Measles outbreak and MMR vaccinations: live webchat with Department of Health director of immunisation Professor David Salisbury, Tuesday 9 April, 2-3pm

[GeraldineMumsnet]

In light of the measles outbreaks in South Wales and higher than average levels of measles in some areas of England, and concerns reflected in MNers' discussions, we've invited Professor David Salisbury, the government's director of immunisation, back to MN to be our webchat guest tomorrow, Tuesday 9 April, at 2pm.

Please post any questions you have about the MMR vaccine for your children, or yourself, to Professor Salisbury.

Thank you.

lily my dd1/2 both had measles despite MMR and GP said they had milder versions as they had some immunity but not fully. Dd2 was still quite ill ( avoided hospital though) and has hearing problems from it.

lily missed a bit off my last post ! They were both tested for measles so think yours might have been a GP decision rather than DoH saying don't test.

So DoH my question can be, is testing for measles (and other such diseases) compulsory for GPs is a patient shows signs? And if not then why not?

My baby is now 6 months so no longer has my protective antibodies but is too young for the vaccine. What advice is there for those with infants in the 6 month to one year bracket?

My DD2 is almost 12mo. She has not yet been 'called' for her MMR vaccine. I'm pretty sure that she's due for it at 13mo, so May this year.

Can I have her vaccinated asap? Phoned the GP's surgery yesterday but the receptionist said no need as there hasn't been a call in our area to bring vaccinations forward.

I don't want to wait until there's an outbreak for it to be bought forward, though.

How many of the cases in the latest outbreak are in vaccinated (partially and as oer the latest schedule) people? (I know it has been asked but didn't want it to get missed.)

Has the DoH investigated whether this outbreak is due to low vaccination rates or a dodgy batch of vaccine? How many of those who have caught the disease have been vaccinated? Newspaper reports say there are 7,000 children who are unvaccinated, I guess that figure has dropped to nearer 5,000 with the panicky vaccination clinics.

Why can't the NHS offer a choice and ensure better training for GPs to discuss vaccinations and vaccination schedules from a dispassionate standpoint? Surely it would be cheaper in the long run?

We are due to go away soon, I have a 6 month old baby. We are currently not in an outbreak area but am worried at the airport/ on the flight at our destination there is more chance for a mix up of population and exposure.

what can i do ?

I never had the measles infection but I am also not vaccinated.

Would you recommend immunisation also for adults who are un-vaccinated and never had measles?

what is the age range of those affected by the swansea outbreak? and what are the breakdown stats of those affected by age bracket (eg 0-5 years, x number affected, 5-10 years y number affected, and so on)

also what is the vaccinated vs unvaccinated ratios (asking this again as am sure it will be overlooked)

given that the efficacy of the vaccination has turned out to be far from what was first touted ('one vaccine for life') - first one 'booster' needed. now sometimes 2 - why is there no routine titre check for mmr immunity pre-puberty (mumps and measles both much more serious as adults, a rubella check for girls before child bearing age would also be wise)?

Another one here who would like to know if my DS, aged 2.5 should have his booster jab early? We are not in the outbreak area but are close to it, and intending to travel to Pembrokeshire in May, where there are also cases.

why is there such a reluctance to test for measles and mumps? (the actual illnesses)

dd2 had mumps last year. it is a notifiable disease, so surely if a child attends a GP, presenting with all the symptoms of mumps, then it should be routinely tested for? I had to push and push, remind the GP that mumps is notifiable (and therefore it is his duty to rule it in or out, and, erm, notify as pr DoH policy), and he was still reluctant to test.

half od dd2's school year had been off with the same illness, so the mumps results for our region last year are certainly skewed to say the least (as far as I am aware she was the only child tested for mumps). It is also ridiculous that I had to push so hard, given that dd2 is unvaccinated - it was clear as anythign that she had mumps.

I also know of 4 families whose children have had 'measles-like virus', when presenting with measles symptoms (this is years ago, not related to current outbreak) - yet not tested to check whether measle sor not. again, if it is suspected, surely the doctor has a duty of care to actually test for it? given that it is a notifiable disease...

so, why are so many doctors so reluctant ot test for these illnesses, and how can you be so sure DoH figures on disease rates are accurate, given this state of affairs?

Can you explain how herd immunity works for vaccination when some vaccine effectiveness wanes over time, what about the older population who were vaccinated decades ago, are they still protected and how does that affect herd immunity?

Hello

I have in my hands a letter dated 22 May 2001, from a member of the Immunisation and Communicable Disease Team' (in reply to me contacting them) which says:

...but can I first clarify in a little more depth the licensing position of the monovalent measles and mumps vaccines. Can I assure you that the Government has not removed any of these licenses. In fact there are 4 extant measles vaccine licenses and one extant mumps vaccine license. The companies that hold these licenses have told the Department of Health however that they are not making or marketing to the UK vaccine which matches these extant licenses. Therefore the measles and mumps vaccines currently being imported into the UK are unlicensed. Like any unlicensed medicines, the availability of these unlicensed vaccines is restricted under the Medicines Act. If manufacturers of these products wish to apply for licenses they are free to do so'.

Obviously the details may have changed in the intervening 12 years but is this broadly speaking still the case?

Secondly. And I guess this is more a comment the letter goes on to say:

Finally, the evidence does not support your assessment that 'confidence in the vaccine (this is the MMR) is extremely low'. Although this may be your perception among the mothers you have contact with, it is generally not the case. Currently 88% of children are immunised with MMR by the age of 2. Twice a year we conduct a representative survey of 1,000 parents of children under 3 to understand their attitudes towards immunisation, including experience of their most recent immunisation visit. This research is vital in understanding whether a media scare story is having a real impact on parents. The research, the most recent wave of which was conduct (sic) in March, showed a small fall in parental confidence, as is understandable given the coverage of the issue in January and February, but nothing more.

Given that that letter was written three years after the press conference (and 88% seems to be being presented a high vaccination rate demonstrating confidence in the vaccination) why is Wakefield often blamed 12 years after that letter was written?

Oh and finally - when quoting measles vaccination rates it would be helpful to include numbers of children who have received single vaccinations, as given the high numbers now vaccinated with MMR, adding in the singles may well show that 95%+ coverage for measles vaccinations has been reached in many (most?) areas.

Oh and I agree with silverfrog's questions. I did see a report - (can't find it now but it was on the BBC website or in a broadsheet which said that 75% of those catching measles in the current outbreak were unvaccinated. I'd be interested in knowing more about the 25% who had been. Were they teenagers? Were they young adults? Had they had one dose or two? I was surprised by the figures (although must state haven't been able to independently verify them anywhere).

Sorry that's two questions, but it's the same as silverfrog's really.

Can you explain herd immunity when the rate of measles infection fell drastically when vaccination rates were only 20 - 50% in the 70's. Way before the 'magic' 95%. Could lack of reporting and misdiagnosis affect this?

So should parents who now are bombarding doctors sugeries to get vaccines for their children, whom they previously deprived of it not be prosecuted for abuse and neglect.

Hi, Our son is 4 and hasnt had the MMR as his older brother was really ill after it. He started suffering febrile convulsions and was put on anti-epilepsy drugs which then made his platelets too low. When his blood was tested to see if he needed the booster, his levels were still very high? We are terrified to go through this all again with our 4 year old but also are terrified of him getting measles. Would we be better to have the single vaccine for measles? Does being that much older now (4 as opposed to 18months) make it less likely he will suffer any reactions? PLEASE HELP AS WE ARE REALLY WORRIED X

Lily -same thing happened to me. DS1 showed the signs of measles - the rash came up in the correct order & he had a cough etc. I was told to go to OOH (and then told to wait in a busy waiting room until I complained when I was told to wait in a sideroom with a baby :face palm: ). When we saw the doctor he said it couldn't be measles as ds1 had been vaccinated against it. No testing was carried out and the only explanation for it not being measles was the vaccination history - not that it didn't look like it or anything.

Yes sympathy to those affected bot what about those being affected now?

Lot of bandwaggoners jumped on that train but who's paying now?!

can I second saintlyjimjams' question please? I find it very disappointing (from a very pro-vaccination perspective) that neither PHW nor HPA are publishing systematic figures detailing age groups and vaccination coverage per age group. Also, it would be great to see the complications detailed (if just to counteract the claims that measles are really a "harmless, get on with it" kind of disease). The delays to (potential) publication in Eurosurveillance are months in the best of circumstances and do little for public confidence in the use of the MMR.

In 1988, ten years before Dr Wakefield raised a red flag, the vaccine policy-makers knew 2 of the 3 original brands carried a risk of meningitis and the third brand was linked with neurological complications. One of the first infants, an eighteen month old toddler vaccinated with MMR, started with severe convulsions and subsequently died during a seizure. This child was one of a number of children awarded Government recognition of vaccine-damage through DWP vaccine damage payments. Why did it take four years to withdraw brands known to cause meningitis even before they were introduced?

What steps did your department take to investigate every child that had been given these vaccines to determine if any others had suffered long term harm or died in similar circumstances to this child?

I'm also interested in the issue of waning immunity. Both of my sons have reported cases of mumps among students at their universities. Clearly not the best time for males to be contracting this disease.