How do I know that the Government isn’t hyping up this measles scare to compensate for the fall in vaccination resulting from its cover-up of the autism link?”

This was the question put to me by a father this week at my surgery, still holding out on giving his daughter MMR (the measles, mumps and rubella vaccine).

In Hackney we know that the measles outbreak is real because we have seen 150 cases over the past three months and ten have been admitted to hospital with pneumonia – the greatest number of cases I’ve known in the 20 years I have been here. The high fever, the hacking cough, the sore eyes, the blotchy rash, the inconsolable misery – all these features of the infant with measles had become a distant memory.

The recent upsurge in measles cases in Britain is a sad tribute to the climate of irrationality. Despite all the paranoid conspiracy theories, there has never been a cover-up of the link between MMR and autism. In ten years those promoting this autism link have failed to produce convincing scientific evidence while numerous laboratory studies and epidemiological surveys have upheld the safety of MMR. Yet uptake of MMR has dropped and, though it is recovering, it has still not reached its level of a decade ago and is still well short of the level required to guarantee herd immunity.

Parents who are worried about MMR still inquire about getting the measles, mumps and rubella components separately. This makes even less sense than rejecting MMR altogether. Campaigners against MMR blame the measles component of the vaccine for causing inflammatory bowel disease (which they believe then causes autism). If this – wildly improbable and utterly unsubstantiated – hypothesis is true, then it is as likely to happen with the separate measles vaccine as with the combined vaccine.

AntiMMR campaigners are critical of the many MMR safety studies: yet there are no studies whatever of the safety or efficacy of the programme of separate vaccinations (though it is certain that the inevitable delays in giving the vaccines will leave children vulnerable to these infections).

The rise of a combination of extreme scepticism towards established sources of authority in science and medicine and anxiety about environmental threats to our wellbeing has led many to put their faith in self-proclaimed mavericks and alternative healers and charlatans. The recent outbreaks of measles, which resulted last year in the first childhood death for 15 years, shows how dangerous this credulity can be.

As doctors, we are grappling in our surgeries with fear and confusion, exacerbated by an apparently endless series of health scares and panics. A campaigner came to me convinced that a local mobile phone mast was causing her breathing difficulties; later she admitted that she smoked 30 cigarettes a day. A young man, committed to the “near-death” experiences offered by inhaling the veterinary tranquilliser ketamine in the course of weekend clubbing binges, inquired whether I would check his serum cholesterol level to assess his long-term risk of coronary heart disease. Patients who consume vitamins, antioxidants and herbs by the bucketful commonly refuse to take medication recommended for high blood pressure or some other condition because they “don’t want to get hooked on tablets”. Some patients even refuse chemotherapy for cancer in favour of homoeopathy, acupuncture or aromatherapy.

One of the most potent forces of irrationality in healthcare, one with a particularly baleful influence in the MMR controversy, has been promoted by the Government. It has elevated consumer choice – and subjective belief – over medical expertise. If, as successive health ministers have proclaimed, patient choice must become the driving force in the health service, then why – as parents inquired in my surgery this week – can they not choose to have separate measles, mumps and rubella vaccinations on the NHS? But the problem revealed by the MMR scare is that individual choice cannot be reconciled with a mass childhood immunisation programme.

The object of immunisation policy is not to provide a “pick and mix” selection to the public, but to provide a coherent programme for the prevention of infectious diseases. A strong body of scientific evidence confirms that MMR provides the best protection for both individual children and for society. As a consequence of ill-informed choices made in a climate of fear irresponsibly cultivated by antivaccine campaigners and vested interests, we now face outbreaks of measles. The choice to refuse MMR to avoid an entirely speculative risk of autism results in children being exposed to the real risks of measles.

As Stevie Wonder so presciently sang:
When you believe in things that you don’t understand, Then you suffer, Superstition ain’t the way.

Michael Fitzpatrick is a GP in Hackney, East London, and author of MMR and Autism: What Parents Need to Know

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