Nobody wants to hurt a child. The howl of pain, the tears, the look of betrayed shock all make it very hard to deliver a cherished small person to the needle-wielding nurse. But that’s part of being a responsible parent. It becomes a lot tougher if mum or dad is being fed mixed and erroneous messages about the benefits and harms of vaccination.
Parents have to make a lot of decisions about what’s right for their child, from the school they should go to and the food they should eat to the hours they should spend on the phone or watching TV. In the US, Donald Trump wants them to add another: do they choose to give their children separate jabs against measles, mumps and rubella, involving six visits to the clinic, or should they opt for the combined MMR vaccine, which does the job in two? For decades, the vast majority of families have been taking the advice of doctors, accepting their assurance that the MMR vaccine is safe and very effective. But what are they to think when a US president announces that the triple jab could be “quite lethal” and signs an executive order advising states to offer separate vaccines?
Andrew Wakefield, pictured in 2010. Photograph: Luke MacGregor/Reuters
For the moment, what Mr Trump is proposing is an empty choice. The individual vaccines are not available. They have not been widely used in decades. In the US and in the UK, they don’t have a licence, and to get one, pharma companies such as GSK and Merck & Co would probably have to run new clinical trials to prove that they work and are safe, which would take years. Both have already said that no published scientific evidence supports splitting the MMR vaccine into single shots. They are not rushing to invest in making them, for all the US president’s enthusiasm.
But we are likely to see a rerun of the furore and distress in 1998 caused by Andrew Wakefield, the British gastroenterologist (not an infectious diseases specialist) who declared that the MMR vaccine was linked to the gut disorder Crohn’s disease and thence to autism. His evidence-free advice was for parents to seek separate vaccines. As now, they were not readily available, so many children went without. Measles vaccination levels dropped alarmingly and measles cases rose.
Struck off as a doctor, Mr Wakefield now lives in Texas, hero-worshipped by vaccine sceptics, and his views are embraced by all those suspicious of or hostile to the medical and scientific establishment, including the president and his health secretary, Robert F Kennedy Jr. They fit an anti-science agenda that has recently seen the pursuit by a congressional committee of Dr Anthony Fauci, who led the US response to Covid-19 and is now being accused of covering up its origins.
Mr Trump and RFK Jr already aim to shrink the vaccine schedule in the US from 18 to 11 shots, citing Denmark, where fewer vaccines are given to young children. But Denmark offers universal high-quality healthcare and excellent screening programmes to pick up those at risk. The US does not, and children fall through the cracks.
No other country recommends single measles, mumps and rubella vaccines. But such is the confusion that some parents are likely to take away the message that the combined jab is unsafe – and that no jab is a better choice. President Trump is putting at risk the very “beautiful, healthy, lovely, delicate little children” that he claims to care about.
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