Daily Mail, Jan 11, 2005

Babies are soon to face yet another vaccination.  But is it safe?  Here, one GP argues that we are taking a reckless gamble.

IT WAS revealed last week that government advisers have approved an injection to protect youngsters against meningitis. But with the MMR controversy still fresh in parents' minds, is this necessary? In this highly personal piece, DR RICHARD HALVORSEN argues the case for caution.

ARE you alarmed by reports that the Government intends to introduce yet another vaccination programme aimed at all our very young children? You should be.

Do we really want a re-run of the bitter and damaging controversy which developed over the combined measles, mumps and rubella (MMR) jab? In spite of intense pressure by ministers, uptake of that injection has fallen to 80 per cent and in some areas is now as low as 70 per cent.

Whether you think this revolt is justified or not, the Government would do well to show a little humility and to recognise that it represents a significant vote of 'no confidence' by worried parents in the advice given to them by officialdom.

Certainly I — a doctor who has spent years investigating the risks and benefits of child­hood vaccinations — am seriously concerned about this new scheme to introduce a vaccination against the pneumococcal bacterium (one cause of meningitis, pneumonia and septicaemia) in spite of the promise by health service chiefs that a final decision will not be made without widespread consultation. Remember that most children under two are already routinely given no fewer than 21 vaccinations in seven injections, including the controversial MMR vaccine.

Do we really need a further series of vaccines at a time when so many parents — and a significant minority of doctors and scientists working in the field — are already deeply concerned about vaccine 'overload' on a developing immune system?

Indeed, there is some evidence that the increasing number of vaccinations given to children may be a factor in the rising numbers affected by childhood diabetes, asthma and other immune-related disorders.

A Health Department spokesperson was quoted last week as saying that a baby's immune system has huge spare capacity.

'The concept of a vaccine overload has been studied carefully and the science says that this does not happen. A baby's immune system could tolerate over 1,000 vaccines.'

To me, such a brash assertion is madness. It is based on theoretical calculations and not the real world. So the remark shows a quite astonishing complacency and arrogance about our ability to control Nature. 

Trying to conquer diseases is admirable but we cannot allow ourselves to assume that science will always win out.

I think, for example, of the unpredicted arrival on the scene of the HIV virus in the Eighties — there is a theory that the emergence of the virus in humans was itself caused by trials of the polio vaccine in Africa in the 1950s — and the prolonged struggle we are now facing to understand Aids, let alone control and eventually eliminate it.                    

I think, too, of the unexpected horrors unleashed by the drug thalidomide a generation ago and more recently government reassurances over BSE right up until the announcement that yes, there was a link between mad cow disease and a fatal degenerative brain disease in humans.

Of course, if we knew that the vaccinations were completely safe and highly effective, these worries would not arise. No sensible person, lay or specialist, could then have any reasonable objections to mass vaccination programmes directed at protecting the very young.

But things are not that simple. The harsh truth is that there is no such thing as a risk-free vaccination.

Vaccinations are not completely safe (no medical intervention ever is) and many are less effective than health officials would have us believe.

When I was a young doctor, vaccinations were given to combat a number of diseases which were both common and deadly serious — diphtheria and smallpox, for exam­ple — and that approach made perfect sense. But most of those diseases, which commonly killed or maimed large numbers of youngsters, have largely disappeared, partly due to vaccination but mainly due to better health, nutrition and housing.

What we are left with are a number of others; common diseases such as chickenpox — a mild illness that is very rarely serious — and further diseases which are serious but thankfully rare.

This is the context in which the Government intends to introduce its new programme of early childhood vaccination against the pneumococcal bug, one cause of meningitis, septicaemia (blood poisoning) and pneumonia.

At which point we should ask three basic questions.

Is this particular new vaccination worth having? Does it work? And finally, is it safe?

We should look first at the scale of the problem it is supposed to address. Children under five have a one-in-7,000 chance of getting a serious pneumococcal infection such as meningitis or blood poisoning — in any one year Of those who do contract such infec­tions, one in five will die and one in five will be permanently disabled.

Of course, the death of any child is a tragedy, as is the possibility of continuing disability. As a doctor, I see the devastating impact this can have.

But when you look at these figures critically, you have to say that the death of children from meningitis or septicaemia is, thankfully, a pretty rare event.

The next question is: does the vaccine work?

The answer must surely be 'not very well'. Estimates are that it would be effective in 66 per cent of cases. That means a one-in-three chance that your child will not be protected by the vaccine.

Finally, and crucially: is the new vaccine, which the Government is embracing so enthusiastically on behalf of our children, really safe? The truth is that I don't know, and neither does anybody else, whatever claims the power be might choose to make.

What we do know is that U.S., where the vaccination is already in use, parent doctors have reported 117 deaths relatively soon after vaccination.  There is no proof that vaccination was the cause, but the deaths remain obstinately unexplained.

GIVEN that there is no widespread, life-threatening epidemic to be fought, we should surely err on the side of caution. The truth is that proper, long-term, follow up research has not been done, either here or in America.

The reason is that really convincing research would involve giving a control group of young children an inert or lifeless form of the vaccine  (a placebo) and observing how they got on over a number of years, compared with those who had been give the active vaccination.

This research — though normally demanded of any new drug---is just not done with new vaccines for obvious ethical reasons.

But suppose such research was permitted and it was demonstrated that some lives indeed had been saved by vaccination but that others who had also received it had died or suffered devastating side-effects.

What possible conclusion you draw?

I am not an enemy of vaccination.  Indeed, I strongly support some vaccinations and I tell my patients so. But I do feel that to introduce a  new   vaccination campaign now, without strong cause, is grossly irresponsible.

I urge ministers to think again while there is still time.

[Dr Richard Halvorsen is a GP in London.]