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Government launches campaign to give MMR vaccine to a million children in England

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f2696 (Published 25 April 2013) Cite this as: BMJ 2013;346:f2696
  1. Gareth Iacobucci
  1. 1BMJ

The UK government has launched a national measles, mumps, and rubella (MMR) vaccination catch-up programme for children and teenagers in England in response to the recent surge in measles cases.

The programme will aim to reach as many unvaccinated and partly vaccinated 10-16 year olds as possible by September (the start of the next school year), by using local intelligence such as general practice case registers to identify and vaccinate around a million young people in practices and schools.

The campaign, coordinated by Public Health England, NHS England, and the Department of Health, is aimed at preventing outbreaks similar to the current epidemic in Wales, which has seen 886 confirmed cases since November 2012 after an outbreak in Swansea.1

New figures show 587 confirmed measles cases in England in the first three months of 2013,2 twice the 253 in the same period last year.3 There was a record annual high of almost 2000 cases of measles in 2012, despite England achieving its highest ever national level of MMR vaccination, with 94% of 5 year olds receiving one dose and 90% receiving two doses.

Experts said that the rise was largely the result of the “legacy” of unvaccinated children in the 10-16 age bracket who missed out on vaccination in the late 1990s and early 2000s, when there was widespread concern over the now discredited link between autism and the MMR vaccine.

Public Health England estimates that around 330 000 10-16 year olds (around 8%) are currently unvaccinated, that an additional 330 000 need at least one further dose of the MMR vaccine to give them full protection, and that a further 330 000 children below and above the 10-16 age band need at least one further dose of MMR. This leaves the overall target population for the catch-up programme at around one million doses.

The launch comes as authorities in Wales continue to battle the Swansea epidemic, which has prompted special drop-in vaccination clinics and a targeted catch-up campaign in schools to try to bring the outbreak under control.4

Measles cases in England in the first three months of 2013 have occurred across the country, but with high numbers in the north west (179) and north east (175).

In the first three months of 2013 almost 20% of people with confirmed measles (108) needed hospital treatment, with 15 experiencing complications such as pneumonia, chest infection, meningitis, and gastroenteritis.

The campaign will be led locally by NHS England’s area teams alongside local authorities, which will produce plans to identify and vaccinate at-risk groups by using GP case registers and tools such as Facebook and Twitter to target individuals. It will focus particularly on generating demand among parents of 10-16 year olds in “hard to reach” populations where vaccination rates are known to be low.

Mary Ramsay, head of immunisation at Public Health England, said, “We are concerned. Although coverage is high, we have this legacy of undervaccinated children.

“The catch-up programme recommends an approach to specifically target those young people most at risk. Those who have not been vaccinated should urgently seek at least one dose of MMR vaccination, which will give them 95% protection against measles. A second dose is then needed to provide almost complete protection.”

David Salisbury, director of immunisation at the Department of Health, said that the situation in Swansea could happen anywhere in England and was “a wake-up call” to parents.

“It is essential that we get ahead of measles, and the only way to do this is to protect people before measles catches them,” he said.

“The safety record of MMR is not in doubt, and the best thing that parents can do, if their children have not had two doses of MMR, is to make an appointment with the GP now.”

Laurence Buckman, chairman of the BMA’s General Practitioners Committee, welcomed the announcement, which he said would be “the first big test” for the different organisations to work together since the NHS was restructured.

“We need to ensure that this is carefully planned so that as many individuals as possible are vaccinated and further measles outbreaks are prevented,” he said.

Notes

Cite this as: BMJ 2013;346:f2696

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