Dáil Éireann debate -
Tuesday, 26 Mar 2002

Vol. 551 No. 2

Written Answers. - Vaccination Programme.

Bernard Allen

Question:

277 Mr. Allen asked the Minister for Health and Children if he will make a statement on recent comments by a person (details supplied) who has called for a major review of a whole scheme to be undertaken due to the fact that the scheme has failed to reach a 95% uptake target and more recently has been the subject of concerns over non-implementation of general practitioner agreements relating to the scheme and on the issue of MMR vaccine safety. [10027/02]

Minister for Health and Children (Mr. Martin)

I assume the Deputy is referring to the article concerning the primary childhood immunisation programme which appeared in the Irish Medical News dated 25 February 2002. The operation of the programme is a matter in the first instance for the individual health boards, who enter into contracts with general practitioners for the delivery of the service. Provisional data provided by the National Disease Surveillance Centre indicates that immunisation uptake for the period 1 January to 30 September 2001 is as follows: DTaP/DT, 85%; Hib, 84%; polio, 85%; and MMR, 75%. Uptake still falls short of the national target of 95%. I am concerned about the unsatisfactory immunisation uptake rates in childhood immunisations because of the risk of unimmunised children contracting 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.

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. The steering committee was assisted by four working groups, which examined the following areas in relation to immunisation: communication, material management, IT systems and planning and organisation. I understand the report of the steering committee will be published shortly.

In relation to the MMR vaccine the international consensus is that this is safe and effective 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 in the USA, the American Academy of Paediatrics and UK professional organisations. Most recently, the US Institute of Medicine also concluded that there was no link between the vaccine and autism or 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 the 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 Joint Committee on Health and Children, in its report on childhood immunisation 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. In 2001, following negotiations with the Irish Medical Organisation in relation to the primary childhood immunisation programme, it was agreed to carry out a review of the GP workload under the programme. This review was to be carried out in the context of the broader review of general practice which has now been further developed in the new primary care strategy, Primary Care – A New Direction. Officials of my Department met recently with representatives of the Irish Medical Organisation and the Health Services Employers Agency to discuss this matter. It was agreed that the immunisation workload review would now proceed as an independent review. The terms of reference of the review and the appointment of an independent evaluator are to be agreed as a matter of urgency.

Contracting general practitioners are entitled to bonus payments for each calendar year where they achieve a 95% uptake in respect of the cohort of children on their panel who reach their second birthday during that year. This payment is due within three months following the calendar year in which uptake levels are calculated. GPs enter into a contract with their health boards and if payment has not been made to them they should raise the issue of outstanding payment with the appropriate health board.

Question No. 278 withdrawn.