Should parents be held legally responsible for not vaccinating their children?

[Saracen]

I don't really think this is hidden to be honest. Maybe it depends on how familiar you are in with the area, but I can't think of anyone I know that doesn't realise the NHS is a business with finite resources.

I'm not saying (or hopefully have not come across as saying) that every treatment the NHS offers is the best one, because that's simply not the case. What you've quoted was a reply to the MMR statement from scaryjim, not the NHS as a whole.

Indeed, but the principles and processes that cover what options are available for vaccinations are the same as those that cover every other NIHCE recomended treatment, device or drug, that being best *available* evidence, and "cost-effective". What is not clear is precisely where the balance lies between 'brst for patient', and cost.

Let me give you an example. There is a medication I've been on (unfortunately) for years. My direct, personal experience is that one particular brand is always effective with minimal direct side-effects, but several alternatives have had varied results, despite the active ingredients being, at least in theory, identical.

To put it a tad more graphical, some varients regularly make me puke. The "leading" brand neverchas yet, in some 10 years or more of taking it daily.

If the prescription gives the generic name, some pharmaxists will usually supply the brand I ask for that doesn't make me upchuck. Others will not. You get whichever generic brand is cheapest this month.

So .... I asked my GP to switch from the generic name on the prescription to the specified brand. He did .... but only after looking up the cost differential, the same differential on which pharmacists had refused, and telling me he could because it was "only about 60p".

60p a month, for the benefit of not having a medicine that unnecessarily has me throwing up several times a month.

That's certainly "better", in my estimation, and by the way, all the drugs, including the ones that made me barf, were "approved". And also, for what it's worth, I pay for my prescriptions.

Whether it is applied to MMR or to healthcare generally, that gives you an example of the effect of money on treatment offered.

Suppose the premium hadn't been 60p, but £1? Or £5? Or £50?

I certainly would have laid the first two, and cheerfully, to not puke regularly. The third too if I could afford it. And I'd bet I'd not be alone in that judgement. But I'd been puking regularly before I worked out what eas doing it, and even then, several pharmacists declined to provide the one I know doesn't adversely affect me, and the GP checked the prices first.

Cost-effective, eh? Hmmm.

[Saracen]

What would you rather me say?

"They will offer it if allowed"
"They will offer it if it fits within the framework of their institute"
"They will offer it if it's within their power to do so"

There are always going to be limitations on what can be provided under the NHS. I wasn't implying that they would be working outside of this.

I would not suggest that you would imply that.

My point is that there are reasons why ...

If they deem it so that you need a different treatment, then they will offer it.

.... is a bit optimistic. They will offer it if it is cost-effective.

It is NOT just about the best treatment, but the best treatment that's cost-effective.

That might be pragmatic for an NHS with limited resources, and I wouldn't dispute that even that it's a desirable guideline, but .... it gives the recipients of ANY threatment a reason to considsr whether they're getting the right treatment, or just an okay but cheaper one. See my last post for personal experience.

[Butcher]

Given that MMR is safe though, why would they offer a more expensive alternative? With the finite resources of the NHS you're basically doing someone else out of a treatment with that approach, which is definitely a worse outcome.

[Saracen]

Given that MMR is safe though, why would they offer a more expensive alternative? With the finite resources of the NHS you're basically doing someone else out of a treatment with that approach, which is definitely a worse outcome.

It's not "safe", though. And no, I'm not talking about the autism thing. Take it as read that that's hokum.

NO vaccine is safe. It 's just safer than getting some of the diseases, especially measles. But not safe. There are risks. The risks of the vaccine are lower than the risk of the disease, but higher than the risk if the child doesn't get the disease. It's about the balance of risk.

But ignore even that for a moment and look at the pragmatics of it.

There are those that will not use MMR. Now, even if we assume they're all ignorant Mail-reading luddites, the fact remains they won't use MMR.

So .... the DoH has two priorities with it's childhood immunisation program. One is to protect the child. The other is "public health". That latter, for instance, is where the herd immunisation incentive comes in.

If an aim of the public health motive is herd immunisation, then they have to consider that if, for example, 20% of parents reject MMR, no matter how ill-advised that might be, herd immunity implies you're better to get them immunised with single vaccines than having them not immunised at all.

You ask why use a more expensive treatment? Because several years of argument have signally failed to convince a lot of people, whatever the merits of the argument, and that given that, the cost of administering single treatments to those that otherwise will reject vaccination entirely is likely to be lower than the cost of dealing with a large-scale outbreak of the diseases, and consequent treatments, should that occur in the future.

Experience so far suggests that for a lot of people, refusing the alternative is not resulting in them using MMR but in them not vaccinating at all.

[Galant]

I have to say this is definitely an interesting thread. I don't have any expertise in the area but I will say that while, two years ago, this would have been an academic question for me, now I have two children it's a far more significant question.

I'm someone who'll try understand rather than just accept it, and I'm also cautious of scams and hysteria. I was fully vaccinated, as was my brother, it wasn't even a question that came up in my family - or with anyone we knew. However, having been exposed to "less than premium", no, wait, "less than reasonably expected" SOP by government or related boards/organisations, and with the new responsibility of caring for my son and daughter, I can now understand the questions and fears people have. The odds might be small, but you want to know the truth, the bottom line, you want to understand because it might be "1 in 10,000" but it's your 1 or 2 then it's your whole world. As a parent you often feel like everything little thing matters, and in some ways, you only get one chance to get it right. When it comes to these big, scary questions about medicine and vaccines and health, you want to do what you feel and understand is best and right.

For what it's worth, I live in Gibraltar, and both my children have been vaccinated so far according to standard practise this far along. I can't imagine we're not going to run the course with them. However, if I ever found out that such a vaccine caused any major issues in my children I'd be furious. I'd also probably feel quite a bit of guilt for not having looked deeper or fought harder or making the difficult call. Still, it'd make me want to overthrow the whole system.

I don't think anyone expects perfection out of the government or NHS etc. I think what people want is honesty, clarity, and the absolute, open, best effort. To know that they actually care about your or your children's welfare and not just the pennies. When that doesn't seem to be the case, it's likely people will rebel and not follow the plan - and quite frankly, why should they?

A case in point - I have family members serving in the military one of whom was given a vaccination prior to be shipped out. As the gentleman left he was reading the leaflet he'd been given and read that in the case of this vaccine all physical contact should be avoided with pregnant women. His wife being pregnant he went back to the nurse to ask and she apologetically and in embarrassment confirmed it. She had said nothing at all about this, not asked any questions. I don't know if the new pregnancy was listed on his records but his marital status will have been. If he hadn't read the paperwork on his own he would without a doubt, have put his child at risk of death. Now I don't know for certain, but I should jolly well expect that asking about such things, or stating a warning should be part of that nurse's job, and she didn't do it. He might have been able to argue that she should have had the responsibility to tell him about the risk, but right or wrong, she didn't and his child could have died. It always come down to individual responsibility and that you have to live with your own choices. Sadly, the government and related organisations haven't always been clear, and helped you make those choices. They haven't always acted in accordance with your best interests.

It's down right frustrating, but we still have to choose. I'll keep watching this thread to see what else shows up.

Has anyone commented on the line that suggests that it is general cleanliness and improvements in sanitation that have kept disease down, rather than vaccinations?

[scaryjim]

I'm kind of sick of being sidetracked onto the MMR question, tbh, but I'll clarify my example as much as possible.

At the time, single vaccines were in production and widely available. They were a long-standing, tried and tested vaccination program that the country had been entirely happy with for many years. MMR had only been in general use about ten years, and there was known public concern about the safety of the vaccine. This was around ten years before mumps vaccine ceased production and single measles was delicensed. And the NHS refused those vaccines to a parent who was aware of the risks of non-vaccination and the widely known public concern over the safety of MMR.

MMR's been in use for another 15 years now. It has the lengthy proven track record (although frankly it will take along time for the negative associations with MMR to fade, and I'm still not entirely convinced I trust it). She might choose differently if her children were born today. But she went to a doctor with as informed an opinion as she could, and was told it was the doctor's way or nothing.

Now yes, the NHS needs to balance finite resource against outcome. But this was a well informed parent trying to do the best for their child within the bounds of what they considered safe. MMR was still relatively unproven at the time, and the concerns about links to autism had only just been made public. Single vaccines were available and still in use in the NHS. An informed parent asked the NHS to vaccinate her child. The NHS refused. So I refute the claim that vaccination programs are *just* about herd immunity. They have both financial and political components in their planning.


However, MMR is a distraction here: it's a well publicised example, and pretty much everyone will probably have a story, or know someone who has a story, about MMR. I'll take you back to the actual question in the OP:

some parents are using homeopathy instead of medicine to vaccinate their children. ... why don't we consider this child abuse or lack of care

And I think the answer is surprisingly simple. A vaccination is not an essential medical procedure. In fact, it's pretty much the definition of a non-essential procedure. It's not even a complete guarantee against catching the immunised disease. And for an individual child, there is no way you can guarantee that the vaccine is safe.

So should children be vaccinated? Absolutely. But should we prosecute parents for not vaccinating their children? Hell no.

[Butcher]

MMR's been in use for another 15 years now. It has the lengthy proven track record (although frankly it will take along time for the negative associations with MMR to fade, and I'm still not entirely convinced I trust it).

This is a big problem with the way the media dealt with MMR - there was never any evidence against MMR, and yet you still don't trust it, despite it being no more risky than any other vaccine. The media have managed to tarnish something based entirely on hearsay. They certainly have a lot to answer for with the nation's health.

[Saracen]

This is a big problem with the way the media dealt with MMR - there was never any evidence against MMR, and yet you still don't trust it, despite it being no more risky than any other vaccine. The media have managed to tarnish something based entirely on hearsay. They certainly have a lot to answer for with the nation's health.

But even takjng that the Wakefield assertions were misleading, it took time for that to become clear, and in the interim, the media would be remiss in not reporting apparently explosive claims. And it isn't as if the were in some backwoods publication, but in one of the most respected medical publications on the planet.

This certainly cannot all be laid at the media's door, or at least, not what is normally meant by the term. It has to include the Lancet.

But then, there's a dilemma.

If you report something that subsequently turns out to be wrong, you're responsible for damaging the nation's health. But if you don't report something and it turns out to have been correct, you'll get lynched for supressing the story and causing kids to be born autistic.

All the media can be expected to really do, at best, is report the facts, with the usual caveats. The latter tend to get lost in the resulting furore, and the soundbite maelstrom, though. And to expect the public to remember that most of the media are not a public information service but commercial organisations seeking to make a profit, or at least break even, and that shocks and scoops sell.

[billythewiz]

there was never any evidence against MMR

Really ? Never ? Are you sure ?

The most famous case (though not the most important) against the MMR is that of Hannah Poling. The US government scientists did not even contest the case against her. They just paid up. Verdict:- MMR caused her autism. Here's a video news article about it. It mentions 9 other cases where compensation was paid for MMR causing autism.
http://www.cbsnews.com/stories/2008/...n3915703.shtml

When MMR was introduced to the UK in 1998, three versions were used, Immravax, Pluserix and Merck's MMR II. At that point Pluserix had already been withdrawn in Canada and SmithKlein Beecham only agreed to supply it if they were given indemnity from prosecution. Immravax and Pluserix were withdrawn in 1992 because they were not safe.
http://en.wikipedia.org/.../MMR_vaccine_controversy#Concerns_about_the_Urabe_strain

Here's a question for you. If a hearing of medical experts rules that a drug was responsible for a death, should you trust a doctor who says the drug didn't cause the death ?
I am of course referring to the cases in the UK where compensation has been paid by the government where MMR was responsible for the DEATHS of children.

A separate tribunal awarded compensation in relation to another case where a child died after suffering brain damage caused by Urabe MMR. And another tribunal was persuaded that Urabe MMR was the likely cause of death in a further case.
Parents who have received compensation in such cases have indeed blamed MMR, including Urabe MMR, for causing the deaths of their children. Moreover, in some cases, their conclusions were endorsed by tribunals.

http://www.foiacentre.com/news-MMR-comment.html

Let's look a little closer at the companies that make the MMR.
One of the withdrawn brands, Pluserix was made by SKB, now GSK ...
http://www.bbc.co.uk/... GlaxoSmithKline to pay $3bn in US drug fraud scandal

The one we still use, MMR II, is make by Merck ...
http://www.nytimes.com/2011/.../merck-agrees-to-pay-950-million-in-vioxx-case.html?_r=0

Merck has agreed to pay $950 million and has pleaded guilty ...
Merck agreed to pay a $321 million criminal fine ...
Merck also is paying $426 million to the federal government and $202 million to state Medicaid ...
In 2007, Merck agreed to pay $4.85 billion to settle 27,000 lawsuits ...
Merck joins Pfizer and most other major drug companies in settling long investigations with prosecutors
“It’s just a cost of doing business until a pharmaceutical executive does a perp walk,” said Erik Gordon, a pharmaceutical analyst and clinical assistant professor

WOW ... drugs can be expensive when you are caught lying !!

You decide for yourself how much of their "science" you trust, especially when they keep half of it secret.

[billythewiz]

Here's something to think about when considering whether to give your kid a vaccine against a sexually transmitted disease.

Whether it's Hep. B or HPV, if you give it to them when they are young and it (the vaccine) is new, it may turn out that it wears off. It may turn out that it has long term side effects. It may turn out that it doesn't work very well. It may turn out that, by the time they become sexually active, there are better, safer, more effective alternatives.

You might also want to consider where you live, whether vaccination is mandatory there and how generous the governments compensation program is. In the US they've paid $6M to 49 girls. There were 26 deaths in 12 months from 09/2010.
http://communities.washingtontimes.com/.../us-court-pays-6-million-gardasil-victims/
Gardasil is another Merck product.

Last week the Japanese government "withdrew its recommendation" for Gardasil.
http://www.tokyotimes.com/.../2013/hpv-vaccine-seen-differently-by-japan-and-the-u-s/

[Mrs Hex]

Hep B isn't only sexually transmitted. And it is on the rise in this country - hence why they wish to add it to the routine childhood vaccinations.

HPV can trigger female specific cancer and will I want to protect any daughter I have from that? Yes. No question. To me it is on a par with undertaking smear tests - and would you consider those bad and unnecessary? After all, they ARE invasive - significantly so

[directhex]

Whether it's Hep. B or HPV, if you give it to them when they are young and it (the vaccine) is new, it may turn out that it wears off. It may turn out that it has long term side effects. It may turn out that it doesn't work very well. It may turn out that, by the time they become sexually active, there are better, safer, more effective alternatives.

"Cases of human papillomavirus, or HPV, have decreased 56 percent in young girls since the vaccine was first introduced in 2006 according to the CDC."

I assume this causes gnashing of teeth amongst the smallpox brigade.

[scaryjim]

HPV can trigger female specific cancer ...

Actually, there's research ongoing into links with throat cancer from oral sex too, which isn't female-specific. But most schools won't vaccinate boys against HPV...

[Mrs Hex]

I'd be thrilled if they made it universal, but it would mean admitting that, you know, oral sex HAPPENS le sigh - we're too British for that I think

[Galant]

Anyone caught this before?

BB4 - Wealth = Health
https://www.youtube.com/watch?featur...&v=jbkSRLYSojo

[Smudger]

I'd be thrilled if they made it universal, but it would mean admitting that, you know, oral sex HAPPENS le sigh - we're too British for that I think

If I give you her number, can you call my wife?