Concern as MMR vaccination jabs fall sharply in Shropshire

Experts say they are concerned at 'worryingly low' rates for the jab, which protects against measles, mumps and rubella.

The proportion of five-year-olds having both MMR jabs in the county is now below 89 per cent – six per cent lower than the target to make it totally effective in the population.

Continued concerns over controversial claims the MMR jab is linked to autism are believed to have influenced parents as they decide if their child is to be protected.

The latest Public Health England figures for 2017-18 show that in Shropshire 88.4 per cent of five-year-olds had received both MMR jabs before their fifth birthday, down from 92.8 per cent the previous year. In Telford & Wrekin the figure was 88.3 per cent.

It means that 276 five-year-olds in the area are unprotected against highly-contagious measles.

The target, set by the World Health Organisation, is 95 per cent coverage.

'Worryingly low'

Experts say the uptake of the jab across England, which is even lower at 87.2 per cent, is 'worryingly low'.

The MMR jab is a 3-in-1 vaccine. It is given to young children in two doses – the first at 12 months, and the second around three years.

The Royal College of Paediatrics and Child Health and the British Society for Immunology are concerned about children getting the first jab, but not the second.

Of the 3,217 five-year-olds living in Shropshire, 3,061 had the first MMR jab, and 2,844 had both jabs.

That means that in addition to those with no protection, 217 children missed out on the second dose of MMR and will only be partially protected.

In Telford and Wrekin, 2,274 out of 2,395 had the first MMR jab, and 2,115 had both jabs. Because of that 159 children will only be partially protected.

One in 10 children will not be protected against measles after the first dose alone. After the second, that falls to one in 100.

BSI chief executive Dr Doug Brown said: "One in 10 people unprotected simply just isn't good enough."

Three-fold increase in measles

This year there have already been 876 confirmed cases of measles in England, more than three times the number recorded in the whole of 2017.

Although measles is now more common in teenagers and young adults, Dr Brown said that it's more important than ever to make sure young children are fully protected. As general immunisation rates drop, the chances of a more widespread outbreak increase.

He said that reduced uptake rates were "disappointing" and added: "If we are in a position of increased outbreaks, low immunisation is even more worrying," he said.

Dr Brown added: "Vaccination is one of the few miracles of modern medicine. It is one of the safest and most cost-effective methods we have to prevent the spread of disease."

The Royal College's immunisation expert Dr David Elliman said that a lack of awareness around the importance of getting both jabs, rather than a decision by the parents, could be causing children to miss the second dose.

Dr Elliman said: "The best solution is GPs sending regular reminders to parents, and all GPs should make sure they have an efficient reminder system in place."

He added that anyone who has missed the MMR vaccine can still get it for free at their GP.

"But even healthy children can get nasty measles and die from it," he added. "A third of measles cases will end up in the hospital."

Public Health England said that they are working closely with the NHS and general practice staff to improve uptake.

PHE's Dr Michael Edelstein said: "We are seeing small reductions in uptake for most of the childhood vaccines, which is why we continue to encourage all parents to get the best protection for their children by ensuring they are fully immunised."

The British Society for Immunology is calling on the Government and the NHS to conduct a review of immunisation rates, to learn from the areas that are doing well and apply that to the rest of the country.

‘One of the miracles of modern medicine’

It was once thought to have been practically eradicated, but earlier this year a leading public health official warned that measles remains a threat to the public.

Figures released today have also shown that the immunisation rates have fallen in Shropshire.

It begs the question, how did the UK end up in a position where measles has reared its head as a genuine risk to health?

The answer comes largely in the form of a discredited medical paper, which falsely linked autism to the MMR vaccine.

The paper was published by the British medical journal, The Lancet in 1998.

It was written by a doctor called Andrew Wakefield.

The paper was fully retracted by the Lancet in the 2010 after a GMC investigation, and Wakefield was struck off.

The GMC panel concluded that Wakefield was found to have acted “dishonestly and irresponsibly” and to have acted with “callous disregard” for the children involved in his study, conducting unnecessary and invasive tests.

It said there had been “multiple separate instances of serious professional misconduct”.

The GMC also described how Dr Wakefield took blood from his son’s friends at a birthday party, paying the youngsters £5 each.

Panel chairman Dr Surendra Kumar said: “In causing blood samples to be taken from children at a birthday party, he callously disregarded the pain and distress young children might suffer and behaved in a way which brought the profession into disrepute.”

Scores of parents decided against vaccinating their children based on the fear generated by the paper.

Outbreak

It led to the coverage level for inoculation dipping below 80 per cent in 2003.

The effects of the dip in level of children being vaccinated were illustrated with an outbreak of measles in South Wales from 2012 to 2013.

In total there were 1,219 suspected cases with 88 people being hospitalised and one 25 year old man dying from pneumonia brought on by the measles infection. The outbreak was directly linked to the number of children who were not vaccinated in the late 1990s.

The question of whether to vaccinate children became a serious issue for parents in the aftermath of Wakefield’s paper.

Prime Minister Tony Blair may have even unwittingly contributed to the concerns when he refused to answer questions over whether he had vaccinated his son, Leo.

It ultimately emerged that the Labour politician and his wife Cherie had decided to give their son the MMR vaccine, but the silence could well have contributed to parents’ anxiety over what was best for their child.

Earlier this year Dr Maliha Moten, part of PHE’s West Midlands Health Protection Team, said that campaigns had increased the level of immunisation but that it was still not high enough. She said: “Despite this progress, measles remains a threat to the UK population.”

Dr Mary Ramsay, head of immunisation at Public Health England, urged people to ensure they have had both MMR jabs.

She said: “In the early 2000s there was a fall in MMR vaccination coverage in children. We are now seeing measles cases in young adults.

“Measles can be more serious in adults with a higher likelihood of hospitalisation.

“Measles is circulating in England and the rest of Europe. We often think about what travel-related vaccines we might need before going on holiday, but it’s also important to check that we are up to date with routine vaccinations like MMR. If you are unsure if you have had two doses of MMR call your GP practice to check and catch up if needed.”

This year there have already been 876 confirmed cases of measles in England, more than three times the number recorded in the whole of 2017.

Although measles is now more common in teenagers and young adults, Dr Doug Brown of the British Society for Immunology said it is more important than ever to make sure young children are fully protected.

He said that as general immunisation rates drop, the chances of a more widespread outbreak increase.

He said that reduced uptake rates were “disappointing” and added: “If we are in a position of increased outbreaks, low immunisation is even more worrying.”

Dr Brown added: “Vaccination is one of the few miracles of modern medicine. It is one of the safest methods we have to prevent the spread of disease.”

MMR vaccine ‘helps to save lives’

Getting the MMR vaccine is “really effective” in protecting against measles, mumps, and rubella and helps to save lives, a GP working in Shropshire has stressed.

The three diseases are highly infectious conditions that can have serious, potentially fatal complications, including meningitis, swelling of the brain and deafness.

They can also lead to complications in pregnancy that affect the unborn baby, and can lead to miscarriage.

The full course of MMR vaccination requires two doses and Dr Deborah Shepherd, who works as a locum GP in the Shrewsbury and South Shropshire area, has spoken about the importance of getting the jabs.

She said: “The vaccines are really effective in preventing these diseases. A lot of people now haven’t actually seen the effects these diseases can have or have forgotten how unpleasant it is.

“There are serious complications from these diseases. Children did in the past die and unfortunately still do when we get outbreaks. Vaccines can prevent this and save people’s lives.”

Encourage

She said outbreaks happen because fewer people are immune to the diseases and this can also put children younger than a year old at risk. The vaccine is given in two doses, at 12 months and at about three years.

Dr Shepherd said there are only a small number of children who will not be eligible for the vaccine, for example those with weak immune systems.

She said: “I would encourage everyone who is able to get the vaccine. Those who have missed it can get a catch-up vaccination. You should consult your own GP practice.

“This is available for children of all ages and adults.”

The MMR vaccine can sometimes be given to babies from six months of age if they may have been exposed to the measles virus, or during a measles outbreak.

Babies under six months old are not routinely given the MMR vaccine. This is because the antibodies to measles, mumps and rubella passed from mother to baby at the time of birth are retained and can work against the vaccine, meaning the vaccine is not usually effective. These maternal antibodies decline with age and are almost all gone by the time MMR is normally given.