Health: Vaccination: do you know the risks?: Jan Roberts meets parents who believe immunisation against measles, mumps and rubella injured their children

It all began in December 1992 when Robert, a healthy one-year-old boy, went with his mother, Jackie Fletcher, to have his measles, mumps and rubella injection.

'Ten days later he started convulsing. We went by ambulance to the Royal Albert Edward Infirmary, Wigan,' says Mrs Fletcher, who comes from Warrington, Cheshire.

'When we suggested our son might be reacting to the vaccination, the doctor looked puzzled. He said the fit coming after the inoculation was a coincidence and would probably not recur. The consultant on the ward said much the same. However, our child continued to have fit after fit.

'Our son was eventually diagnosed as epileptic as well as having a very rare acquired immunodeficiency problem.' Robert, now two-and-a-half, has several fits a week. The Fletchers have been granted legal aid to take a compensation claim to court.

There were many hospital visits after the first crisis in December. In May 1993 Robert was again admitted but he was so ill that he was transferred to the Royal Manchester Children's Hospital. There Mrs Fletcher met another mother, Gill Dean, from Ashton, whose daughter Clare appeared to have a similar problem.

This seemed an extraordinary coincidence - like two needles meeting in a haystack. Both mothers had been told their child's sudden ill health was 'rare and nothing to do with the injection', but they decided to investigate.

One of Mrs Fletcher's first steps was to contact her local Community Health Council, which agreed to place an item in the local paper to find if any more parents had had a child suffer adverse reactions which they believed were connected to the MMR vaccination. Thirty responded.

By December the parents had formed a group called 'Jabs', for Justice, Awareness and Basic Support. Similar groups exist in the US, Australia, New Zealand and France. Mrs Fletcher stresses that they are not 'anti-vaccination' but they do want better information and compensation for their children.

'We don't want to damage the vaccination programme but if there is a problem it should come out,' says Mrs Fletcher. 'We know the majority of children go through the programme without any problems. What we want is more accessible information at clinic level so parents know about adverse reactions as well as the protective factors. Then we can make informed choices.'

Richard Barr, of Dawbarns, King's Lynn, is one the solicitors acting for Jabs. 'We are all saying that it is not wrong to vaccinate. But we are saying that parents must be given more information. The leaflets some parents saw said that there was no measurable risk. One parent told me that if she had been told there was even a remote risk, she would not have had her child vaccinated,' he said.

To date 180 parents have contacted Jabs, about 120 of them concerned about the MMR vaccination. All these were sent questionnaires from which Jabs has compiled a list of UK children and their alleged adverse reactions. They are now analysing the data.

Three makes of vaccine are implicated. Two of these ceased to be used by the Department of Health in September 1992, subsequent to reports of 'mild transient meningitis'. The Department has always denied formally 'withdrawing' the vaccines, stating that it had simply changed its source of supply. Mrs Fletcher and her colleagues want to know why Canada withdrew the two brands 18 months before the UK. Japan has also suspended use of the two vaccines.

One of these vaccines was called Pluserix-MMR, manufactured by SmithKline Beecham. Jabs has so far identified 24 children on the list who received this. The other withdrawn vaccine was Immravax, made by Merieux UK Ltd. Thirteen of the children on list were given it.

Jabs has identified seven children who received MMR-2 vaccine, made by the US company Merck. This vaccine is the one currently used in the UK. A Department of Health spokesman said last week the risk of MMR-2 causing meningitis was so small as to be 'unquantifiable' and there was no direct risk of epilepsy. Richard Barr confirmed that one of the cases granted legal aid was given MMR-2 as were four of his cases in the process of applying for legal aid.

A Merck US spokesman says: 'Three hundred million doses of MMR-2 have been distributed worldwide. There is no causal relationship established between meningitis, mumps and encephalitis and the MMR-2 vaccine. It has an unsurpassed record of safety.'

Jabs says that three Pluserix-MMR children in the UK died shortly after receiving the vaccine. Other reactions listed by the parents include arthritis, epilepsy, affected speech, deafness, delayed development, fits, convulsions, and attacks of measles and mumps.

Since 1988 about four million children have been through the MMR programme. The Government does recognise that children can be damaged by vaccination. Since 1979, when the Vaccine Damage Payment system was set up, some 600 have won state compensation. The maximum pay-out is pounds 30,000 but cases are difficult to prove and disability would have to be very severe.

Meanwhile the pressure is on for GPs to achieve their vaccination targets. They receive a bonus of pounds 1,905 if 90 per cent of children under two on their list are vaccinated. If only 70 per cent are vaccinated, they receive pounds 635. Below this they get no bonus. Mrs Fletcher says these payments threaten the objectivity of medical decisions.

Jabs: Jackie Fletcher, 1 Gawsworth Road, Goldborne, Warrington, Cheshire, WA3 3RF (0942 713565). Jabs will feature on the ITV programme '3D' on Thursday at 7.30pm.

(Photograph omitted)