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Dáil Éireann debate -
Tuesday, 3 Apr 2001

Vol. 533 No. 6

Written Answers. - Vaccination Programme.

John Gormley

Question:

234 Mr. Gormley asked the Minister for Health and Children if children who have only had one dose of the MMR two dose regime are classed as only partially vaccinated and are therefore considered unvaccinated; and if he will make a statement on the matter. [9537/01]

John Gormley

Question:

237 Mr. Gormley asked the Minister for Health and Children when MMR was introduced here; and if he will make a statement on the matter. [9540/01]

John Gormley

Question:

239 Mr. Gormley asked the Minister for Health and Children if he has the annual percentage for MMR uptake since its introduction; and if he will make a statement on the matter. [9542/01]

I propose to take Questions Nos. 234, 237 and 239 together.

MMR vaccine was introduced into the national primary childhood immunisation programme in 1988. The national immunisation committee of the Royal College of Physicians of Ireland recommends that MMR vaccine be administered at 15 months with a booster dose administered at four to five years of age. The use of a second dose of MMR vaccine is considered to improve the control of the diseases and some countries have now managed to interrupt the transmission of the diseases by achieving high vaccination coverage for both doses. The booster dose offers a second opportunity to vaccinate children who have not received the vaccine and offers a second chance to protect those children who fail to seroconvert following a single dose of the vaccine, primary vaccine failures. Primary vaccine failures represent less than 5% of children immunised above the age of 12 months. However, these children can contribute to the maintenance of disease transmission. The second dose of MMR vaccine given at school entry also contributes to the prevention of school outbreaks.
The current GP delivered primary childhood immunisation programme was introduced in December 1995. Therefore, national immunisation uptake data in respect of MMR vaccine and other primary immunisations for children at two years of age is available from 1998. Detailed information in respect of earlier years is not available for all health boards or for all years concerned. The national MMR uptake rate in respect of children at two years of age since 1998 is as follows:

1998

77%

1999

77%

2000 (up to 30 September)

78%

I am concerned that immunisation uptake rates are still below the target of 95%. It is necessary to achieve this target in order to achieve herd immunity. My Department is in regular contact with the health boards at a senior level about the issues which need to be addressed in order to meet the target. A national immunisation steering committee has been established to address a wide range of issues in relation to the primary childhood immunisation programme and this committee will in a systematic way identify and address the difficulties which are hampering achievement of the uptake target.

John Gormley

Question:

235 Mr. Gormley asked the Minister for Health and Children if he can supply the safety studies and trials regarding the giving of the first dose of MMR at six months followed by a second further dose at 15 months and school entry; and if he will make a statement on the matter. [9538/01]

John Gormley

Question:

236 Mr. Gormley asked the Minister for Health and Children if he can supply the long-term safety studies of the three dose regime of MMR commencing at six months of age; and if he will make a statement on the matter. [9539/01]

I propose to take Questions Nos. 235 and 236 together.

The Irish Medicines Board, IMB, is the regulat ory body for human medicines in Ireland. The licensing of vaccines for use in Ireland is therefore a matter for the IMB which must satisfy itself as to the safety and efficacy of vaccines before granting a licence.
The national immunisation committee of the Royal College of Physicians of Ireland recommends that MMR vaccine be administered to children at 15 months with a booster dose administered at four to five years of age. The IMB recommends that children under 12 months should not normally be given MMR vaccine unless they are at special risk, for example in an outbreak situation, since the presence of maternal antibody may interfere with their ability to respond to the vaccine. The national immunisation committee of the Royal College of Physicians of Ireland also recommends that when measles outbreaks occur, most susceptible children will be protected by giving MMR vaccine within 72 hours of contact with a case. The younger the infant the lower the likelihood of seroconversion. When immunisation below the age of 12 months is deemed necessary it is recommended that a second dose of vaccine be given at 15 months and a further dose should be given at school entry age. This is in line with the recommendations from other EU member states and the schedule in the US.
The IMB also advised that children given MMR vaccine before their first birthday should be considered as potentially susceptible to all three diseases and should be revaccinated with two doses of MMR. The purpose of the two dose vaccination schedule is to produce immunity in the proportion of persons who fail to respond immunologically to one or more components of the first dose.
The international consensus, including the WHO, is that the MMR vaccine is safe and effective and this is supported by a number of well-validated studies on this issue.
Question No. 237 answered with Question No. 234.
Question No. 238 answered with Question No. 222.
Question No. 239 answered with Question No. 234.
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