I read with concern Tom Moberly's report that the British Medical Association is trying to open a debate about mandating vaccines in the United Kingdom  having already made a number of relevant observations under an earlier article . Most fundamentally, I would urge the medical establishment to exercise a little humility when today's scientific orthodoxy could so easily in retrospect become tomorrow's horrific misjudgement. It does not help when we see all vaccine critics dismissed by the Guardian newspaper or, by CEO of Gavi, in the Spectator in abusive terms as "anti-vaxxers" [3, 4], when it is far from clear that every issue in vaccine safety has been resolved - or that we can even begin to assess the risks while denying a respectful hearing to patients or their families, which pre-empts both evidence and argument in an inappropriate way. In my experience the most vociferous vaccine critics hitherto have not so much been people with an ideological objection to vaccination as people who had had their children vaccinated and regretted it. Such indiscriminate (scorched earth) strategies scarcely command the moral high ground.
Moreover, disregarding the highly intolerant atmosphere which is being generated in some quarters it is not evident that even if the science involved could approach the level of being definitive that it is anywhere near that at present. For example, three successive reports by Cochrane on the safety of MMR have declared [5,6,7]:
"The design and reporting of safety outcomes in MMR vaccine studies, both pre- and post-marketing, are largely inadequate."
which would indicate that the science has never been done (and some might consider it a bit late now). I also note the current complaint to the European Ombudsman regarding HPV vaccines and the European Medicines authority from Nordic Cochrane [8,9]. Though HPV vaccines may or may not be mandated the complaint partly relates to the uncertain science surrounding aluminium adjuvants which are also used in scheduled infant vaccines such as Infanrix Hexa , Prevenar  and Bexsero . Yet this science is being publicly promoted as if infallible. There are surely lessons here from history. Meanwhile, it is far from apparent that Dr Farah Jameel who proposed the motion at the BMA had the remotest idea of these shortcomings .
Nor is it immediately obvious that the threat from infectious diseases has increased in any degree to justify such an abrupt change in policy (and in a way which could antagonise people presently much more well disposed to the vaccine programme than I might be myself). A greater problem which presently demands attention from health officials is the steep, unexplained rise in neurological disorders such as autism, which even now seem to be gathering dramatic momentum [13, 14, 15].
 Tom Moberly, 'UK doctors re-examine case for mandatory vaccination', BMJ 2017; 358 doi: https://doi.org/10.1136/bmj.j3414 (Published 18 July 2017)
 Rapid Responses to Peter Doshi, 'US government website for collecting adverse events after vaccination is inaccessible to most users', http://www.bmj.com/content/357/bmj.j2449/rapid-responses
 Editorial: 'The Guardian view on vaccination: a matter of public health' , The Guardian 7 July 2017, https://www.theguardian.com/commentisfree/2017/jul/07/the-guardian-view-on-vaccinations-a-matter-of-public-health#_=_
 Seth Berkley, 'Anti-vaxxers have embraced social media; we paying for fake news with real lives' Spectator Health 28 June 2017, https://health.spectator.co.uk/anti-vaxxers-have-embraced-social-media-were-paying-for-fake-news-with-real-lives/
 Jefferson T, Price D, Demicheli V, Bianco E, 'Unintended events following immunization with MMR: a systematic review' 2003 https://www.ncbi.nlm.nih.gov/pubmed/12922131
 Demicheli V, Jefferson T, Rivetti A, Price D., 'Vaccines for measles, mumps and rubella in children', 2005 https://www.ncbi.nlm.nih.gov/pubmed/16235361
 Demicheli V, Rivetti A, Debalini MG, Di Pietrantonj C, ''Vaccines for measles, mumps and rubella in children', 2012.
 Stephane Foucart , http://www.lemonde.fr/planete/article/2016/12/09/papillomavirus-les-autorites-europeennes-dans-la-tourmente_5046054_3244.html
 Gøtzsche P, Jørgensen K, Jefferson J, Auken M , Brinth L, 'Complaint to the European ombudsman over maladministration at the European Medicines Agency (EMA) in relation to the safety of the HPV vaccines', http://nordic.cochrane.org/sites/nordic.cochrane.org/files/public/uploads/ResearchHighlights/Complaint-to-ombudsman-over-EMA.pdf
 Helen McArdle, 'Call for investigation as 20 young Scots a day are rejected fro mental health care', Sunday Herald 20 December 2016, http://www.heraldscotland.com/news/14975962.Call_for_investigation_as_20_young_Scots_a_day_rejected_for_mental_health_care/
 Brett Campbell, 'Autism assessment list now at crisis level, says MLA', 22 December 2016, http://www.belfasttelegraph.co.uk/news/northern-ireland/autism-assessment-waiting-lists-now-at-crisis-level-says-mla-35313064.html
 Jane Dreaper, 'Autism diagnoses 'could be reduced under NHS plan'', BBC News 27 May 2017, http://www.bbc.co.uk/news/health-40058482
The motion has been raised to look at the advantages and disadvantages of making childhood immunisation mandatory. I'd like to share some thoughts to help the discussions.
Our group JABS is a support group of parents of vaccine-damaged children and I'd like to draw your attention to the fact that doctors' children are not immune to vaccine damage. We have parents from many groups of the medical establishment (consultants, doctors, nurses etc) that have reported serious life-changing events following reactions to routine vaccinations. Some of the doctors have actually vaccinated their own children and now have to live with the consequences. We have asked some if they will speak out but they have told us of their fears for their reputations, promotion prospects even their final pension plans. I can understand this.
Parents have reported to us that their children were healthy and developing well and regardless of the age when vaccinated the children have suffered adverse reactions within the incubation periods of the vaccines and developed long-term problems also recognised by the manufacturers' in their own product information sheets. Treating physicians have been unable to give an alternative explanation for the children's medical decline other than it was coincidental to the vaccinations.
We have a strange double standards in operation. When a child is due for a vaccination medical staff are happy to discuss the minor reactions and state that they are very common but the serious reactions also known to the drug companies are supposedly so 'rare' that background prevalence of a disease is always the answer. Yet if a child were to have a vaccine preventable disease and suffer the exact same symptoms and long-term consequences medical staff would have no hesitation in blaming the disease and the parent for not vaccinating.
Where do medical staff get their information on how 'rare' a serious reaction is? The passive surveillance system is recognised as a poor collection service with less than 5-10 per cent of serious reactions being put forward through the yellow card system.
And those reactions that are put forward to the MHRA? In conversations with staff I have been told that if a card contains details of a reaction known to be associated with the vaccine, for example a febrile convulsion, it is just ticked off and no further action taken. There apparently is no follow-up six to 12 months later to determine if the child fully recovered from the reaction or if the child's health and mental state has seriously changed. I know this from personal experience.
Mandatory vaccinations were tried once before in the UK in the late 1800s. It did not go well. There was great hostility and considerable resistance and the plans had to be abandoned. There is no mandate in the UK for any government to impose compulsory vaccination. Without democratic consent such a policy would face escalating opposition.
You only need to see what is going on in Italy right now following government plans to pass laws quickly through its parliament, without public consultation, for mandatory vaccinations with threats of heavy fines, children to be excluded from nurseries, potential prison sentences for non-payers and the diabolical announcement that children could be forcibly removed from their parents and vaccinated.
Ever since the plans were announced, Italian people have been taking to the streets of their major cities each weekend in huge numbers (thousands and thousands) to peacefully protest against this attack on civil liberties. Is this really the way UK doctors want to take us?
And how could compulsory vaccinations be enforced? My son, who is severely vaccine-damaged, has had many hospital emergencies because of his conditions and from being a baby through infancy to adulthood every time we are in the A & E department bloods need to be taken and staff have told us many times over the years that they are not allowed to restrain our son. My husband and I are expected to hold and calm him whilst they draw blood. If you as a doctor are faced with parents who refuse to give consent and a distressed, screaming child who is thrashing their arms about and refuses to co-operate, how do you vaccinate the child safely? And how do you expect that child or the parents to ever trust you again?
Competing interests: Mother of MMR vaccine-damaged son
21 July 2017
Warrington, Cheshire UK