The despair I expressed nine years ago in a piece for the LRB on the MMR disaster – ‘Why can’t doctors be more scientific?’ – persists. Anti-vaccination proponents still peddle junk science with vigour.
So it’s a relief to see on TV the families in South Wales queuing to get the MMR vaccine for their children. The last time citizens there queued like this was during the smallpox outbreak that started in Cardiff in January 1962; 47 people fell ill and 19 died. The smallpox vaccine was very popular, but quite risky – complications were not rare, particularly in those with an eczematous disposition. Officials rightly resisted a big vaccination programme. They failed; about 900,000 people took it up, of whom 35 developed eczema vaccinatum, the virus spreading rapidly from the scratch on the arm. Two died from it.
In Swansea at the moment public health doctors are working hard to promote the uptake of MMR. They are right, again. The only potentially life-threatening complication of MMR is an allergic reaction. It is treatable and occurs in less than one in a million vaccinations. In the 10 years before the introduction of MMR in 1988, 140 people died of natural measles – one in every 6100 cases.
A campaign in 1997 against MMR – ‘MMR Parent’s fight for facts’ – by the South Wales Evening Post coincided with a 13.6 per cent fall in MMR uptake in the newspaper’s distribution area. In the rest of Wales there was a 2.4 per cent fall.
There is an idea that the best vaccination programme from an individual’s point of view is one where almost everyone else is vaccinated while they are not, so that they get indirect protection. But the measles virus is more infectious than any other microbe. Evolutionary forces have shaped it to seek out the non-immune with great efficiency. Even so, fewer than 5 per cent of them in a population leads to its extinction. This was achieved throughout the Americas more than a decade ago. But last year the UK ranked second in the European measles league, with 1902 notified cases. Romania had 3843, France 859, Germany 682 and Spain 446. Gambia has been vaccinating vigorously for years. It had no measles cases in 2011 or 2012. What a scandal!