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European research not applicable to Sri Lanka
MBBS(Cey), DCH(Cey), DCH(Eng), MD(Paed), FRCP(Edin), FRCP(Lond), FRCPCH(UK), FSLCPaed, FCCP, FCGP(SL) Consultant Paediatrician, Colombo. Formerly, Consultant Paediatrician Lady Ridgeway Hospital for Children, Colombo 8, Sri Lanka. Joint Editor, Sri Lanka Journal of Child Health

This article has reference to the report titled "Babies should be given MMR jab earlier to cover immunity ‘gap’ for measles" which appeared on page 11 of The Island on the 20th of May 2010. It is a research study done in Europe which has been reported in The British Medical Journal (BMJ). The Sri Lankan situation is quite different to that found in Europe. Measles vaccine is administered by the Expanded National Immunisation Programme of the Ministry of Health of Sri Lanka at the age of nine months to all babies. It is given that early for the same reason as has been advocated in the BMJ report, namely, to counteract the waning immunity transmitted by the mother, by early infancy. In Europe, measles vaccine is not administered to children but a combined vaccine against measles, mumps and rubella (MMR) is used, generally after one year of age. The Sri Lankan Programme administers the additional measles, rubella (MR) vaccine at the age of three years to boost immunity to measles and to immunise the child against rubella too. The MMR vaccine is available only in the private sector in Sri Lanka and that too has been advocated to be administered at the age of three years, if the parents prefer to give it rather than the MR vaccine.

After the measles vaccine came into general use in the late eighties in Sri Lanka, there has not been any significant outbreak of the disease up to the present time. The measles vaccine cannot be advocated earlier than nine months as the degree of immunity that would be produced if it is given earlier, may not be optimal. The general public has to be reminded that measles, which is almost totally eradicated in this country at the present time, used to produce horrendous complications in children, perhaps just up to about three decades back. We do not see it anymore, thanks to the efficiency of our "Golden Immunisation Programme". Europe, particularly the United Kingdom has a very special problem regarding measles. Due to false claims by certain researchers in their own countries of a possible causal link of childhood autism to the MMR vaccine, parents stopped giving it to their children. Although these claims of autism and MMR have been scientifically disproved, the stigma left by the earlier reports left an indelible adverse impression in the minds of parents in those countries. Now, as a result, they are experiencing major outbreaks of this once dreaded disease. Most of their research now is geared towards re-convincing their populace to give the vaccine again.

There is a tendency in Sri Lanka to think that Westerners know everything and to take everything that they say as gospel truth. The quoted BMJ report is not applicable to Sri Lanka at all as the situation in this country is totally different to that in Europe. There is no scientific basis for changing our immunisation programme in Sri Lanka for any reason, least of all because of some research done in Europe.

@ The Island: By Dr. B. J. C. Perera