The MMR vaccine is available under the primary childhood immunisation programme. This programme provides for the immunisation of children 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. The World Health Organisation has indicated that the MMR vaccine does not cause autism and that there has been no new scientific evidence that would suggest impaired safety of the vaccine. The WHO strongly endorses the use of the MMR vaccine on the grounds of its convincing record of safety and efficacy.
The international consensus from professional bodies and international organisations is that MMR is a safe and effective vaccine and that the recently published research does not support a causal link between the MMR vaccine and autism or inflammatory bowel disease. The institutions include the Medical Research Council expert committee in the United Kingdom, the UK Committee on Safety of Medicines, the Centres for Disease Control and Prevention in the USA and the American Academy of Paediatrics. Most recently, the United States Institute of Medicine 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. A large Finnish study involving 1.8 million individuals demonstrated that no case of inflammatory bowel disease or autism was linked to the MMR vaccine. A similar Swedish study found no increase in cases of autism in the ten years during which the vaccine was introduced.
The MMR vaccine is in use worldwide. Most countries implement a two dose MMR vaccine programme and this policy has been very success ful in controlling measles where high uptake of the vaccine has been achieved.
The primary concern of the Department concerning immunisation is that the vaccines in use are safe and effective. The Irish Medicines Board and the Royal College of Physicians of Ireland support the use of MMR on the grounds that it has been demonstrated to be a very safe and effective vaccine. There is a sound evidence basis for the use of MMR in the national programme.
Additional InformationThe Irish Medicines Board, IMB, 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.
In addition, the report of the Joint Committee on Health and Children 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.
To reassure the public about the safety of the MMR vaccine and to address the negative media coverage on this issue which adds to the confusion of parents in deciding whether to vaccinate their children, I recently launched a document entitled, Measles, Mumps, Rubella Vaccine Discussion Pack – an information guide for health professionals and parents. The pack was produced by the National Disease Surveillance Centre and the department of public health in the Southern Health Board. It was published by the health boards executive on behalf of the health boards. It sets out the facts on the most common concerns about MMR in a way that will help health professionals and parents to explore these concerns together, review the evidence on MMR, and provide the basis for making an informed decision. The pack addresses such issues as the alleged link between MMR and autism, the safety and side-effects of the vaccine, combined versus single doses and contra-indications to the vaccine.
The national uptake rate for MMR in 2001 was 73%. This falls considerably short of the national target of 95% which is required to provide population immunity. I am concerned about the unsatisfactory immunisation uptake rates because of the risk of children who have not been immunised contracting the potentially serious diseases concerned.
In 2001 a national immunisation steering committee was established by the health board chief executive officers to address a wide range of issues relating to the childhood and other immunisation programmes, including the identification of issues that were hampering the achievement of uptake targets. On 22 April 2002 I launched the report of the steering committee. This is the first step towards improving immunisation uptake and enhancing and developing the key systems which underpin the immunisation programmes. A group under the auspices of the health boards executive is examining the report with a view to drawing up a detailed implementation plan.
I urge all parents to have their children immunised against the diseases covered by the childhood immunisation programme to ensure that both their children and the population generally have maximum protection against the diseases concerned. General practitioners are aware of the contra-indications 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.