MMR Vaccination Rates in the United
Kingdom Before 1998
The Herald published an article titled “Parents of Autistic Children 'Feel Guilty' Over MMR (1) on March 30, 2007.
The following is not a commentary on the article or the study on which it was based. It is in response to one statement: “After Dr Wakefield's article was published in 1998, immunization levels of MMR dropped…”
* * *
I have carefully researched immunization levels in the United Kingdom prior to 1998. The following information is based on two Department of Health documents that I obtained via www.doh.gov.uk.
A: “NHS Immunisation Statistics, England: 1997-98” [Accessed in 2003 at www.doh.gov.uk/pub/docs/doh/imstat98.pdf]
B: “Immunisation against Infectious Disease 1996. The Green Book” - Measles, Mumps and Rubella chapter, p. 125 – 146 [Accessed in 2003 at http://www.doh.gov.uk/greenbook/greenbookpdf/chapter-22-layout.pdf]
Reference B was published before the Wakefield article but shortly after a rather significant national vaccination effort.
The officially recommended and available primary pediatric vaccination schedule in the UK was:
*The HIB vaccine was added in 1992-1993.
The following table is a replica of Table 5 from Reference A.
It lists the number of children (x1000) who completed the primary series of vaccinations every year between 1988-89 and 1997- 98.
DTP and Polio vaccines had been in use for years before the introduction of the MMR. HIB statistics started in 1993-94.
Proportionately more children were vaccinated during the 3 years that followed the introduction of a new vaccine: 1988 to 1991 for the MMR and 1993 to 1996 for HIB. It is likely that children older than 2, who received MMR for the first time, were included in the statistics for the first 3 years listed, when more than 1 million children a year were vaccinated.
It is not clear why the number of children receiving 3 doses of DTP/ Polio vaccines and one dose of MMR vaccine, decreased between 1994 and 1998, as shown in the following table, also based on Table 5 of Document A.
It should be noted that Pre-1998, the drop in vaccination rates was substantially more significant for the MMR vaccine.
When one compares 1994-95 with 1997-98, the percent decrease (16.1) in the number of children receiving MMR vaccinations (1 dose per child) is 222% larger than the average percent decrease (5.0) in the number of children receiving 3 doses of Diphtheria, Tetanus, Pertussis and Polio vaccines.
English parents have historically been concerned about the safety of the whooping cough vaccine. Many have also questioned its effectiveness. The result was that pertussis vaccination rates dropped to 30% in the late 70’s. (Document A: Figure 1)
“In the case of pertussis, coverage rates have regained the ground lost in the mid-1970’s due to public anxiety about the safety and efficacy of the vaccine. The recent fall in MMR coverage may be the result of similar concern over the vaccine.” (Document A: 2.1.1)
It is evident from the above that while 19,000 (3.3%) fewer children received 3 doses of pertussis vaccine in 1997-1998 than in 1993-1994, some 87,000 (13.6%) fewer children received one dose of MMR vaccine during the same period.
Conclusion: Thousands of British parents were not in favor of MMR vaccination before Andrew J. Wakefield published his original study in The Lancet in February 1998.
This is a fact.
Henderson D. Parents of Autistic Children 'Feel Guilty' Over MMR- The Herald, March 30, 2007. Available at http://www.theherald.co.uk/news/news/display.var.1296611.0.0.php
F. Edward Yazbak, MD, FAAP
VAP © 2007