Silvia Rosetti contracted measles when she was 32 weeks pregnant
Silvia Rossetti tightly holds the hand of her toddler son Nathan as they walk to their front door. The little boy has spent the day at nursery school and now they will have tea at the family’s apartment, filled with his toys, in the hills overlooking Rome.
Every day is precious for this mother and her child. For Silvia nearly died when she caught measles during pregnancy and unborn Nathan’s life was at risk from the virus, too.
In what Silvia, 42, describes as a ‘double miracle’, it was only the skill of doctors at St Peter’s Hospital in Rome that saved her and her baby.
‘I never had a measles vaccination as a child,’ she said. ‘I am part of an Italian generation that didn’t have the jab. When I suddenly got a high fever two months before Nathan was due, I was taken to hospital and no one knew what was wrong.
‘I struggled to breathe. I had pneumonia and [was] minutes away from dying as they gave me an emergency Caesarean to save his life.’ It was six hours after the operation that the doctors diagnosed Silvia with measles.
She was immediately quarantined in an intensive care ward and gradually recovered. Baby Nathan was also placed in isolation because there was a 50 per cent chance he, too, had caught the potentially deadly ailment from his mother and could pass it on to his father, Gianluca, 43, who had not had the measles vaccination either.
Silvia, an administrator at a cellular biology research lab, explains: ‘It was nearly a month before we could cuddle our son properly and bring him home to start our lives together.’
Today, she urges everyone to get a measles jab. While Silvia was pregnant, Italy was the centre of a measles epidemic spreading across European countries, including the UK.
More than 44,000 cases of the contagious virus were recorded by the European Centre for Disease Prevention and Control between 2016 and March 2019 — almost a quarter of them in Italy. Last year, the country had 2,517 incidents — down from a high of 5,000 in 2017, when four unvaccinated people died of measles.
In the UK, the World Health Organisation (WHO) recently removed our precious measles-free status (granted in 2017) because 489 cases were recorded in the first six months of this year.
In response, Health Secretary Matt Hancock, who this week championed the Mail’s campaign encouraging parents to vaccinate their children, briefly floated the idea that childhood vaccinations (for a range of diseases and infections, including meningitis) should be mandatory for state school pupils.
2017 demonstration in front of Parliament against the Compulsory vaccination issued by the Italian goverment
However, the Government has distanced itself from this, while nonetheless declaring it an ‘urgent priority’ to persuade parents that the vaccinations are safe.
Dr Martin Friede, the WHO’s head of vaccine research, was among the first to sound the alarm that families in a ‘number of European countries’ had stopped vaccinating children.
He says: ‘In Europe, we are seeing vaccine hesitancy becoming more of a problem than elsewhere (in the world). In quite a few populations, it is spread by false concerns about vaccine safety.
‘Industrialised countries must not forget that the disease can come back like a storm. Measles is not just a rash — it can cause blindness and brain problems.’
Yet scepticism over vaccines has taken a firm hold in Europe.
A 2016 survey by the London School of Hygiene and Tropical Medicine showed that in France, for instance, 41 per cent of those questioned said vaccines are not safe.
In Italy, it is a similar story; here there has been a heated jabs controversy which has spread into the political arena.
It began in 2012 with a landmark ruling by a court judge in the north-eastern city of Rimini. The judge said the devastating disabilities of an autistic boy called Valentino Bocca were provoked by a routine childhood inoculation for measles, mumps and rubella (MMR) that he received when he was a healthy, babbling 14-month-old.
Valentino became unable to speak or even hold a pencil and his family was awarded £140,000 to be paid by Italy’s Ministry of Health.
Crucially, Antonio Barboni, a doctor of forensic medicine independently advising the court, wrote a report saying: ‘In the absence of any other pre-existing conditions’, it was a ‘reasonable scientific probability’ that Valentino’s autism could be ‘traced back to the administration of the MMR vaccine.’
This view was supported by two other eminent Italian medics who examined Valentino and his medical history. The judge concluded it was ‘conclusively established’ the boy’s illness was linked to the MMR jab.
Controversially, Italy’s High Court of Law (equivalent to our Supreme Court) later ruled the Italian Government must pay compensation to any Italian child damaged by any vaccinations — even though they were then not compulsory.
Unsurprisingly, after the high-profile case, jab rates in Italy faltered.
Pier Luigi Lopalco, a leading epidemiologist at the University of Pisa, said the Rimini court ruling was seized on by anti-vaccine campaigners (so-called ‘anti-vaxxers’) for propaganda. He claims it relied wrongly on discredited research published in 1998 by now notorious British doctor, Andrew Wakefield, which first raised the possibility of a link between the MMR jab and autism.
Published in the Lancet, Wakefield’s research was later denounced; he was found to have severe undeclared conflicts of interest and was later struck off.
Only the Rimini judge, therefore, knows how he came to the decision that a link between MMR and autism was ‘conclusively established’. Since Wakefield’s 1998 paper, 21 studies have found no evidence for a link between the MMR jab and autism.
The Rimini court’s ruling was overturned in 2015 by the Court of Appeals in Bologna, which accepted a plea by the Italian Ministry of Health that no scientific evidence existed for the link.
Crucially, the Appeals Court accepted that while Valentino’s autism had indeed occurred after he received the jab, this was not sufficient to link the two events.
And there the matter might have rested if vaccine panic had not spread among Italian parents. The measles inoculation rate fell to 91 per cent in 2017, short of the 95 per cent that the WHO says is necessary to avoid outbreaks. (In the UK, the MMR jab rate also dropped to 91 per cent the same year, while some parts of London a third of children are unvaccinated.)
Vaccinations are good for society. Because of them, deadly childhood diseases have been eradicated in the West and much of the world.
The paralysis of polio; the curse of German measles (rubella) that meant an infected pregnant woman could give birth to a blind or deaf baby; swift-killing diphtheria. All are history, at least in Britain.
In 2012, I spotted a paragraph in the British press about the Rimini ruling and, intrigued, I went to see the Bocca family.
Valentino, by then nine, had been taken to a world-renowned children’s clinic in Milan, because his parents were bewildered why their son kept screaming, could not sit still or look them in the eye.
After a fortnight of genetic tests ruled out hereditary ailments, his mother Antonella remembers that doctors handed her a fat file with Valentino’s name on it, stamped with the word ‘autism’. Heartbreakingly, he will never be healthy. His devoted parents told me they wouldn’t dare have another baby.
The consensus of British medical opinion is that autism symptoms emerge inexplicably — often around the time MMR is administered. In this country, this is when a baby reaches one years old — slightly younger than in the past.
Most doctors argue that it is, therefore, inevitable that some autism cases arise just after the jab, but that this is mere coincidence. Research into autism and MMR has continually ruled out a link.
The latest study this year, and on NHS websites, followed 650,000 Danish children until eight years old. Around 1 per cent developed autism. Most had received the MMR vaccine, but there was no difference in the rates between those who’d been vaccinated or not.
After the Rimini ruling was overturned, the Italian Government in 2017 made vaccines obligatory for schoolchildren. ‘No jabs. No school,’ became the slogan.
But last year, the Health Ministry introduced a temporary caveat allowing children to stay in school if their parents merely promised they had been vaccinated. A doctor’s note was not needed. The government, at the time run by the anti-Establishment Five Star Movement, was condemned for going ‘back to the Middle Ages’.
During the country’s 2018 general election campaign, the Movement and the hard-Right Lega party, led by outspoken Matteo Salvini, doggedly opposed compulsory jabs. When the two parties formed a new government in June last year, Salvini called the vaccinations ‘useless, in some cases dangerous if not harmful,’ without saying why. The former Italian PM Matteo Renzi has said Five Star’s policy was ‘crazy’, adding: ‘They need to renounce their ‘no-vax’ stance. Science is right, they are wrong.’
The temporary caveat expired in March and today all Italian state school pupils must again present certificates proving they’ve had ten vaccines against common childhood diseases. Four additional jabs, including those combating some forms of meningitis, are free, but not compulsory.
This policy of compulsory vaccination, which the British government has distanced itself from for fear it is too divisive and risks galvanising anti-vaxxers into action, is too late for Italian parents who have lost a child because they were not vaccinated.
One is Antonella Salimbene, 41, who lives near Milan. A carer for the elderly, her daughter, Azzurra, died aged 11 from meningitis C. Choking back tears, she told the Mail this week: ‘I gave my daughter life and then took it away from her. Azzurra had all the vaccinations apart from this one for meningitis. It had just been introduced when she was about to go to nursery.
‘The doctor told me it wasn’t necessary and he was not giving it to his own children. I trusted the doctor, but he was wrong.’
Azzurra came home from school early with a fever one day in 2014. It seemed like a cold. She was given some medicine and felt better. The next day she stayed off school with a temperature.
Antonella took her other daughter to school that morning. In the meantime, Azzurra violently vomited while being looked after by her grandmother. When her mother returned, she said: ‘My head is exploding.’
Azzurra went to her room and collapsed on the bed face-down.
As her mother recalled: ‘When I turned her over, her eyes were rolled back and foam came out of her mouth. I shouted and slapped her to try and wake her up. The ambulance came and took us to hospital. They wheeled her into a room and closed the doors.’
Doctors took spinal fluid from Azzurra and found meningitis. She was put on a life support machine for a day, but was getting worse. The doctors said there was no hope.
Antonella now runs a foundation which enlightens parents sceptical of vaccines. It is called A Kiss for Azzurra.
After her daughter died, 300 children in the family’s area were vaccinated who wouldn’t otherwise have been. ‘I want parents to know how many lives vaccines save,’ she says simply.
In Rome, Federico Galluccio, a 15-year-old student at hotel college, died of meningitis C in January this year. His mum Valeria tells how he woke her up one morning at 5.30am complaining of a fever.
‘By lunchtime he was so ill, it scared us. We didn’t wait for an ambulance but drove him to hospital ourselves.
‘I could only say, ‘Ciao, Pippi,’ my nickname for him, before he was taken off in a wheelchair. The next time I held him in my arms, it was too late.’
Federico’s family are in favour of vaccines, but the meningitis one was forgotten. After his death, all 1,100 of the children at the college asked for, and received, the full range of jabs.
Dr Antonio Miglietta, a public health medic in Federico’s area, said he hoped the teenager’s death marked a turning point.
‘That a child should die of a disease preventable by vaccines cannot be tolerated today. They should not be forced on families, but become a moral obligation for everyone.’ A sentiment Silvia Rossetti would doubtless agree with.