People have ‘forgotten’ the risks of measles, top children’s doctor says

Dr Ronny Cheung, officer for health services at the Royal College of Paediatrics and Child Health (RCPCH), warned that measles will “at best will cause children great discomfort and at worst deaths” and the virus is “almost entirely preventable” with the measles, mumps and rubella (MMR) vaccine.

Official figures show that uptake of the vaccine is at its lowest point in over a decade.

In 2022/23, some 84.5% of youngsters in England had received both doses of the jab by the time they were five years old – the lowest level since 2010/11. Some 92.5% had received one dose.

Dr Cheung, a general paediatrician, said that a combination of factors could be behind the low uptake, but parents are less likely to report concerns linked to a 1998 report by Andrew Wakefield linking it with autism.

The claims have been discredited and Wakefield struck off the medical register but there have been lasting effects in vaccine uptake rates.

He said parents were more likely to report wider concerns or say that they were unaware that they could catch up on vaccines if they had missed the initial offer.

“We’re just really keen to make sure people recognise it is safe and successful, and it’s never too late,” he said.

In the West Midlands, there have been more than 300 suspected cases of measles.

Figures released on Monday by the UK Health Security Agency (UKHSA) show there were 198 lab-confirmed cases and 104 “likely” cases between October 23 2023 and January 15 2024.

Four-fifths (80%) have been found in Birmingham while 8% were identified in Coventry, with the rest spread around the West Midlands.

Unvaccinated children who come into contact with the disease are being advised to stay at home for 21 days.

Dr Cheung told the PA news agency: “We have seen pockets of outbreaks over the country in the last year or so – there have been outbreaks in Wales and London – essentially it’s due to the fact that vaccination rates for the measles mumps and rubella (MMR) vaccine have come down and it is the lowest it has been for more than 10 years.

“In a nutshell, it is about vaccination rates.”

He said that more needed to be done to reassure people about the safety profile of the vaccine, adding: “(We need to) reassure people about the benefits and remind people of the potential risks of measles, which I think a lot of people have forgotten about.

“And also to remind people that it’s never too late – if you’ve missed that slot in the schedule you can actually catch it up.”

Asked if the country would see more outbreaks outside of the West Midlands, he said: “I’m afraid to say that we almost certainly will, party because we know that vaccination rates are very low and they are not equally distributed – there are areas where vaccination rates are much lower than others, usually in urban conurbations.

“Also measles is incredibly contagious, so if you have pockets where lots of people are not immunised, you only need a few cases to cause a pretty significant outbreak. So unfortunately this is something that is going to occur.”

He said further outbreaks are more likely in cities and in communities where there are low uptake rates of the MMR jab.

Asked about the reasons behind the dip in vaccine coverage, Dr Cheung said: “In the last 10 years, the conversation has changed a bit, we don’t often hear the Wakefield theories directly anymore in the way that we used to, which is good and bad I think because often now we get a much wider vaccine hesitancy in general… so isn’t necessarily so much pinned on that one case.

“Whilst there is still a bit of hesitancy around actually there are also a significant number of people who say they didn’t know that they could get catch-up vaccines or they don’t know where to go if they have missed that.

“I think we have a lot to do in terms of signposting people to the right place to access it as well rather than just blaming it on vaccine hesitancy.”

He said that there is also an element of vaccine “fatigue” adding: “Some people just don’t want to talk about vaccines any more when we talk about them”.

Dr Cheung added: “It (measles) is almost entirely preventable with the MMR vaccine. Among the childhood vaccinations, MMR is among the most effective and among the safest of the lot.

“It is something that is incredibly safe, it is incredibly effective and it can prevent something that at best will cause children great discomfort and at worst deaths.”

Dr Naveed Syed, consultant in health protection for the UKHSA in the West Midlands, said on Monday: “We are seeing cases of measles rising every day in the West Midlands.

“Uptake of MMR in the region is much lower than the 95% needed to protect the population, which is giving this serious disease a chance to get a foothold in our communities.

“That’s why it’s vital that anyone who hasn’t had two doses of the MMR vaccine by the time they started full-time school gets immunised as soon as possible.”

Helen Bedford, professor of children’s health at UCL Great Ormond Street Institute of Child Health, added: “Measles is a potentially very serious infection.

“About 1 in 1,000 people with measles develop inflammation of the brain and even in high-income countries like the UK, about 1 in 5,000 die from the infection.

“Measles is often more severe in adults.

“Apart from managing the symptoms of measles, there is no treatment.

“There is no upper age limit for vaccination so if you or your loved ones have missed out, now is the time to get that protection. We can stop this infection in its tracks with vaccination.”