Written Answers. - Vaccination Programme.
Eamon Gilmore
Question:
179
Mr. Gilmore
asked the
Minister for Health and Children
the steps being taken to deal with the significant decline in the level of immunisation, especially among children under two; and if he will make a statement on the matter.
[3405/03]
Data provided by the National Disease Surveillance Centre, NDSC, indicates that immunisation uptake rates in children of 24 months of age are as follows:
|
1999
|
2000
|
2001
|
Q1, 2002
|
Q2, 2002
|
Q3, 2002
|
|
%
|
%
|
%
|
%
|
%
|
%
|
|
DTaP-DT (Diphtheria-Tetanus-Pertussis)
|
86
|
86
|
84
|
83
|
83
|
83
|
|
Hib (Haemophilus Influenzae Type B)
|
86
|
85
|
84
|
82
|
82
|
82
|
|
Polio
|
86
|
86
|
84
|
83
|
82
|
82
|
|
MMR (Measles-Mumps-Rubella)
|
77
|
79
|
73
|
70
|
72
|
73
|
Uptake, particularly in relation to MMR, 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 un-immunised children contracting the potentially serious diseases concerned. The outbreak of measles in 2000, which resulted in three deaths and approximately 2,000 cases, is evidence of the consequences of insufficient immunisation uptake.
The health board chief executive officers 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 that 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: (a) communication, (b) material management, (c) IT systems and (d) planning and organisation.
I launched the report of the steering committee on 22 April 2002. This report is the first step towards improving immunisation uptake and also enhancing and developing the key systems which underpin the immunisation programmes. In July 2003, a national immunisation implementation group was established and is responsible for co-ordinating the planning and implementation of immunisation programmes in order to improve uptake. This group reports to the national steering committee. Some €2.116 million is being made available at national level in 2003 in respect of specific projects and measures which are being designed to improve immunisation uptake particularly in areas of low uptake. Health boards were requested to submit proposed projects-measures to the national immunisation implementation group by the end of January 2003. The chief executive officers are currently considering the proposals and will shortly submit them to my Department.
Based on information available from the National Disease Surveillance Centre there has been a significant increase in recent weeks in the number of reported measles cases. In the first four weeks of 2003, 96 cases have been reported compared with ten cases in the same period in 2002. Specific outbreak management measures have been put in place in the two regions concerned – the Eastern Regional Health Authority and the Midland Health Board. In addition, chief executive officers in all health boards and the ERHA have been asked to ensure that specific immunisation measures are prioritised in all regions in order to prevent a serious outbreak.
On a positive note, since the introduction of the national immunisation programme against group C meningococcal disease in October 2000 there has been a dramatic reduction in this disease in Ireland. The aim of this programme was to immunise all children and young people up to the age of 22 against the disease. Data provided by the NDSC indicates that in 2002, 14 cases of group C disease were notified compared to 139 cases in 2000, a reduction of 90%. The most dramatic reductions were seen in the age groups targeted by the meningitis C vaccine, ranging from a 100% reduction in five to nine year olds to an 86% reduction in the one to four years age group. This represents a very significant reduction and highlights the importance and success of the campaign.
There is concern among some parents in relation to the measles, mumps and rubella, MMR, vaccine. Negative coverage on this issue has added to the confusion of parents in deciding whether or not to vaccinate their children. In April 2002, I launched the MMR vaccine discussion pack, An Information Guide for Health Professionals and Parents. The pack was produced by the NDSC and the department of public health, Southern Health Board, and was published by the Health Boards Executive on behalf of the health boards. The pack sets out the facts in relation to the most common concerns about MMR in a way that will help health professionals and parents to explore these concerns together, review the evidence in relation to MMR and provide the basis for making an informed decision. The information is presented in such a way as to allow full discussion between health professionals and parents on each issue. The pack also contains an information leaflet for parents. The layout of the pack is in question and answer format and addresses such issues as the alleged link between MMR and autism and Crohn's disease, the safety and side effects of the vaccine, the purpose of a second dose of vaccine, combined vaccine versus single doses and contraindications to the vaccine. The pack will be of great assistance to health professionals and will enable them to respond to the very real concerns of parents.
I would like to take this opportunity to again 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. This is particularly important at present in light of the increase in reported measles cases.
