In February 1998 Dr Andrew Wakefield, a Gastroenterologist at London's Royal Free Hospital, suggested that the MMR vaccine could be linked with bowel disorders and a varient form of Autism in children. This ignited a great debate between medical professionals, the government and parents regarding the safety of the vaccine. In August 2003, Dr Sarah Brewer, iVillage's medical expert answered members questions and concerns about the multiple vaccine.

i_helenax: Does the government admit that there are a small number of kids who are sensitive to autism? If so, their approach seems to me to be completely irresponsible.

Dr Brewer: No medicine is 100% safe for everyone - there is always going to be a small number of individuals who have a rare reaction. The important point is, that however awful a reaction may be for the individual concerned - and their family - the number of people who do have bad reactions is much, much lower than the numbers who have bad reactions to the diseases themselves. I would hope that, with the uptake of MMR falling so low, the government would bow to common sense and make single vaccines available privately to those who prefer to use them - as long as they are aware that their children would not be protected as quickly as they would be if given the MMR as one jab.

clucks: Can you tell us why the government will not supply single jabs on the NHS and how safe and effective they are, anyway.

Dr Brewer: Personally, although I feel that the vaccines should be available privately for those who wish to have them, I think the philosophy behind this is illogical. If someone is going to develop a very rare reaction to one component of the MMR vaccine, surely they will develop that reaction if the vaccines are given separately too?

There is no evidence that the combined MMR is unsafe. All the good quality clinical trials have shown that it is one of the safest vaccines available. Like all medicines, however, it cannot be 100% safe for all people - a few will have a very rare reaction. That risk is much less than the risk of complications from the diseases it is protecting against, however.

frances19682002: If the MMR is such a successful vaccination then why is it necessary for our children to go for a booster? One of the arguments against the single vaccine was that the child would have to be put through three injections instead of one, but at least you didn't need a booster with the singles.

Dr Brewer: The reason the booster was introduced was because up to 10% of children were found not to develop a protective level of antibodies when they received a single MMR. The majority of these go on to develop full protection after the booster dose.

i_helenax: I have read that mercury, used as a preservative, may be the cause of problems with the MMR vaccine. Is it still being used and if so are there any plans to change this?

Dr Brewer: As MMR is a live vaccine, it does not need a preservative, and there is no mercury (in the form of thiomersal) used in its production (see link at end for more info).

cl-loujadams: Am I right in saying that ALL single vaccines available via private clinics, or GPs acting privately, are unlicensed for use in the UK and their efficacy is therefore not established?

Dr Brewer: As far as I am aware, no single vaccines for M, M or R are now available via the NHS. Those used privately are unlicensed. Their use is therefore 'off license' and the GP is personally liable for any problems that occur as a result. Because the single vaccines are untested to British standards, their effectiveness is also uncertain.

denisebrum: It is true that the single vaccine is less effective than MMR? Would it be 'safer' to postpone vaccination until my child is two or more?

Dr Brewer: Yes, the single vaccines are less effective than the MMR (see links at the end for more info) The problem with waiting until your child is two or more is that he/she is then at risk of catching measles, which is a potentially dangerous infection. If you feel very strongly about this, however, then having MMR at age two is better than not having it at all. The best time to have the MMR seems to be around 13 months.

emmadibbs: Is there a general age for a child starting to show autism, and how does this relate to the time MMR is administered?

Dr Brewer: MMR is normally given between the ages of 12 and 15 months, around the same time that signs of autism start to show - usually between 12 and 24 months. This is the main reason why a link was first suggested. However, there does not seem to be a greater incidence of autism in children who have had MMR compared with those who have not.

rosehawk3: I was wondering what the chances of my daughter getting autism from the MMR shot are? I have reason to believe my son got Aspergers from the MMR shot he had in America. I'm scared to give it to my daughter after what happened to my son.

Dr Brewer: You need to ask your GP to refer you to a consultant paediatrician for a full discussion about whether or not your daughter should receive MMR. Your doctor should be willing to do this - you are in a very difficult situation and need individual advice from an expert to help reach a decision. You are perfectly entitled to request a second opinion, too.

i_helenax: What do you think personally about the vaccines?

Dr Brewer: MMR is a very emotive subject, and as a mum myself I know how difficult it is to make the decision about whether or not to let your loved ones have the vaccination. Having looked into the issue very carefully, I decided I did want my children to be protected against measles, mumps and rubella. My seven-year-old is fully vaccinated, and my three-year old twins are, by coincidence, booked in for their booster MMR next week.

For more information go to www.mmrthefacts.nhs.uk the NHS website outlining many of the issues relating to the vaccine and www.jabs.org.uk(Justice Awareness and Basic Support) for information on vaccine-damaged children.

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