A major measles epidemic in Wales has prompted record numbers of parents to have their children immunised against the disease. However, with adolescents and young adults accounting for a large proportion of cases, the outbreak may be far from over.
More than 95% of two-year-olds in Wales have now had the MMR vaccine which can protect against measles, mumps and rubella. This is the first time MMR uptake has passed the 95% mark in this age group, according to public health officials who said parental confidence in immunisation was on the rise.
The measles outbreak sparked serious concern among parents, prompting many to queue with their children outside hospitals where temporary immunisation clinics have been set up in an effort to stem the outbreak.
Almost 1,200 cases of measles have now been recorded by Public Health Wales and, while officials are heartened by the surge in MMR uptake in children under two, they remain concerned about older age groups.
Experts in the UK recommend two doses of MMR by age five but uptake of the second dose in this age group remains at 90% in Wales. This figure is an average, meaning there may be towns and cities where the 95% target is being exceeded as well as others where the rate is considerably lower.
The real battle ground against measles can be seen in the campaign to reach adolescents through an MMR catch-up campaign. The majority of cases in the measles outbreak centred on the Swansea area are aged between 10 and 18, according to authorities.
“We are delighted to see average uptake of the first dose of MMR passing the 95% target for the first time,” said Dr Marion Lyons, Director of Health Protection for Public Health Wales.
“It’s fantastic to see that parents of younger children understand the importance of this vaccine. However, vaccination levels in the generation of children and young people between 10 and 18 is still too low.”
She said that as long as uptake remains lower than 95% in some parts of Wales, there is always the risk of measles outbreaks.
“Our message remains that anyone born after 1970 who has not had measles or received both doses of MMR should catch up at the earliest opportunity,” said Dr Lyons.
The situation in Wales mirrors outbreaks elsewhere in the European region, including Romania and Turkey where thousands of cases have been reported over the past 12 months.
These epidemics are jeopardising a Europe-wide effort to wipe out measles by 2015 and will require a collective effort from the public, health professionals and policymakers if vaccine uptake targets are to be reached across all age groups.
“We’re paying the cost of decisions that were made many years ago by parents of young children who are adults and adolescents now. With the outbreaks we are seeing now in Europe, adults and adolescents are accounting for almost 50% of cases,” Robb Butler of the WHO Regional Office for Europe told Vaccines Today.
He added that simply blaming parents who opt out of vaccination will not be enough to defeat infectious diseases. Healthcare workers and politicians play a crucial role.
Policymakers need to stand by their commitment to eliminate measles and rubella by 2015 and ensure that the required resources are made available to support immunisation, according to Butler.
“We can’t afford to have complacent healthcare workers – they are our frontline. If your healthcare worker is not vaccinating the likelihood that you will vaccinate your children is pretty minimal. Up to 70% of parents tell us the key trigger for their behaviour is their healthcare worker.”