Measles in the UK: a test of public health competency in a crisis
BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f2793 (Published 1 May 2013)
Cite this as: BMJ 2013;346:f2793
Rapid Response from Jackie Fletcher (see the online thread at BMJ.
In my opinion public health competency has been tested and it has unequivocally failed the British public.
The authors refer to 'Wakefield's legacy' and seem to imply that problems with MMR vaccine started with the publication of The Lancet case series report in February 1998. This is their preferred start of the MMR controversy because it is more convenient to destroy one man's character than deal with the failings of the DH policy makers.
The DH and JCVI knew before the MMR programme began in October 1988 that 2 of the 3 brands carried a risk of meningitis and the third brand was linked with neurological complications, yet they sanctioned the use of all three brands.  
During the first week of the new MMR campaign in 1988 an eighteen month old infant was given it, started with severe convulsions and subsequently died during a seizure. This child was one of a number of children awarded Government recognition of MMR vaccine-damage through vaccine damage payments following medical assessment of the individual cases.
The two Urabe mumps containing brands were subsequently withdrawn in September 1992 after four years of use and having had an 85% share of the MMR UK immunisation programme. As mentioned, the DH and JCVI knew of the link with mumps meningitis from these brands. They also knew it was down to a chance finding due to a cluster of meningitis cases in a short period of time coming to light in a Nottingham hospital which finally led to the full exposure of the problems. The hospital had a strict policy of routinely conducting lumbar punctures whenever a child was brought in following a febrile convulsion and the Urabe mumps vaccine strain showed up in the spinal fluid samples.
And what of the Urabe mumps MMR withdrawal? Did the DH contact every doctor in the country to cross check their patient records to determine if each child who had received either of the brands was developmentally well and thriving to the same degree as before the vaccine was given? The answer is no!