Nikki Turner: Enough of this 'debate' on vaccine

COMMENT

Meningococcal disease is terrifying. As a parent I was delighted to know there is now a vaccine available to help protect my children. However, how do I as a parent react to a headline in the Herald headed "Dispute over vaccine risk goes on"?

The report from the independent Safety Monitoring Board on this vaccine has been excellent and there appears to be a large amount of safety data with rigorous analysis.

So where is the dispute?

What stands out is that this article gives equal weight to a large randomised control trial and an individual's opinion. Now while my opinion as an individual is valid it is not rigorous enough for scientific decisions.

The important message here is knowing the difference between side-effects and coincidence. If a large number of children are given a vaccine, there will be some children to whom something happens which is purely coincidental but comes soon after a vaccine is given.

That is why it is vital that large, rigorous trials are performed to show whether an event is coincidence or caused by the vaccine. I notice chronic fatigue syndrome was attributed to the vaccine in the Norway trial on 180,000 school children, half of whom were given the meningococcal B vaccine, and half no vaccine.

There was no more chronic fatigue reported in the group given the vaccine than in the placebo group. That is why randomised controlled trials are so vital to tell what is cause and what is coincidence.

Individual anecdote is strong but can be misleading. My own daughter was born with a severe congenital handicap. I have spent years trying to find a reason, because having a reason seems to make it easier to cope with.

There are many things I could blame her condition on but I have no evidence for them. I would like a reason and I sympathise with parents who feel a event was caused by a vaccine when we have no other evidence.

The most recent example of that was autism. A British scientist proposed in 1998 that the MMR vaccine might cause autism. Many parents with autistic children and no answers as to why assumed it was the vaccine, and many more chose not to use the vaccine.

The overwhelming evidence of science is now very clear that the vaccine is not the cause of autism, but the memory lives on and fewer children continue to have the vaccine and Britain continues to have outbreaks of mumps and measles.

New Zealand historically has not been good at monitoring vaccines. We have relied on international evidence and the work of other countries.

Now that we have a disease and a vaccine for it specific to our country we need our own rigorous monitoring process.

There is a monitoring system in place that involves several different approaches. First, there is active follow-up of every hospital admission in this age group, data matching with children who have been given the vaccine.

There are "sentinel" general practices around the country at which all data from the children given vaccines is linked to all their GP visits to see if there could be any links.

There is also the existing system by which parents and health professionals can notify any event of concern.

Last but not least there is a database of all children given the vaccine so any long-term or unexpected events can be followed up. There is an independent safety monitoring board in place with international expertise and advice. This is an excellent, academically rigorous system, on top of the international data already from randomised controlled trials of the parent and cousin vaccines.

While with new vaccine there is always caution, it is certainly much less now it has been well received in more than 200,000 children who have been actively monitored for side-effects.

Sore arms, fever, nausea and vomiting are unpleasant and occasional allergic reactions. However, no child has died or had any long-term effects from the meningococcal vaccine

The anti-meningococcal vaccine campaign was a beat-up. While it is trendy to beat up on science and anecdotes of scary conditions make a good read, this is unfair on parents.

How do we do the best for our children when people continue to blame vaccines despite good, rigorous science? Science is never perfect, the vaccine will not stop all meningococcal disease, nor will it work in all children, yet it will reduce the number of children suffering this disease.

I have studied a lot of the science, I have read the safety trials, I am aware there are limits to science, I have seen the New Zealand safety data and I will use this vaccine for my children to reduce their risk of this terrible disease.

* Dr Nikki Turner is director of the Immunisation Advisory Centre.