Britain is facing a measles outbreak that could soon spread through the nation after a surge in cases was uncovered in the West Midlands last week. More than 300 confirmed and probable cases have been reported there in the past few months and the prospect of further outbreaks looks worrying.
Measles predominantly affects children and can cause severe disease, complications and occasionally death. It is also one of the most highly contagious ailments known to medicine. A single infected person can pass on the disease to nine out of 10 of their unvaccinated close contacts.
On its own, such infectivity would not be a problem – in a properly vaccinated population. Sadly, this description no longer fits the citizenry of the UK. Measles vaccinations have slumped in Britain in recent years. Those who have been given double doses of the MMR vaccine – which provides powerful, safe protection against the virus – have dropped to well below 85% of individuals in many areas, including the West Midlands. To achieve herd immunity against measles, about 95% of the population needs to have had the vaccine, doctors have warned.
Nor is the West Midlands an isolated problem area. In London, up to 20% of children are now entering school having never been vaccinated, Prof Dame Jenny Harries – head of the UK Health Security Agency – revealed last week. As she put it: “Vaccination coverage is clearly not where we want to be.”
Harries’s analysis is an understatement, to say the least. The nation is facing the return of a very serious, occasionally lethal ailment. Yet only eight years ago it was announced that the disease had been eliminated in the UK. Its return raises urgent questions. How did this slump in vaccinations occur? And what needs to be done to restore the nation’s past resilience to the disease?
It might be tempting to pin the blame on anti-vaxxers, those misguided zealots who believe that vaccines pose a risk to health and who promote their cause vociferously on social media. Such an argument would be lazy and dangerous, however. Very few people accept the arguments of anti-vaxxers, and research has made it clear that the majority of men and women in the UK believe vaccines are safe and effective. However, many families lead complex – often chaotic – lives and sometimes fail to ensure their children are vaccinated. They need reassurances about the importance and safety of immunisation and the actions that are needed if they have let vaccine appointments slip. In fact, it is never too late to be vaccinated, but that information is not always clear.
Asking questions about vaccination is to be encouraged, but trained staff are required to provide this information, and the NHS and GPs are already under pressure and facing cuts both in funding and in staff. It is at this level that the nation has faltered.
In England, the NHS recently published a strategy to improve its vaccination services, including proposals to provide more flexible and convenient facilities where they can be administered. It was a welcome development.
Less cheering was the proposed implementation date for this improvement scheme: 2025-26. This represents a two-year gap, which completely fails to recognise the predicament facing the nation. It is incumbent upon ministers and senior health officials to bring a new sense of urgency to the strategy’s execution and provide proper resources to ensure its fulfilment. A failure to do so would put many lives at risk. As Prof Andrew Pollard, director of the Oxford Vaccine Group, has put it: “The clock is ticking to get children who have missed doses vaccinated before this virus kills.”
