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Dáil Éireann debate -
Wednesday, 20 Feb 2002

Vol. 549 No. 1

Written Answers. - Vaccination Programme.

Derek McDowell

Question:

67 Mr. McDowell asked the Minister for Health and Children the steps which are being taken to reassure the public as to the safety on the MMR vaccine, in view of the decreasing level of take up and the dangers of a measles epidemic; and if he will make a statement on the matter. [5773/02]

Ivor Callely

Question:

157 Mr. Callely asked the Minister for Health and Children the benefits of the MMR vaccination; the known side effects; his views on whether such vaccinations can have serious side effects; and if he will make a statement on the matter. [5967/02]

I propose to take Questions Nos. 67 and 157 together.

The primary childhood immunisation programme provides for the immunisation of children up to two years of age against a range of potentially serious infectious diseases. Under the programme parents may have their children immunised free of charge by the general practitioner of their choice. The schedule of immunisation is in accordance with the recommendations of the immunisation advisory committee of the Royal College of Physicians of Ireland (RCPI).

The international consensus is that MMR is a safe and effective vaccine and that the recently published medical evidence does not support a causal link between MMR and autism. The institutions involved include the Medical Research Council Expert Committee UK, the British Committee on Safety of Medicines, the World Health Organisation, the Centres for Disease Control and Prevention (CDC) USA, the American Academy of Paediatrics, and UK professional organisations (the RCGP, the Royal College of Paediatrics, the Faculty of Public Health Medicine, the BMA, the Royal College of Nursing and the Royal Pharmaceutical Society). Most recently, the United States Institute of Medicine also concluded that there was no link between the vaccine and autism/inflammatory bowel disease. This consensus is based on large-scale epidemiological studies and more specific studies done in the laboratory setting.

The World Health Organisation has indicated that observations made regarding the onset of autism following the administration of MMR vaccine do not meet the scientific criteria required to suggest that the vaccine is the cause. It has also indicated that there has been no new scientific evidence that would suggest impaired safety of MMR. The WHO strongly endorses the use of MMR vaccine on the grounds of its convincing record of safety and efficacy. This view is supported by the Irish Medicines Board and by the RCPI.
The Irish Medicines Board is responsible for the monitoring and safety of all pharmaceutical products in Ireland. The monitoring of vaccine safety is ensured through clinical trials prior to licence and post-licence surveillance by the IMB. The IMB liaises closely with international bodies including the European Medicines Evaluation Agency and the World Health Organisation.
The Joint Committee on Health and Children in its report on childhood immunisation which was published in July 2001, concluded that there is no evidence of a proven link between the MMR vaccine and autism and that there is no evidence to show that the separate vaccines are any safer than the combined MMR vaccine.
Immunisation uptake rates in respect of the years 1999 and 2000 were 77% and 79% respectively. The most recent MMR uptake figure – January-September 2001 – shows that the national MMR uptake rate in children at 24 months has declined to 75%. This falls considerably short of the target figure of 95% uptake which is necessary to generate ‘herd immunity'.
I am concerned about the unsatisfactory immunisation uptake rates because of the risk of unimmunised children contacting the potentially serious diseases concerned. The outbreak of measles in 2000, which resulted in three deaths and over 1,500 cases, is evidence of the consequences of insufficient immunisation uptake. Measles is a highly infectious disease and is not a trivial illness. Approximately one in 15 children with measles suffers serious complications. These include pneumonia, ear infection and, less commonly, inflammation of the brain (encephalitis), myocarditis and sub-acute sclerosing panencephalitis (SSPE) which may result in permanent brain damage usually occurring many years after infection.
The chief executive officers of the health boards established a National Immunisation Steering Committee to address a wide range of issues relating to the childhood and other immunisation programmes including the identification of issues which are hampering the achievement of uptake targets. I expect this report to be published shortly.
I would like to take this opportunity to urge all parents to have their children immunised against the diseases covered by the childhood immunisation programme in order to ensure that both their children and the population generally have maximum protection against the diseases concerned. General practitioners are aware of the contraindications to the recommended childhood immunisations and parents should discuss any concerns they may have with their general practitioner before making a decision about their child's immunisation.
Question No. 68 answered with Question No. 35.
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