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expert reaction to childhood vaccination coverage statistics for England in 2018-19

A report, co-authored by Public Health England (PHE) and NHS Digital, gives the childhood vaccination coverage statistics for 2018-19.

 

Dr Jonathan Kennedy, Senior Lecturer in Global Public Health, Queen Mary University of London, said:

“It is not really surprising that MMR coverage has fallen again. Andrew Wakefield’s ideas about the link between MMR and autism remain influential – despite that fact he has been struck off by the GMC and his research retracted by the Lancet.

“A survey of 2,600 parents published in January by the Royal Society for Public Health shows that 21% of parents in the UK think MMR causes unwanted side effects and almost 10% of parents chose not to give their child the MMR vaccine, mainly because of fears about side effects.

“In June, The Wellcome Trust published the results of a survey of over 140,000 people. Only 73% in Northern Europe (which includes the UK) agreed with the statement that vaccines are safe. The figure in France was even lower at 47%. The World Health Organization listed vaccine hesitancy as a top ten global health threat for 2019 and one that “threatens to reverse progress made in tackling vaccine-preventable diseases”.

“The news that MMR rates have fallen again is really concerning. When vaccination rates for measles fall below 90-95% of the population there will be outbreaks.  

“Measles outbreaks are currently occurring across the world, including in high income countries. Last month The World Health Organisation announced that it no longer considers measles to be eradicated in the UK. This is part of a broader public health crisis. In European region, there were about 5,000 cases of measles in 2016, 24,000 in 2017 and 84,000 in 2018. According to recent WHO data, there have already been 90,000 measles cases in the first six months of this year. And the US is experiencing its biggest measles outbreak for 27 years.

“All this raises the question: why do so many people believe unproven theories over the informed advice of medical doctors and public health authorities?

“The internet plays a role. The aforementioned survey by the Royal Society for Public Health showed that half of the parents of children under five in the UK are often or sometimes exposed to negative messages about vaccines on social media and online forums.

“Interestingly, a study published last year revealed that the same Russian trolls and bots that interfered in the US presidential elections on behalf of Donald Trump spread disinformation about vaccines. This suggests that the Russian state is using the topic of vaccine safety to spread discord in the West.

 

“But growing vaccine hesitancy indicates a broader breakdown in trust in elites and experts that also seems to be behind Brexit and other political crises. In the run-up to the 2016 referendum, Michael Gove claimed that people have had enough of experts. He was referring to economists, but this sentiment has wider relevance in the so-called “post-truth” age, when appeals to emotion appear to be more effective at influencing opinion than facts and evidence.

“According to a study by The Guardian carried out before the rise of the Brexit Party, one-third of UKIP voters believed vaccines were unsafe compared with 10% of Labour voters and 11% of Conservative voters. We found similar patterns throughout Europe: supporters of right-wing populist parties were much more likely to question the safety of vaccines.”

 

Prof Helen Bedford, Professor of Child Public Health, Institute of Child Health, UCL, said:

“Although the overwhelming majority of children in the UK are vaccinated, the fall in uptake of MMR vaccine is a cause for concern. Vaccination is the most effective and safest measure available to protect our children from serious infectious disease. Parents who are unsure whether their child had been vaccinated can check their child’s red book. It’s never too late to catch up with missed vaccines. Parents with questions or concerns about vaccines should speak to their health visitor, GP or practice nurse for information.”

 

Dr David Elliman, Consultant in Community Child Health, said:

“The continued fall in uptake of MMR vaccine is worrying, especially in London. We need to ensure that we are providing appropriate family friendly opportunities for children to be immunised. The recent Royal College of Nursing recommendation that practice nurses should be allocated 20 minutes for a child immunisation appointment is to be welcomed.”

 

Prof Jonathan Ball, Professor of Molecular Virology, University of Nottingham, said:

“Given the statistics out today, it is no surprise that we are seeing outbreaks of easily preventable, and often very dangerous viral infections such as mumps and measles. The MMR vaccine is a tried and tested way to prevent communities and populations from these diseases yet still the numbers of children who are being vaccinated continues to fall. This isn’t just in the UK, it’s a wider trend and happening in many parts of Europe and the rest of the world.

“The reason that rates of immunisation have fallen is complex. Some of it is down to mis-information of vaccine dangers that still do the circuit on social media, and some communities and groups of people have consistently been difficult to engage with, but I suspect that much of it is down to the fact that we have forgotten just how serious these infections can be, and have started to think of them as simply trivial childhood infections.  We all lead busy lives and it might be tempting to put off a trip to the GPs for convenience’s sake. But the importance of getting our children immunised cannot be overstated.

“We need to reach immunisation levels of at least 95% to protect the population against measles outbreaks, and we are way short of that. This is a serious public health issue. There needs to be increased effort to educate people on the need for immunisation and proactively reach out to greater vaccine uptake; both of which will need investment.

 

Dr Doug Brown, Chief Executive of the British Society for Immunology, said:

“Today’s publication of the childhood vaccination statistics marks another year where England does not reach the recommended uptake level of 95% on any of the routine childhood vaccinations at the correct timepoint. Now is the time for positive action to address this downward trend to ensure we can prevent the spread of infectious diseases within our communities. Vaccines save lives and are the safest and most effective method to protect our children against disease.

“The statistics for England paint a concerning picture with decreases observed in the uptake of all 13 routine vaccinations. Low levels of vaccination coverage matter as it means these diseases have the potential to spread within our communities, infecting unvaccinated people, including vulnerable individuals unable to have vaccinations such as young babies or people with cancer. We have already seen the consequences of this in the high number of measles cases recorded in England over the last year and the subsequent loss of our ‘measles-free’ status by the World Health Organization.

“Measles is a highly infectious disease and to stop its spread, and indeed that of other diseases, we need to meet the World Health Organization target of 95% vaccine uptake. Today’s statistics show that only 90.3% of children receive the first MMR vaccine by age 2, with 86.4% receiving the second MMR vaccine by their fifth birthday. We can and must do better.

“There are many positive actions that we can take to increase vaccine uptake, many of which were outlined in the Government’s recent announcement of a forthcoming vaccine strategy. Initiatives such as strengthening the role of immunisation co-ordinators, ensuring services are accessible and widening services to go out into communities are all strategies that we know work. Additionally, engaging with parents to answer their questions and provide accurate information on vaccines is key to success. However, for these initiatives to be successful, we must ensure our immunisation services are properly funded.

“The UK is a world leader in vaccine research and the British Society for Immunology is committed to working with healthcare professionals to ensure that this excellence is reflected in the provision of vaccines to our children to prevent disease.”

 

* https://digital.nhs.uk/data-and-information/publications/statistical/nhs-immunisation-statistics/england-2018-19

 

Declared interests

Dr Jonathan Kennedy: “I have no conflicts of interests to declare.”

Prof Helen Bedford: “No conflicts of interest.”

Dr David Elliman: “No conflicts of interest.”

Prof Jonathan Ball: “None.”

None others received.

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