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MEASLES


NHS LOTHIAN’S MMR UPTAKE FIGURES ARE CONSISTENTLY HIGH AND YET THE BOARD RECENTLY EXPERIENCED A MEASLES OUTBREAK. HOW CAN THIS HAPPEN?


MEASLES OUTBREAK D


espite having MMR


immunisation uptake of 95.3 per cent at 24 months and


97.6 per cent at fi ve years of age, NHS Lothian recently experienced an outbreak of measles: an outbreak which was said to be centred on the University of Edinburgh.


As a result, the university’s students were urged to ensure they were fully vaccinated against what is a potentially fatal disease.


At its height, the outbreak saw 17 cases of the disease confi rmed in the city, with most connected to the university, where a clinic was set up on campus to give students the MMR vaccine.


Even in today’s world, measles remains a highly infectious virus. Before immunisation was widely available, half a million children in the UK caught measles each year, with 100 dying from it annually.


According to World Health Organization, in 2008, there were 164,000 measles deaths globally – nearly 450 deaths every day, or 18 deaths every hour.


The only way that measles can be prevented is by immunisation.


BACKGROUND TO MMR


To date, more than 500 million doses of MMR vaccine have been used in over 90 countries since the 1970s. By the time it was introduced to the UK in 1988, it had already been in use for many years in other parts of the world. The practical experience of tens of millions of MMR doses showed that it was highly effective and very safe.


More than ten years ago, controversy surrounded the vaccine, when reports based on a study published in the Lancet by Wakefi eld et al, reported on twelve children with gasterointestinal problems and behavioural symptoms (similar to signs of autism), which, it suggested, were linked to the MMR


10 - SCOTTISH PHARMACIST vaccination.


Perhaps unsurprisingly, panic spread among parents of babies who were due to have their vaccinations, but it wasn’t until 2004 that ten of the thirteen co-authors of the paper published a statement retracting the interpretation of the study.


OUTBREAK IN NHS LOTHIAN


So why should a measles outbreak occur in the 21st century when MMR uptake is so high – particularly in an area such as NHS Lothian?


About this release


Well, according to NHS Lothian, in all the recent Lothian cases, the individuals had not completed the full course of measles vaccine.


LATEST STATISTICS: Main Point


According to the latest statistics from Information Services Division Scotland, rates of childhood immunisations continue to be high across Scotland in the quarter ending 30 June 2016 in Scotland, ranging from 92.8 per cent to 98.3 per cent across the different age bands and vaccines.


 Rates of childhood immunisations continue to be high in the quarter ending 30 June 2016 in Scotland, ranging from 92.8% to 98.3% across the different age bands and vaccines.


Primary and booster immunisation uptake rates by 24 months of age in Scotland, by quarter


Information Services Division Publication Summary


Subsequent scientifi c research has concluded that MMR does not cause autism.


Childhood Immunisation Statistics Scotland Quarter ending 30 June 2016


‘It is crucial,’ said Professor Alison McCallin, Director of Public Health and Public Policy at NHS Lothian, ‘that people have two doses of the MMR vaccine. Children and young people may have missed out on one or two doses when they were younger and we would urge parents to get their child or children immunised with MMR. We would also encourage young people who have missed out on MMR previously to get themselves immunised.’


Publication Date – 27 September 2016 TIMETABLE FOR VACCINE


MMR is currently offered to a child at between twelve and thirteen months of age after the immunity a baby gets from its mother fades.


But it is the second dose of the MMR vaccine that gives the best level of protection to the most number of children. After the fi rst dose, between fi ve and ten per cent of children are not protected against each of the


diseases because their immune system has not responded to the vaccine. After two doses of MMR, less than one per cent of children are left unprotected against measles.


This second dose is usually given at the same time as other routine childhood immunisations – usually when a child is aged around three years and four months.


Teenagers who haven’t had two doses of the vaccine are also offered the MMR vaccine during their routine teenage immunisations at school.


Although normally given at these times, if the MMR vaccine is missed, it can be given at any age.


This publication from Information Services Division provides a quarterly update of immunisation uptake rates for children at 12 months, 24 months, five years and six years of age, by NHS Board and local authority. Vaccination programmes for children in Scotland aim to both protect the individual child from many serious infectious diseases and to prevent the spread of disease within the wider population.


As a result of the recent NHS Lothian outbreak, the board has now encouraged people to ensure they are fully immunised against the virus, ie, to ensure that they have had two doses of the vaccine. •


Key: DTP/Pol/Hib = The 5-in-1 vaccine which protects against diphtheria, tetanus, pertussis, polio and Haemophilus influenzae type b (Hib), MMR1 = Measles, mumps, and rubella vaccine (1st dose), Hib/MenC = Hib/MenC booster vaccine, PCVB = Pneumococcal conjugate vaccine booster.


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