Immunisation in Brent

A few days ago, I went to an interesting meeting on immunisation with a speaker from the NIBSC. Brent has a pretty low rate of immunisation even by London standards. I was shocked to be told that the database on child immunisation is so poor that it is holding back any major efforts to improve the vaccination rate. Apparently the cuts to the number of health visitors, together with the use of a paper based system, meant that a lot of the data simply did not get recorded. Another case of unintended consequences.

However, the NIBSC speaker spoke more generally on the suspicion that many people have over vaccination. As well as the MMR example of a few years ago, he cited a seventies scare about pertussis (whooping cough). Essentially, whooping cough outbreaks slid strongly downward as a result of a vaccination programme until about 1975. In that year, there was a scare that the vaccination caused babies to suffer permanent neurological damage. The scare led the take up of vaccination in England to drop from about 80% to about 30% over three years. Naturally, this was followed by a sharp rise in whooping coughs and a number of children died. Scarily, it took about 15 years for the immunisation rate to recover. So, like the MMR scare, a rumour was started fairly easily, caused tremendous health problems, and those problems took a huge time to recover from.

The worry is that these scares seem to be ignitable out of very little, and the actual arguments don't seem to matter very much.

Dr Wakefield's research was pretty ropey scientifically, but his assured manner seemed to count for more. Many people seem to have an ingrained distrust of medical experts, surprising given the popularity of the NHS. There also seems to be a fear of taking official medicine that sits bizarrely with peoples' willingness to consume all kinds of other things. The argument that taking your MMR doses all at once would overwhelm your immune system suggests that the number of things in a slice of Camembert should finish you off for good.

In Brent, we also apparently have rumours spreading in from other parts of the world. In 2005, some predominantly Muslim parts of Nigeria had a movement to stop the polio eradication programme, as it was thought to be a western programme to sterilise people. As a result there was an outbreak of polio that quickly spread across several countries. I have been told that similar rumours have circulated in some Brent Mosques.

It is difficult to see how these fears can be countered by rational argument, since they are inherently irrational. The two ways I can think of to improve the immunisation rate would be engaging health and education workers, and peer groups through the Children Centres. However, I still don't see these as total solutions.