Swiss Campaign for Measles, Mumps and Rubella Immunization (Original title: Schweizerische Impfkampagne gegen Masem, Mumps und Roeteln. Merkurstab 1994; 47: 517-8. English by A. R. Meuss, HL, MTA.)

JAM Vol. 12, Nr. 4 Summary

When the campaign was initiated in 1987, the USA was cited as an exam- ple because 20 years of enforced vaccination in the States had reduced the incidence of measles by 99%. Recent developments in the USA give pause for thought, however.

Major measles epidemics have developed repeatedly since 1982. Adolescents are increasingly affected, in spite of vaccination, and so are infants, because mothers no longer confer adequate immunity. Childhood diseases are more dangerous for both these age groups than for other children. According to official statements, measles mortality has increased by a factor of 10 in the USA. American experts refer to this as an unexpected and partly inexplicable development. Warning voices are increasingly heard among vaccination experts.

It may be said that the incidence in the United States is still much lower than in the period preceding the mass immunization campaign. One thing is abundantly clear, however: there are compulsive elements to the MMR immunization campaign that inevitably intervene profoundly in the sphere of the individual. When obligatory immunization had enforced high levels of compliance in many places, the unexpected epidemics necessitated rigorous measures including quarantine, exclusion from school, house-to-house immunization. MMR re-immunization has already been made obligatory. Similar reports are coming from other countries with high immunization rates.

Recent investigations in Switzerland and other countries have also shown that in practice it is impossible to eradicate measles, rubella and mumps. This deprives MMR vaccination strategies based on mass immunization of young children of any kind of rational basis.

In Switzerland, measles, rubella and mumps cannot be said to represent an emergency situation that would justify such rigorous government intervention. Prevention of the serious complications of these three childhood diseases relates to three entirely different spheres, and a single combination vaccine cannot do justice to these.

The Medical Group for Differentiated MMR Immunization and the Groupe Medical de Reflexion sur le Vaccin ROR are not against immunization as such. They do, however, advocate a cautious approach, taking account of the individual situation and of the specific problems of each of the three childhood diseases, avoiding fundamental changes to their epidemiology and respecting parents' freedom of decision.

The critical studies of the Swiss MMR immunization campaign published in the two papers mentioned below result from three years of fundamental research done by the Medical Group for Differentiated MMR Immunization and the Groupe medi- cal de Reflexion sur le Vaccin ROR. Essentially they base on the following:

- Documents from the Swiss Federal Department of Health (BAG) relating to the MMR campaign, especially information material for the medical profession issued in 1987 and 1989.

- 30-page correspondence between the Group and BAG.

- Detailed study of the specialist literature on the subject.

- A. Tschumper and Th. Abelin's study of the literature entitled Die Impfstrategien gegen Masem, Mumps und Roetein (MMR-Impfung) im Lichte der epidemiologischen Literatur. Bern, December 1988.

- Correspondence and discussions with experts in Switzerland, Germany, the USA - esp. the US Centers of Disease Control (CDC) - on the subject of protective immunization, and Prof. Dr. D. Jachertz in Bern (on matters of epidemiclogical concern).

- The professional experience of the c. 240 physicians in the two groups.

The Medical Group for Differentiated MMR Immunization (est. in 1987) and the Groupe Medical de Reflexion sur Ie Vaccin ROR (est. in 1988) include c. 240 Swiss medical practitioners whose aim is to gain acceptance for a differentiated MMR immunization practice.

The fundamental aspects are presented in leaflets for parents published by the groups which are entitled "Masem-, Mumps- und Roeteln- Impfung - Warum die Eitern mitentscheiden sollen" and "Vaccination ROR - Parents vous etes con- ceme's" (MMR immunization - why parents should have a part in the decision). They may be obtained from the Secretariat, Postfach 3009 Bern, Switzerland.

Hansueli Albonico, MD

Bemstr. 13

CH-3550 Langnau

Switzerland

Literature

Albonico H, Klein P, Grob Ch, Pewsner D.

Schweizerische Impfkampagne gegen

Masern, Mumps, Roetein. Schweiz Zschr

Gamheitsmedizin 1994, Nos. 1 and 2.