GPs set to ignore advice on child jabs

Concern over risk of needlephobia

The vaccination jab, one of the most traumatic experiences of a child's early life, is set to cause a rebellion by GPs against the Department of Health.

Doctors are furious at government advice which warns them against a policy of allowing children who have been upset by their measles jab to come back at a later date for their tetanus shot. They said the warning - given by civil servants as an efficiency measure - could lead to traumatic scenes in surgeries.

Dr Harvey Gordon, consultant in communicable disease control for East Surrey Health district, called the warning "ignorant and disruptive". He said: "If we took any notice of that, the result would be more screaming kids and more trauma for the mums and the doctors giving the jabs."

Dr David Elliman, a consultant paediatrician at St George's Hospital, south London, said:"Whatever the DoH says, a lot of people will simply go on doing what they have been doing. If the child was distressed I would not do it. I certainly would not hold a child down.

"The important thing is that they get their doses. It matters not a ha'p'orth whether it is given at the same time as the [tetanus jab] or not."

From last October, pre-school children have been required to have an extra jab to protect them against measles, mumps and rubella (MMR). It tops up an earlier MMR vaccination which they should have had at 12-15 months of age. DoH officials have suggested to doctors that the best time to give the second MMR jab is when children are given their pre-school booster against tetanus and diphtheria.

Dr Gordon said that many children developed "needlephobia" and that it made sense to give the second MMR jab to the child when it was only two years old and had less memory of pain when attending a doctor.

"Immunologically there is no reason why you could not do the second jab any time as long as its at least three months after the first," he said.

The new DoH advice was contained in a letter issued earlier this month. It had become apparent that many doctors were ignoring the advice to do the second MMR jab at the same time as the pre-school booster because of the distress being caused.

Chris Harris, of the NHS executive general medical services branch, wrote: "It should not be a matter of routine for two appointments to be set up to deliver the pre-school booster programme as this runs a risk of lowering overall uptake of the pre-school boosters where children and parents fail to return for the second visit."

Mr Harris, who was writing to clarify the payment system for GPs, also said that no payments would be made for jabs given to children under the age of three years and four months.

Dr Elliman said: "This is not helpful advice. As long as GPs leave the requisite gap of three months it is up to them to organise how best they do this."