Britain is facing a measles outbreak that could quickly spread across the country after a surge of cases was discovered in the West Midlands last week. More than 300 confirmed and probable cases have been reported there in recent months and the prospect of further outbreaks appears worrying.
Measles mainly affects children and can cause serious illness, complications and sometimes death. It is also one of the most contagious conditions known to medicine. One infected person can transmit the disease to nine out of ten unvaccinated close contacts.
In itself, such contagiousness would not be a problem – in a well-vaccinated population. Unfortunately, this description no longer fits the citizens of Great Britain. Measles vaccination rates have fallen in Britain in recent years. Those who have received double doses of the MMR vaccine – which provides strong, safe protection against the virus – have fallen to well below 85% of people in many areas, including the West Midlands. To achieve herd immunity against measles, about 95% of the population must have had the vaccine, doctors warn.
The West Midlands is also not an isolated problem area. In London, up to 20% of children now go to school without ever having 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’ analysis is an understatement, to say the least. The country is facing the return of a very serious, sometimes fatal disease. Yet it was only eight years ago that the disease was announced to have been eradicated from Britain. Its return raises urgent questions. How could this decline in vaccinations occur? And what needs to be done to restore the country’s previous resilience to the disease?
It can be tempting to shift the blame to anti-vaxxers, those misguided fanatics who believe vaccines pose a health risk and who loudly promote their cause on social media. However, such an argument would be lazy and dangerous. Very few people accept the arguments of anti-vaxxers, and research has made it clear that the majority of men and women in Britain believe vaccines are safe and effective. However, many families lead complex – often chaotic – lives and sometimes fail to ensure that their children are vaccinated. They need reassurance about the importance and safety of immunization and the actions needed if they have missed vaccination appointments. It is actually never too late to get vaccinated, but that information is not always clear.
Asking questions about vaccination should be encouraged, but trained staff are needed to provide this information, and the NHS and GPs are already under pressure and facing cuts to both funding and staff. It is at this level that the nation is faltering.
In England, the NHS recently published a strategy to improve vaccination services, including proposals to provide more flexible and convenient facilities where they can be managed. It was a welcome development.
The proposed implementation date for this improvement scheme was less encouraging: 2025-2026. This represents a two-year gap that completely disregards the dire situation facing the nation. It is up to ministers and senior health officials to bring a new sense of urgency to the implementation of the strategy and to provide the right resources to ensure its fulfillment. Failure to do so would endanger many lives. Like Prof Andreas Pollarddirector of the Oxford Vaccine Group, has put it: “The clock is ticking to get children who have missed doses vaccinated before this virus is fatal.”