology (the bible for urologists) states that postpubertal mumps leads to unilateral orchitis in 30% of cases and bilateral in 10%. Bilateral orchitis is likely to have some impact on male fertility although not always permanent. There is also question about whether these kind of testes infections can then lead to autoimmune responses which lead to sperm being attacked by the body. The link may have been overstated in the past but the risk still exists.

I would have thought the main reason that the government changed from immunising teenage girls to all babies is that you are more likely to 'catch' babies as they are in the system and having lots of contact with health care professionals, as you get older I am sure the system 'loses' people, and obviously if you are trying to achieve herd immunity you need the greatest possible number of people covered from a young age.

I am in no way saying that the government should now call mumps a killer disease or try and use emotional blackmail to coerce people into doing something they are not happy with. I think they are also guilty of this re the terrorism threat and putting lots of soldiers on the streets of London to persuade people that perhaps we do need to bomb Iraq after all, but thats a different thread

aloha, why do you think the government wants to 'terrify' parents who have chosen the single jabs?

keepingmum- do you really think that the sterility link has been discounted? I've seen it mentioned a lot. Also - as mentioned in the book- it's a problem if mumps is caught after puberty- so why not vaccinate boys at 12 or whatever (I would condsider giving ds2 mumps vaccination at 12- to date he hasn't had a single jab- so yes I do think the sterility stuff is important)

Do you really think kids leave the system when older? Surely if the vaccination programmes are coordinated through schools they catch almost everyone (eg the meningitis c jab was given through schools). Actually being present on the day vaccinations are given in schools is classified as parental consent (which I think is disgusting- but that's another issue).

I do think the timing of all these jabs is a bit dodgy. For exampe I've heard a few times that the maximum number of teteanus jabs you're allowed in a lifetime is 6 (not entirely sure why- haven't really looked into it). So why give three before babies are even crawling? Seems bizarre to me. If you're only alowed 6 and you have three in the first year of your life you've only got three left. They last for 10 years- so lots of your adulthood (when you must be more at risk of puncture wounds) will be unprotected.

Yes these diseases are killers, but if there are (possibly) safer, more sensible ways of protecting against them why don't we use them?

JimJams, it was aloha who said that the government didn't believe that there was a link between male infertility and mumps. I sit in a room with 3 urologists and was just intereted in reading the facts from their textbooks especially because of dh's grandfather who had it and became sterile. Maybe doing vaccination through school still gets the same number of people, but you won't achieve herd immunity by only vaccinating girls (or boys for mumps) and then you can't protect the minority of children who can't have the vaccination for medical reasons (such as those with suppressed immune systems or those who you suspect might react badly). I'm still not either advocating or dissing mass vaccination programs, but if the government has decided that it wants to achieve herd immunity theres a minimum proportion of the population who need to be immune in order to prevent spread of the disease.

Jimjams, it's not that you are only allowed 6 tetanus, but that after 6 you are immune for life. DH had to have one recently, because he cut himself in the garden, and they said he wouldn't need any more, because his immunity would last.

But keepingmum- this whole herd immunity thing is a bit of a problem anyway- measles outbreaks have occurred in populations with supposed 100% vaccination cover in the states (and in outbreaks around 60% of people have been vaccinated -US figures again- references elsewhere in this thread I think). Anyway absolutely no effort is made to find which children shouldn't receive the jabs or should receive delayed one. I'm pretty sure if DS2 was assessed we'd be told that the only one he should be given is tetanus - when he's older- but I've been left to do the risk analysis myself. The dept of Health risk analysis is as follows- "if your child catches any of the diseases we immunise against they will die and vaccination is 100% safe and we will hound anyone out of the country who suggests otherwise" (bit tongue in cheek) . When that blatently isn't true. Of course vaccination carries a risk as does not vaccinating- I object to the fact that it isn't really recognised that the balance may be in the other direction to the standard line.

Having said all that I need to distinguish between the dept of health and the individuals that work ont he front line. The d of H is very anti my decsion not to vaccinate ds2, but the HV came and spoke to me and said at the end "I totally understand your reasons and in your shoes I'd do exactly the same, I just wanted to make sure you understood what it is you're doing". Likewise to date I've had no hassle from the GP's.

musica- that's not what I've heard- let me check this out- brb!

musica- found it this is from "the vaccination bible" and ties in with what I remember the practice nurse telling me when I tried to get a tetanus booster after 9 years (as I was going to be working with wild animals) rather than after 10- she wouldn't give me the booster:

"Once an infant has its tetanus shots, medicine recommends a booster every 10 years. However, there's evidecne that thew more shots you get the lower your immunity. Each additional booster reduces the sensitivity of response of teteanus toxoid antigen after three or four challeneges according to a Lancet editorial (1996; 348:1185-6). In another study older people only showed a 20% protective immunity to tetanus (Age and Aging 1995; 24:99-102)"

Jimjams, I agree that we should be more vigilant at detecting those children who may be susceptible to adverse effects or not suitable for immunisation and not deny that this susceptibility may be present. I guess the medical practioners would say that this isn't feasible with the their time and resources and so they have to resort to coercion in order to comply with mad rules and targets handed down from on high from the D o H. Sorry I am no expert in epidemiology, but someone has worked out the optimum immunisation rates for herd immunity, though 60% sounds very low, not sure what happened with the measles outbreak where 100% immunity was expected

The link between orchitis and sterility hasn't been disproved, but there is quite a lot of doubt that they are linked. I will try to find some links, though I am rubbish at doing them. The evidence for an association isn't very strong and if damage to fertility does happen, then it is very rare, and almost unheard of for total sterility to follow mumps - by coincidence or not. Quite a few things that are common knowledge aren't true. Like everyone knows that yo-yo dieting permanently damages your metabolism - but it doesn't. I'm not saying mumps is nice, but for small children it is a pretty minor virus in nearly every case, and to describe it as a 'killer disease' as Vivienne Parry - a woman who sits on a lot of government appointed committees - does, is IMO just a silly nonsense which sounds to me as if it is designed to frighten parents who have been deprived of the single mumps virus by the DoH.

Enid, I believe the government is happy for parents to be terrified because they very much don't want their expensive and mainly very effective MMR programme to fall apart. This gives the DoH a big motive to stir up fear and doubt about the safety of single vaccines , and to create a disproportionate fear of the illnesses children are being vaccinated against. I'm not against immunisation - my son is vaccinated against everything except mumps (for the reason given above) - I just want to exercise my choice not to give him the MMR. I may be foolishly wary but I'm not hurting anyone else by making this choice, so I think I should be allowed to make it. Let's face it, the 'scandal' of the dr who made up a few doses of measles vaccine 6hrs in advance is hardly on a par with the Bristol heart babies scandal, yet when a dr blew the whistle on the completely unnecessary deaths of babies there (at a time when many deaths could have been prevented) he was ignored and shunned for years. Two drs report this guy for much, much less and it is dealt with and made public amid much scaremongering within days. It just seems a little suspicious to me.

To return to the Rubella issue. As I said, I rang Sense and they pointed out that if you don't eliminate Rubella from the community (by vaccinating everyone very young) pregnant women still risk catching it - whether they are vaccinated or not. The results of catching it can be totally horrific. The stats on how many fewer cases there are can be seen in Frieda's post. I found this convincing, even though rubella in itself is not a dangerous illness.

sorry keepingmum- I haven't been very clear- what I meant was that in measles outbreaks in the states it was found that apporx 60% of those ctaching measles had been vaccinated against it appropriately (ie received the correct no of vacinations and boosters at the correct age).

Can't do links, have tried. Anyway copied this from the Public Health Laboratory's website.
It starts, symptoms of

f symptomatic mumps include swelling of the ovaries (oophoritis), swelling of the testes (orchitis), aseptic meningitis and deafness. Cases may have no salivary gland involvement but develop symptoms elsewhere (orchitis, meningitis). Despite common belief there is no firm evidence that orchitis causes sterility.

keepingmum- actually I have no issue with the doctors etc- they're just doing their job- but this mad insisitince form the doh of "vacinate everyone and damm the consequences" really p*** me off. And not really linked- but three million on a bloody MMR advertising campaign and they can't fund 15 hours one to one for my autistic son at nursery (well they can now but not after April- cuts are needed in the lea busget) just has me screaming. (He needs the one to one- nursery say they can't provide for his needs without it and I agree).

I wouldn't mind so much if they would admit that sometimes vaccination goes wrong and were then around to pick up the consequences- both financially and socially. We're having to spend 1000 pounds (which we don't have) on a proper assessment for my son (through- BIBIC- a charity) as the NHS has managed to spend the last year cocking his up-and he still isn't getting the help he needs. This may seem not to be linked to vaccination- but it is when the DoH spends millions promoting the bloody things rather than giving parents the choice they want! And in the meantime probably produces more children like my son.

Also, I tend to agree with JimJams that I bet we are given wildly inflated ideas of how effective vaccination really is. A friend of mine's daughter recently got whooping cough despite being fully vaccinated. She had every symptom of the disease (and it was distressing, with the whooping cough and the vomiting) but her GP refused to accept it could be whooping cough 'because she had been vaccinated." So I suppose she never appeared on any official statistics. I'm not normally a conspiracy theorist, but I saw this kid and I know her very sane and practical mother who was at the end of her tether.

aloha- was that recently? there was a lot of whooping cough this year and according to the New Scientist it was due to a new strain that isn't protected against by vaccination and has evolved because of vaccination. A few weeks later a mass outbreak of whooping cough in a shcool- and what did the doh do? vaccinate everyone (reported on the BBC). Guess they don't bother reading the New Scientist. Actually this has a serious side as well- the pertussins vaccine has a very high incidence of side effects (and its efficiency has never been very good)- so much so that some countries eg Sweden have binned it all together- so to give children a vaccination that had no hope of protecting them was just stupid in the extreme.

Aloha I'm surprised to hear that as my GP has always made clear to me that no vaccination is 100% effective. I thoguht this was generally accepted.

My daughter had whooping cough 4 1/2 years ago when i was pregnant with ds1. She wasn't allowed the vaccination when she was due it, and nor was I as a child. She saw 6 different doctors before someone realised what it was, and that was only due to the fact that he had worked abroad a lot and seen so much of it there. Doctors over here knew v little about it, and couldn't even tell me if I was at risk of passing it to ds1 while he was inside me, as I hadn't been vaccinated either.

She caught it in August, and it finally went enough for her to return to school in January.We spent night after night with her watching her face turn purple from coughing so hard and unable to draw breath, finally vomiting from the force of it. I didn't think someone could cough so hard and for so long without something bursting, honestly it was really really distressing for her and me. If I ever doubted about whether or not to give the vaccine to my others then this changed my mind. She couldn't attend school, couldn't eat properly, sleep properly, her chest hurt, her throat was sore, she was terrified each time a bout started, which made it worse by panicking. The school was a complete a**e about it,when I made a fuss about the lack of help in trying to get her back to school they had a fit. I said I wasn't going to send her in if they wouldn't help her in a coughing fit ( she was no longer contagious after about 3 months of having it) so they threatened to prosecute me! I ended up getting a physiotherapist to see her to sign her off school until the new year, and she gave her some breathing exercises to do when she started a spate of coughing, to help her get it under control again.

Eventually these worked and she was able to go back to school, but it was something I would never want anyone to go through.

Interestingly enough on finding a doctor who knew about whooping cough,they said the vaccination either works completely or not at all ,so even if she had been done, she could still have caught it.

Ds1 was born during this time and fortunately he was ok, but it didn't help my stress levels worrying about it at the time.

lou- that sounds very distressing. I know what you mean about finding someone who knows about whooping cough. When ds2 was 4 months (and unvaccinated) he was exposed to whooping cough (quite a big exposure- and of course 4 months is a big risk age group). It was impossible to get information on what was the best course of action.

Interesting about the vaccine ether working or not. Research from Sweden and Italy has shown the vaccination to be effective in just 48% and 36% of cases respectively (J AM Med Assoc 1995 274: 446-7). Apparently the whooping cough epidemic of 1978-9 (when my best frined caught whooping cough- I had measles at the time- and we played together whilst convalescing!) which has always been linked to the drop in vaccination also included age groups where vaccination would have occurred before the scare (in fact my friend had been vaccinated). May aunt said that of her two children who caught whooping cough the one who had been vaccinated had it worse- rather backs up what the doctor told you.

Whooping cough is a horrible illness but the vaccination seems to have such a chequered history- high level of side effects (acknowledged by the drugs companies- and the reason for the acellar pertussis vaccination in the pre-school booster- less side effects) and really doesn;t work very well. It's a dodgy one to do the risk analysis on. Becuase it doesn't work very well apparently siblings are still passing it onto their baby brothers and sister - who the vaccination is meant to protect. Apparently lots of adults were walking round with whooping cough this year as well (from New Scientist). In adults the "whoop" was missing but it was a cough that went on and on for weeks- when someone started culturing swabs they found pertussis apparently.

Croppy, I know, but I think they didn't want her as an official statistic. She had the same thing, struggling to breathe, gasping, choking, making the noise and them vomiting. I actually saw her do it - and that was weeks after it started. Her gp wouldn't give her a diagnosis at all. It really was a horrible disease, just as lou described. I'm not anti-vaccination, but how can the government assess the efficacy of vaccination if drs are reluctant to diagnose an illness after vaccination?