Fear of measles epidemic as jab rate drops

Children returning to school after the Christmas holidays could fall victim to an outbreak of measles for the first time in a decade, because of low uptakes of the MMR jab.

Large numbers of parents have not had their children immunised after fears that the combined measles, mumps and rubella jab is linked to autism and bowel disease.

The World Health Organisation recommends that 95% of children be immunised against measles to guarantee protection of the entire population. In the UK, 88% of children have been immunised and this figures drops to 75% in some areas.

Public health officials warned yesterday of the seriousness of the situation, stressing that Britain could again see children dying of a preventable childhood infection.

The fall is most serious in London and the south-east. The latest figures collected by the public health laboratory service (PHLS), up to June last year, reveal that in six London boroughs less than 80% of children under two have had their first MMR jab. In Croydon, only 74% have been vaccinated. In Kensington, Chelsea and Westminster, Lambeth, Southwark and Lewisham, only 76% have had their first MMR. In Berkshire, 79% of two-year-olds have been immunised.

The figures for the first MMR jab are higher than for the second injection, which is given shortly before a child starts school. Most children will have immunity after the first dose, but some will not. Only 61.5% of five-year-olds in London have had the second jab. Trent, the south-east and the north-west of England are all on around 74%.

An epidemic of either measles, mumps or rubella is now possible. In the Netherlands, the disease rampaged through a community which refused to vaccinate its children. There were 1,750 cases and three children died. Ireland, where vaccination has dropped below 80%, is experiencing its worst measles outbreak for seven years, with 1,220 cases so far and two deaths.

Parents' worries stem from research carried out at the Royal Free hospital in London. A group of scientists, led by Andrew Wakefield, have spent years in pursuit of their theories that there are links between bowel disease, autism and the measles virus. The crucial paper raising the possibility that the vaccine was to blame, published in the respected medical journal the Lancet in February 1998, caused uproar in the public health community and received wide publicity.

A group of experts convened by the Medical Research Council at the request of the chief medical officer, then Sir Kenneth Calman, studied the Wakefield research, interviewing the scientists and looking at their source material. They found no evidence to implicate the MMR jab in either bowel disease or autism.

But the scare took hold and vaccination rates dropped. The first generation of children not immunised before their second birthday three years ago are now starting school, and the PHLS is urging parents to get then vaccinated.

Brian Duerden, medical director of the PHLS, said: "This is a serious situation. We have to do all we can to convince parents that the MMR jab is safe. We have a safe vaccine which we have looked at in detail because of concerns that were raised and we have found it is not linked to these side effects people are worried about.

"The government is well aware of the problem we are facing and is determined to educate people about the importance of having the vaccine, and quite rightly so."

Some parents have asked GPs for single doses of measles vaccine for their children, instead of the combination, but the government is against this. It argues that the triple jab is just as safe and more efficient.

Some 2,000 families are contemplating legal action against the vaccine manufacturers.

The worries do not seem to have taken root in Scotland, however. Statistics show that 93% of children had been given the vaccine by their second birthday.