A stark warning about the dangers of measles is to be sent to the parents of three million unvaccinated children in an unprecedented move to increase uptake of the MMR vaccination, the Government will announce today.
Department of Health scientists say Britain faces a greater threat of a measles epidemic, which would result in up to 100,000 children and young people being infected, than at any time for decades.
Doctors are desperate to push vaccination rates back to the level they were before claims that the MMR vaccine could cause autism – never substantiated – drastically reduced immunisation levels from the late 1990s onwards.
The NHS has stockpiled 500,000 doses of the vaccine with a further one million on order for delivery by October, in an attempt to vaccinate everyone up to the age of 18. The extra vaccine is in addition to the supplies for the routine childhood immunisation programme.
England's 150 primary care trusts will receive £30,000 each on average – twice that in London – to identify unvaccinated children and encourage their parents to bring them in for the injection.
Professor David Salisbury, director of immunisation for the Department of Health, said: "We have got so many susceptible [unvaccinated] children, there will be an epidemic at some point. You cannot carry that number without having an epidemic. There is measles in Switzerland, Austria, Germany and Italy – there is a lot of it about. We can either sit on our hands or do something about it."
Measles cases have risen sharply in the past two years. There were 1,726 cases in 2006 and 2007 in England and Wales, more than in the 10 previous years put together, when there were a total of 1,621 cases. The Health Protection Agency (HPA) warned in June that the number of unvaccinated children was now large enough to sustain the "continuous spread" of the potentially lethal virus. It said measles had become endemic 14 years after its spread was halted in the resident population, as reported by The Independent.
The HPA blamed a failure by parents to take their children for the MMR vaccine during the past 10 years, after the scare about a supposed link between the vaccine and autism.
Sir Liam Donaldson, the Government's chief medical officer, launched the campaign yesterday by writing to all health authorities and GPs telling them of the "urgent action" required to avert an epidemic.
"Measles is serious. It can lead to pneumonia and encephalitis and it can kill. Around 10 per cent of cases of measles require hospital admission and fatality rates of one per 5,000 are still seen in the UK, with recent epidemics in industrialised countries having even higher rates," his letter says. It adds that there have been two deaths from measles in recent years – in 2006 and 2008 – after more than a decade in which there were none.
The catch-up campaign will target all those up to the age of 18 who have been identified from health records as unvaccinated or having received only one of the recommended two vaccinations, normally given at 13 months and three and half years.
Letters to parents will warn of the recent rise in cases and urge them to bring their children for vaccination at a specific date and time.
London is at greatest risk because vaccination rates are lowest in the capital. In the last quarter of 2007, the rate stood at 71 per cent for children at age two (first dose) and 50 per cent at age five (second dose) compared with the 95 per cent coverage needed to maintain herd immunity and prevent endemic spread.
Nationally, MMR vaccination rates fell from 92 per cent a decade ago to 79 per cent in 2004, at the height of the scare over the vaccine's supposed link with autism. They have since recovered to 84 per cent at age two (75 per cent at age five) but are still well below the target level of 95 per cent.
Professor Salisbury defended the decision to offer parents the triple MMR vaccine for defence against the single virus disease of measles.
"Exactly the same children need to be protected against mumps and rubella. The fact we have got measles now is because it is highly infectious but we will have mumps and rubella outbreaks.
"In 1994, when we ran a similar catch-up campaign, we could only get a measles and rubella vaccine because [the triple] MMR was in short supply on the world market. In 2005, we had a mumps epidemic among teenagers affecting that same group of children who had missed their mumps vaccination a decade earlier. That lesson is not one we need to learn again."
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