Dáil Éireann Debate, Thursday - 2 December 2004
117 Mr. Penrose asked the Tánaiste and Minister for Health and Children the current 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 that are 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. [31566/04]
View answerThe 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 in order 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 two of 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% as shown in table 1.
|
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 this time 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 un-immunised 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 46, inclusive, of 2004, that is, up to 20 November 2004, 314 cases of measles were notified which compares with 555 cases notified for the comparative period in 2003; this represents a significant reduction in the number of measles cases reported to date this year.
However, since early November 2004 there has been an increase in mumps cases occurring in teenagers and young adults, more than double that reported for the first ten months of 2004. The cases appear to be occurring mainly in individuals who were never immunised or only received one dose of MMR, the vaccine that contains mumps vaccine. In third level colleges where outbreaks are occurring, students between the ages of 16 and 25 years of age with no history of a second dose of MMR have been advised to contact student health services or their own GPs about vaccination. Outbreaks have occurred in Athlone Institute of Technology, Letterkenny Institute of Technology and NUI Maynooth. Vaccination clinics have been held in these colleges.
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 regard 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 HeBE specifically for regional and localised projects focused on measures to improve immunisation uptake.
There is concern among some parents in regard 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 HeBE on behalf of the health boards. The pack sets out the facts in regard 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 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 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 in order 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 World Health Organisation 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 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.
