Written Answers. - Vaccination Programme.
Billy Timmins
Ceist:
411
Mr. Timmins
asked the
Minister for Health and Children
his plans to permit the MMR three-in-one vaccine to be administered in single dosages; if the vaccine is available in such form here or the EU; if his attention has been drawn to the study by a person (details supplied) which outlines the advantages of administering the vaccine in separate dosages; and if he will make a statement on the matter.
[8964/02]
The MMR vaccine is available under the primary childhood immunisation programme. This provides for the immunisation of children against a range of potentially serious infectious diseases. Under the programme parents may have their children immunised free of charge by the general practitioner of their choice. The schedule of immunisation is in accordance with the recommendations of the immunisation advisory committee of the Royal College of Physicians of Ireland, RCPI. There is no provision for children to receive separate measles, mumps or rubella vaccinations under this programme. Information provided by the Irish Medicines Board, which has responsibility for licensing all pharmaceutical products in Ireland, indicates that individual vaccines for measles, mumps and rubella are currently licensed in Ireland but only single dose rubella vaccine is marketed in Ireland. My Department has no information regarding the marketing of single measles, mumps or rubella vaccines across the EU.
There are sound public health reasons for not administering the MMR as separate vaccines. First of all, the scientific evidence does not support a link between MMR and autism or inflammatory bowel disease. There is no evidence that administering the three components of MMR as separate vaccines is safer. The immune system is well capable of responding to the small number of components in the MMR vaccine and there is no evidence that the component parts of the MMR vaccine interfere with each other. In any event, vaccines are designed to strengthen the immune system and not weaken it.
If the vaccines were to be given separately, this would also mean that a total of six injections would be required to complete the course instead of two which could also mean an increased risk of local reactions at the injection site. The practical aspect of giving six injections would mean that children are unprotected for a greater period of time from these diseases and therefore at significantly greater risk of contracting these infections. The protracted time involved in administering the vaccines would result in the diseases in question circulating in the community for longer. Unprotected children would, therefore, be at greater risk of catching these infections. This would include younger children, below the age of 15 months, and children who are immuno-suppressed.
To my knowledge no other country advocates the use of three separate vaccines rather than the MMR vaccine. The MMR vaccine is in use worldwide. Most countries implement a two-dose MMR vaccine programme and this policy has been very successful in controlling measles where high uptake of the vaccine has been achieved. My primary concern and that of my Department in relation to immunisation is that the vaccines in use are safe and effective. The international consensus from professional bodies and international organisations is that MMR is a safe and effective vaccine and that the recently published medical evidence does not support a causal link between MMR vaccine and autism or inflammatory bowel disease. The institutions include the Medical Research Council expert committee in the UK, the British Committee on Safety of Medicines, the Centres for Disease Control and Prevention in the USA, the American Academy of Paediatrics, the World Health Organisation and UK professional organisations. Most recently, the United States Institute of Medicine also concluded that there was no link between the vaccine and autism or inflammatory bowel disease. This consensus is based on large-scale epidemiological studies and more specific studies done in the laboratory setting.
With regard to the study referred to by the Deputy, the researchers themselves indicated that a link between MMR vaccine and autism had not been proven. Further research from the same hospital as Dr. Wakefield's found no causal link between MMR vaccine and autism. This was supported by a large Finnish study involving 1.8 million individuals which demonstrated that no case of inflammatory bowel disease or autism was linked to the MMR vaccine. A similar Swedish study found no increase in cases of autism in the ten years during which MMR vaccine was introduced. Dr. Wakefield's research was subjected to critical review and the general conclusion, having evaluated his research and other studies, is that there is no causal link between the MMR vaccine and autism.
The World Health Organisation has indicated that observations made regarding the onset of autism following the administration of MMR vaccine do not meet the scientific criteria required to suggest that the vaccine is the cause. It has also indicated that there has been no new scientific evidence that would suggest impaired safety of MMR. The WHO strongly endorses the use of MMR vaccine on the grounds of its convincing record of safety and efficacy. This view is supported by the Irish Medicines Board and by the Royal College of Physicians of Ireland. The Irish Medicines Board is responsible for the monitoring and safety of all pharmaceutical products in Ireland. The monitoring of vaccine safety is ensured through clinical trials prior to licence and post-licence surveillance by the IMB. The IMB liaises closely with international bodies including the European Medicines Evaluation Agency and the World Health Organisation.
The Joint Committee on Health and Children, in its report on childhood immunisation which was published in July 2001, concluded that there is no evidence of a proven link between the MMR vaccine and autism and that there is no evidence to show that the separate vaccines are any safer than the combined MMR vaccine. I would like to take this opportunity to urge all parents to have their children immunised against the diseases covered by the childhood immunisation programme in order to ensure that both their children and the population generally have maximum protection against the disease concerned. General practitioners are aware of the contraindications to the recommended childhood immunisations and parents should discuss any concerns they may have with their general practitioner before making a decision about their child's immunisation.
