Dáil Éireann Debate, Thursday - 28 October 2004
18 Mr. Rabbitte asked the Tánaiste and Minister for Health and Children the level of the take-up of the MMR vaccine in each health board area for the latest period for which figures are available; the steps being taken to promote fuller take-up, especially in view of reports of a significant increase in the number of cases of measles in some areas of the country; and if she will make a statement on the matter. [26313/04]
View answer28 Ms Enright asked the Tánaiste and Minister for Health and Children her views on the increased incidence of measles being reported in the eastern region. [26218/04]
View answer46 Mr. Connaughton asked the Tánaiste and Minister for Health and Children the steps her Department is taking to reduce the incidence of measles, in view of the fact that over 70% of measles cases identified have involved unvaccinated patients. [26220/04]
View answerI propose to take Questions Nos. 18, 28 and 46 together.
The MMR vaccine protects against measles, mumps and rubella and, in accordance with the recommendations of the Immunisation Advisory Committee of the Royal College of Physicians of Ireland, 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 concerned and to stop the spread of the diseases in the community. Measles, in particular, is a highly infectious and serious disease; approximately one in 15 children who contract measles suffer serious complications.
In Ireland, uptake of the first dose of the measles, mumps and rubella vaccine, MMR1, is calculated on a quarterly basis among children of 24 months of age. In quarter 2, 2004, the national uptake rate for this vaccine was 81%. This represents an increase of 1% in the national uptake rate when compared with the previous quarter and an increase of 4% in comparison with the same quarter in 2003. In addition, uptake rates reported by individual health boards ranged from 76% to 91% — Table 1 refers.
|
Uptake at 24 months — Q2 2004 |
|
|
% |
|
|
ERHA |
76 |
|
MHB |
91 |
|
MWHB |
84 |
|
NEHB |
84 |
|
NWHB |
87 |
|
SEHB |
86 |
|
SHB |
82 |
|
WHB |
76 |
|
IRELAND |
81 |
*The most recent period for which uptake figures are available from the NDSC
The national uptake rate of MMR1 has increased from 69% in Q4 2001 to 81% in Q2 2004. This trend has been reflected in each of the health boards, with all health boards having reported an increase in the uptake rate for MMR1 over that period. Although MMR1 uptake rates have been improving over the past year and a half, they are still 14% lower than the national target rate of 95%.
I am concerned about the unsatisfactory MMR immunisation uptake rates because of the risk of unimmunised children contracting the potentially serious diseases concerned. The outbreak of measles in 2000, which resulted in approximately 2,000 cases and three deaths, is evidence of the consequences of insufficient immunisation uptake. However, I am encouraged by the fact that the immunisation uptake rates are steadily improving. Meanwhile, data provided by the NDSC indicate that from week one to week 40, inclusive, of 2004, that is, up to 9 October 2004, 296 cases of measles were notified, which compares with 541 cases notified for the comparative period in 2003; this represents a significant reduction in the number of measles cases reported to date this year.
A National Immunisation Steering Committee was established 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 report of the steering committee was launched in April 2002 and a National Implementation Group was subsequently established to draw up a phased national implementation plan based on the report's recommendations.
Following consideration of proposals in relation to childhood immunisation, which were submitted by the National Implementation Group through the Health Boards Executive, HeBE, on behalf of the health boards, €2.116 million was allocated by my Department in 2003 to fund initiatives to improve childhood immunisation uptake. A further €2.778 million has been allocated for that purpose this year. Funding in the region of €800,000 has been allocated to health boards, via the HeBE, specifically for regional and localised projects which will focus on measures to improve immunisation uptake.
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, the MMR vaccine discussion pack, an information guide for health professionals and parents, was launched. The pack was produced by the NDSC and the Department of Public Health, Southern Health Board, and was published by the HeBE 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 pack is set out in Q&A 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 enables health professionals to respond to the very real concerns of parents.
In 2003, CEOs in all health boards and the ERHA were asked to ensure that specific immunisation measures were prioritised in all regions in order to prevent a serious measles outbreak. Health boards have undertaken a range of measures in their regions to improve vaccine uptake in their region. These include: information sessions for professionals, for example, doctors and nurses in the area; information sessions for parents; distribution of information to the public, for example, leaflets on MMR available in public areas; advertisements taken out in local papers; advertisements on local radio stations; advice regarding 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; follow up with GPs and nurses regarding children in their area who have not been vaccinated; and information sessions for staff.
Furthermore, my Department has convened a measles eradication committee to develop a national five year action plan for the elimination of measles and rubella in line with the WHO strategic plan for 2010. This committee had its first meeting on 30 September 2004 and is due to report to me by the end of June 2005.
I 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.
