Glasgow Herald, 30/06/2003

British doctors' leaders have rejected the idea of compulsory immunisation for children in the United Kingdom but stressed that the triple MMR vaccine was the most effective way to immunise children against measles, mumps and rubella, according to a new report.

The British Medical Association published a report on childhood immunisation on the eve of its annual conference. It calls on doctors and health workers to stress to parents that vaccination is the safest and most effective way to protect children from infectious disease. They should therefore be encouraged to choose immunisation for their children.

However, the BMA said it did not support the idea of compulsory vaccinations. The BMA chairman, Dr Ian Bogle, said: "We have looked carefully at the issue of compulsory vaccination and it is true that some countries do operate immunisation programmes where there is some degree of compulsion. However, the BMA does not think this would be right for the United Kingdom. The doctor-patient relationship is based on trust, choice and openness and we think introducing compulsory vaccination may be harmful to this."

The report also looked at the issue of whether parents should have a choice of vaccine - for example, single doses instead of the triple MMR jab.

Parents first became worried about the MMR jab after a paper by the British gastroenterologist, Dr Andrew Wakefield, in 1998 speculated about a possible link between the jab and autism and bowel disease.

The BMA report pointed out that the paper had not proven any link and that only one of the 13 authors suggested that MMR should be given as separate injections one year apart.

Glasgow Herald, 9 and 10/06/2003

Uptake of the triple MMR (measles, mumps, rubella) vaccine has fallen to its lowest level since 2000 in Scotland, it emerged on June 8.

Scotland's Chief Medical Officer, Mac Armstrong, renewed his call for parents to immunise their children with the combined jab after the publication of quarterly figures to the end of March showing that the uptake rate had fallen from 86.6 to 86.1 per cent.

Mac Armstrong said that failure to inoculate children would result in the return of the potentially fatal diseases of mumps, measles and rubella.

Uptake of the MMR vaccine has fallen to well below the 95 per cent level required for herd immunity as a result of studies claiming a possible link to autism and bowel disease.

Dr Armstrong said: "Immunisation in early childhood is still the safest and most effective way of protecting all children and the wider community against the risks of serious infectious diseases. The Scottish Executive will continue to work with health professionals and parents to restore confidence in MMR."

He added: "It should be remembered that postponing vaccination, or leaving children unvaccinated, poses risks to the whole community and could result in an outbreak of these potentially fatal diseases."

Opposition politicians called for parents to be given the choice of inoculating their children with three single vaccines for the three diseases.

Shona Robison, the Scottish National Party health spokesman, said the figures were "concerning". She said: "The messages which were used to try to reassure parents appear to have had a limited effect with some not heeding the warnings and choosing to opt out from having their children vaccinated. This is why we must consider making single vaccines available."

David Davidson, the Tory health spokesman, said many parents were "most alarmingly" choosing not to vaccinate their children at all. "Scottish Conservatives have always believed that MMR is the most effective way to tackle measles mumps and rubella."

He added: "A significant number of parents are refusing to have their children vaccinated with MMR and most alarmingly many are choosing not to vaccinate their children at all. It is now crucial that the Scottish Government allows parents who wish to have their children vaccinated with a single injection to do so. Parents must be given choice over the way their children are treated."

Uptake of the pre-school booster at age up to six years was higher, and rose slightly from 90.56 per cent last year to 90.88 per cent for January to March this year. However, this still means that some 6,600 infants and nearly 6,000 five-to-six year-olds did not get MMR last year.

As for the diseases themselves, measles, mumps, and rubella have all been lower so far this year compared to the same period last year.

NPR News, 03/06/2003

When a volunteer at the privately run Stars and Rain Education Institute for Autism  fell seriously ill with SARS - Severe Acute Respiratory Syndrome - in late April, the woman who founded this unique school on the outskirts of Beijing, Tian Huiping, was faced with many hard decisions.

First, she had to find a hospital that would treat the young woman, a graduate student named Cui Lei. The search took Tian across Beijing as she was turned away from one hospital after another. Cui Lei lay near death, and Tian felt responsible.

But Cui Lei was not her only burden. She also worried about what to do with the 50 autistic children and their families who were attending the school from all over China. Then, she had to try to convince the 50 families staying at the school not to leave. If they headed for their homes in towns and villages around China, they could be carrying the contagious disease with them.

"Nine families in one classroom. That means over 20 people in such a small room, and this is why I was so worried about the virus spreadeding, so this situation is not very positive. It's very dangerous," Tian told NRP Radio.

More than 330 people in mainland China have died from SARS. That stark number hides uncounted stories of fear and pain and struggle.

Herself the mother of an autistic son, Tian Huiping opened the school 10 years ago. It remains the only private school for autistic children in mainland China, but the programme also teaches parents how to cope with the disorder.

MELBOURNE, Australia: Parents in the state of Victoria have been given the green light to create genetically-screened "designer babies" to save the life of sick siblings. Under the new policies, permission to test for conditions such as autism and Asperger's syndrome before the embryos were planted in the womb would also be considered by the state's Infertility Treatment Authority (ITA) on a case-by-case basis.

However, the ITA said on March 28 that any requests would involve a last resort and would have to be approved by both the ITA and the ethics committee of the clinic where the procedure was done.

Under the procedure, embryos are genetically screened to ensure they are compatible tissue donors for the sick child before being implanted into the womb.

In a Victorian first, an Epworth Hospital ethics committee this month gave a Melbourne couple permission to use the ground-breaking technique to save their terminally-ill child. The sick child is understood to be suffering from the rare blood disorder, Fanconi's Anaemia. The child's only chance of survival was said to rest with a transfusion of umbilical blood from a perfectly matched sibling.

The ITA's chief executive officer, Helen Szoke, said that the authority had approved the procedure in April 2002 under its interim policies.
Szoke said the new policies, which were developed after 12 months consultation, were intended to provide the public and clinics with guidelines about what they could do.

In order to obtain permission to conceive a genetically screened IVF baby, all other avenues must have been explored for the treatment of the ill child and the condition of the child must be life-threatening.
However, permission would not be required to screen for single-gene disorders such as cystic fibrosis and Huntington's disease.

But the Reverend Gordon Preece, from the Centre for Applied Christian Ethics, said he was concerned that the sibling would be conceived as a "means to an end."

Dr Preece added: "The child would forever be the back-up, particularly if there was an ongoing need for treatment."

He also said the ITA could come under increasing pressure to screen embryos for things like obesity or gender.