A doctor who in 1994 administered the oral polio vaccine (OPV) to a child whose unvaccinated father subsequently contracted polio told the High Court yesterday he had routinely issued a warning to parents of vaccine recipients. This included a warning of the need for strict hygiene when disposing of nappies.
Dr Fergus McKeagney (45), with a practice at Main Street, Portarlington, Co Laois, said he believed that implicit in his warning was a message that unvaccinated persons who would be in close contact with the inoculated child had a remote risk of contracting polio. This message seemed "very clear" to him.
He accepted his patients would not have the medical knowledge he had.
People were intelligent and if they were unclear about something, they would ask questions and he would answer.
He disagreed his warning would have been ineffective in delivering the message that non-vaccinated contacts of an inoculated child had a remote risk of contracting polio. He denied he had "softened" his warning in order to encourage the vaccination of children in Ireland.
If it had been the policy of the Midland Health Board to include on its vaccination card a written acknowledgement that a warning had been received that there was a remote risk of contact polio for unvaccinated contacts of a child who had just been inoculated, that would have been very helpful.
He was being cross-examined in the continuing action taken by Mr Anthony Blanche (42), of Ballybrittas, Co Laois, against the MHB and Dr McKeagney. Mr Blanche, who was never vaccinated for polio, has alleged negligence against both defendants arising from the circumstances in which he contracted polio after his daughter Isabel received the OPV in 1994. The defendants have denied the claims.
Cross-examined yesterday by Mr Turlough O'Donnell SC, for Mr Blanche, Dr McKeagney said the gist of his warning was that the OPV was a live vaccine excreted in the child's faeces which was likely to remain in the faeces for some six weeks and they would have to be very careful with nappy disposal and with personal hygiene.
He believed he would give that warning each time he gave the vaccine. He presumed the person who received the warning would pass on the message about hygiene to those at home.
He would be very surprised if he had not given a warning during consultations with Mrs Anne Blanche, wife of the plaintiff, when her children were being vaccinated. He said it was not possible, because Mrs Blanche was a nurse, that he would have forgotten to give her the warning.
He disagreed that his form of words would not have conveyed to Mrs Blanche that Mr Blanche, if unimmunised, was at risk.
Dr McKeagney said there was a problem with all vaccinations in 1992 and 1993 and in 1994 the emphasis in Ireland was to ensure uptake of the OPV. If he had come straight out and said the reason for strict hygiene with nappies was that there was a risk that an unimmunised contact of a vaccinated child could contract polio, that could have frightened the parent with the child to such an extent they would not come back for the second dose of the vaccine. He said the risk to unimmunised contacts was "very slight", about one in two million. It was his view the warning he gave was adequate.
He had read a leaflet accompanying the Welcome polio vaccine, which advised that unvaccinated parents and siblings of inoculated children should be immunised at the same time and should be warned of the risk of contact polio in advance of the vaccine being administered.
He did not know when he had read that leaflet. It expressed an opinion different from that held by GPs in Ireland in 1994.
The case continues today.