Measles, mumps and rubella (MMR) vaccine

February 2006

The BMA:

  • supports the triple MMR vaccine as the safest and most effective means of protecting children against measles, mumps and rubella;
  • rejects calls for compulsory childhood immunisation, and
  • supports the abolition of the immunisation target payments system without financially penalising GPs.
Two million children in the world die every year from vaccine-preventable diseases. Immunisation programmes have probably saved more lives than any other public health intervention apart from the provision of clean water.

Independent research has found no link between the childhood MMR vaccination and either autism or Crohn’s disease (a chronic inflammatory bowel disease). This should encourage parents to follow the advice of their family doctor and have their children immunised with the triple dose vaccine.

Measles, mumps and rubella can be serious diseases with potentially fatal consequences. Using single dose vaccines would leave children exposed to the risk of infection for longer periods.

A colossal amount of work has been done by GPs and their primary health care teams to convince parents of the value of vaccination. MMR is an extremely safe vaccine and has been used worldwide for nearly 30 years. Over 500 million doses have been used in over 90 countries.Go to reference 1 The MMR vaccine was introduced in the UK in 1988.

By protecting their own children, parents are also protecting other people’s children from the serious health risks associated with the illnesses of measles, mumps and rubella.

Vaccination levels for MMR fell following adverse publicity in 1998 after the publication of a paper suggesting an association with the MMR vaccine and autism and inflammatory bowel disease. Dr Andrew Wakefield suggested that if there was a link between MMR and these conditions, the risk might be avoided by giving three separate doses one year apart.

No independent studies, however, have been able to find any evidence of a link between the MMR vaccine and autism or bowel disease.

Latest figures on uptake
Immunisation levels for MMR had been falling every quarter since April 2002. For the cohort of children reaching their second birthday In 2004-05, 81% had been immunised against measles, mumps and rubella with the combined MMR vaccine, slightly higher than the 80% uptake in 2003-04, but well below the peak coverage of 92% achieved in 1995-96. At a local level 290 Primary Care Oraganisations reported uptake less than 90%, including 206 with uptake below 85%. Only 12 reported a uptake of over 90%. Go to reference 2

Uptake is below the 95 per cent level recommended by the World Health Organisation to prevent outbreaks of disease. Coverage required for population immunity for measles is 92 to 95 per cent.

According to the Health Protection Agency, no country in the world recommends giving the MMR vaccine as three separate injections. There is a real danger that we will see measles, mumps and rubella recurring in the population. To prevent this, parents should follow the advice of their GP and have their children immunised.

Compulsory immunisation
The BMA’s annual conference in July 2002 rejected a call for compulsory childhood immunisation. The BMA subsequently published a report 'Childhood immunisation: a guide for healthcare professionals - go there now' on the merits and drawbacks of introducing a programme of compulsory immunisation in the UK.

The report looked very carefully at the issue of compulsory vaccination and it is true that some countries do operate immunisation programmes where there is some degree of compulsion. However, the BMA does not think this would be right for the United Kingdom.

It is far preferable to inform and educate parents about the overwhelming benefits of vaccination, not only for their children, but for society in general. The doctor-patient relationship is based on trust, choice and openness and we think introducing compulsory vaccination may be harmful to this.

The BMA continues to believe that the safest way of protecting children from the potentially serious illnesses, measles, mumps and rubella, is the triple dose MMR immunisation. single vaccines are not the solution as this would leave children unprotected for extended periods and raise the likelihood of epidemics.

Immunisation target payments
The BMA's general practitioners’ committee calls for the abolition of the immunisation target payments system without financially penalising GPs. The reasons for this are as follows:
  • the current controversy over the safety of the MMR vaccine, and the government's inability to adequately address it, has exposed the target payments system as unworkable;
  • the target payments system has a detrimental effect on the doctor/patient relationship resulting from the perceived link between medical advice and pecuniary interest;
  • it has a negative impact on vaccination levels;
  • it does not take into account parental choice;
  • it does not recognise 'informed refusal'.
Facts and figures
  • Infectious disease remain a major cause of mortality world-wide, accounting for 17 million deaths annually in the developing world and 500,000 deaths in the industrialised world.
  • Before the introduction of the diphtheria vaccine in 1939, around 45,000 suspected cases were recorded annually in the UK with over 2,000 deaths. In 1957, only 37 cases were recorded with 6 deaths.
  • The dangers posed by a fall in immunisation cover are real. Fears in Japan that the whooping cough vaccine was unsafe lead to a mere 10 per cent coverage of 2 year olds in 1976 - in 1979 the country suffered a major epidemic with more than 13,000 cases and 41 deaths.
  • Since the MMR vaccine was introduced in the UK in 1988 the number of suspected cases of measles has fallen from between 50,000 and 100,000 cases per year to less than 10,000. The number of deaths from acute measles has also fallen from an average of 13 per year to only 4 deaths between 1988 and 1996.
  • Several countries (Barbados, the Czech Republic, Canada, USA, Belgium, Singapore, France, India, Kuwait) have some form of compulsory immunisation, either in general of for entrance to nursery/school.
For further information, please contact the parliamentary unit:
Address: BMA House, Tavistock Square, London WC1H 9JP
Tel: 020 7383 6223/6520
Fax: 020 7383 6830
Email here to:
  1. NHS Immunisation Information 2006, Health Protection Agency
  2. NHS Immunisation Statistics, England: 2004-05, Department of Health