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‘Junk Science’: MMR in the courts

Carol Vorderman won’t. Ken Livingstone won’t. Almost 30 per cent of new London parents won’t – won’t allow their children to receive the triple vaccine for measles, mumps and rubella (MMR). The Department of Health says levels of immunisation have fallen by almost 10 per cent since 1998, when Andrew Wakefield alleged that the vaccine caused autism in some inoculated children, and the Health Protection Agency is warning of an impending measles epidemic, the first in more

than 20 years.

Overwhelming epidemiological and clinical data favouring immunisation are met with allegations that drug company profits and GP bonuses are driving the MMR programme. Dr Wakefield is presented as the persecuted hero of a populist, anti-establishment campaign similar to that which achieved the repeal of compulsory vaccination laws in 1909.

The High Court entered this contested field in the recent case of A v B. Two fathers sought to compel their separated partners to submit their daughters to a range of vaccinations, including MMR. The mothers objected, fearing adverse side-effects and favouring ‘holistic’ methods. Although vaccination of children is not obligatory, parents in dispute can refer to the court for a decision under the Children Act 1989. The child’s welfare is paramount.

Dr Donegan, a general practitioner and homeopath, supported the mothers’ case. The fathers’ expert witnesses, both leading paediatricians, comprehensively undermined her doubts about the safety and efficacy of the various vaccines. Indeed Mr Justice Sumner found that she had failed in her duty to provide the court with objective medical evidence. Her dogmatic opposition to vaccination led her to misinterpret previous research and to suppress unfavourable opinion.

The court has to consider the children’s emotional as well as medical best interests. A procedure will not be imposed if to do so would damage the bond between the child and the parent with whom they live. A separated father’s request that his child be circumcised was refused on this basis: the mother’s religious objections and resultant distress would have harmed the child.

However, the facts of A v B were different. The mothers would be able to bear the ongoing requirement to have their children immunised, and the benefits of this were much clearer than in the circumcision case.

On appeal, Lord Justice Sedley accepted this framing of medical necessity. He said the mothers’ case was based on ‘junk science’ and directed the parents to the High Court judgment, which contains a methodical and well-founded demonstration of the arguments for vaccination.

In the battle for credibility over MMR the media has been accused of inflating the claims of quacks and cranks. By reinforcing the authority of orthodox medical opinion, the courts have tried to restore a sense of proportion to a badly skewed public debate.