Following the news that the UK has succeeded in eliminating measles, Dr Emma St Clair Pearce, the ABPI’s newly appointed Research and Collaboration Policy Officer, writes that while the UK’s success of limiting the spread of the virus through vaccination should be heralded, national figures for MMR vaccine uptake show we should still prioritise maintaining and improving coverage.
Measles is a highly contagious infectious disease with potentially serious, if not fatal, complications. The UK's success in eliminating measles brings the total number of European countries to 33, out of a possible 53, that have now achieved measles elimination status, defined as the virus no longer spreading through the population for a period of at least three years.
This is very encouraging progress towards the global elimination of this entirely preventable infectious disease; however, this statement by the WHO should not be misconstrued.
The UK has not wiped out measles but has instead managed to limit the spread of the virus through widespread vaccination. Vaccination is known to be one of the most effective public health tools for both controlling and preventing infectious disease outbreaks; In a 2008 report the UK's then Chief Medical Officer, Sir Liam Donaldson, estimated the value to society of the NHS immunisation programme at £6.6 billion per year.
In the UK, the measles, mumps and rubella (MMR) vaccine is part of the routine vaccination schedule. Since the introduction of the MMR vaccine in 1988, all three infectious diseases are now relatively rare in the UK.
This, however, is not the end of the story. The national coverage figures for MMR vaccinations across the UK has shown a steady, albeit small, decline over the past few years. To protect a population against an infectious disease, the WHO recommend that 95% of the population should be vaccinated.
In the case of the MMR vaccine, two doses are required to be fully protected. Whilst the UK met the WHO target for 95% of children having received the first MMR dose by their fifth birthday last year, only 89% received the second dose and were therefore fully protected.
This comes at a time when measles cases are rising in European countries, with recent large outbreaks in Italy and Romania.
In the UK last year, over 500 cases of measles were reported, a five times increase in the number of cases compared to the previous two years, demonstrating the current need for high MMR vaccination coverage.
The impact of falling vaccination rates was made clear with the recent measles outbreakin the UK in 2013. This outbreak was mostly linked to children who had not received the MMR vaccine during their childhood due to an unsubstantiated scare about the vaccine.
With over 11,000 measles cases reported in Europe this year so far, alongside regular travel abroad and falling MMR vaccination rates, measles may well make a comeback. The general public should be reminded that measles is not a mild illness and can be associated with severe complications, including vision loss or meningitis.
This is not the time to become complacent about vaccination. Instead, we should be working on improving vaccination rates in children, catching up older children and adults who had previously missed out, and working toward eliminating other diseases through focused vaccination programmes.