When my son was just two months old - a creamy, curled-up cinnamon bun of knitwear and breastmilk - I took him up to Liverpool, on my own, for a night.
I was visiting a friend who had her own baby and a toddler to boot. We were going to sit in front of the television together, feed our babies together, talk in low voices and warm our babies in front of her wood fire.
As I arrived, I got a text from my boyfriend. There was a measlesoutbreak in Liverpool. Twenty-nine children had been diagnosed.
I felt my entire body go cold with what I can only describe as a Medieval dread. I had brought my son into danger. He was too little to have been vaccinated, his lungs, brain, skin, liver and kidneys had only existed outside my body for a matter of weeks, there was nothing to protect him from the droplets of spit coughed into the air of a bus or wiped across the surface of a cafe table.
If he sat in the same train carriage, in the same cafe, lay on the same changing mat as a child with measles, he could catch it. My friend’s son went to nursery in the city - I knew he was vaccinated, but the fear that he may carry home the virus on his clothes, rucksack, shoes, flashed through my mind unbidden. I wanted to cry. I wanted to run away. More than anything else, I wanted my son to be safe.
The anti-vaccination movement has spread across economically developed countries (fittingly) like a rash in the last decade.
According to UNICEF and the World Health Organisation, 1.5 million children die globally, each year because they aren’t vaccinated, while over 100,000 people, including children, died from measles in 2017.
In the UK, over half a million children did not receive the first measles dose between 2010 and 2017 making it the third highest rate in high income countries behind the United States and France. Globally measles rose by 300% in the first three months of 2019.
The movement has been popularized by several self-appointed celebrity spokespeople, including Jessica Biel, Jim Carey, Lisa Bonet and Alicia Silverstone (who also, incidentally argued that tampons can cause infertility). What was once seen as a small, strange, minority view is, worryingly, becoming more common.
I’m lucky. My child had no underlying health problems; he was able to have his jabs at eight weeks; he got the MMR when he was one. I will gladly hold his chubby limbs or tip back his small, rose bud mouth as he gets every single vaccination the NHS can offer. I consider it a privilege and an honour to do so, however anxious it might briefly make me feel.
Not all families are so lucky. There is a child I'll call Alice, at the nursery I’d previously wanted to send my son to, who has leukemia. She is only three, and undergoing chemotherapy. As a result, not only has the immunisation from her MMR been wiped out, but her immune system is so compromised that she cannot have it again until six months after the treatment finishes, which may be 18 months away.
Alice is utterly vulnerable to infection. Being immunocompromised means she is not only more likely to catch viruses like measles if in contact with them, but also more likely to develop serious side-effects from those viruses. Side-effects like pneumonia which would, in her case, be life-threatening.
With a kind of fear and frustration I can only imagine, Alice's father, Muir, discovered that four of the children at his daughter’s nursery had not been immunised. When asked by the nursery's director why those parents hadn't vaccinated their children, two parents replied saying that they considered vaccination a conspiracy.
One parent explained that they didn’t believe in vaccination as neither she nor her husband had ever got ill – a view which overlooks the reality of herd immunity - if everybody around you is vaccinated against an illness then, of course, you are unlikely to get it because all those immunised people stop it being passed to you.
Another parent even wrote that they would actually quite like their daughter to get measles because they thought it would increase her immune system.
Vaccinations build up your immune system, of course. But those people wanted to instead build up immunity in a way that would threaten the lives of other children who, through illness, chemotherapy, unavoidable medical conditions or by being simply newborn, cannot be vaccinated.
'We had a meeting with our daughter’s consultant at Great Ormond Street,' says Muir, 'and he explained that she is more at risk from the current outbreaks - as he saw it, those other parents were basically being selfish. They were just thinking about what they saw as their child’s benefit and not considering any other children around them.
'No one particularly wants to give their child the MMR vaccine but if we all chose not to there would be an epidemic. It’s only the parents who are vaccinating their children who are stopping that happening.'
I have a friend, here in London, whose partner wasn’t vaccinated. His mother, back in the 80s, thought she was doing the right thing. And yet, in his twenties, he caught measles and got so ill he ended up in A&E, narrowly avoiding intensive care only thanks to my friend’s quick action.
This was a young, fit, extremely healthy man who was laid so low by measles that he couldn’t walk to the doctor’s surgery - his urine looked like coca cola, he had impaired kidney and liver function, was jaundiced and ended up with secondary pneumonia. A girl he’d given a piano lesson to earlier that week turned out to have not been vaccinated either, and so also ended up being hospitalised from the illness.
All the while, my friend - the woman who had shared a house, a bedroom, mugs and towels with this man - remained absolutely fine because, you guessed it, she had been vaccinated.
Of course, I do not want to label all parents who don’t vaccinate their children as selfish, misinformed, dangerous conspiracy theorists. I would also not pretend that vaccinations are a pleasant, fun or easy thing to go through.
My friend Kirsten had her first baby when she was 39 - a little daughter weighing in at just 5lbs 13oz. Although Kirsten was very pro-vaccine (her mother was a vaccination nurse in New Zealand) she found herself uneasy at the prospect of giving such a tiny baby so many injections during her first year. 'I think we were slightly railing against being told there were no options,' explains Kirsten. 'We lived in London at the time so talked to someone privately about what possible options there might be away from the NHS and that’s when we came up with this plan of a delayed schedule and splitting the MMR into three separate vaccines.'
Kirsten says that when she put this plan to her GP he became very annoyed, despite not being able to give any research on why the vaccines had to be grouped as they were. As a result Kirsten became, in her words, 'That person really aggravating all the nurses by bringing my baby in on this weird schedule for separate vaccines'
But what was it she was hoping for, by splitting the vaccines and delaying them in this way?
'It was basically the fact that we could have a bit of control,' says Kirsten. 'I had a fair degree of nerves because it was my first baby. It’s not logical in the slightest. But then when my son was born a few years later, he had a good chunk of weight on him. We’d also moved to a new city, I didn’t know my doctor and couldn’t conceive of going through all that again. So just went with it: bish, bash, bosh. Also, there are no single rubella vaccines now so my daughter had to have the MMR when she was seven anyway. It was a complete illusion of control, really. But I also think this whole shutting down of the single vaccines just pushes people to either vaccinate or not.'
At my son’s eight-week injections I watched his face turn puce, his body go rigid and felt a guilt incomparable as he stared into my eyes, wondering why I - the source of all his comfort and protection - was allowing this pain in his arm to happen. I do not blame other parents for wanting to put this off or even to avoid it entirely. But I also knew that those seconds of pain, the following hours of grumpy discomfort and the days of irritation were worth it to protect my child against diphtheria, tetanus,whooping cough, polio, Hib (Haemophilus influenzae type b) and hepatitis B, rotovirus and meningitis.
Just like changing his nappy or making him put on a warm coat to go outside - two things that rarely failed to make him scream with fury and confusion - I was doing something momentarily unpleasant in order to keep him healthy, safe, comfortable and happy in the long term. It's hard to understand why some parents don't see it that way.
As one paediatric registrar - who preferred to remain anonymous - explained that there are different types of vaccine averse parents. ‘There are children who aren’t vaccinated because they have a good medical reason not to be. You also get children who aren’t vaccinated because their parents are a bit disorganised. Then we have those people who are genuinely scared.
‘They are absolutely convinced that there is a member of their family that had something terrible happen after having a vaccine. We give babies vaccines at two, three and four months; these are the times when Sudden Infant Death Sydrome is highest. (In fact, babies who are vaccinated have a much lower incidence of SIDS). But if a baby has been vaccinated and a couple of days later dies, that family may really struggle to vaccinate their next child. Even the most rational person would struggle with that.
And then there’s the last group: people who don’t vaccinate because they believe in Big Pharma.
‘There is no way of getting through to a person who has had their child admitted to hospital, with a totally preventable condition, who looks you in the eye and tells you that you’re out to poison their child. These people are rarer than all of the others, but they are incredibly vocal. For them it is ideological and they are trying to convert people. They will seek out parents writing about losing a child and question them about vaccinations. They can be very cruel, very persuasive and are very dangerous.
‘As a doctor, you have to have that conversation, but it’s not one that you’re going to win. I can’t take it personally when they accuse me of being out to hurt their kids. But it is frustrating when you know that preventable harm is being done to a child.’
When it comes to the MMR vaccine there is an additional, rather unpleasant side to people’s fear and reluctance, centering around autism. You don’t need me to tell you that there is absolutely no link between the MMR vaccine and autism; Andrew Wakefield’s claim has been debunked over and over and over again.But I would point out that by arguing that you are more scared of autism than, say, measles, you are perhaps missing the reality of both conditions. You do not realise the innate ableism you are labouring under.
‘It is offensive,’ one anonymous obstetrician and mother to a child who has autism tells me. ‘They’re saying they would rather that their child was really, really ill, potentially dead, than be like my child.’ This woman’s eldest child is autistic - it is a condition that runs in her family and she is quick to point out that there was categorically no difference in his behaviour before or after his immunisations. She never for a moment considered not getting all her children vaccinated.
‘Vaccination is the best thing we’ve done in terms of public health, ever. Probably better than antibiotics,’ she says, calmly. ‘People in the developing world will queue for days to get vaccinations for their children. To have access to this, for free, on your doorstep, at a time of your choosing and to not do it is just so ungrateful.’
Even if the link between autism and the MMR hadn't been comprehensively disproved, I would rather get my child vaccinated against Haemophilus influenzae type b than watch him die of epiglottitis, or subacute sclerosing panencephalitis (SSPE) - a swelling in their brain that has no cure, which had been eradicated by the measles vaccine.
Thanks to herd immunity (which in turn is thanks to the free, easily-available, nationwide programme of immunisations) most people are unlikely to ever come across a child suffering from measles, rubella, diptheria, whooping cough or polio. For most of us, these are dangers unknown, abstract and imagined, while autism, fevers, pain and post-injection swelling are familiar, difficult and feared.
Noam, a neonatal doctor at Royal London Hospital put it to me this way: 'Imagine if we could cure cancer, but it meant taking a pill to prevent getting it; within a few decades, perhaps just two generations, people would start to question why they were giving this tablet to healthy children, why they were taking a tablet when there was nothing wrong with them, why the drug companies were pushing a medicine on people that didn’t even have a disease.'
Vaccinations are the equivalent of that magical tablet. Anti-vaxxers are doing the equivalent of refusing it. Vaccinations have been so successful in this country that many of us have lost sight of what it is to put a child at risk, to watch a child suffer from disease, to know someone devastated by side effects.
That day, as I sat in a dark house in Liverpool, I felt a fear that doesn’t belong to this era, that no parent should face, that we should and nearly had eradicated forever.
There is great care taken not to offend the principles and beliefs of those people who choose not to vaccinate their children and rightly so - everybody deserves respect and freedom in the way they parent. But we must also take enormous care to protect the health of all those children who rely on vaccinations and herd immunity to simply survive. Children like my newborn son. Children, perhaps, like your own.
My son can now walk through life protected from the sorts of illnesses that I would not wish on my worst enemy. All I wish is for those around him - the vulnerable, the ill, the newborn - to be just as safe