Written Answers. - Vaccination Programme.
Denis Naughten
Ceist:
346
Mr. Naughten
asked the
Minister for Health and Children
if his attention has been drawn to a UK report which highlights the fact that medical professionals provide their own children with single vaccines rather that the MMR combined vaccine; if his attention has further been drawn to similar statistics here; the percentage uptake of the MMR currently and since its introduction; his plans to introduce the single vaccine here; and if he will make a statement on the matter.
[12739/03]
I am not familiar with the report to which the Deputy refers. MMR vaccine was introduced into the primary childhood immunisation programme in 1988. The current GP delivered primary childhood immunisation programme was introduced in December 1995. Therefore, national immunisation uptake data in respect of MMR vaccine, for children at two years of age, is available from 1998. Detailed information in respect of earlier years is not available for all health boards or for all years concerned. The national MMR uptake rate in respect of children at two years of age since 1998 is as follows:
|
1998
|
77%
|
|
1999
|
77%
|
|
2000
|
79%
|
|
2001
|
73%
|
|
2002 – Quarter 1
|
70%
|
|
2002 – Quarter 2
|
72%
|
|
2002 – Quarter 3
|
73%
|
The primary childhood immunisation programme provides for the immunisation of children up to two years of age 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.
MMR vaccine is available under the primary childhood immunisation programme and there is no provision for children to receive separate measles, mumps or rubella vaccinations under this programme. Information provided by the Irish Medicines Board, 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 does not believe these single vaccines are currently marketed here. There are sound public health reasons for not administering the MMR as separate vaccines. On the basis of currently available information there is no evidence that giving each of the component vaccines separately has any greater benefit than the combined vaccines.
Splitting the MMR vaccine into separate components would involve extra injections for children and would cause both children and the people with whom they come in contact to be exposed to these potentially serious diseases for a much longer period of time and be at greater risk of contracting the diseases concerned. To my knowledge no other country advocates the use of three separate vaccines rather than the MMR vaccine. MMR vaccine is in use worldwide. 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 primary concern and that of my Department in relation to immunisation is that the vaccines in use are safe and effective. There is a sound evidence basis for the use of MMR in the national programme.
The international consensus from professional bodies and international organisations is that MMR is a safe and effective vaccine and that the recently published medical evidence does not support a causal link between MMR vaccine and autism or inflammatory bowel disease. The institutions include the Medical Research Council Expert Committee the British Committee on Safety of Medicines in the UK, the Centres for Disease Control and Prevention, the American Academy of Paediatrics in the USA as well as the World Health Organisation and UK professional organisations. Recent studies by the United States Institute of Medicine concluded that there was no link between the vaccine and autism or inflammatory bowel disease. A large Finnish study involving 1.8 million individuals demonstrated that no case of inflammatory bowel disease or autism was linked to the MMR vaccine. A similar Swedish study found no increase in cases of autism in the 10 years during which MMR vaccine was introduced. 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.
The World Health Organisation has indicated that observations made regarding the onset of autism following the administration of MMR vaccine do not meet the scientific criteria required to suggest that the vaccine is the cause. It has also indicated that there has been no new scientific evidence that would suggest impaired safety of MMR. The 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.
The Irish Medicines Board, IMB, is responsible for the monitoring and safety of all pharmaceutical products in Ireland. The monitoring of vaccine safety is ensured through clinical trials prior to licence and post-licence surveillance by the IMB. The IMB liaises closely with international bodies including the European Medicines Evaluation Agency and the World Health Organisation.
The Joint Committee on Health and Children in its Report on Childhood Immunisation which was published in July 2001 concluded that there is no evidence of a proven link between the MMR vaccine and autism and that there is no evidence to show that the separate vaccines are any safer than the combined MMR vaccine.
There is concern among some parents in relation to the measles, mumps and rubella 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 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. 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. Any decision regarding immunisation of a child is a personal and private one for the parent(s) concerned; my Department's role in the matter is to enable parents to be fully informed prior to making such a decision.
