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Deteriorating trust to blame for public's MMR scepticism

The public scepticism on MMR is not surprising. Society has always had a love/hate relationship with science and scientists and in recent years the deterioration of trust has become more apparent. Incidents such as Three Mile Island, Bhopal and BSE have fed that distrust.

Three other factors are also important:

 · Suspicion of scientific evidence when linked to public policy

The public fears the loss of personal autonomy and sees public health policy as another manifestation of authoritarianism. Some of my patients have protested about the 'moral blackmail' implicit in emphasising the need to immunise individuals to protect society from possible epidemics.

 · The information gap Interpreting scientific data based on long-term research is difficult, not least the concept and meaning of risk ­ relative and absolute. There is a gap between what is known to medical scientists and their capacity to make the esoteric understandable and relevant to the ordinary individual.

 · The tabloid factor Medical scares sell newspapers and their emotive power depends on anecdote. Anecdote lacks context and power in scientific terms and defies analysis, but is immediately understandable to the non-scientist.

Some years ago the poor uptake of pertussis vaccine was reversed by the single showing on TV of a very ill infant displaying all the distressing signs of whooping cough.

Dr Rod Manton

Marple

Cheshire

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