A good jab well done by the NHS

23 August 2001 14:36 GMT+1

Independent http://www.independent.co.uk/story.jsp?story=12708

By Jeremy Laurance

04 January 2001

"We are all very calm people not prone to displays of emotion but we are very pleased with the success of this programme." That was the only note of triumph Professor Liam Donaldson, the Government's Chief Medical Officer, allowed himself yesterday, announcing the near-disappearance of meningitis C. No flag-waving, no back-slapping, just a job well done by the NHS.

It is actually an astonishing achievement for the immunisation programme led by David Salisbury. In 1998, meningitis C claimed the lives of 105 people, most of them young and previously healthy, and hospitalised 1,193. This year, the expectation is there will be no deaths and a mere handful of cases.

Since the programme was launched in November 1999, every child under 18 has been offered the vaccination and the vast majority have accepted it.

Vaccination is probably the single greatest success story of 20th-century medicine. It has saved millions of lives around the world - from smallpox, polio, diphtheria, typhoid, tetanus, measles - and now meningitis. Odd, then, that in the last decade it aroused such controversy and distrust.

This has a lot to do with coincidence. A child has a vaccination and happens to develop an illness shortly afterwards. This was the problem with the MMR (measles, mumps and rubella) jab and autism. The first signs of autism tend to appear in the second year of life, just as infants are getting their MMR jab. Yet despite intensive research efforts around the world, no group has been able to confirm the link.

There was, briefly, a scare about the meningitis-C vaccine last summer when it was reportedly linked with 11 deaths. But as Dr Salisbury observed, in a year when every child under 18 has been vaccinated, any death in the age group will be a death following vaccination. Investigations have ruled out any link. Eight of the deaths were cot deaths, two were caused by meningitis B and there was one case each of pneumococcal septicaemia, bronchiolitis, pneumonia, infantile spasms and encephalitis. One case was described as "sudden death - unexplained".

There were 237 cases of convulsions following the meningitis C jab and 44 cases of anaphylaxis. But some children suffer unexplained convulsions anyway, and the incidence following vaccination was no higher than the background rate.

The success of the meningitis-C programme, contrasted with the MMR programme, leaves us facing the prospect that more people could be killed by measles in the coming 12 months than by meningitis C.

In some areas, especially in London, vaccination rates of MMR have fallen so low that an epidemic is now a serious threat. Dublin has already experienced one with over 1,500 people affected, 100 hospitalised and two dead. Could Croydon, with a similar low rate of vaccination to the Irish capital (74 per cent), be next?