One of the problems facing health services is that of communicating effectively essential information concerning their services and care plans with deaf people. Planners and providers of health services need to recognise their responsibilities and the rights of deaf people to have full information and access to services available to the community as a whole.

Under the Disability Discrimination Act 1995 (DDA), it is unlawful for a service provider to discriminate by offering a lower standard of service or providing a service in a worse manner to deaf people.

MMR is regarded by the scientific and medical community as an effective and safe triple-vaccination against Measles, Mumps and Rubella, all of which can cause serious illness and lifelong sensory impairments, including deafness, as well as physical and learning disabilities.

There is some disagreement about the MMR immunisation because of claims that it might lead to autism and Crohn's Disease (disease of the bowels) in a small number of children. However, the conclusion of experts from all over the world, including the World Health Organisation, is that evidence is firmly against any such links.

Nevertheless, some parents have refused to have their children immunised with the MMR vaccine, thus exposing their children and others in the community to possible infection with measles, mumps and/or rubella.

As a result, there has been an increase in the number of cases of measles in the UK. It is also likely that we will see an increase in the number of cases of mumps and rubella if MMR immunisation uptake rates do not improve.

An increase in rubella infection in the community will lead to babies being born with congenital rubella syndrome (CRS) which causes deafness, blindness and other physical and learning disabilities from birth.

Using separate single vaccines against each of these three diseases is possible but is regarded as less effective than MMR immunisation. This is because:

• fewer children will be protected at any one time against the diseases, leading to an increased risk of outbreaks of measles, mumps and rubella;
  
  
• some children may not complete the course and would remain unprotected;
  
  
• children would need six injections instead of two and every injection carries a slight risk.

Single vaccines are therefore not recommended by the medical profession. However, some people claim that giving single vaccines is better than no vaccination at all. The scientific evidence points to MMR being the safest and effective choice. A decrease in MMR uptake will result in outbreaks of all three diseases; many children will be seriously ill and some will die.

The Scottish Council on Deafness therefore recommends that:

1. Before their children are vaccinated, parents should receive full information about MMR and single vaccines, including their advantages & drawbacks. Such information provided should be without medical jargon and be easy to read and understand, e.g. videos with British Sign Language or plain English with graphics. This will enable them to make informed choices about the type of vaccination their children should receive.
   
   
2. Parents should be given the time to talk over their concerns with the health care providers. Health services have a duty to provide and pay for appropriately trained and registered communication service providers (e.g. Sign Language Interpreters, Lipspeakers, Notetakers, Deafblind Communicators) to enable deaf parents to reach decisions about immunisation for their children.

Selected Bibliography

A guide for immunisations for 3 to 5 year olds, 2001; a booklet from HEBS.

A new guide for childhood immunisations for babies up to 15 months, 2001; a booklet from HEBS.

MMR - The Facts, 1999; a leaflet from HEBS.

MMR: your questions answered, 2001; a leaflet HEBS.

The MMR discussion pack and information guide for health professionals and parents, NHS Scotland, 2001.

Report of the MMR Expert Group, Scottish Executive, 2002.

Sense Scotland MMR Briefing, 28 March 2002.