Frightened parents are preparing to pay £240 for seperate measles, mumps and rubella jabs when the Government insists that the MMR triple vaccine is safe. Health Correspondent Barry Nelson weighs up the arguments.

SOONER or later, Jane O'Byrne is going to have to make her mind up about the MMR triple vaccine. Like many parents of young children, Jane, from Darlington, has powerful doubts about the three-in-one measles, mumps and rubella jab.

Her first child, seven-month-old Samantha, is due to have her first MMR injection in August and Jane is wondering whether to go through with it, as the debate about whether the vaccine is safe rages around her.

"I am really wondering about letting her have it because I am scared," says Jane, who admits her husband has no such doubts about MMR.

After reading regular stories about the triple vaccine, including suggestions that it may be linked to the brain disorder autism, or inflammatory bowel disease, Samantha's mum is filled with doubt.

"She is such a bright child, I would hate to think of giving her something that would take that away. You would never forgive yourself if that happened," she says.

Don't get Jane wrong, she believes in immunising children to protect them from potentially-harmful diseases - but wonders why her baby daughter can't have the jabs separately. "I have every intention to have her immunised, but why do they have to be all together and why, if I want to have them separately, do I have to pay for them?" she says.

Jane plans to find out more about the forthcoming visit to Darlington of the Direct Health 2000 private health organisation, which is offering separate MMR injections at the cost of £240. The clinic is so over-subscribed that Direct Health is laying on extra sessions to cope with more than 1,200 children.

Jane says: "It seems to me that the Government has completely failed in getting its message across. They suggest they know better, but so many things have happened, it makes you think. They should be explaining things better - and the fact that Tony Blair won't say whether Leo has had the MMR hasn't helped people like me."

The fact that the Government may be in danger of losing the battle for the minds of people like Jane is a matter of great concern for Tees Health Authority's long-serving consultant in communicable disease, Dr Ian Holtby. He recalls the damage done to children's health in the 1970s, when there was a health scare about whooping cough vaccine.

"The uptake fell away and then we had quite a nasty outbreak. It is only in the last few years that the whooping cough vaccine has reached the same level as other childhood vaccines," he says.

What baffles Dr Holtby is why so many caring, intelligent people are choosing to believe what he says are unsubstantiated scare stories about the triple vaccine, when virtually every reputable expert - from the World Health Organisation to public health consultants around the North-East - is lining up to endorse the MMR vaccine.

"The history of MMR goes back 25 years and, around the world, 500 million shots have been given to children," says Dr Holtby. "Surely, if there was anything wrong with it, something would have come to light by now."

International studies involving millions of children have failed to find any connection between the MMR vaccine and diseases such as autism or bowel disease, the consultant insists. "Very often, autism becomes evident during the second year of life when children have their first MMR session, so a lot of people will make the connection," he says.

Recent research shoots down criticism that the triple vaccine places too great a strain on the developing immune system. "A US study looked at the body's ability to handle all these antigens. By giving the triple vaccine, the body was still using less than one per cent of its capacity," the consultant adds.

He is also unimpressed by attempts to link MMR with bowel disease, which have not been substantiated. "Why would the Department of Health promote MMR so strongly if they didn't think it was safe."

And he is not impressed by suggestions that parents should be won over by offering separate injections. "I support the Department of Health in sticking to its guns on MMR. If we were to revert to three single vaccines, there would be a lot more injections and they wouldn't all get done."

This would lead to more children exposed to diseases which have all but disappeared in the UK. "A lot of children suffered complications when these diseases were around. In the Third World, measles remains the biggest killer."

Dr Holtby points out that well over 80 per cent of the North-East population are still opting for the MMR, even though the Government wants to see 95 per cent rates nationally. "People are wondering about it but then they are going for it. We just have to keep plugging away," he says.

Such arguments fail to impress Paul Shattock, director of the Autism Research Unit at Sunderland University.

The father of a autistic child - now a young man - Mr Shattock has been researching the metabolical causes of autism for 20 years. He is convinced there is a link between the MMR vaccine and autism, a condition which often leaves young people in a world of their own, suffering from profound communication difficulties. "Parents of autistic children who took part in our research told us this was happening but we didn't believe it," says Mr Shattock.

But being told the same thing over and over again made him look at the evidence. "We realised that there was a group of autistic children that didn't fit the pattern. They were slightly different and more sociable than the others," says Paul, who admits that he has no proof that the sub-group are victims of MMR.

The "different" autistic cases began appearing in the early 1990s, a few years after MMR began in 1988.

The Sunderland unit is in touch with 7,000 families in the UK and Europe. Mr Shattock reckons around 500 - all from Britain - may have been MMR-damaged. "We believe this should be taken seriously. What we need is an independent inquiry to look at all the evidence."

As Vice-President of the World Autism Organisation, he has asked the Department of Health to hold an inquiry into the available evidence. So far, the answer has always been no.

Mr Shattock believes that legal action taken by hundreds of parents, who claim that their children have been damaged by the MMR vaccine, will help to confirm his worst fears. "It will be interesting to see what the courts make of it. In my view, the evidence is very powerful," he says.

Mr Shattock is not anti-vaccine, but he has firm views on MMR. "I am saying that people should consider having separate injections," he says.

While he rails against the health establishment for stifling debate, Mr Shattock says at least the UK is more open than America or Australia, where there is virtually no controversy about MMR despite claims that autism levels are rising. "Maybe it's because we had Mad Cow Disease," he says.