Research into Practice

The debate about the MMR (measles, mumps and rubella) triple
vaccine is still raging. There have been many column inches
dedicated to the conflicting research findings, the issues raised
and government responses.

However, it is not just parents who may have to consider the
research; it also affects social care workers who work with
children and families. You may be placed in a dilemma: do you
follow government guidance or do you consider the research and make
up your own mind? If you disagree with the Department of Health, do
you say so? What line does your employing authority take?

The message from the advisers at the Department of Health is that
the triple MMR jabs are safe. They are expressing concerns about
the low level of take-up in some areas. They say that this is
placing all children at risk, as an epidemic may arise resulting in
deaths and disability. This is backed by a publicity campaign to
encourage parents to immunise their children. The government is not
currently responding to the demand for single vaccine doses.

However, the Autism Research Campaign for Health (Arch) has called
on the government to drop all publicity that claims MMR to be
“indisputably” safe. Arch cites a study by John O’Leary, a
professor at Trinity College, Dublin, which found the MMR strain of
measles in the guts of 12 autistic children who had received the
triple vaccine. Arch says the research raises “important questions”
about the safety of the triple vaccine and calls on the government
to commission a new study to investigate any links between MMR,
autism and bowel disease, and demands single jabs to be made
available on the NHS to parents who want them.

The research conflicts with a study published in June, which found
no link between MMR and autism or inflammatory bowel disease. The
Irish results were based on samples from a 1998 study by Andrew
Wakefield, which found possible links between the MMR jab and
developmental disorders in 12 children with bowel symptoms. David
Salisbury, the principal medical officer with the NHS, said that it
was unable to assess O’Leary’s results until they were published,
and it has not received a response to a request for information
about the research.¹

Jackie Fletcher, of immunisation pressure group Jabs, said new
research was “highly significant”. Jabs has been raising concerns
since issues about the safety of the vaccine were first raised in
1994. Jabs is now claiming that the government has consistently
refused to take meaningful research seriously and always criticises
the presenting researcher.

The controversy is significant for social care workers. Parents are
worried about having their children immunised with the triple MMR
vaccine and may ask social care workers for advice. Does a social
worker say, “Well, I haven’t had mine done”? The local authority is
the corporate parent for looked-after children. Does a social
worker, who has not had their own child immunised, go ahead and
arrange for a looked-after child to have the jab? Is a social
worker obliged to follow government advice, if parents, with whom
the local authority shares parental responsibility, say they are
not sure whether their child should immunised. Is the social worker
obliged to persuade them? Should local authorities pay for the
single vaccine doses?

The research in this area is important for social care workers as
it raises ethical issues as well as simply an analysis of the
research findings. It may be important to debate the practice
issues further.

Gaynor Wingham is director of the Professional Independents
Consultancy.

¹ For more information on MMR research go
to:
www.doh.gov.uk/mmr
or
www.vaccinationnews.com
or
www.jabs.org.uk