Incidents of meningitis linked to the measles, mumps, rubella (MMR) vaccine in Japan are far higher than first thought, affecting around one in 1044 vaccinations. The Japanese Ministry of Health withdrew the vaccine in April 1993, but has only recent

The domestically produced MMR shot was initially mandatory but, within a year, had been reclassified as being on request once reports of adverse reactions started coming in (The Lancet, 8 January, 1994).

Rubella or german measles remains a childhood disease among the self contained Amish communities of the US. It has increasingly become a disease of adolescence and young adulthood in the rest of the States because of the vaccination programme.

Cases among the Amish community which makes up less than 0.05 per cent of the US population have been almost always mild, and pregnant women appeared to be naturally protected. Despite this, the Department of Preventative Medicine at the Vanderbilt University School of Medicine in Nashville says the Amish should be encouraged to be vaccinated (JAMA, 5 January 1994).

For the first time since records began in 1912, no measles cases were reported in the US for three consecutive weeks during November 1992 (JAMA, 5 January, 1994).

Another case which links Guillain-Barre syndrome to the MMR vaccine has just been published in the UK. Two earlier UK cases have been reported, while a further 20 have been reported worldwide to the vaccine’s manufacturer. The syndrome had previously been linked to influenza immunization following a high number of cases reported in the 1970s (The Lancet, 1 January 1994).

There was a mumps outbreak in Maury County, Tennessee shortly after children there had received the vaccine. Apparently, say authorities, the vaccine had failed. It is, in any event, only 95 per cent effective (Journal of Infectious Diseases, January 1994; 169: 77-82).

Cases of whooping cough are on the increase in America, even with high vaccine coverage. In 1993, the highest number of cases were reported to the Centers for Disease Control and Prevention since 1976 and double the number of cases reported since 1992. This isn’t due to a drop in vaccine coverage, said the CDC, but possibly the cyclical nature of the disease and waning immunity.

!AJAMA, 5 January 1994.

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