We need to increase MMR vaccine uptake urgently: expert

Professor Helen Bedford at UCL Great Ormond Street Institute of Child Health and Helen Donovan at the Royal College of Nursing, say two doses of MMR vaccine are necessary for optimum protection and 95% vaccine coverage is required to prevent outbreaks. “Even a small decline in MMR vaccine uptake can herald disease outbreaks,” they warn.

We must improve vaccine uptake by ensuring all parents are aware of its importance. There is no upper age limit for MMR vaccine, so this extends to unvaccinated young people and young adults.

The latest data for July to September 2021 reported 88.6% uptake of the first dose of MMR at 24 months, with 85.5% uptake of two doses at five years– a decline on previous quarters, they explain.

The Office for Health Improvement and Disparities (OHID) have launched a campaign to increase uptake of MMR vaccine in England, in response to the decline in uptake.

Despite a lack of evidence, the decline in uptake has been blamed on COVID ‘vaccine fatigue’ among the public.

COVID-19 vaccines have been shown to be highly effective in protecting against severe disease, but less effective at preventing transmission, which may have impacted on parents’ perceptions of the effectiveness of routine childhood vaccines, they explain.

Also, parents were reported to have interpreted the March 2020 lockdown instructions to “stay at home” as vaccine services not being available. Research also identified parents’ concerns about overstretching the NHS.

Successful vaccine programs can be a victim of their own success, they suggest. In the absence of disease, their seriousness can be forgotten with vaccination seeming unnecessary. They note that almost half the 2000 parents of young children recently surveyed were not aware that measles could result in serious complications.

Yet, as a sharp reminder, between 2018-2020, nine children and adults died from measles in England and Wales.

Although the focus of the current campaign is measles, we must not forget mumps and rubella. A cohort of young adults who did not receive MMR in childhood may remain unprotected against rubella.

The dramatic fall and subsequent return of vaccine confidence following the 1998 MMR vaccine safety debacle, demonstrated that recovery is achievable. A survey of 600 parents of young children conducted in August 2021, over 95% agreed that vaccines were important for their child’s health.

“We must build on this confidence to prevent the re-emergence of these potentially devastating infections,” they conclude.

More information:
Opinion: We need to increase MMR uptake urgently, The BMJ (2022).