Vol. 279 No. 2
asked the Minister for Health if his attention has been drawn to a report (details supplied) in relation to the injection known as the three-in-one which provides immunity against whooping cough, diphtheria and tetanus; and if his Department have carried out or propose to carry out any investigations in relation to the connection between this injection and the possibility of mental retardation in children.
6.
asked the Minister for Health if he considers that diphtheria and tetanus injections should be given separately from ones for whooping cough; and if he will make a statement on the matter.
7.
asked the Minister for Health if any investigation has been made by his Department into the incidence of brain damage in children resulting from triple-antigen inoculations; and, if so, if he will give details.
8.
asked the Minister for Health the measures he proposes to take regarding the future of brain-damaged children resulting from triple-antigen.
With the permission of the Ceann Comhairle I propose to take Questions Nos. 5 to 8, inclusive, together.
I am not aware of any evidence to show that there are children in this country who have been brain damaged as a result of immunisation with triple antigen.
I have seen the report referred to by Deputy Enright. I am aware that there have been suggestions that adverse reactions to vaccinations against pertussis may arise. The medical officers of my Department have discussed the matter on different occasions during the past 12 months with chief medical officers who are responsible for vaccination in their own areas. No serious adverse effects have been reported. I am also advised that the National Drugs Advisory Board which is responsible for receiving reports of adverse reactions to drugs have also had no such reports.
As I pointed out in reply to a parliamentary question on this matter on 14th May, 1974, pertussis can be a serious and sometimes fatal disease. Vaccination against it was recommended by my Department in 1955. In the six years preceding that—that is, from 1950 to 1955—the average number of deaths from pertussis was 64 per year. After the introduction of vaccination there was a marked decrease and during the last decade— from 1964 to 1974—the average number of deaths had fallen to 2.8 per year.
Following adverse publicity since last year concerning adverse reactions to pertussis vaccination there is reason to believe that a drop in vaccination levels may have occurred. Concurrently with this there has been an increase in the number of cases of whooping cough notified and two deaths from the disease were recorded in the first three quarters of 1974.
All vaccines can cause reactions and there is some evidence to suggest that in rare cases these reactions may be serious. It is very difficult however to discern between chance-associated reactions and vaccine-attributable reactions in infants. In all the circumstances I am advised that vaccination against pertussis is still a procedure which should continue to be recommended, subject of course to the exercise in individual cases of his own clinical judgment by the immunising medical officer. The combination of vaccines to be used in individual cases is also a matter for the immunising doctor. Vaccinations are, of course, not compulsory.
Would the Minister be good enough to ask his Department to undertake a survey into the incidence of brain damage resulting from this triple antigen? Would he also take into account the information available from Britain in regard to this?
All the information in my Department is to the effect that such vaccination has not been responsible for brain damage. I am also informed that, as a result of a special committee which met in Britain, the conclusion arrived at was that this triple vaccination should still continue. There are reports also in the other European countries—in fact throughout the developed world—that this vaccination has not been proved to have effect on the brain. I should tell the Deputy that consultations between my Department and the county MOH's have been going on during last year.
Is the Minister aware that a number of health board doctors have advised against such injections? They have recommended that two of the injections be given and that the one for whooping cough be given on a separate date. If there is any possibility of a weakness in the child, such as a cold, and he has the three injections together, is it true that this aggravates the matter and could lead to such damage as appeared in this article?
It is possible that some medical officers or GPs have recommended that the vaccination for whooping cough be not included. I presume these doctors have taken into account possible ailments in the child or a possible adverse medical history in respect of the family.
Has the Minister received any complaints on this matter from the public or from people who claim their children have been damaged? Would he ask his Department to conduct an investigation into the matter?
There is one particular case—I do not want to mention names —at present in a hospital in Dublin for examination and assessment. I think I should await a report on the matter before commenting further.
Is the Minister aware if there are further cases throughout the country? Would his Department communicate with the health boards and ask them to have investigations carried out with regard to mental retardation in some children who have received the three injections?
As I have explained already, the Department have been constantly in touch with county medical officers and with general practitioners. No report of brain damage has been received in my Department, neither has such a report been received from the National Drugs Advisory Board. There has been no report to the effect that after immunisation there has been brain damage.
Is the Minister aware that in at least some of the public health clinics parents are being advised of the risk of brain damage if this vaccination is given? This is happening in the case of infants with no background of risk of the kind the Minister envisaged and, as a consequence, most parents who receive this advice refuse to have the injection administered to their children. This probably accounts for the drop in the number of injections referred to by the Minister. This being so, will the Minister accept that there appears to be a conflict between the advice given to parents in the clinics and what he is now saying as a result of the advice available to him? It is desirable that this matter be clarified as soon as possible.
Certainly it should be clarified as soon as possible but I do not know what "as soon as possible" means in this case. Investigations have been carried out not only in this country but in Britain also and by the World Health Organisation and it still has to be proved there is an association between this vaccination and brain damage. As I said in my reply, the incidence of death from whooping cough has gone down dramatically and it is believed in medical circles it is due to this vaccination. It would be a pity if there were such a scare that those who need the vaccination would not avail of it.
The Minister will understand that when parents are warned by properly qualified people in the clinics that there is a risk of brain damage to their children they will not take that risk.
I agree and I presume the medical profession would act like that. The children are usually introduced by the public health nurse and, in view of the scare in recent times, I presume there would be a detailed examination of the history of the child and the family.
I am calling Question No. 9.
