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Sometimes, doctor does know best

Dr david turner duo 3x2

Any GPs out there of a particular nervous disposition may wish to stop reading now, as what I am about to say may offend.

We sometimes need to be totally doctor-centred and tell patients what is best for them.

A recent example of why this is sometimes the case is the shocking news that measles is on the rise again. There were 828 confirmed cases this year in the UK up to 13 August, and 37 deaths from the disease across Europe.

For those young GPs out there who may have still been at school at the time, this problem started in 1998 because of the actions of the disgraced and discredited doctor, Andrew Wakefield. He published a now retracted paper in The Lancet, which claimed to link MMR vaccine to autism and colitis.

None of us has the time in a ten-minute consultation to begin to debunk the myths about vaccination

We dissected this paper at the time it was published in my GP VTS group and even then we considered it to be dangerous nonsense. Sadly we were proven correct.

However, a large sector of the public it would seem, prefer to believe anecdote, hearsay and the ramblings of self-promoting zealots rather than boring old statistics. For example the stale old fact that the serious complication rate with MMR vaccination is less than one in a million, a lower risk than dying in an aeroplane crash. I wonder how many people who refuse the MMR on behalf of their child will be jetting off on holiday somewhere this summer?

None of us has the time in a ten-minute consultation to begin to debunk the myths about vaccination that sectors of the population have been brainwashed with by social media and poor journalism, so I would propose when it comes to MMR, we just have to become militant and tell parents that sorry but we do know what is best for your child and that is to be vaccinated against potentially fatal diseases, with vaccines that have been extensively used and have an excellent safety record.

I say this because most decisions in healthcare affect only the individual making them, but vaccination does not. For MMR to be effective we need 95% herd immunity and this dropped to 80% in the UK in 2003.

So no, vaccination is ‘not just about you’, it is about us all. Some European countries will not allow children to enter the state education system without evidence of vaccination. I can see no reason why this would not be a reasonable policy in the UK.

Similarly, is it fair the unvaccinated can sit in hospital and GP waiting rooms putting potentially vulnerable patients at risk from disease?

Ultimately we do all have free will, and parents still sadly have the right to make idiotic choices on behalf of their children. But equally, the state has the obligation to protect the many, even sometimes at the expense of the few.

I did warn you this one was not for the faint hearted.

Dr David Turner is a GP in north west London


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