New campaign warns parents and guardians of serious risk to children’s health from measles and reminds them to ensure their children are protected by taking up two doses of MMR vaccine.

 

The Institute of Health Visiting supports the call by the UK Health Security Agency (UKHSA) and the NHS for parents and guardians to ensure that their children are up to date with the measles, mumps and rubella (MMR) vaccine, and all other routine childhood immunisations, as the latest data shows MMR vaccination uptake has dropped to the lowest level in a decade.

In a new campaign drive, parents and guardians are being reminded that, during the pandemic, the NHS has continued to provide routine childhood immunisations and they are crucial in protecting children against preventable diseases.

Since the start of the COVID-19 pandemic, in March 2020, there has been a significant drop in the numbers getting their children vaccinated against MMR and other childhood vaccines at the right time.

Coverage for the two doses of MMR vaccine in five year olds in England is currently 85.5%, well below the 95% World Health Organisation’s target needed to achieve and sustain measles elimination. Coverage of the first dose of the MMR vaccine in 2 year olds has dropped below 90%. This means that more than 1 in 10 children under the age of 5 are not fully protected from measles and are at risk of catching it.

Alison Morton, Executive Director at the Institute of Health Visiting, said:

“It is very worrying that more than 1 in 10 five-year-olds are not fully protected against measles. Measles is highly infectious (much more than COVID) and can make children very ill indeed. During the pandemic, the measures we have all taken to protect ourselves and our communities from infection resulted in a reduction in measles. However, this does not mean it has disappeared. Measles is waiting in the wings and it only takes a small fall in vaccine uptake for us to start having outbreaks. Fortunately, it is never too late to have the MMR vaccine, two doses are needed to give best protection. The vaccine is also very safe.

“Parents can check their child’s red book to see if they have had their two doses. If they have not, or it is not clear, parents should contact their GP practice and book an appointment. Combatting measles will take a whole system approach and health visitors are ideally placed to support parents to access the vaccine for their child, and also answer their questions if they are unsure or have concerns.”

Measles is highly contagious, so even a small decline in MMR uptake can lead to a rise in cases. As international travel resumes, it is more likely that measles will be brought in from countries that have higher levels of the disease and so it is important that we recover MMR vaccination rates to help prevent a rise in cases.

Measles can lead to complications such as ear infections, pneumonia, and inflammation of the brain which require hospitalisation and on rare occasions can lead to long term disability or death. Since the introduction of the measles vaccine in 1968 it is estimated that 20 million measles cases and 4,500 deaths have been prevented in the UK.

New research commissioned by the Department of Health and Social Care and the UKHSA, conducted by Censuswide, shows that many parents are not aware of the risks that measles poses to their unvaccinated children.

Out of 2,000 parents and guardians of children aged five and under:

  •  Almost half (48%) are not aware that measles can lead to serious complications such as pneumonia and brain inflammation
  • Only 4 in 10 (38%) are aware measles can be fatal
  • More than half of parents (56%) are not aware that two doses of the MMR vaccine gives 99% protection against measles and rubella

Children are offered two doses of the MMR vaccine by their registered GP surgery – the first when they turn 1-year old and the second at around 3 years and 4 months, before they start nursery or school. The NHS has continued to prioritise routine vaccinations throughout the pandemic, however some parents who haven’t had their child vaccinated against MMR said this was because they didn’t realise the NHS was still offering appointments, or they didn’t want to burden the NHS.

 

Public Health England (PHE) is calling for all parents to get their children vaccinated against measles, mumps and rubella (MMR) when the vaccine is offered, or for them to take it up now if they didn’t have it at the scheduled time.

In the first quarter of 2019, there were 231 confirmed cases of measles. This figure is slightly lower compared to the same quarter last year. As measles is highly infectious, anyone who has not received two doses of MMR vaccine is at risk, particularly unvaccinated people travelling to countries where there are currently large outbreaks of measles. The recent measles cases are mainly occurring in under-vaccinated communities, particularly those with links to other countries with ongoing measles outbreaks. There has also been some spread into the wider population, such as those who may have missed out on the MMR vaccine when they were younger.

In the final quarter of 2018 94.9% of eligible children aged five received the first dose of MMR. To achieve herd immunity for measles at least 90-95% of the population need to be fully protected. One dose of the MMR vaccine is about 90-95% effective at preventing measles. After a second dose the level of protection is around 99%. Coverage of the second dose is at 87.4% for children aged five. PHE is therefore urging those who have only had one dose to ensure they are fully vaccinated with two doses.

This quarter, 795 cases of mumps have also been confirmed. No new cases of rubella were reported.

The MMR vaccine is given on the NHS as a single injection to babies as part of their routine vaccination schedule, usually within a month of their first birthday. A second injection of the vaccine is given just before starting school, usually at 3 years and 4 months. The vaccine is also available to all adults and children who are not up to date with their two doses. Anyone who is not sure if they are fully vaccinated should check with their GP and those planning to travel to Europe should check NaTHNaC travel health advice.

Public Health England (PHE) has issued a press release highlighting recent measles outbreaks that are linked to ongoing large outbreaks in Europe, with Romania, Italy and Germany being the worst affected countries.

PHE calls on anyone travelling to Romania, Italy and Germany this Christmas to ensure they are up to date with their MMR jab

Measles is highly infectious and can lead to serious complications, particularly in immunosuppressed individuals and young infants. It is also more severe in pregnancy, and increases the risk of miscarriage, stillbirth or preterm delivery.

Members of the Romanian community and unimmunised individuals travelling to Romania, Italy and Germany are at particularly high risk of acquiring measles. Experience from recent outbreaks shows that, despite living in the UK for a number of years, many individuals infected with measles were unvaccinated, and that families are often not registered with a GP practice.

PHE is asking health professionals to note the following:
Individuals with suspected or known measles:

  • should be isolated immediately when attending health care settings to reduce the risk of other patients being exposed
  • recent travel to countries with ongoing measles outbreaks like Romania, Italy and Germany increases the likelihood of a measles diagnosis
  • all suspected measles cases should be promptly notified by phone to the local Health Protection Team (HPT) to facilitate timely public health action

MMR vaccine:

  • children should receive their two scheduled doses of MMR vaccine on time at the ages of 12 months and 3 years and 4 months
  • the MMR vaccine can be given from six months of age before travel to a high risk country
  • patients over the age of three years and four months who do not have two recorded doses of MMR vaccine should be caught up opportunistically. There is no upper age limit to offering MMR vaccine.
  • new entrants from abroad and newly registered patients should have their immunisation history checked and missing doses caught up
  • postnatal women should have their MMR status checked and offered any outstanding doses
  • all health professionals should make sure they are fully protected against measles, mumps and rubella

Under-vaccinated communities:
Health professionals who work with under-vaccinated communities should collaborate with local partners to raise awareness about measles with those most at risk and ensure unregistered populations can access immunisation services.

Measles resources

Measles resources including national guidelines for health professionals and free to order posters and leaflets for patients are :

National guidelines

Free copies of PHE leaflets and posters can be ordered through the Health and Social Care Orderline: https://www.orderline.dh.gov.uk/ecom_dh/public/contact.jsf Alternatively, you can call 0300 123 1003.

Public Health England has recently published new posters and leaflets designed to raise awareness of measles in young people and healthcare workers. The attached document outlines each of the three resources.

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