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Immunisation

Immunisation

Deciding to give my child MMR (measles, mumps and rubella)

The UK Immunisation Schedule recommends that children be given two doses of the MMR vaccine; the first at 12 months of age and the second at 3-5 years of age. For more information on why MMR is recommended see ‘What is immunisation?’ and ‘Why do we immunise?’.

Immunisation of children is not compulsory in the UK, as it is in some other countries, so parents we interviewed chose whether or not to have their child immunised. The vast majority of parents believe in immunisation for their children. We have however included here the views of a few parents who do not believe immunisation is right for their own child based on their personal beliefs. Their views represent a small proportion of the population.

It is absolutely right and normal that parents are concerned about the optimal health of their children and it is important that parents seek reliable scientific evidence on which to base their decisions and there is now a mass of this information available (see ‘Resources & Information’ section).  

Every parent should have access to a trained health professional to chat about the risks of catching the diseases and about the benefits and potential risks of immunisation for their own child, and the population in general. In addition to their GP, health visitor or practice nurse, there is also an immunisation advisor in each local health protection unit, whom parents can talk to about their child's immunisations.

Although the weight of scientific evidence shows that MMR is safe, some parents continue to have initial concerns about the risk to their child and making the decision whether or not to give their child MMR is a difficult one. 

However, the majority of parents do decide to give their child MMR. Here, parents explain their reasons for their decision.

They didn't believe there was a strong link between MMR and autism
Some parents, and in particular ones who had knowledge of the characteristics of autism through their work, or through friends or family who had an autistic child, had no problem deciding to go ahead with MMR because they didn't believe there was any link to autism. 

 

She had taught children with autism and believed that the MMR vaccine had nothing to do with autism.

She had taught children with autism and believed that the MMR vaccine had nothing to do with autism.

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So can you tell me what you based those, that decision on?

I think it, well, several factors really. One, I knew I wanted them to be immunised. It was a case of, 'How? Would, would it be a split vaccine or would it be the triple vaccine?' So I, you know, there was always the, there was never a decision to make whether she was going to have them or not. And then secondly, I spoke to GP, my GP, the nurse, you know, who were, well, health professionals and again they gave me the relevant literature. I didn't do any extra research on the Internet or anything like that; I just took the NHS leaflets. But I think as far as I was concerned, having taught children with autism and that was obviously the main fear, and I had been on professional courses as part of my job. I already had some insight into autism and the causes of autism and I was clear in my mind that the vaccine had nothing to do with it. And that's why I prompted, I, it prompted me to go for the triple vaccine.

The research study by Wakefield et al (1998) was not strong research evidence and had suspicious motives
Some had learned through subsequent media coverage or personal researches via the internet that the Wakefield study (1998), which suggested a link between MMR, inflammatory bowel disease and autism wasn't strong enough evidence to warrant not giving their child MMR.   

They discovered that the research was based on a small sample of 12 children, that the findings were not conclusive, that the motives behind the research were suspect as there might have been a conflict of interest. They believed that the evidence in favour of MMR was more reliable. A couple of mothers who started gathering information when they were making their decision were amazed to find that so much fuss had been made over just one research study.

 

The scientific basis of the research study was dubious and had conflicts of interest.

The scientific basis of the research study was dubious and had conflicts of interest.

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The issue later on about MMR was not a difficult one really. I suppose a sort of political conviction about public health and the need to be part of collective good health and obviously our own children. Not to say I wouldn't, you know, I care obviously about my own children's health. And also having felt as though the main proponent of some of the difficulties with MMR and autism etc was actually the institution which he worked for, which I understand was the Royal College or maybe not, no, maybe a central London hospital anyway, that had very, very significant links with a producer of an alternative set of immunisation possibilities. So I felt as though there was kind of insider dealing and it was all very dodgy that kind of research.

 

There is no convincing evidence to suggest that MMR is not safe.

There is no convincing evidence to suggest that MMR is not safe.

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Well, I'm not sure that I, there was really a decision to make. I didn't really waver for very long because I think I just believe that vaccinations are a good thing and that the risks of not having a child vaccinated vastly outweigh the risks of anything that might occur from the vaccination. And I think that in everything you do in life carries a certain risk and you've got to live with that really, you can't expect everything you do to be risk free.  

Again, I think with MMR, just because of all the publicity I was bit more apprehensive about that. But even then I didn't really do much reading because, I think because I'd come from a research background and I know there's actually no that, you know, there are contradictory studies on everything and you've got to take the sort of weight of evidence and the weight of evidence is towards it being safe. And so there's this one very highly publicised study that was claiming these links but, but everything else suggested that it was absolutely fine. And for me the risk of a link with, of him contracting autism was so much smaller than him contracting mumps and him suffering sort of negative impact from that. So it wasn't too difficult a decision.  

I think I'm quite lucky at having access to research papers and if I read something in a sort of much more, I don't know, reliable, if that's fair, source, then I would be more worried. But even then studies are funded but, I mean, that's what, that's what swung it for me about the MMR was that this guy had a, a serious conflict of interest. You know, he was representing the parents of children with autism and you can see how it happens. Somebody stakes their career on a certain, making a certain point and they get a certain reputation and they can't really back down. So, I think knowing that, knowing that background, that piece of information in itself was enough for me to really dismiss, I think [laughs]. Although I mean it's funny because you have a rational head and then you have your sort of mother head on and so it's not that I got him immunised and didn't worry about it. It was still, I was still looking for signs of [laughs] withdrawing from the world and not wanting affection enough to, which is ridiculous, I knew it was ridiculous but you still sort of do that, you still kind of watch afterward to see if, if he's changed. But there was absolutely no sign of that.

 

She was amazed that to find that so much fuss had been made over just one research study.

She was amazed that to find that so much fuss had been made over just one research study.

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Yes so I was interested in looking into what Andrew Wakefield had said on his report. What I discovered was that he had linked the MMR jabs along with the bowel, inflammatory bowel disease and also autism. Obviously these, this is a concern, what I then went, I thought there must be more information on this, there can't just be one person's report that has caused this whole furore. But it really did appear that it was just this one report. And that lots of other reports have looked, looked in to his report and had come to the conclusion that there was no real evidence to suggest as yet that the things were linked. 

MMR has been used worldwide for many years
Some parents said that another factor that influenced their decision was that they had learnt that MMR had been used worldwide in many countries for many years without any significant problems. They had felt reassured that the same MMR vaccine used in the UK had been used in the USA since the early 1970s and of the millions of children given MMR, accounts of reported adverse reactions were rare.

 

Learning that MMR had been used in America and worldwide helped her to reach a decision.

Learning that MMR had been used in America and worldwide helped her to reach a decision.

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And then another thing actually I did look up and the MMR's been going on, and I can't remember how long but I think it's been going for over twenty years in America and in other countries and they've never had this problem. And I mean I lived in America for ten years and I know if there had been any kind of problem with the MMR, believe me the Americans would be suing and they'd be up in arms and it would be taken off. So that was also something actually, that in other countries it's been fine, it's been going for years and, and it's been going long enough that if autism was related to the MMR I think they would have picked up on that by now. So we're, we're a lot later giving that immunisation than anywhere else. And I do believe in America they'd be on it if there were any problems, any side effects. So that was something else I did believe.
 

Single vaccines had problems
Quite a few parents had investigated single vaccines in the process of making their decision. They had decided against having single vaccines because they had heard that there could be problems with them, for example, they were difficult to get hold of, were costly, were possibly less reliable than the MMR which was approved by the government, or there was a shortage of the mumps vaccine. In the light of some or all of these concerns they had opted for MMR. In addition, some parents also said that they chose MMR because they didn't want their child to have more injections than necessary and have a risk of reaction at each one.

 

Single vaccine clinics were difficult to access and difficult to know which clinics were...

Single vaccine clinics were difficult to access and difficult to know which clinics were...

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So I then spent time looking for clinics who would immunise, and I found one that seemed a possibility. The cost was phenomenal. I think it was about '150 per injection. And then it, because of the time we wanted to have it done, then there was a shortage of the mumps vaccine, so we wouldn't be able to have that anyhow. So it seemed, you know, when I found that out, then for a few weeks we toyed with the idea that it would probably be best to give him the individual vaccinations.  

But, to be honest, going to a clinic seemed a bit seedy in the end. You know, it seemed to be like putting these things into my child and, and we had to go through the back door to get it. And it, I didn't feel like I wanted to do that. So I suppose the chat to the friend in America was, kind of was my green light. We were moving more towards the MMR because the clinics were so difficult to, not just to access, but then it was no problem to pay the money, but it just seemed like a ludicrous amount of money for individual injections. And they seemed to be cashing in on my concerns.

 

There was evidence that single vaccines especially as offered by private clinics might not be a...

There was evidence that single vaccines especially as offered by private clinics might not be a...

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I investigated it. What, I mean what I found slightly annoying was I mean you couldn't, you couldn't do it. But I did feel that you ought to have the option through your GP. You ought to have to pay for it extra if it was costing more. But I probably would, had it been available to my GP, I probably would just at the time. I don't know that I would, I don't think I would with the next one. But I think I would at the time possibly have, have sort of paid for it, the extra, whatever the extra was, you know, through the GP. But the whole idea of going private, I was never, you know, sort of particularly comfortable with doing, doing that, without there being any hard evidence that it was necessarily going to be more beneficial or safer or whatever else. 

Because there's always people who are willing to exploit it in that degree. And equally there were articles about how, you know, having single jabs didn't necessarily provide the protection that the children needed, and, you know, there were, it wasn't conclusive that, that was going to be a kind of good way forward. And I didn't, I, it sort of wasn't, in a way wasn't really the issue for me. The issue was whether it was safe or not safe. And I just wanted to, you know, sort of make sure that I was fully reassured that I felt that it was statistically going to be, you know, overwhelmingly okay at the end of it, although you can never rule anything out altogether. But I mean all of life and you know, health is, is, you know, kind of best-fit scenario. So you just have to kind of take what you can with it.

 

Single vaccines had their own problems so she decided to give her son MMR.

Single vaccines had their own problems so she decided to give her son MMR.

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Because the single vaccinations are something I looked into. But they have their problems as well like, like, I looked into it. I actually booked him in twice to have the single vaccines and both days he was meant to go he had a cold or he was a bit down, so I didn't take him. And, and it was going to take a long time because it's three different vaccinations. And then I started looking onto that, and some companies say the second vaccination should be after three months, some said six months, and some said a year. So again I was just, 'Oh' you know, my head was spinning. 'Is it, is it three months? Am I doing the right thing? Should I wait a year, because then it means he's not fully vaccinated till he's 3 years old?' There was also, at the moment there's a shortage of the mumps vaccination so you put your name on a list for that, you know. Also the vaccinations were coming in from different countries, and I'm sure they were sort of okay, but it just got all very complicated and had its, and, so that, you know, it wasn't as simple as just going to give him the single vaccination. It had its own issues as well, and I, it just was too much.  

And why did you consider, consider the single vaccines?

Because I thought if it was an easy option between, if it was a choice of single or the MMR, and there was always this doubt that maybe the MMR could cause autism and other things, then I would go for the singles. But then when it turned out the singles had their issues, then I preferred the MMR. If the singles had just been very, very straightforward and very, go bang, bang, bang, there's your immunisations, every three months, he'll be done, you know. I mean, yes, 80, '80 a pop, you know, and the travel from my, you know, the, outside London to a clinic. But, no, they started having their own issues and then, so when I weighed it up the MMR just seemed the, the most sensible.

 

She decided against single vaccines because it would take longer for her sons to acquire immunity...

She decided against single vaccines because it would take longer for her sons to acquire immunity...

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The only immunisation that we really had to think long and hard about was the MMR, because there was quite a lot of controversy about at the time when he had his first MMR. And basically what I did was listen to a lot of other parents, who all had various views on it, and there was also a lot in the press at the time, on the television, in the papers, and listened to that and, you know, read up on that. And we basically understood that if he were to have the three separate jabs, there would be quite a large time lapse between the times that he'd be allowed to have each of the three, during which time he would be at risk of contracting one of the three, or rather the, you know, the second two, the mumps and the rubella, if he had the measles first. And there was I think measles and mumps going round in our area at the time. And we basically took the decision to have the, the single jab for him so that he wasn't at risk to catching either of those. And that's really how we made our decision. And he didn't have any reaction to it at all. And then he had his booster three months or so after the first jab. And because he was fine with those jabs we then proceeded to do the same with our other two sons, who have both subsequently been absolutely fine, haven't had any adverse reactions at all to the jab.

 

She considered single vaccines but was glad she hadn't chosen them when there was a measles...

She considered single vaccines but was glad she hadn't chosen them when there was a measles...

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One of my friends actually has autism in her family, and she has a son, and I think she was sort of umming and ahhing and in the end she went for the triple jab as well. And most of what everyone said was, 'Go for the triple jab' because getting the single ones a) are expensive, they're very, very difficult to get hold of, and then it's even harder to try and find a doctor who will actually administer them. And I think you have to do two for each, for each disease and then you have to leave them six weeks apart or something, so all the time that you're delaying they're running the risk. And if I'd done that and we had the nursery situation when measles came up, you know, it just wasn't worth it. So I think in the end I just decided, after talking to friends and, and all the research I did, it just made sense to, you know, to not put her in any more harm and to just go ahead and do it. So I did.

 

The safety of the single vaccines worried her so she decided to have MMR.

The safety of the single vaccines worried her so she decided to have MMR.

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I spoke with the health visitors and the nurses and the doctors at the medical centre and they gave us leaflets. And also there was an advert on the telly that the government did not so long back which sort of made me think as well. And also in the news there had been reports of a measles epidemic at, at Christmas time and so that made me more aware that, that something had to, or a decision had to come one way or the other. The decision for me was not to have her immunised or not, it was the way that, that we chose to do it, whether in the triple vaccine or, or single vaccinations and the single vaccinations worried me because I couldn't be assured of where they'd come from or how they'd been stored and, and, and also friends of ours that have had the single vaccine they were the last set of parents that were able to have the mumps vaccines because then the supplies had run out and so I didn't like the fact that here, I would only be able to have measles and rubella and, and you know we'll just have to forego mumps, so that sort of discounted the single vaccines.

They found an information source they trusted 
Many parents who gave their child MMR did so because they had found a source of information they trusted, generally either from a health professional, or from reading research papers, or from friends. A few mothers also said that they did not believe that the government would back an immunisation programme that might be unsafe (see 'Information for making decisions').

 

She trusted her GP who was also a friend.

She trusted her GP who was also a friend.

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We had no problem with her having the other immunisations, the normal ones, but the MMR was quite an issue obviously, as it was for everybody. But even more so really because [our daughter] had had, she'd always had viruses and ear infections and then she started with bowel problems. And the decision was just a dreadful one to make for that. And then we decided eventually after much anguish, listened to what was on the television, what was being said, that we would take her to have measles only done, privately. So we went to a clinic in Liverpool, and by this time she was coming up to 2' and we hadn't had the first MMR done yet. So we took her to the clinic in Liverpool and when we got there they wouldn't do the measles injection because she'd had antibiotics the previous week for something else. And we didn't know that she couldn't have the measles injection. Anyway they sent us packing, sent us home.  

And we went to see our own doctor who, but, you know, he, who persuaded us and staked his career on the fact that this MMR wouldn't harm our little girl. And he said he'd even give her the injection himself, just to prove how confident he was in it. And he hasn't given an injection to a child for a long time. Anyway he gave her, gave it to her there and then before we could change our minds or have time to think about it. And we were just, in just such a state. I couldn't tell you how worried we were.  

And these health professionals, I'm trying not to say the names, they were sort of, they've got no reason to say otherwise. If they for one minute thought that there would be a problem with MMR it's more than their careers are worth to push me to give it to my little girl. And in the end that's where I thought, 'Well' because my doctor who is a family friend and, as well, I just knew he wouldn't, he would not have staked his career on it. And, you know, I mean he just said, 'Come on, give her here, I'm going to do it now'. And, and he did it. And it was, and it was talking to them really and realising that they wouldn't say those things if they didn't truly believe them, you know.

So you trusted your doctor?

Oh, yes, yes, I trust him with anything. And I hadn't actually spoken to him himself, we went over another issue with her. And it was, I thought, 'Oh, I should have spoken to him long since really' because he was that last bit of reassurance that we needed, you know. And it was a good thing, it was, you know, the best thing we did.

 

She trusted a specialist at Great Ormond Street Hospital for Children.

She trusted a specialist at Great Ormond Street Hospital for Children.

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There was a period of time that I think I felt quite strongly that we wouldn't go down the route of the MMR and I think after having read various articles in the papers, probably nothing based on fact but just the articles I'd read in the papers, were enough to make me think I don't want, I don't feel happy about this so I don't think we're going to go ahead and do this.

And to be honest I think everything changed when I then phoned up Great Ormond Street and spoke to someone on the front desk and said what my concerns were and is there a paediatrician or somebody there that I could speak to who might have some comments based on facts, that, who could talk to me. And they, that's when I was directed through to the lady there who helped. And I think that was the big turning point for me in that we had a long conversation on the telephone I think then a week later I phoned her back and we had another long conversation and I also had her email address. So every time something just popped into my mind I was emailing her and she was emailing back and also our friends next door, their one of their god-parents is a paediatrician in Ireland and she was saying that his comment was very much that I would go ahead and have, I would, you know, their little girl has the MMR.

So, I think it was having heard that comment from her and then also the fact that this other lady was giving all of this, what seemed like very grounded advice based in, on fact. 

The risk of the diseases was greater than the risk of side effects from MMR
Other parents, after gathering information, decided that the risk from the diseases was greater than the risk of any of the possible side effects from MMR. (See 'Weighing up the risk'.)  Some parents felt that the risk of catching one of the diseases was far greater because there had been local outbreaks of mumps or measles or because there were known to be a lot of children in their neighbourhood who had not been immunised. Others decided to give their child MMR because their child was starting nursery and were likely to be more exposed to infectious diseases.

 

Where they lived a lot of parents didn't immunise, so they decided in favour of MMR because of...

Where they lived a lot of parents didn't immunise, so they decided in favour of MMR because of...

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It was a concern and obviously if you focus on the autism side of things, you know, it's not a nice thing to have by any means, and it is serious. But having said that it didn't look that the research that had been done was particularly conclusive and especially the timing with us, it was actually, the main bit of research was being discredited. So, you know, we just factored that in. And also we were quite worried because in the area that we live in quite a lot of people weren't having the MMR and it seemed that actually the risk of getting, you know, measles, mumps and rubella, was going to increase, so all the more need for the injection.

Did you ever consider single vaccines for the MMR?

Not really, only because I hadn't, you know, read or heard anything that, that made it sound like, you know, that was particularly beneficial thing to do. And it wasn't offered routinely. I mean, I suppose that I felt happy from what I'd heard and seen about the MMR that, you know, in the combined jab that, you know, that I was happy enough for my daughter to have it. So, I didn't really look into any alternatives.

 

Believes the risk of the diseases far outweighs the risk from the MMR vaccine.

Believes the risk of the diseases far outweighs the risk from the MMR vaccine.

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The first time, the second time round, when I went to immunise my second daughter I kind of thought back, and I did actually speak to my health visitor about it. And they assure you that everything's fine and completely normal. And obviously we went ahead and just, and had my second daughter immunised exactly the same way. Because I would much prefer them to be fully immunised against mumps and measles and, than to have no immunisation at all, because that far outweighs the possibility of anything going wrong with an immunisation and having reactions. I mean neither of my children have reacted in any way immediately after the immunisation whatsoever. They've both been completely normal.

They felt a responsibility towards the community at large to stop infectious diseases returning.
Some chose to give their child MMR because they believed they had a public health responsibility to stop infectious diseases returning or to help to eradicate them. (See 'Parents' attitudes to childhood immunisation' and '‘Why do we immunise?’) One mother said she gave her son MMR to protect herself from measles should she become pregnant again and to also protect other pregnant women.

What happens in life comes from God
One Bangladeshi mother and one Orthodox Jewish mother believed through their religious faith, that though they could not prevent any side effect their child might develop because whatever happened came from God, they could do something to prevent their child getting a disease by giving them MMR.

 

Believed that what will be, will be.

Believed that what will be, will be.

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The way I went about thinking about immunisation was, the thing is I work in the Child Health department, putting in information on children anyway. So I've got that background anyway. And I've got some leaflets from the health visitors and GPs about all the immunisations and the causes of not having it. So I made that decisions that I would want my daughter to have the immunisations for, to protect her from any illnesses.

I think it's really important to have all the immunisations because it's protecting your child from other illnesses. Because I mean I couldn't forgive myself if anything was to happen, and as a parent I would want to protect my baby as well as I can. And so there, there are vaccinations available, so that's why I took the opportunity to, for my child to be immunised.

And did you discuss it with anybody? Apart from the leaflets that you got from your GP and here?

Well, there was a lot of people saying about the MMR, like friends and family saying that autism and, but, and then you get leaflets as well and it says it's not really linked to it. But it's just, you just have to make that decision as a parent. Because at the end of the day what happens is, what's going to happen is, is going to happen. You can't really stop anything. But if I can, you know, help my baby to be more protected, then I'll do my best. So I'll know I tried.

Feelings now about the decision they made
Although many parents had felt very concerned before making the decision to give their child MMR, they said they were now happy with their decision and they personally believed it was the right decision for their child. Many said they felt relieved and reassured that their son or daughter was now protected from infectious diseases when any outbreaks occurred. 

 

Feels very glad she had given her daughters MMR and feels relieved that her children are...

Feels very glad she had given her daughters MMR and feels relieved that her children are...

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Basically now that I've had them done, it's years ago now, I mean [daughter's name], my younger daughter, she still has to have her booster MMR in a year or so's time, but I don't feel worried about that. I will have her done, I don't have any worries. I've experienced with my older daughter that she was absolutely fine and, and my younger daughter's had the first lot and I, and was fine. I've got no worries about that. But basically now that they're both done, whenever anybody talks about immunisation and the issues surrounding immunisation, you know, I'm very relieved that I've had it done. And when they worry on the television particularly about outbreaks of all these childhood diseases, measles, mumps, rubella, the lot I just feel, 'Well, that doesn't concern me. My children are safe. I've got, I've got nothing to worry about because I made the decision and they're protected.' It's other people who haven't had their children immunised who have got future concerns. I've, I had initial concerns and I, and I made the decision and I had, you know, worries while I was doing it. But now that's it. I'm free from those sort of anxieties because I've done that, I've made the, the right step for us.

 

She no longer has to worry about her daughter catching measles, mumps or rubella when she goes to...

She no longer has to worry about her daughter catching measles, mumps or rubella when she goes to...

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I would then worry about her being at nursery and swimming pools and ball parks and, you know, there's a lot of places where you come into a lot of contact with a lot of other children that, who you've no idea what, you know, what they may be catching from them. And I do feel that, at least I don't, when she's in those situations I just don't worry about the kind of more serious things. Because you're worried about her falling over and breaking her leg, not about her catching those sort of things. And I think it's a huge reassurance from that. I would be a lot more tense permanently. So although it was horrible at the time thinking, 'Ahh, I'm about to damage her permanently' at least now that she's, you know, sort of okay there are a lot of other things I now don't have to worry about as a consequence. So on balance because she's okay, I wouldn't be saying it at all if the, you know, obviously if the outcome had been any different, it, you know, I've now got a life basically where I'm not having to kind of be overly concerned every day of the week about her coming into contact with other children, which inevitably she's going to do. And she's been in full-time nursery from quite a young age, so it was even more important that she, you know, had some sort of protection against other things that she might come into contact with.

A few parents who believed their child had a severe reaction to MMR, felt differently about the vaccine. (See 'Severe and disputed reactions to MMR' and 'Deciding not to give my child MMR'.)

Last reviewed October 2015.
Last updated October 2015.

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