Children 'put at risk by single vaccines'

Parents who choose to give their children single vaccinations instead of the combined MMR jab against measles, mumps and rubella may be putting their offspring at greater risk, scientists warn today.

In one of the most powerful justifications for using the triple vaccine, the child health experts say there is "overwhelming" evidence to show the MMR jab is safe and highly effective. By contrast, some single mumps vaccines carry a small increased risk of children contracting meningitis. Another fails to give youngsters adequate protection against the disease.

No country in the world gives pre-school children separate vaccines for measles, mumps and rubella as an alternative to MMR, so the use of single jabs is "untried and untested", the paediatricians add. Giving the vaccines separately over a period of time also means that children are not protected against all three diseases as early as possible.

Writing in this month's edition of the Archives of Disease in Childhood journal, the authors also dismiss research which has linked MMR to autism or inflammatory bowel disease as flawed and highly selective.

Professor David Elliman, of St George's Hospital, south London, and Dr Helen Bedford, of London's Institute of Child Health, reviewed all the evidence on MMR to date. They conclude that there is no case for introducing single vaccines and that scare stories over MMR are unjustified.

"There is no good scientific evidence to support a link between MMR vaccine and autism or inflammatory bowel disease: indeed there is mounting evidence that shows no link," they say. "There is considerable evidence of the effectiveness and safety of MMR vaccine. Using separate vaccines is an untried and untested policy and, as far as protecting children from infectious disease is concerned, a backward step," they conclude.

In support of their argument, the authors say that numerous studies have set out to investigate a possible link between MMR, autism and bowel disease and in the end found no association.

Earlier research, including work by Dr Andrew Wakefield, the researcher at the Royal Free Hospital in London who triggered the first concerns over MMR, has been widely discredited.

A further paper by Dr Wakefield published in January this year, which claimed that safety studies on MMR were inadequate, had ignored an important Finnish study. This paper, which studied effects on twins, reported a very low rate of side-effects from MMR and no link with bowel disease.

"The paper [by Dr Wakefield] contains no new information, it has many errors, and is highly selective in the studies it includes," Professor Elliman and Dr Bedford say.

After a major review in the United States, where the MMR vaccine has been used for nearly 30 years, the American Academy of Paediatrics backed the continued use of the combined vaccine and said that the use of separate jabs had no place in practice.

The authors add that children currently have two doses of MMR, the first at 13-15 months and the second before they start school. But if they received single jabs they would need six injections at intervals, exposing them to the risk of catching one of the diseases while they wait to complete the course.

No single vaccines are licensed in the UK and unlicensed vaccines for mumps had been shown to cause a small increased risk of meningitis or they had been ineffective.

The authors say: "While the final decisions rest with the parents, the evidence of the safety and efficacy of MMR vaccine is so overwhelmingly conclusive that health professionals should have no hesitation in recommending its use."

Their hard-hitting report was endorsed by Dr Elizabeth Miller, of the Public Health Laboratory Service, in a commentary for the journal.

Dr Miller points out that the concerns about MMR have been reviewed on numerous occasions by independent expert groups. "The consensus in their conclusions is remarkable," she writes. "None has found any scientifically robust evidence in support of these hypotheses."