Dr Howard Lee, the iVillage family doctor, chatted to members about their concerns over the MMR vaccine on the Mums of Little'uns board. Here's what was said:

Cerys2001: How old do kids have to be to have MMR?
Dr Howard Lee: Usually at 12 months and again at 4-6 years.

cl- juliekduncan: Just what does Dr Wakefield suggest in his paper? Was the study aiming to find a link between MMR and Autism (or similar conditions) or was it looking for something else? How many children did he study? Was this an adequate sample size? When the vaccine was registered there must have been several clinical trials run - have these ever been re-examined to see if any of the participants have developed autism?
Dr Howard Lee: Dr Wakefield was trying to state that he had found a link between MMR and autism - he wasn't however able to really show exactly what this link was. In this country nearly 500 records of autistic kids were looked at in one trial - no relationships between the appearance/onset of autism and the giving of MMR could be found.

Yes, extensive trials - lasting over several years are/were carried out with regard to MMR and any vaccine - and yes these records were reviewed by various agencies - no links found to be useful pointers.

cl-juliekduncan: How many children are reported to have 'suddenly' developed autism following the MMR? How many showed some tendency towards autism and then it worsened after MMR. Just what sort of numbers are we looking at here if we are to believe that there is a link?

Also, does it always seem to happen overnight, and therefore if my child is immunised and is okay after a week am I in the clear and can I stop worrying?
Dr Howard Lee: Uncertain figures should really be used; [the word] 'suddenly' is trying to make the distinction between those kids about whom the parents have had worries for some time (often years)?and those kids who, following MMR (and sometimes other 'traumatic' incidents within their life cycle) seem to develop autism over a relatively short period. 'Small' numbers only. Diagnosis is often a prolonged period of various assessments - taken into consideration with other features reported by parents, etc.

lydiajane2000: I have worked with many parents who have said that their child showed signs of autism before MMR and some hadn't given it anyhow. Some had and some felt the child was affected, but there does seem to me to be a link [between] babies suffering with ear infections at time of MMR, or a history of tummy upsets, [and] then seeming to develop autism.

My worry is my ten-month-old daughter has had two bouts of gastro-enteritis, one lot meant a stay in hospital, the second lot was campylobacter. I am concerned that this means she will be at risk [of] more of a side effect. I know we have time to think about it and know the facts but should we insist on waiting an extra month, say? I have heard that the single vaccine may not be so effective and only means three stabs of a needle against one, and even in a single vaccine they get the MMR all in one dose, just three times. I just want to know the risk of having MMR after a gastric history and milk protein intolerance. I intend to immunise: measles is a killer, and causes many problems, rubella is well known to cause problems and mumps is just as bad.
Dr Howard Lee:Awareness is right. When you are about to consider a further 'clinically engineered insult' on the immune system. As you say there are more likely to be evident links when there are possible pre-existing changes going on in a little one's auto-immune system. This is just the point. I, too, would be very aware of giving a further possible problem to the system. You have, I feel, made the correct decision - measles not only causes death, it more often causes much long-lasting morbidity.

Brit2001: I have a special needs child of my own with some autistic traits. I have had contact with many autistic children and parents. Although these children tend to get diagnosed with autism around two, usually mums are aware that their child is 'different' early on they do not follow a normal pattern of behaviour. What concerns me is the fact that some children who have had the MMR had no problems previously and then appear to acquire autism/autistic traits overnight. This does not appear to be a normal pattern of autism, more like 'something' has triggered it. As highlighted on the Panorama programme.

As my daughter has these tendencies I am very wary of giving my son the MMR and also my daughter the school booster. What would be your advice?
Dr Howard Lee: Your points/comments are totally valid - and with regard to the 'autism overnight', this is the key factor, I feel - and would not be the normal presentation of autism. I, too, would not be very happy about adding a further - as yet not totally understood - risk factor.

nichih: My son has Down's syndrome and I am worried about giving him the MMR. He's 18 months old and should have had it six months ago. My health visitor has advised me, due to my concern, to leave it until he is nearer two as by that time any autistic tendencies will show themselves. Fortunately we live in an area with quite a high take-up so she tells me his chances of catching mumps, etc., is fairly low.

I have read the leaflets but to be honest a lot of the time I feel that parents' concerns aren't even acknowledged because they are so preoccupied with telling us how great the triple vaccine is.

Obviously I am concerned for my son who, quite frankly, has enough to deal with without chucking autism on top!
Dr Howard LeeI can totally understand and also sympathise with your worries and concerns; the recommendations of most specialists would be that if there is an existing 'vulnerability' (Down's), then protection from other damaging conditions should be even more important.