The Department of Health is making extra supplies of the combined measles, mumps and rubella (MMR) vaccine and new funds available to help all English NHS primary care trusts offer to vaccinate every child up to the age of 18 against measles.

Sir Liam Donaldson, Chief Medical Officer, is asking PCTs to help reduce the risk of a measles epidemic by offering the MMR vaccine to every child up to the age of 18 who has not been vaccinated. He also encourages them to target campaigns at the parents of unvaccinated children.

Rising incidence of measles
The number of cases of measles in England is rising, following ten years of relatively low vaccine uptake. In 2006 and 2007 there were 1,726 confirmed cases in England and Wales - more than the 1,621 confirmed cases from 1996 to 2005. Measles causes meningitis in 1 in 1,000 cases, and death in 1 in 2,500. In 2006, the first death from measles for 14 years in the UK occurred. The WHO recommends that 95% vaccination rate of the popoulation is needed to acghieve 'herd' immunity: in 2006, English rates stood at 86% and 72.5% in London.

The DoH estimates that around three million children aged 18 months to 18 years have missed either their first or second MMR vaccination. Scientific advice from both the DH and the Health Protection Agency suggests that levels of MMR immunisation need to be increased urgently.

New money for the campaign
The DoH will provide PCTs with extra supplies of the MMR vaccine, information materials and additional (new) funding. An average PCT will receive additional funding of £30,000 – in London, the sum will be £60,000 to reflect the lower rates of vaccination uptake.

Professor David Salisbury, Director of Immunisation at the DoH, said, “parents who have not had their children vaccinated with the MMR vaccine should do so now. The evidence on MMR is absolutely clear - there is no link between the vaccine and autism. The MMR vaccine coverage is not high enough to remove the threat of recurrence of measles outbreaks. Measles is serious and in some cases it can be fatal. Delaying immunisation puts children at risk."

Estimates suggest that a measles epidemic in Britain could result in 30,000 cases, or in a worst case scenario more than 100,000 cases of measles in children and young people. These children and young people will also be susceptible to mumps and rubella.

Why the drop in vaccination?
The questionable distinction of responsibility for the fall in vaccination belongs to Dr Andrew Wakefield, the doctor whose 1998 paper in The Lancet first suggested a causal link between the MMR vaccine and autism and bowel disease. Dr Wakefield is currently charged with professional misconduct by the General Medical Council, which he denies.

The GMC’s charges relate to failure to get proper ethical approval for Wakefield and colleagues’ research; to carrying out procedures on children that had not been sanctioned by the ethics committee; to recruiting to their study children who, on the basis of their behavioural symptoms, did not quality; to failing to tell The Lancet how they recruited patients and in Dr Wakefield’s case, to failure to declare a potential conflict of interest due to expert witness fees he was receiving from parents’ groups concerned about their children’s autism.

In 2007, The Lancet publicly announced it should never have printed the study. No researchers anywhere else in the world have been able to replicate Wakefield’s findings, and he has refused offers to collaborate on corroborative studies.