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MMR key facts for parliamentary candidates
MMR Briefing
Introduction
Sense Scotland works with people who have complex support needs because of deafblindness or sensory impairment with other disabilities - many the result of the damage caused by rubella in pregnancy.
There is much speculation about the safety of MMR . Scientific evidence points to it being an effective method of protecting children and the wider population yet public confidence in the vaccine is falling. This is extremely worrying. The devastation and damage caused by rubella, measles and mumps has been forgotten. As a family-oriented organisation with roots in the rubella epidemics of the 50s, 60s and 70s, we cannot afford to forget, nor can the families affected.
We need to protect the community from rubella, measles and mumps, and need to build public confidence to do so. The answer is not to replace the triple vaccination with separate single vaccinations as some have suggested. This would simply lead to children being at risk of exposure to rubella, measles and mumps for longer and increase the spread of disease. This in turn will lead to more children being born with deafblindness, blindness and other impairments because of rubella infection in pregnancy, and more children suffering the complex consequences of measles and mumps infection.
What is rubella?
- An infectious disease once very common in children
- It comes with flu-like symptoms and sometimes a rash - often so mild you might not even know you have it
- It can cause lifelong disability if caught during pregnancy
Why is MMR important in preventing congenital rubella?
Any pregnant woman not immune to rubella is at risk, particularly if in contact with children (their own included). That's why both boys and girls are immunised. The rubella component of MMR is essential in eliminating the circulation of the disease and thus, preventing children being born with congenital rubella syndrome.
Between 1971 and 1980 (before the introduction of MMR ) 447 children were born with congenital rubella and there were 5,711 terminations because of rubella infection in pregnancy in Scotland, England and Wales. Between 1991 and 2000 (after the introduction of MMR ) only 38 children were born with congenital rubella and there were 61 terminations.
Any woman contemplating pregnancy should ask her GP to take a blood test to check her rubella immunity. If the test indicates she is not immune or her immunity is low, she will be offered a jag to protect her against rubella.
Is the MMR vaccine safe?
Many scientific studies have been carried out on MMR and all point to the vaccine being safe and effective.
The MMR vaccine was tested extensively in Scandinavia and in the USA before it was introduced in the UK in 1988. Safety has also been reviewed repeatedly by the UK Government’s independent expert committees – the Committee on the Safety of Medicines and the Joint Committee on Vaccination and Immunisation.
Does it contain mercury?
No. The MMR vaccine does not and never has contained any form of mercury. A small amount of mercury is contained in a vaccine preservative called Thiomersal. This has been used in some other vaccines since the 1930s to prevent bacterial and fungal contamination.
What is the effect if MMR rates fall?
There will be outbreaks of all three diseases, many children will be seriously ill and some will die:
- Rubella, which during pregnancy can cause, deafness, blindness, heart defects and other difficulties
- Measles, which can lead to severe illness, convulsions, lifelong disability and death
- Mumps, which can cause mumps meningitis and permanent deafness
Would the choice of single vaccines help to compensate for the drop in MMR uptake?
No. Even if every parent followed a single vaccination programme, the time delay would still mean the spread of all three diseases in the community.
- Fewer children will be protected at any one time increasing the risk of outbreaks among them
- Some may not complete the course and remain unprotected
- Some may opt to miss out rubella in the mistaken belief that it is less dangerous than measles and mumps
- More children will be born with deafness, blindness and other lifelong difficulties because of rubella infection in pregnancy
Single vaccines would require six separate trips to the GP and an increase in invasive procedures increases the incidence of local reactions.
What happens in other countries?
Most other countries use MMR and where they don't, there are considerable problems with the spread of disease. A real success story is Finland which began to use MMR in 1982 and nearly all children are immunised. They no longer see cases of all three diseases unless someone brings infection into the country.
Why is MMR given when it is?
The first MMR immunisation is given at 12 - 15 months to coincide with a decrease in maternal antibody protection and an increase in susceptibility to disease. The second dose at school entry protects those who did not respond to the first dose and decreases the accumulation of unprotected children amongst whom disease outbreaks are likely.
The two-dose strategy aims to eliminate cases of all three diseases but uptake around 95% is needed for this to occur.
What about a link between MMR and autism?
There is no scientific evidence of a link between MMR and autism. Recent studies in both the UK and the United States show that although incidence of reported autism is increasing, the rise began prior to the introduction of MMR .
Graph: Percentage of Children Receiving Measles-Mumps-Rubella (MMR ) Immunization in Second Year of Life and Caseload of Children With Autism, by Year of Birth, California, 1980-1994
If MMR caused autism, we would expect to see an increase in autism coinciding with the introduction of MMR . We also would expect to see the incidence of autism levelling off as MMR rates stabilised. This has not happened. The graph above (from a California research paper) shows a continuing increase in reported autism while the rate of MMR uptake remains constant.
Are there any advantages in delaying MMR until the immune system is better developed?
No. The immune system is continually developing. Maternal protection against disease begins to decrease around the time of the first immunisation at 12 - 15 months. It's important to know that breast-feeding offers little, if any, protection against rubella, measles and mumps.
The individual components of the MMR vaccine do not all take effect at the same time. The measles component starts to work right away, followed by the mumps and rubella.
Vaccines actually help the immune system to defend the body. By providing protection against diseases, vaccines prevent the "weakening" of the immune system. Vaccines also help prevent the occurrence of secondary infections that are more likely to occur after natural infection with the disease.
This paper draws on a number of other information resources. If you would like any further detail - or have suggestions as to what other questions should be included - please contact:
Linda Long, Health Development OfficerSense Scotland43 Middlesex Street
Kinning Park
Glasgow G41 1EE
Tel: +44 (0)141 429 0294
Fax: +44 (0)141 429 0295
Text: +44 (0)141 418 7170