Vaccination (Hansard, 21 November 1977)

§ Mr. Ennals

I had made plans to launch a publicity campaign at the end of October in order to draw attention to the danger of leaving children unprotected from three serious infectious diseases, diptheria, whooping cough and poliomyelitis. I then found, by coincidence, that the Report of the Parliamentary Commissioner for Administration on Whooping Cough Vaccine was to be published the day before. In the circumstances I thought it best to postpone the campaign lest its effect be lost in discussion of the Commissioner's findings.

Also at the end of last month, the Committee on Safety of Medicines held a meeting, at which it had before it a paper based on a preliminary examination of some of the cases which had been submitted by the Association of Parents of Vaccine Damaged Children. The Committee is examining the Association's evidence at my request.

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Its study has not gone far enough to allow the Committee to reach any conclusions but, on this preliminary sample, the Committee thought that the degree of risk of neurological adverse reactions needed to be reassessed. The chairman of the Committee recorded the conclusion which it reached at their meeting as follows: The Committee are unable to comment on the crude figures before them, but, in the light of the current concern, and their knowledge that an examination of a number of cases is at present being undertaken, they doubted whether this is an opportune time to promote an advertising campaign for pertussis vaccine.

I have since consulted the chairman of the Committee, and also the Chairman of the Joint Committee on Vaccination and Immunisation, who have advised me that there will be serious difficulties in drawing firm conclusions about the degree of risk now associated with whooping cough vaccine from the Committee on Safety of Medicines' study even when it is completed. Some of the cases go back many years, and it is difficult to distinguish coincidence in time from a causal connection between vaccination and damage. Moreover, the vaccine used in a proportion of the cases has been superseded, and many of the children whose cases are being examined were vaccinated at a time when less was known about contraindications than is known at present.

At the same time a separate study, the National Childhood Encephalopathy Study, has been in progress since 1976 under the auspices of the Joint Committee on Vaccination and Immunisation. By contrast to the Committee on Safety of Medicines' study, this is a study of current cases rather than a retrospective one, and it should therefore provide a more reliable basis for assessing the risk associated with vaccine.

In the light of the advice of the Committee on Safety of Medicines quoted above, I cannot for the time being proceed with a publicity campaign of the kind originally envisaged. I am, however, seeking further advice from the Joint Committee on Vaccination and Immunisation. In particular, I am asking it:

(a) when the National Childhood Encephalopathy Study is likely to be completed;
(b) whether any new material has come to light which makes it desirable for further advice to be given to members of the medical and nursing professions, and if so, what its content should be;
(c) to comment on the form and content of material about vaccination to be made available to the public, so that it fully reflects the latest available information about vaccination against whooping-cough and other serious infectious diseases, including both the benefits and the risks.

I am also asking the Committee on Safety of Medicines when it expects to complete the study which it is carrying out.

I will report further to the House when the two Committees have had a chance to consider these matters. The Chairman of the Joint Committee on Vaccination and Immunisation has advised me that it is his view that, pending consideration of these issues by the Joint Committee, whooping-cough vaccination should continue to be offered as part of the programme for routine immunisation of babies and infants. I consider this particularly important in view of the likelihood of a serious outbreak of the disease this winter. The number of cases of whooping-cough up to 11th November this year was 9,251, compared with 3,392 over the same period in 1976; and the number of cases in the week ended 11th November was 704, compared with 448 in the preceding week.

It remains important, of course, for all concerned to pay great attention to indications against use of the vaccine in individual cases; and where parents, in consultation with their doctors, decide against whooping-cough vaccination for a particular child, it also remains most important to protect them against the other serious diseases of poliomyelitis, diphtheria and tetanus. I strongly urge parents not to neglect this precaution.