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Children received vaccine despite meningitis link

Celia Hall,Medical Editor
Tuesday 15 September 1992 23:02 BST

THOUSANDS of children were given measles, mumps and rubella injections days after the Department of Health decided to stop supplying two types of the vaccine because of a risk of meningitis, it emerged yesterday.

Although the decision was made last week, the department had not planned a public statement or to tell doctors not to use the two brands of the vaccine until tomorrow.

A letter to hospital pharmacists, however, was sent out last week 'inadvertently' early, a department spokesman said.

As a result the decision to supply only the remaining measles, mumps and rubella vaccine, MMR II, that has not been linked to 'mumps meningitis' was revealed in press and radio reports yesterday.

One GP accused the department of choosing administrative neatness over maximum safety. 'They wanted the MMR II supplies to be in place before they told us,' Dr David Bevan, of Outwell, near Wisbech, Cambridge, said.

'As a result a load of children have continued to be vaccinated with a second-class product. I have vaccinated three children since the decision was made. Even if, on a risk benefit analysis, it was still preferable to vaccinate them, I find the department's attitude cynical,' he said.

Eight children had been vaccinated at his practice in the past three weeks - the time in which meningitis would develop. 'Three of these were avoidable,' he said.

A patient in his practice was one of the children who developed mumps meningitis after receiving vaccine that had been withdrawn. 'Fortunately the little boy made a full recovery but he was in hospital for a short time,' Dr Bevan said.

The MMR vaccine was introduced in 1988 and pronounced to be very safe. Three brands have been used, two containing the same 'Urabe' mumps vaccine virus strain and one, MMR II, made by Merck, Sharp and Dohme, containing the 'Jeryl Lynn' strain.

The department decided to stop using the Urabe strains made by Merieux and SmithKline Beecham when detailed laboratory investigation over four years made the link with cases of meningitis.

The department stressed that the risk was very small - one in 11,000 cases - compared with one in 400 cases of meningitis when people catch mumps naturally. It also said that the meningitis following vaccination was milder than the meningitis following 'wild' mumps.

Dr David Salisbury, senior medical officer at the department, said yesterday: 'We had to be very certain that MMR II was as effective as the other two vaccines and that it didn't give rise to side effects before we decided to use MMR II only.

'We found only eight cases over four years. The evidence did not exactly leap out at us. I feel we have acted properly when the evidence was scientifically justified.'

In a statement, Dr Kenneth Calman, the Chief Medical Officer, said yesterday that MMR II was preferable. 'The risk of contracting vaccine-related meningitis is extremely rare and the benefits of immunisation, whichever vaccine was used, overwhelming.'

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