With all the controversy surrounding vaccinations, one in four children under five has not had both MMR injections, which are needed to give full protection against measles, mumps and rubella.

As a result there have been measles outbreaks across the country, and experts at the Health Protection Agency now fear a measles epidemic is likely.

A former chairman of the British Medical Association is calling for the MMR jab to be made compulsory. Public health expert Sir Sandy Macara, believes children should not be able to go to school unless they have first been vaccinated.

Sir Sandy has submitted a motion for debate at the annual BMA conference later this month.

Uptake of the MMR vaccine fell sharply after controversial research wrongly linked it to a raised risk of autism.

Sir Sandy said: "Our attempts to persuade people have failed. The suggestion is that we ought to consider making a link which in effect would make it compulsory for children to be immunised if they are to receive the benefit of a free education from the state."

However, linking vaccinations to school admission is controversial but common in other countries. The US, most of Australia, Spain and Greece require compulsory vaccinations prior to entering the school system.

Persuasion

But in the UK vaccination programmes have relied on persuading and educating parents that immunisation is not only beneficial to their children but to society as a whole.

The BBC reports, however, through a freedom of information request that the strategic health authority in London asked the government if it could introduce compulsory vaccinations.

Specifically the SHA asked about the "feasibility of requiring an immunisation certificate for measles before children go to school."

In documents seen by the BBC, the Department of Health acknowledges that immunisation rates in London are consistently lower than the rest of the country.

But officials said: "Our strategy is to maintain a voluntary immunisation system and invest efforts in educating parents about the benefits of vaccination and dispelling 'myths' about vaccine safety."

Media blame

Professor Adam Finn, a vaccine expert in Bristol, said the media was largely to blame for scaremongering over the MMR jab.

But, although he sympathises with Sir Sandy's concerns about the possibility of a measles epidemic, Professor Finn believes compulsory vaccination would be counter-productive.

"There is a real risk we would end up with less MMR immunisation not more," he said. "I think this would be handing a gift to the anti-vaccine lobby, because they would say 'look they can't persuade you it is right, so they are going to have to force you'."

But as fears of a measles epidemic grow, serious questions are now being asked as to whether persuasion on its own is enough.

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