Monday, August 11, 2008

The casual callousness of alternative medicine

In the Independent on Sunday this week (10/08/08) there was a letter from a naturopath called Pat Rattigan. He makes the claim, whilst dismissing the need for vaccination against measles, that:

"There are no cases in recorded medical history of any child, in reasonable health to begin with and with properly managed treatment, being harmed by measles."

I'm not going to examine whether this is true or not, I'm mainly concerned with what it says about the mindset of those who deny the need for and usefulness of measles vaccinations. He is not denying that children die from measles, he is pointing out that it is mainly (he claims only) those children who are most vulnerable who will die from or develop other problems from measles. Is it just me, or is that a chilling statement? To me his statement sounds like 'Well my child is healthy, and coped with a measles infection ok, so screw those kids too  poorly to have a robust immune response.'  This is in other words, survival of the fittest. This is a foundation stone for evolutionary theory, but it's no way to run a modern compassionate society where we protect those who are vulnerable. Maybe you think I'm over-reacting, but put yourself in the shoes of a parent with a chronically ill child reading that sentence.

There is no doubt that measles vaccination has lead to a massive reduction in the number of people contracting measles and also dying of measles.  One of the consequences of a high percentage of children being vaccinated is that a condition called 'herd immunity' develops. This basically means that even if measles is caught by a few people it never becomes epidemic, thus protecting almost all people, including those most vulnerable. I ought to point out here that vulnerable adults can also die from measles.

Not convinced? Here's a graph I prepared from information sourced from the health protection agency. I have plotted together the figures for Measles Notifications and Deaths and the measles vaccination coverage. Because the figures for measles notifications are so much higher than those for deaths they are plotted on the right. The other data is plotted on the left.

I think this data disproves several of the anti-vaxers favourite theories, such as the only improvement in measles being down to improvements in hygiene - there may have been a big improvement when proper sewerage etc. was installed in towns, but the big drop here happens in the 80's, when vaccination rates were soaring. I don't think there was a massive difference in public hygiene from the beginning of the 80's to the end, do you? But as you can see there was a big difference in vaccination rates.

And just as an aside, because it's a whole big blog post on its own, there is no link between MMR and autism. Just in case that was worrying you.

Edited following comment from Gina.


Gina said...

If the letter is from Pat Rattigan the naturopath, then the author is male (see the cached amongst other sources that identify him as Patrick Rattigan.

Your point about the social contract of vaccination and protecting those who are unable to be vaccinated is well-made. Professor Salisbury recently sent around a memo with this poignant reminder of such susceptibility.

"I cannot emphasise enough the risk that measles presents to immunosuppressed individuals, particularly children. Between 1974 and 1984, of 51 children who died when in the first remission from acute lymphatic leukaemia, 15 of the deaths were due to measles or its complications. While the incidence of measles has declined since then and the coverage of measles-containing vaccine has increased, there have been about 1000 confirmed cases reported in England and Wales in the last 12 months. There are ongoing outbreaks in other European countries.

MMR vaccine cannot be given to immunosuppressed individuals, so their protection is dependent on avoiding exposure to the virus."

Norbury said...

Thanks Gina. I'll amend it as soon as I get proper net access.