Vaccination debate: Dr Alan Walters
Here is the full interview with Dr Alan Walters, medical director of Cape Medical Response in Cape Town, who argues for vaccinating your child.

Is there a trend in South Africa not to vaccinate?

There is. I can't give you numbers obviously, but I have certainly come across several families – three or four, that I've just come across coincidentally – that have made the decision not to.

Why not?

The main reason they give is they are worried about harming the baby, particularly in view of the hoo-ha in the UK and USA about autism – that they thought the pertussis vaccine could possibly cause autism. It has been shown that it doesn't – in fact, there was a report in the British Medical Journal in January 2002 which showed evidence that the MMR vaccine did not have any effect at all on autism.

There was also a query that it could cause some gastroentrological or bowel problems – it's been shown that it does not cause any problems whatsoever.

What do you think of the anti-vaccination movement?

There have been lots of articles in books and things over the years – I tend to dismiss them. In fact, it's quite alarming if you look at the internet... there are one or two websites that completely state that there is a problem. They say things like "vaccines are a conspiracy set up by the drug industry just to sell useless vaccines at a great profit" – which is complete nonsense.

I was a doctor years ago, when we didn't have any measles vaccine, and unvaccinated kids – healthy, unvaccinated kids – would die of measles or end up blind or brain damaged.

Worldwide, the death rate for measles is 1 in 350. That's not including kids that get severe problems – meningitis, brain damage, blindness and deafness and all these kinds of things that are due to measles. In fact, if a kid is HIV positive, the death rate then is 1 in 3. It's unbelievable.

I have seen mothers that have said to me, "Look, I've decided not to have my kids vaccinated", and then the kid gets some serious illness or dies, or is brain damaged due to a disease, and the guilt trip then for those mothers is unbelievable. They say, "I am not going to have the vaccine – how worried I would be if it caused a problem, and it would be my fault". But then the kid actually gets something, and the guilt trip in that case is 50 times worse. They can have a job living with that.

Who is choosing not to vaccinate, and why is it such a concern?

It tends to be among the middle class, the slightly better-off parents that make that decision. The problem is they are not vaccinating against anything! For instance, the polio vaccine is very safe – and polio has almost been eradicated. But there is some still about. In fact, by not having a kid vaccinated, there is a risk of keeping a pool of the disease in the community. So they are putting other kids at risk.

So, an unvaccinated child could be a danger to other children?

They can be. If they pick a disease up and become a carrier, definitely. This can certainly happen. Something like measles, the incubation period is 9 to 12 days, but you are infectious a few days before that. So if you are carrying it, you know, and you are in contact with a baby, or someone before they've had a vaccine, they could pass it on.

And they'd have no spots, no sign of it yet?

Yes, in the prodromal stage, before it comes out, there's no sign.

What diseases are of most concern?

The diseases that worry me most are probably polio, measles, tetanus. The other thing that's alarming in this country is TB [tuberculosis]. TB is increasing, you see a lot of TB. I'm afraid HIV-positive people are very susceptible to TB, as many as 1 in 3 can carry TB.

Is it true TB's so infectious that even if you're vaccinated you can still get it?

Yes, it's not 100%, unfortunately you can't guarantee not to get TB. People who've had BCGs still do get it, yes, but you cut the chances down a lot. And the earlier you can have it the better. That is one disease where a healthy lifestyle and a good diet does help prevent it, I agree with that. But that doesn't give you a reason not to have the vaccine.

The vaccination against TB, the BCG, is far more effective in a baby than in an adult or an older child. That's a very good reason for having them protected early, it gives them more immunity.

In the UK they used to do them in the older child, but in this country they do them almost at birth – that's better, the younger the better. At birth they do polio and TB in this country, which is great, provided they have it done.

Vaccines may not be 100% safe, but are they better than risking contracting disease?

Well, yes, they are not 100%. But we are talking very serious reactions of something like one in a million. And I've told you the chances of dying of measles. It's just mad, it's just mad. And, in my career, I have never, ever seen a serious reaction in a vaccinated child. Ever.

Please could you comment on the following theories?

1. "Vaccines contain ingredients that may harm children."

All vaccines have little preservatives and they have tiny pieces of formaldehyde – you can say, well, insulin, which people use every day, has a little bit of formaldehyde in it to preserve it.

I qualified in 1968, so I'm an old doctor. With lots of experience. I've been a GP in the UK for 20 years, I've been a military army doctor, I've worked in UK hospitals as a gastroentrologist and colonoscopist, and now I'm the medical officer for CMR, which is a paramedic and ambulance unit. So lots of different aspects of medicine.

In my life I have never seen any side effects from the additional bits that they have in vaccines. I have never seen it. Ask [anxious parents] to say, well, what does it cause? I've never seen a problem. You get local reactions – you get a bit of redness, a bit of itching, you can get a slight fever, minor stuff like that.

To say look, I'm worried about the additives, I don't think that holds up... bear in mind there are millions of kids who have these vaccines, and the manufacturers are pretty good, they are not going to put in anything that will cause real problems.

2. "Living a healthy life, eating well and relying on the body's natural defences will protect you from disease."

The answer to that is, let's take the example of the measles vaccine. I worked in a middle-class practice in the UK, in the early days before the measles vaccine, and I was dealing with healthy, fit kids – in fact, kids in those days were fitter, because they weren't as fat. Healthy kids that had the advantages of the modern lifestyle, that were looked after by their mothers and themselves – and they still died of measles and had its side effects. It didn't make any difference.

So having a healthy lifestyle didn't make any difference to the mortality. Bear in mind that since the vaccine has been out... most of the doctors I work with, they have never seen measles, I've seen a thousand cases of measles. They have never seen it, they have a job recognising what it is when it turns up.

There's no question that we've lost some of our fear of these diseases. You take a disease like tetanus, one of the worst deaths you can have is tetanus. The tetanus vaccine is a good, safe vaccine to have. There's no reason not to have the tetanus vaccine, but to die of tetanus is a horrific death and would destroy any mother looking at her child.

Mainly they get muscle spasms. If you get cramp in your leg, remember how painful that is. Imagine every muscle in your body going to cramp, into pain like that. Your whole back arches and becomes rigid, and people are screaming in pain. And that goes on for several weeks, coming and going every few minutes. Now what kind of death is that?

3. "It's a conspiracy. Drug companies and governments are pushing vaccines we don't need just to make money."

I've read it on some of the websites, the vaccines don't work, they say, it's a conspiracy by the companies and big business in America, blah di blah ... it just makes me so mad!

It's very difficult to convince [someone there isn't a conspiracy]. But all I can say to them is look, these diseases that can be prevented – in my long career, I have seen children die of them – unvaccinated children. I have never seen a vaccinated child die of a disease they have been vaccinated against. Yes, occasionally they can get reactions – like with measles, very rarely, you can get a mild form of measles. But I have never seen any serious problems in vaccinated children.

4. "Taking homeopathic alternatives. Is this a viable option?"

No. It's rubbish. Absolute rubbish. Give them water – it's just the same, it makes no difference.
I have never seen a child protected by a homeopathic "vaccine", never. I know of no evidence where homeopathic vaccines work. I don't know of any trials, I don't know of any information or medical, apart from anecdotal evidence where people say "oh, I had it and my child never caught anything".

Well, there is a chance ... you don't have to catch things. But yes, it's rubbish.

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