Tuesday, 22 June 2004

Questions (18)

Jan O'Sullivan


15 Ms O’Sullivan asked the Minister for Health and Children the uptake level of the MMR vaccine in each health board area for the latest period for which figures are available; and the steps being taken to promote greater uptake, especially in view of reports of a significant increase in the number of cases of measles in some areas. [18376/04]

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Written answers (Question to Minister for Health and Children)

The MMR vaccine protects against measles, mumps and rubella. In accordance with the recommendations of the immunisation advisory committee of the Royal College of Physicians of Ireland it can be administered to children between 12 and 15 months of age. A vaccine uptake rate of 95% is required to protect children from the diseases and to stop them spreading in the community. Measles is a highly infectious and serious disease and approximately one in 15 children that contract measles suffer serious complications.

I am concerned about the MMR immunisation rates because of the risk of children contracting potentially serious diseases. The outbreak of measles in 2000 resulted in approximately 2,000 cases and three deaths. It is evidence of the consequences of insufficient immunisation uptake.

Data provided by the National Disease Surveillance Centre indicates that MMR uptake rates for children of 24 months of age per health board region for the fourth quarter of 2003 are as follows:

Quarter 4, 2003*




















*The most recent period for which uptake figures are available from the NDSC.

Based on information available from the NDSC, there was a significant increase in 2003 in the number of reported measles cases. In 2002 as many as 243 cases of measles were reported but provisional returns for 2003 indicate that there were 576 measles cases during that year. It underlines the importance of raising the immunisation uptake level to the optimal level of 95% against measles and the other potentially serious infectious diseases. I am encouraged by the most recent statistics from the NDSC that show that MMR uptake for children up to 24 months of age was 80% for the fourth quart of 2003, an increase on 75% in the comparative quarter in 2002. Data provided by the NDSC indicate that from week one to week 23, inclusive, of 2004, or up to 12 June, as many as 92 cases of measles were notified compared with 460 cases notified for the comparative period in 2003. There appears to be a significant reduction in the number of cases reported so far this year. However, we cannot afford to become complacent particularly as the number of notified cases of rubella has risen from 28 in the period from week one to week 23, inclusive, of 2004 compared with 26 cases notified in the comparative period last year.

In 2003 the chief executive officers in all health boards and the ERHA were asked to ensure that specific immunisation measures were prioritised in all regions to prevent a serious measles outbreak. A national immunisation steering committee was established to address a wide range of issues related to childhood and other immunisation programmes, including the identification of issues that are hampering the achievement of uptake targets. In April 2002 I launched its report. A national implementation group was established to draw up a phased plan based on the report's recommendations.

Following consideration of proposals for childhood immunisation that were submitted by the implementation group through the Health Boards Executive, on behalf of the health boards, a sum of €2.116 million was allocated by my Department in 2003 to fund initiatives to improve childhood immunisation uptake. A further €2.778 million was allocated for that purpose this year. At present funding in the region of €800,000 is being allocated to health boards via HeBE specifically for regional and localised projects that will focus on measures to improve immunisation uptake.

Some parents are concerned about the MMR vaccine. Negative coverage has added to their confusion about whether to vaccinate their children. In April 2002 I launched the MMR vaccine discussion pack. It is an information guide for health professionals and parents. It was produced by the NDSC and the Department of public health and the Southern Health Board. It was published by HeBE on behalf of the health boards. The pack sets out the most common concerns about MMR in a way that will help health professionals and parents to explore them together, review the evidence and provide a basis for making an informed decision. The information will allow a full discussion between health professionals and parents on each issue. The pack also contains an information leaflet for parents. The pack is set out in a question and answer format. It addresses such issues as the alleged link between MMR, autism and Crohn's disease, its safety and side effects, the purpose of a second dose of vaccine, combined vaccine versus single doses and contraindications to it. The pack will enable health professionals to respond to the real concerns of parents.

Some health boards have undertaken measures in their regions to improve vaccine uptake. These include the following: information sessions for professionals such as doctors and nurses in the area; information sessions for parents; distribution of information to the public such as providing leaflets on MMR available in public areas; advertisements taken out in local newspapers; advertisements on local radio stations; advice on immunisation, including MMR, forms part of every public health nurse consultation with parents; information leaflets displayed prominently in all health centres; information given to schools regarding the booster MMR; follow-up of parents by letter and telephone where children have not been vaccinated; a follow-up with general practitioners and nurses about children in their area who have not been vaccinated; and information sessions for staff.

I urge all parents to immunise their children against the diseases covered by the childhood immunisation programme. I want them to ensure that their children and the population have the maximum protection against such diseases. This is important in light of the increase in reported measles cases during 2003.