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Friday, May 03, 2013

More on the single measles vaccine

raised in the Senedd eleven days ago my own concerns about a private company targetting the Swansea area with the single measles vaccine and in particular the fact that their website continues to link MMR with autism despite that fact that there is no evidence for that claim. It was interesting therefore to see that the British Medical Journal is now covering this story.

Like me they have noted that in the midst of the measles outbreak in Swansea, the Children’s Immunisation Centre, a private company with clinics in several UK cities, set up a temporary clinic in the city over the weekend of 20 April. They say that the company is still advertising availability in Swansea with the single measles vaccinations at £110 each:

On its website it says that the single vaccination is for children “whose parents had concerns regarding the safety of the MMR [measles, mumps, and rubella] vaccination offered to them by their NHS GPs.” The website goes on to say that single vaccination is the “only safe way for MMR.”1 Under the question “Does the MMR jab cause autism?” the site links to three newspaper reports that allege a link between autism and MMR2 3 4 5 but not to NHS or Cochrane review advice about safety. Beneath these links is the line “for peace of mind.”

Use of the single measles vaccine comes with potential problems. It does not have a licence from the Medicines and Healthcare Products Regulatory Agency (MHRA). More vaccinations are needed for complete coverage than with the combined MMR vaccine, meaning that the default rate is likely to be higher. The total cost of the vaccinations is several hundred pounds. Mumps vaccine is not available singly in the United Kingdom, meaning that the complication of mumps, including the risks of male infertility, meningitis, and deafness, are carried by an unprotected group, and outbreaks have occurred in the recent past in the UK.

They add that clinically there is no good rationale behind the use of single vaccines rather than the triple vaccine:

Niall Dickson, the chief executive of the GMC, told the BMJ, “Any doctor who makes false and misleading claims about the treatments or services they provide should be in no doubt that they are putting their registration at risk. We are unequivocal on this—when advertising services, doctors must always make sure the information they publish is factual, can be checked, and does not exploit their patients’ vulnerability or lack of medical knowledge.”

What is interesting is that the Children’s Immunisation Centre says on its website, “All our thousands of patients are healthy, with no autism, no hospitalizations or fits (anaphylaxis shock), no febrile convulsions. We have a 100% Safety Record and have given over 70 000 vaccinations (over 18 000 patients).”

They say that in support of this claim Fiona Dickson, the centre’s director, has told the BMJ that the centre would know if any of its patients later had a diagnosis of autism because “parents are spending £600 on vaccines—they would sue us if they did.” But she was unable to cite any audit or follow-up study that the clinics had done to support the claim, saying that they relied on parents to tell them of any diagnoses after vaccination:

In September 2012 the MHRA upheld a complaint about the Children’s Immunisation Centre’s advertising when its website published an “unbalanced view of the safety and efficacy of an unlicensed mumps vaccine.” Its website was subsequently amended.

Additionally, the MHRA told the Breakspear Medical Group and Clarion Health to amend their advertising when it was found to be misleading or incomplete.13 14 The BabyJabs clinic, based in London, had three complaints against it upheld by the Advertising Standards Authority in 2012 after it falsely claimed that the MMR vaccine “could be causing autism in up to 10% of autistic children in the UK.”

Single vaccination clinics exist because of fear and misinformation. This is compounded by misleading advertising on some websites. Their argument is that single vaccines offer a valid choice to parents who are concerned about the triple vaccine. Yet the ethics of using an unlicensed and expensive product that leaves gaps in vaccination coverage, when an evidence based and licensed one is available, should require the GMC to investigate now.

I think that is pretty clear.
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