As highlighted by Professor Helen Bedford in the February 2024 iHV podcast “Stemming the measles surge”, measles is on the rise in the UK, with 6/10 of the confirmed cases in the under 10s in England1.

At the same time, rates of MMR vaccination continue to decline2, this can be seen in the graph below, which highlights the recovery in MMR vaccination uptake, following the discrediting of the Wakefield study. However, from 2019/20 the rates start to fall again. In 2022/23, for the uptake of both doses, this had fallen to 84.5% in England, 89.5% in Wales, 90.2% in Scotland and 87.9% Northern Ireland, all of which are below the World Health Organization (WHO) target of 95%2.

There are a number of reasons why parents choose not to have their children fully vaccinated against MMR. In some cases, there is a lack of awareness of the potential severity of measles, mumps and rubella if contracted. For some parents, vaccination appointments are delivered in locations that are not easily accessible for them, with limited choice or flexibility around timings to make sure that they are available at convenient times for busy families. Some parents may also be anxious about the MMR vaccine and its side effects.

It is therefore important that all families have access to accurate information and opportunities to have their questions answered by trusted health professionals.

New Video

iHV and Barnardo’s have worked together to develop a film for families about the MMR vaccination to improve vaccine uptake. It features a real-life couple, Radhika and Manish, discussing their decision to get their son, Kabeer, vaccinated and their experience of the process. They share their initial challenges finding trusted information online, and the importance of vaccination, not only for their own child but for vulnerable family and friends at greater risk of serious complications linked to these diseases. They also strongly advise parents who may have doubts about the MMR vaccine to talk to a health professional, such as their health visitor or GP, who can provide trusted and evidence-based advice. A lovely moment in the video is hearing them describe how proud their son Kabeer was of his vaccination certificate, as he showed it to his friends at nursery.

The video is freely available on the link below, so please share with families and on your social media.



Health visitors’ vital role

When discussing the MMR vaccination with families, as well as encouraging them to have their child/ren vaccinated, it is important to remind them that:

  • Unvaccinated children are at high risk of contracting measles, mumps and rubella – these are all potentially serious diseases that can cause significant health problems.
  • Measles can lead to pneumonia, meningitis, blindness and seizures in children; and miscarriage, stillbirth, premature birth or a baby born with a low birthweight in those who are pregnant3.
  • Mumps can cause viral meningitis, although serious complications are thankfully rare4.
  • And while rubella is rare in pregnancy, it can cause miscarriage and serious problems in the baby including with their sight, hearing, heart or brain5.
  • There is a measles surge in the UK now – it is never too late to get their child vaccinated to protect them and the wider community.

Health visitors and the wider skill-mix team have a vital role to play in improving vaccine uptake. Please use every opportunity to support families to check their child’s vaccine status, answer any questions that they might have with accurate information, and connect families to their GP, or local vaccine initiatives in your area, to promote vaccine uptake.

RCPCH resources

The Royal College of Paediatric and Child Health has some great resources about measles which you can access here.

References
  1. UKHSA (2024) News story Latest measles statistics published.
    https://www.gov.uk/government/news/latest-measles-statistics-published 
  2. Harker, R. (2024) Childhood Immunisation Statistic. House of Commons Library. Number 8556. https://researchbriefings.files.parliament.uk/documents/CBP-8556/CBP-8556.pdf
  3. NHS (2022) Measles.
    https://www.nhs.uk/conditions/measles/
  4. NHS (2021) Mumps.
    https://www.nhs.uk/conditions/mumps/
  5. NHS (2022) Rubella (german measles).
    https://www.nhs.uk/conditions/rubella/

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.