December 2, 2008
A "healthy and robust" baby who died just ten days after being given the MMR jab had earlier suffered a fever fit which can be aggravated by the vaccine, an inquest heard today.
George Fisher, aged 18 months, was discovered dead in his cot in Cheltenham, Gloucestershire by his mother Sarah Fisher just hours after he was heard "chatting away on the baby monitor", a coroner was told.
Mrs Fisher, 44, and husband Christopher, 43, believe the vaccine is "implicated" in their son's death in January 2006 as the temperature-raising effects of the drug on children who have suffered febrile convulsions were not explained to them - knowledge they say might have allowed them to act sooner.
Department of Health guidelines say the jab should be given "with caution" but does not ban child sufferers of febrile convulsions from taking it and recommends temperature monitoring.
Two doctors confirmed that giving MMR to sufferers like George, who contracted the fever four months earlier, was permitted under patient guidelines with careful watches recommended.
The coroner heard George was born at a healthy 8lbs 10oz, and came through his routine injection with no side effects.
His GP Dr Annette Bugaighis confirmed that George fell ill on 25 September 2005 after returning from a holiday in Spain and developed a high temperature.
After suffering a fit at the Overton Park surgery he was rushed to hospital where it was found he had suffered febrile convulsion - a fit caused by a fever.
Dr Bugaighis said: "There was nothing obvious in his medical history to explain his sudden death."
A Department of Health pamphlet advises only that MMR2 should be given "with caution" to those who "with an individual or family history of cerebral injury or any other condition in which stress due to fever should be avoided. The physician should be alert to the rise in temperature that may follow".
George was admitted to hospital from the surgery with high temperature, stiff neck, crying and puffy eyes, and green-tinged stools.
Both Dr Bugagis and consultant paediatrician, Alan Day, of Cheltenham General Hospital, agreed that George was safe to be given the vaccine on 9 January 2006 - adding that he should be monitored for the warned raised temperature.
Dr Day said his advice to parents whose child had suffered a febrile convulsion before being given the vaccine would be to take paracetamol and "purchase a good thermometer".
In evidence Mrs Fisher, a hotel receptionist, said her son was a "healthy and robust" child who had breast-fed for 11 months - longer than her other three children.
After his febrile illness he was given antibiotics and on the Wednesday before he died was "running around playing football with his father".
The night before he died he was "chatting away on the baby monitor", she added.
She said: "He took his bottle of water and I put the quilt over him, stroked his head and said goodnight. I went to bed, heard him drink his water, then throw the bottle on the floor. I heard him shuffling around."
At 8am his sister Meg, who was sharing a room with him, called out to her.
She added: "I was surprised he was not awake. I tried to wake him but it was clear he was dead because of his colour and he was cold."
She explained that he was due to attend a doctor's appointment for his worsening symptoms on the day he died.
She added that she now knew George should have been more closely monitored because of his previous condition.
Mr Fisher, a pipe-fitter, said that no Patient Information Leaflet on the MMR precautions to be taken with children who had previously suffered fever had been given to the family. Nor was any verbal advice specific to his circumstances.
He said: "How I remember it, we were told if he had a rising temperature to give him Calpol if he got grisly. I had been present at all my children's vaccines and it's the same spiel on every occasion.
"Given his condition they should have been aware of his medical history. At no point were we asked for this before his vaccination."
"If we had (been given the leaflet) we would have gone to hospital much quicker because of the information in that list. We would have been much more concerned than we actually were."
Nurse Heather Mitchell, who gave the injection, said she trusted parents' instincts and was satisfied when they told her George was well on the day.
Nurse Mitchell, who vaccinates "in excess" of 1,000 babies a year, said no specific advice was required other then regular checking of temperature.
Ten years ago research led by Dr Andrew Wakefield, a gastroenterologist at London's Royal Free Hospital, sparked fears that the combined Measles, Mumps and Rubella (MMR) vaccine was linked to autism.
Several studies in Britain, Finland and Japan have since disproved connection but popular anxiety over 'the jab' has persisted.
Last week it emerged that cases of measles had topped 1,000 for the first time in more than a decade.
Mary Ramsay, of the Health Protection Agency, attributed the rise to the "relatively low" uptake of the MMR vaccine.
Gloucestershire Coroner Alan Crickmore will hear up to three days of evidence at the Shire Hall, Gloucester, before recording a verdict.
Comment: As Dr. Wakefield has said:
"I was accused of going beyond the science when I suggested that parents should have single jabs until the MMR had been properly assessed for risk.
"I had assessed the data and the safety study relied upon by the Department of Health and it was derisory. It was no way as good as the research into the single jabs.
"Bernadine Healy, the former head of the US National Institute for Health, admitted they had altered evidence on the epidemiological studies conducted by the US Government to suit the official line. She admitted the evidence both the US and UK relies on is useless.
"The UK Government has a big dirty secret that it doesn't want the public to know . . . they agreed to under write any compensation claims for the MMR. This is why they can't and won't let their position fail.
"It was inevitable I was going to be dragged in front of the GMC because I dared to question big business. They always come after those who don't toe their line."