Dáil Éireann díospóireacht -
Tuesday, 4 Nov 2003

Vol. 573 No. 3

Written Answers. - Vaccination Programme.

Seán Crowe

Ceist:

499 Mr. Crowe asked the Minister for Health and Children the take up of the MMR vaccine in the Tallaght area; the steps being taken to increase the take up of the MMR vaccine; and if he will make a statement on the matter. [25524/03]

Minister for Health and Children (Mr. Martin)

I understand from the National Disease Surveillance Centre, NDSC, that MMR uptake is calculated on a quarterly basis among children of 24 months of age. The data are collected by health board region, rather than on specific areas. Therefore data specifically in relation to Tallaght are not readily available. However, the Eastern Regional Health Authority, ERHA, has indicated that the MMR uptake rate for community care area 4, which encompasses Tallaght, for quarter two of 2003 is in the region of 70% which is a sizeable improvement on the same quarter in 2002 when it was approximately 55%, both percentages not verified by the NDSC. According to figures supplied by the NDSC, the MMR uptake rate for quarter one of 2003, which is the most recent period for which statistics are available from the NDSC, in the ERHA region was 71%. This is a marked improvement on quarter one of 2002 for which an uptake rate of 60% was recorded by the NDSC.

The ERHA has conveyed that the following measures are being undertaken in order to improve uptake in their region: 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 such as Tallaght Shopping Centre and Liffey Valley Shopping Centre, advertisements taken out in local newspapers for six months, January – June 2003, 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 two information sessions were held in Tallaght for staff working in the voluntary sector and social inclusion managers.

Uptake of MMR nationally falls short of the target of 95%. I am concerned about the unsatisfactory immunisation uptake rates in childhood immunisations because of the risk of unimmunised children contracting the potentially serious diseases concerned. The outbreak of measles in 2000, which resulted in three deaths and approximately 2,000 cases, is evidence of the consequences of insufficient immunisation uptake.

Based on information available from the NDSC there has been a significant increase this year in the number of reported measles cases. Up to 31 October 2003, 568 cases were reported compared with 187 cases in the same period in 2002. This underlines the importance of raising the immunisation uptake level to the optimal level of 95% against measles and the other potentially serious infections. Earlier this year, chief executive officers 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 outbreak. However, I am encouraged by the most recent statistics from the NDSC which show that for the first quarter of 2003 there was an increase in the uptake level for most vaccines in the primary childhood immunisation programme, including that of MMR which rose by 2% in that period.

The health board chief executive officers established a national immunisation steering committee to address a wide range of issues relating to the childhood and other immunisation pro grammes, including the identification of issues that are hampering the achievement of uptake targets. The steering committee was assisted by four working groups which examined the following areas in relation to immunisation: communication, material management, IT systems and planning and organisation. I launched the report of the steering committee 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 and to identify the costs involved.

Following consideration of proposals submitted by HeBE on behalf of the health boards in relation to childhood immunisation, €2.116 million was allocated by my Department to HeBE in 2003 in order to fund the following initiatives in relation to childhood immunisation: communications – that is, information and awareness initiatives, information systems and material management systems.

There is concern among some parents in relation to the measles, mumps and rubella or MMR vaccine. Negative coverage on this issue has added to the confusion of parents in deciding whether 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 HeBE on behalf of the health boards. The pack sets out the facts in relation to the most common concerns about the 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 Q and 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 will be of great assistance to health professionals and will enable them to respond to the very real concerns of parents.

In this regard, I am pleased to note the letter from Dr. Simon Murch of the Centre for Paediatric Gastroenterology, Royal Free and University College Medical School, London, who had originally questioned the safety of the MMR vaccine, in this month's edition ofThe Lancet which categorically supports use of the MMR vaccine. He says:

. . . by any rational standards of risk/benefit calculation, it is an illogical and potentially dangerous mistake for parents to be prepared to take their children in a car on the motorway or in an aeroplane on holiday, but not to protect them with the MMR vaccine. An unprotected child is not only at personal danger, but represents a potential hazard to others, including unborn children.

I 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. This is particularly important at present in the light of the increase in reported measles cases.