Dáil Éireann Debate, Thursday - 28 October 2004
101 Mr. Connaughton asked the Tánaiste and Minister for Health and Children if her Department has made inquiries or reached conclusions regarding the reason such large variations in the vaccination rates exist between different regions of the country. [26221/04]
Amharc ar fhreagraIn Ireland, immunisation uptake is routinely calculated on a quarterly basis among children at 12 and 24 months of age. The latest figures available from the National Disease Surveillance Centre for immunisation uptake relate to the second quarter of 2004. The statistics relate to children who have received three doses of vaccines against diphtheria, pertussis, tetanus, Hib — Haemophilus Influenzae Type B, polio, and meningococcal group C; and one dose of vaccine against measles, mumps, and rubella, MMR1.
In Quarter 2, 2004, the national uptake rate for vaccines against diptheria, pertussis, tetanus, Hib and polio was 88-89% at 24 months — Table 1. The uptake rate for menC vaccine was 87% and the uptake rate for MMR1 was 81%. Two health boards reached the target rate of 95% uptake for diptheria and tetanus. One of these health boards also reached the target rate of 95% for pertussis and polio.
|
D3 |
P3 |
T3 |
Hib3 |
Polio3 |
MenC |
MMR1 |
|
|
% |
% |
% |
% |
% |
% |
% |
|
|
ERHA |
86 |
86 |
86 |
86 |
86 |
84 |
76 |
|
MHB |
93 |
92 |
93 |
93 |
93 |
93 |
91 |
|
MWHB |
89 |
88 |
89 |
89 |
89 |
88 |
84 |
|
NEHB |
95 |
94 |
95 |
94 |
94 |
93 |
84 |
|
NWHB |
95 |
95 |
95 |
94 |
95 |
94 |
87 |
|
SEHB |
91 |
90 |
91 |
91 |
91 |
90 |
86 |
|
SHB |
87 |
86 |
87 |
87 |
87 |
86 |
82 |
|
WHB |
90 |
90 |
90 |
90 |
90 |
86 |
76 |
|
IRELAND |
89 |
88 |
89 |
89 |
89 |
87 |
81 |
D3 = Diptheria, P3 = Pertussis, T3 = Tetanus.
Hib3 = Haemophilus Influenzae Type B.
MenC = Meningococcal Disease Group C.
MMR = Measles, Mumps, Rubella.
Uptake, particularly in relation to MMR, falls short of the national target of 95%. I am concerned about the unsatisfactory immunisation uptake rates in childhood immunisations because of the risk of non-immunised 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.
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 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 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.
On a positive note, since the introduction of the national immunisation programme against group C meningococcal disease in October 2000 there has been a dramatic reduction in this disease in Ireland. The aim of this programme was to immunise all children and young people up to the age of 22 against the disease. Data provided by the NDSC indicates that between January and September 2004 five cases of the disease were notified compared to 121 cases in the same period in 2000, a reduction of 96%. This represents a very significant reduction and highlights the importance and success of the campaign.
The health board CEOs established a national immunisation steering committee 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 steering committee was assisted by four working groups, which examined the following areas in relation to immunisation: (a) communication; (b) materials management; (c) IT systems; and (d) planning and organisation.
The report of the steering committee was launched in April 2002. This report is an important step towards improving immunisation uptake and also enhancing and developing the key systems which underpin the immunisation programmes. In July 2003, a national immunisation implementation group was established and is responsible for co-ordinating the planning and implementation of immunisation programmes in order to improve uptake. This group reports to the national steering committee.
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 HeBE specifically for regional and localised projects which will focus on measures to improve immunisation uptake.
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 e.g. 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.
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.
