How the MMR scare led to the return of measles

The Sunday Times, February 8 2009

There were 1,348 cases of measles in the UK last year, according to the Health Protection Agency, up 36% from 2007. In 1998, the year that Andrew Wakefield published his research in The Lancet, there were 56 cases.

Last year 84.5% of two-year-olds in the UK received one dose of the MMR vaccine. By age five, when the second dose is due, the rate is 77.9%. The World Health Organisation (WHO) recommends that 95% be vaccinated to achieve “herd immunity” (in which unvaccinated individuals are too few and far between to allow an infection to spread).

Through herd immunity, the WHO hoped to eradicate measles by 2010, but there are now “serious doubts” that this will be possible. The UK has been identified as one of the worst European countries for measles – along with Romania, Italy, Switzerland and Germany. The high rate of measles in Europe was labelled “embarrassing” by WHO scientists, especially after outbreaks in otherwise measles-free South America were traced back to Europe.

Measles is a highly contagious disease characterised by a high fever and a rash. It can be passed on without direct contact before the rash appears. About one in every 15 children has complications that can include meningitis, pneumonia, fits, encephalitis (swelling of the brain), blindness and brain damage.

In very serious cases measles can be fatal. In 2006 a 13-year-old boy from a travelling family living in northwest England became the first person in the UK in 14 years to die from measles.

Ideally, children should receive two doses of the MMR vaccine by their fifth birthday. The vaccine has been found to be safe in several studies carried out around the world.

Within a month of Wakefield’s controversial paper appearing in The Lancet, a Medical Research Council panel of 37 researchers reviewed the available evidence and said there was no reason to change policy on MMR vaccination. Experts in virology, epidemiology, gastroenterology, immunology, paediatrics, autism and child psychiatry concluded there was “no evidence to indicate any link” between the MMR vaccine and autism in children.

In February 2001 an analysis published in the British Medical Journal found that while autism had increased among boys in the UK from 1988 to 1993, the rate of children vaccinated with MMR had stayed approximately the same.

In November 2002 a study analysed the records of 537,303 children born in Denmark between January 1991 and December 1998. It found no link between MMR and autism.