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NHS Hull
You Love Them So Protect Them.

Frequently Asked Questions

Information taken from www.immunisation.nhs.uk

When should you immunise?

In the UK, childhood immunisations start when a baby is 2 months old.

The first MMR vaccination should be given at 13 months when the immunity acquired from the mother starts to wear off because if the vaccine is given when the baby still has antibodies to the disease it protects against, the antibodies may stop the vaccine working.

It is important to stick to the schedule as delaying immunisation can leave a baby unprotected. You can find out exactly when each vaccination is given on the NHS produced Immunisation schedule.

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What is MMR?

MMR is the combined vaccine against measles, mumps and rubella. It is the safest way to protect your children against these diseases.

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What are the reasons for not giving MMR?

People are not given the MMR vaccine if they:

  • are very ill
  • have already had a severe reaction to MMR
  • are pregnant - women should avoid pregnancy for 1 month after MMR
  • have had an injection of immunoglobulin or another blood product in the previous 3 months
  • react severely to neomycin or kanamycin
  • have untreated malignant disease or altered immunity

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How and when is the vaccine given?

The MMR vaccine contains weakened versions of live measles, mumps and rubella viruses. Because the viruses are weakened, people who have recently had the vaccine cannot infect other people.

The vaccine is injected into the muscle of the thigh or upper arm. It is given to a child at around 13 months of age after the immunity the baby got from their mother fades. It is given again when children are aged between three and five.

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How effective is the MMR vaccine?

MMR has been responsible for almost wiping out the three diseases in children since it was introduced in the UK in 1988.

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Why are two doses of MMR vaccine needed?

To give better protection.

After the first dose, between 5% and 10% of children are not protected against the diseases. After two doses of MMR, less than 1% are left unprotected.

Not all children receive the first dose of MMR. This means that each year the number of children who remain susceptible to measles, mumps and rubella will increase. The second MMR visit is needed to protect those children who did not respond to the first dose, and provides an opportunity to give a first dose to children who didn't receive the vaccine earlier. Children who did respond to the first dose get a boost to their antibodies with a second dose.

For this reason, all countries in the European Union and the US, Canada, Australia and New Zealand recommend two doses of MMR.

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If a child didn't respond to the first MMR, will they respond to the second?

A second dose of vaccine has been shown to significantly increase protection. Amongst children who did not respond to a first dose of MMR vaccine, over 90% have a good response to a second dose. Children with low levels of antibodies after the first dose, are boosted.

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Top 10 truths about MMR

  1. MMR immunisation is the safest way that parents can protect their children against measles, mumps and rubella - diseases that can be serious for babies, young children and their families.
  2. Over 500 million doses of MMR have been used in over 90 countries around the world since the early 1970s. The World Health Organization states that MMR is a highly effective vaccine with an outstanding safety record (WHO, 2001).
  3. No country in the world recommends giving MMR vaccine as three separate injections.
  4. Children who are not immunised with MMR increase the chance that others will get the diseases. Before MMR, pregnant women would catch rubella from their own children.
  5. The evidence is that MMR vaccine does not cause autism or inflammatory bowel disease (IBD). There are now numerous studies that do not support a link between autism and IBD and the MMR vaccine (CSM, 1999; Gillberg and Heijbel, 1998; Taylor et al, 1999; Davis et al, 2001; DeWilde et al, 2001).
  6. The Wakefield et al study published in the Lancet in 1998 actually said 'We did not prove an association between MMR vaccine and the syndrome described' and none of the studies since have found a link.
    Berelowitz, one of the contributors to the Wakefield study, has subsequently said 'I am certainly not aware of any convincing evidence for the hypothesis of a link between MMR and autism...' (Berelowitz, 2001).
  7. Single vaccines in place of MMR put children and their families at increased and unnecessary risk. The combined vaccine is safer as it reduces the risk of children catching the diseases while they are waiting for full immunisation cover.
  8. The normal procedure for licensing was used for MMR and the vaccine was thoroughly tested before being introduced into the UK in 1988.
  9. Two doses of MMR vaccine are needed to give children the best protection before they go to school. Ninety per cent of those who did not respond to the first dose are protected by the second. Those with low antibodies after the first dose will be boosted.
  10. There are very few children who have a true contraindication to having the MMR vaccine.

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Top 10 myths about MMR

  1. Getting protection by catching the diseases is better than having the vaccine.
  2. Giving three viruses at the same time is too much for young children's immune system.
  3. Other countries around the world give MMR as three separate vaccines.
  4. Measles, mumps and rubella are rare in the UK so you don't need to immunise kids against them.
  5. MMR causes autism and bowel disease.
  6. There was a scientific paper that showed a real link between MMR and autism and bowel disease.
  7. Giving the MMR vaccines separately reduces the risk of side effects.
  8. The vaccine was not properly tested before it was licensed.
  9. My child has already received one dose so there is no need for a second one.
  10. My son doesn't need protecting against rubella; my daughter doesn't need protecting against mumps.

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MMR and autism

There have been reports in the media that there is a link between MMR and autism. These reports followed a paper that was published in the Lancet (a medical journal) in 1998.

Since then there have been many studies on the subject, and parents are understandably concerned that there might be a link.

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Why do some parents link MMR with autism in their child?

Autism is a Developmental Disorder which usually appears in the second year of life.

The MMR vaccine is given to children in the UK when they are aged between 1 and 2 years.

Because of this, some parents will see signs of autism in the weeks and months before MMR is given, and others will notice them in the weeks and months after MMR is given.

Parents who see changes in their child will often link the change to a particular event.

For example, at one time it was thought that a second child born within two years could affect the development of autism in the first child.

Those parents whose children show signs of autism after MMR understandably often link the two events, but there is no evidence to show that there is cause and effect between MMR and autism.

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Autism and the introduction of MMR

Another way of looking at the possibility of a link between MMR and autism is to see if there is any evidence that the introduction of the MMR vaccine has led to an increase in autism.

A recent article in the British Medical Journal concluded that although there was greater awareness of autism, there was no evidence for or against an increase cases of autism.

The following observation appeared in the British Medical Journal in 1998:

'national data seem to indicate a rise in the incidence of autism, but it started over a decade before MMR's introduction in 1988 and showed no change at that time'.

Another study in Sweden looked at cases of autism in Gothenburg. During the course of the study MMR vaccination was introduced. The number of cases of autism did not change as a result of the MMR vaccination programme.

There is a lot of evidence against a cause and effect link between MMR and autism. Information from this country and from Sweden shows that, whatever the trends in the number of autistic children, they are not linked to the introduction of MMR.

There has also been an independent inquiry by the Medical Research Council into the possibility of a link between MMR vaccine and autism. This inquiry also looked into possible links with Crohn's disease. The inquiry, which was published in March 1998, came to the conclusion that there is no evidence to indicate any link between MMR vaccination and bowel disease or autism and that there is no reason for a change in MMR vaccination policy.

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What is 'regressive autism'?

It has been suggested that there is a new condition called Regressive Autism - where children lose skills like speech and actions, and that this occurred after MMR.

This has been studied and it has been proved that the proportion of autistic children with regression is the same whether they have had MMR or not, and that there has been no increase in the proportion with regression after MMR was introduced.

This means that MMR has not caused their regression.

Despite what the stories say, there has not been a single study that has shown a risk of the MMR vaccine causing autism. But, there have been many studies that cannot find a link.

The scientific evidence is that MMR does not cause autism.

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Single vs triple vaccine

Key Points:

  • MMR is the world standard
  • Giving single measles, mumps and rubella vaccines as a programme has not been properly tested in the UK
  • Separate vaccines could leave children open to infection
  • Your child's immune system is not put under strain or used up by having 3 vaccines all at once
  • Catching the diseases naturally is not beneficial for a child's immune system
  • Cost is not an issue for the government
  • Triple MMR is recommended rather than single vaccines because it offers better protection to children.

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