is the mmr vaccination safe?

Lopez okhiai biology case-study

Introduction

MMR basically stands for measles, mumps, and rubella and is a combined vaccine that protects against measles, mumps and rubella and was introduced in 1988. It replaced giving three separate vaccinations for the three diseases and since this vaccine was developed, the number of children that have developed these conditions has fallen significantly. These diseases can lead to very serious problems such as encephalitis (swelling of brain which can lead to brain damage). I will be debating whether it is safe for children to be given the MMR vaccination and discuss how controversial this procedure has become and people have begun to wonder if it would be safer to give three separate vaccinations

Measles

Measles is a highly infectious viral illness caused by the rubeola virus and is best characterized by the rash that would occur in young children. However it can also infect adults as it is very contagious and can be spread from person to person very quickly and easily through ‘droplet transmission from the nose, throat, and mouth of someone who is infected with the virus. These droplets are sprayed out when the infected person coughs or sneezes’. Symptoms of measles are fever, rash and feeling unwell for a few days for 7-10 days; however the time might be different for adults. In very serious cases, measles kills. In 1987 (the year before the MMR vaccine was introduced in the UK), 86,000 children caught measles and 16 died. (Kingston pct)

Mumps

Mumps is also very transmittable viral disease caused by the mumps virus and ‘spreads from person to person through contact with respiratory secretions such as saliva from an infected person.’ Symptoms of it are the painful swelling of the salivary glands and more common symptoms are headaches, fever, parotid inflammation and Orchitis which is the painful inflammation of the testicles. Before a vaccination was introduced, mumps was seen as a common childhood disease. ‘In teenage males and men, complications such as infertility or sub-fertility are more common, although still rare in absolute terms' it is also the biggest cause of viral meningitis in children. In the year before MMR vaccination was introduced, the mumps virus produced around a thousand hospitalisations and five patients died. (h2g2)

Rubella

‘Rubella, commonly known as German measles, is a disease caused by the rubella virus. ’ it can last for 1-3 days but children recover faster than adults and can spread in much the same way as the flu or cold virus which means that if the droplets of moisture that comes out of the nose and mouth of the person that is infected and is inhaled by a uninfected person. That person would become infected those droplets would be spread when the person sneezes, coughs or even talks. It is very serious in unborn babies as it can lead to eye problems such as ‘cataracts, deafness, heart abnormalities, and even brain damage.’ However since the vaccine had been introduced in the UK, cases of rubella have been very low for example in 2007 there was only one recorded case of Rubella. In 2010 there were only ‘12 cases in England and Wales.’ This would make vaccination really important because many young children may be in contact with pregnant women. In the year before MMR vaccination was introduced, around 40 babies were born with congenital rubella syndrome. (h2g2)

Number of cases per year in Finland

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Since these vaccinations were introduced in 1988, the cases of these diseases appearing in people have dropped significantly.

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Number of cases per year in Finland

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Since these vaccinations were introduced in 1988, the cases of these diseases appearing in people have dropped significantly.

In Finland, the amount of cases for measles used to be 15,000 before the MMR vaccination, ‘since 1985 the number of cases was tiny, and in 1996 fell to zero’ (medicine.ox). In terms of mumps and rubella, the number of cases used to be ‘a few thousands to a few tens of thousands a year’ (medicine.ox). But since the MMR vaccine was introduced, we can see from the graph above that the cases of mumps and rubella have fallen to but ‘fell sharply after the introduction of MMR to a few hundred or tens’ (medicine.ox). And since 1997 there have been no reported cases of the two diseases. This has prevented the death of a large number of children and has benefitted a millions of them because now the chance of them contracting the disease has become very little.

How does the MMR vaccination work and give immunity?

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In a basic sense, vaccinations are a method of giving your body protection against a disease it may be exposed to in the future. Inside the vaccine is a number of smaller and purposefully weaker micro-organism that causes that disease. This would allow your body to initiate a defence mechanism in the form of your immune system so that you wouldn’t catch the disease itself and also have protection against it.

‘The vaccine consists of 'attenuated' live organisms, meaning that the organisms are weakened and thus are not infectious, though they can cause some very mild symptoms.’ (h2g2). Because they are weakened, it means that the diseases wouldn’t produce the full effects. And because they aren’t infectious, it means that the body wouldn’t get harmed by the microbes but the immune system still sees the micro-organism as foreign as ‘each cell in your body has a marker to distinguish it as 'self.’(Whole food supplements). The microbes would not have this marker which is an antigen and is found outside the cell so the immune system would go into effect and work to remove them but in actuality there is no damage to the cells.

Scientific background

A vaccine is a biological preparation that improves immunity to a particular disease. A vaccine contains a weakened or inactive form of the disease causing microorganism. They work by ‘stimulating your immune system to produce antibodies (substances produced by the body to fight disease) without us actually becoming infected with the disease.’ This would make our immune system produce antibodies against that microbe as if the body had been infected by it even though the inactive microbes cannot cause harm. This is called ‘active immunity’. If the person that had been vaccinated was to come in contact with that same disease again, their immune system would already have recognised it and would produce the appropriate antibodies against it which would prevent the onset of the symptoms of an illness.

Newborn babies would already have a certain degree of immunity against certain diseases because they would have been immunized against ‘several diseases, such as measles, mumps and rubella, because antibodies have passed into them from their mothers via the placenta. This is called ‘passive immunity’. However the passive immunity would only last for a short time, maybe a few weeks or months. This is why it is vital to give children a vaccination for MMR typically before their first birthday.

The problem with combining vaccinations is that it may result in more unwanted side-effects such as fevers even though the fevers themselves aren’t harmful. ‘Although it’s not completely understood, these problems with combination vaccines probably happen because of the extra buffers and stabilizers needed to keep the vaccines themselves stable.’ And parents are worried that by using combination vaccinations, their child would be overloaded with too many vaccinations which might overload their immune system.

This idea about the MMR vaccine causing autism was coined through the publication in ‘1998 of a paper in the medical journal The Lancet which presented apparent evidence that autism spectrum disorders could be caused by the MMR vaccine.’ This scared parents in regards to giving their children the MMR vaccination and because of this, the number of vaccinations declined significantly.

What is autism?

Autism is an incurable disease that affects the brain and is a ‘lifelong developmental disability that affects how a person communicates with, and relates to, other people. It also affects how they make sense of the world around them.’ People with autism may have difficulty with social interaction and responding to new situations that they may be in. this would make meeting new people difficult. It is generally called ASD which means autistic spectrum disorder because while the people with autism may share similar difficulties, the way it affects them in their everyday lives. This would mean that some autistic people may be able to live a pretty normal life even with their difficulties; however others, as in the more serious cases of autism may require a lifetime of support from specialists. There are three difficulties which all autistic people have in common which are; ‘difficulty with social communication, difficulty with social interaction and difficulty with social imagination’.

‘Autism is much more common than most people think. There are over half a million people in the UK with autism - that's around 1 in 100 people.’ The exact cause of autism is unknown.

Andrew Wakefield and his proposal

Many people believe that the MMR vaccination causes autism in young children due to the publication that was put up in 1998 by Dr. Andrew Wakefield. He was a ‘gastroenterologist once associated with the Royal Free Hospital of London’, (skepdic) ‘reporting a study of twelve children who had autism spectrum disorders and bowel symptoms, in many cases with onset observed soon after administration of MMR vaccine.’ (Yahoo answers). Even though this caused a big deal in the previous years, he had no legitimate evidence to prove this claim and eventually this claim was dispelled.

The science behind his flawed theory was that he suggested that the immunisation by the MMR vaccine leads to the measles part of the vaccination ‘becoming colonised in the lining of the bowel’ (thpc.scot). This would have damaged the bowels and would have caused ‘ inflammatory bowel disease and a leaky bowel’ (thpc.scot). The places that would more commonly be affected are ‘the large intestine (colon) or in the lower part of the small intestine (ileum), it causes pain and swelling and may lead to diarrhoea, Weight loss, fatigue, and fever.’ (humanillnesses).The ileum is the final part of the small bowel. It is where the dissolved food is absorbed into the bloodstream through the ‘Villi which are finger-like projections in the small intestine.’ (wisegeek). He suggested that this bowel disease ‘allows harmful peptides or toxins, which wouldn’t normally be absorbed to enter the bloodstream, enter the brain and cause autism.’ (thpc.scot). this is why he believes that the MMR vaccination may be a cause of autism.

It was dispelled as false due to many studies proving that there wasn’t a link between autism and the MMR vaccination. For example ‘researchers looked at the incidence of autism in a Japanese city before and after the withdrawal of the measles, mumps and rubella jab in 1993.’ (news.bbc)They found out that the rates of autism kept rising even after the MMR vaccination was withdrawn.

Even though it was false many people still have negative feelings in regards to this vaccination and have an irrational fear that it would cause their child to be autistic when it has been proven that that is false. This fear in some people resulted in lots of people not wanting to go ahead with this vaccination which meant that the number of MMR vaccinations administered each year decreased significantly.

Arguments for use of MMR vaccination

In some parts of the UK, the amount of children that were received the MMR vaccination dropped to 60%. This meant that there were an increased number of measles outbreaks which sparked fears of an epidemic about to take place. If more than ‘15 per cent of the population fail to vaccinate their children’, it could result in an epidemic taking place so
to prevent an epidemic taking place, more MMR vaccinations should be administered.

This figure above shows ‘autistic conditions in birth cohorts to age seven years, and MMR vaccination rate in Japan: autism, all autistic spectrum disorders (ASD), and autism with regression’ this graph shows that even after MMR vaccinations were terminated in Japan, there was still a rise in cases of children with autism and ASD. This would mean that whatever factor that was causing autism, it was not this vaccine.

Also doctors believe that giving the vaccines all at once is better than giving three separate vaccines because in three separate vaccinations, there is more chance of side-effects as a result of the vaccination as opposed to a combined vaccination and if they are to be given as three separate vaccinations, they wouldn’t be able to be administered one after the other but instead they would have to be spread out which in that space of time would leave the child susceptible to the disease he/she has not been vaccinated against it between those inoculations. This could also result in the parents failing to complete the course of ‘three single vaccines followed by a booster for each’.

Are separate vaccinations better than their combined counterparts?

A physician by the name of ‘Dr Wakefield claims combining three live viruses in one injection could be dangerous.’ This is because the child’s developing immune system could react to it which may overwhelm their immune system and suppress it in the later stages of their life. Also the protection may wear off which would leave the child vulnerable to the diseases later in life. However there has been no evidence that supports this idea because as soon as babies are born, they would be exposed to a large quantity of microbes every day. As bacteria are on everything, anything the baby eats would have bacteria on it which would mean that the child would be ingesting the bacteria and also when they touch something it would also have bacteria on it which they would put into their mouth and also when they put their hands or feet in their mouths.

Should we care about the mercury in vaccinations?

Some vaccinations contain a form of mercury which could poison the child and injure them for life. These increased levels of mercury in their body could lead to a multiple of neurological disorders such as Alzheimer's disease, autism or dementia. This form goes by the name of ‘Thimerosal and it is a mercury-containing preservative used in some vaccines and other products since the 1930's’. (cdc.gov) however, there is no thimerosal in the MMR vaccine so neurotoxicity wouldn’t be a problem.

Arguments against use of MMR vaccination

There have been several cases in which ‘healthy children developing these conditions after being given the vaccine’. This would make parents concerned with letting their children take these vaccinations and getting three separate vaccinations instead is a pretty straightforward procedure and plenty of doctors would do it instead.

Even though every vaccine causes side effects which for most of the time are minor for example a sore arm after injection. The MMR vaccination can cause some very serious side-effects such as a severe allergic reaction to the substance. It occurs 1 in every 100,000 doses so it is rare.

The parents would often fear that the vaccine that is given to their children might actually cause harm to them through deadly side effects such as arthritis, epilepsy, paralysis and encephalitis.

Alternatives to vaccination

There are a number of alternatives to vaccinations such as homeopathic substances and ensuring that the child is breastfed so that antibodies form the mother would be transferred to the bay via the breast-milk.

In the case of homeopathic substances, they are less toxic than vaccines. They say that ‘nothing" is there, so "nothing" cannot be toxic. Vaccines, however, contain a number of toxic substances’ (worlwidehealth). These toxic substances may be in the form of the preservative thimersol. Due to a vaccination containing the actual disease, the person would become infected with it. This is the reason some people may develop some of the symptoms associated with the disease and some side-effects. However, homeopathy uses a remedy that would produce effects similar to the disease such as the symptoms. This is why this alternative would not make the person a bad reaction to the vaccine.

Conclusion

By weighing up the arguments for the use and against the use of the MMR vaccination, I can see that the benefits of using the vaccine such as preventing an epidemic and immunising millions of children against the three diseases outweigh the risks associated with it such as the potential side-effects which in the rarest case may cause a severe allergic reaction.

The people that may argue that the MMR vaccination is unsafe would base their arguments on the fact that a study was done which claimed that there was a link between the MMR vaccine and autism. Since they would want to take precautions for their child’s health and safety they would not want their child to have it. They think that there would be a risk when administering this vaccine, and because of a risk they would think of the precautionary principle and not let their child have it.

However even with these negative feelings, the risks that the MMR vaccine may impose are relatively low and through the ALARA principle which is ‘as low as reasonably achievable’, it would mean that having the vaccination would be more beneficial for the general populous than not having it.

From the information I have gathered above in the sections ‘Arguments for use of MMR vaccination’ and ‘Arguments against use of MMR vaccination’ I have deduced that the MMR vaccination is safe. I also think that it should be continued to be given to children not just in the UK, but all over the world in places such as Japan. This would make cases of Measles, Mumps and Rubella drastically reduced worldwide until these diseases would be finally eradicated like the disease smallpox.

Bibliography and references