Choice Healthcare Services

Are doctors allowed to give the single vaccines for measles, mumps and rubella (German measles)?

Yes, doctors are legally allowed to obtain and give these vaccines, provided they comply with the Department of Health regulations on unlicensed medicines.

Then why do more doctors not offer them?

Because doctors are under strong pressure from the Department of Health (DoH) to promote and give the MMR vaccine, in the same way as you are being encouraged to give it to your children. Most doctors believe that the MMR is a better and safer option than the single vaccines for your child and the population at large..

What are the implications of the vaccines being unlicensed?

This means that they have not passed through the DoH's quality control procedures. It also means that they have to be ordered on a 'named patient' basis. This requires that each vaccine be ordered for an individual named child with the clinical reasons that the vaccine is needed.

My child is healthy. What would the clinical reason be to order the single vaccines for my child?

If, after appropriate counselling, you refuse to allow your child to be given the MMR vaccine, then your child is at risk of contracting measles, mumps and rubella. The only way to protect your child in these circumstances is to give him or her single vaccines. This is the clinical indication.

Have the single vaccines always been unlicensed in the UK?

No. The measles single vaccine was used in this country from 1968 until 1988 when the MMR was introduced. It then continued to be available for those parents as an alternative to the MMR until the DoH withdrew it from ready circulation around 1998.

Where are the single vaccines made?

They are manufactured either in Europe or the USA by large multinational pharmaceutical companies. See the separate vaccine sheets for more information on this.

Are they 'licensed' for use in other countries?

Yes, they are all licensed for use in other countries including many major European countries and/or the USA.

How are the vaccines transported to your clinic?

They are imported by a company that specializes in importing drugs from abroad and has approval from the DoH to import the single vaccines. They arrive at our premises in temperature controlled conditions like all our other vaccines.

Do the vaccines contain mercury?

Neither the MMR nor any of the measles, mumps or rubella single vaccines contains mercury.

How do you store the vaccines?

They are stored, along with other vaccines, in temperature controlled fridges especially designed for vaccine storage.

How long can the vaccines be stored?

The 'shelf life' or expiry date will vary from batch to batch, but is usually a year or longer.

Are the single vaccines safer than MMR?

Choice Healthcare Services do not advise on the safety of the single vaccines over that of the MMR three in one vaccine. However, in the light of some reports about the possible diseases and mental disorders that have been identified after the MMR has been administered, we are here only to offer you the ability to make informed decisions about your child's health, and to choose a method for protecting your child that you feel is suitable.

Do the vaccines have side-effects?

All vaccines have side-effects. Please see the vaccine information sheets for more information.

Who is liable if something goes wrong?

The doctors and nurse practitioners at Choice Healthcare Services remain responsible in the normal way for any advice and treatment that we offer. The pharmaceutical companies remain responsible for the quality of their product.

Do you keep a record of the batch number of the vaccines?

Yes, we keep a record of the batch number of the vaccine in our own records, and we also give it to you for your records.

How will my GP know that my child has been immunised?

We will write to your GP with information on your child's immunisation and/or we will insert a Choice Healthcare vaccination sheet into your child's health book.

What are the disadvantages of giving the vaccines separately?

The DoH has several concerns about the giving the MMR as separate vaccines, a course of actionof which they strongly disapprove:

• The vaccines are not licensed in the UK (see above)
• There will be periods when your child will be unprotected against one or more of the illnesses whilst waiting to have the next vaccine
• The single vaccine route requires your child to have more injections.
• The DoH are concerned that you may not bring your child back to have all the vaccines.

Are the single vaccines as effective as the MMR?

Individually, they are at least as effective as the MMR. However, your child will not be protected against all three illnesses at the same time with the single vaccines.

Do the three separate vaccines contain the same strength as the MMR?

They contain the identical or equivalent strength of vaccine.

Which vaccine do you recommend my child has first?

Measles, this illness poses more of a risk to your child than mumps or rubella.

How long do you recommend between the vaccines?

We recommend three months between each immunisation as long as they are given in the order of:

1. Measles
2. Rubella
3. Mumps

We recommend that the interval between the Measles and the Mumps is at least 6 (six) months, with the Rubella in the middle. However parents can choose a longer period of time if they wish.

Why so long? Can my child have them sooner?

The purpose of having the vaccine separately is to minimise any risk of interaction that could occur between the three live viruses that make up the MMR. Some centres offer the vaccines at much shorter intervals.
We are concerned that this may not minimise the risk of interaction which we are trying to avoid. We will offer the vaccines at intervals of longer than three months if you wish. This can be discussed when you bring your child for the first immunisation.We will insist on at least six months between measles and mumps.

What strains do your vaccines contain?

The vaccines we currently offer contain the following strains:

• Measles: Rouvax (Schwarz Strain) or Moraten Berna (Edmonston Zagreb strain)
• Mumps: Jeryl Lynn strain (Mumpsvax by Merck USA or Adventis Pasteur MSD)
• Rubella: RA 27/3 strain (Ervevax SmithKline Beecham), Rudivax by Adventis Pasteur or Rubeaten by Berna

However, please bear in mind that these may change from time to time because of supply problems.We would never use any vaccine that we did not feel was one of the safest and most effective available.

Do you administer the controversial Pavivac mumps vaccine?

Pavivac is not used by Choice Healthcare. The mumps vaccine that we use is supplied under the brand name of Mumpsvax , manufactured or supplied by Merck or Adventis Pasteur.

Will my child require a booster?

A pre-school (3 1/2 to 5 years) booster is always recommended, however, we do offer the option for your child to have a blood test that can determine their current levels of immunity. This can be discussed during your consultation.

My child has had the MMR. It is now time for his 'booster'. Is he able to have the single vaccines?

Yes, having the MMR once does not prevent your child from receiving any or all of the single vaccines, though your child may not need to have them all again. It may be worthwhile having a consultation to discuss this.

Will I be able to travel after my child has been given the vaccine?

Yes. Unless your child shows immediate signs of a bad reaction to the vaccine (which is extremely unlikely) you will be allowed to leave shortly after your child has received the immunisation.

What happens if the single vaccines become available on the NHS after I have ordered them for my child? Will I get my money back?

If you decide not to go ahead with a single vaccine for any reason having ordered and paid for it, then there is an administration fee of up to 50% of the fee paid.

Can I obtain the vaccine elsewhere?

No, all clinics nationwide have been affected by the shortage if they use the Jeryl Lynn strain mumps.

Are there any other strains available?

There are other strains of the mumps vaccine but Jeryl Lynn strain is the only strain deemed safe for use in the UK.

If I haven't paid yet, will I still receive it?

Yes but you will be subject to the price increase.

Do you know the date you will receive your batch of mumps?

No, but as soon as we do we'll be in contact with you.

My child hasn't had any vaccinations against mumps, what if there's an outbreak?

We have no control if there is an outbreak. However, for a boy yet to go through puberty, mumps is not a threat. Mumps is only is given to girls for herd immunity, ensuring that she doesn't give it to a man or pubescent boy.

Does my child still have protection from their first mumps vaccine?

Yes there is always a certain amount of coverage.