Written Answers - Vaccination Programme.
Róisín Shortall
Question:
382
Ms Shortall
asked the
Minister for Health and Children
the reason each of the vaccines contained in the MMR vaccine is not given in single doses; if his Department has considered allowing individual doses where parents so request; his views on the concern among some parents that three vaccines in one dose may be harmful to their children; and if he will make a statement on the matter.
[5339/03]
MMR vaccine is available under the primary childhood immunisation programme, which 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, RCPI.
There is no provision for children to receive separate measles, mumps or rubella vaccinations under this programme. Information provided by the Irish Medicines Board, IMB, which has responsibility for licensing all pharmaceutical products in Ireland, indicates that while single dose vaccines for measles, mumps and rubella are licensed in Ireland, it is not aware that these single vaccines are currently marketed here.
There are sound public health reasons for not administering the MMR as separate vaccines. First of all, the scientific evidence does not support a link between MMR and autism or inflammatory bowel disease. There is no evidence that administering the three components of MMR as separate vaccines is safer. The immune system is well capable of responding to the small number of components in the MMR vaccine and there is no evidence that the component parts of the MMR vaccine interfere with each other. In any event, vaccines are designed to strengthen the immune system and not weaken it. Recent UK research published in the journal Archives of Disease in Childhood has confirmed that there are no adverse effects on the immune system.
If the vaccines were to be given separately, this would also mean a child requiring a total of six injections to complete the course instead of two which could also mean an increased risk of local reactions at the injection site. The practical aspect of giving six injections would mean that children are unprotected for a greater period of time from these diseases and, therefore, at significantly greater risk of contracting these conditions. The protracted time involved in administering the vaccines would result in the diseases in question circulating in the community for longer. Unprotected children such as younger children, that is, children below the age of 12 months, and children who are immuno-suppressed would, therefore, be at greater risk of catching the diseases concerned.
Most countries implement a two-dose MMR vaccine programme and this policy has been very successful in controlling measles where high uptake of the vaccine has been achieved. My Department's primary concern in relation to immunisation is that the vaccines in use are safe and effective.
The international consensus from professional bodies and international organisations is that the MMR is a safe and effective vaccine. The institutions include the Medical Research Council Expert Committee and the British Committee on Safety of Medicines in the UK, the Centres for Disease Control and Prevention, CDC, and the American Academy of Paediatrics in the USA as well as the World Health Organisation. The World Health Organisation, 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 Royal College of Physicians of Ireland.
A recent UK study where researchers analysed 2,000 studies from 180 countries found no evidence of a causal link between MMR vaccine and autism or inflammatory bowel disease. In late 2002, theNew England Journal of Medicine published details of a study of more than 500,000 children born in Denmark between January 1991 and December 1998 which indicated that the risk of autism was the same for children regardless of whether or not they were vaccinated with MMR.
In a statement on 14 November 2002, the IMB advised parents and doctors against the use of unlicensed single component measles, mumps and rubella vaccines. Specifically, the IMB has concerns in relation to the manufacture, testing and storage of the single component vaccines Pavivac, single mumps vaccine, and Movivac, single measles vaccine, as there is insufficient information about these two vaccines to be able to offer any assurances about the safety, quality or efficacy of these products which are manufactured by Sevapharma in the Czech Republic. The IMB's counterpart in the UK, the Medicines Control Agency, has issued similar recommendations pending further investigation. The IMB further stated that the two combined MMR vaccines, MMR II and Priorix, currently in use in the childhood immunisation programme in Ireland have undergone rigorous assessment and are licensed by the IMB.
In view of the recent outbreaks of measles that are predominantly affecting the Eastern Regional Health Authority, ERHA, and the Midland Health Board, MHB, regions, 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. This is in order to ensure that both children and the population generally have maximum protection against the disease 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.
