Mark Drakeford, Minister for Health and Social Services
I wrote to you on 16 April to provide an outline of the actions being taken in Wales in response to the current outbreak of measles centred in the Swansea area. I would like to provide a further update on the latest position.
From the start of the outbreak in November 2012 to 16 May 2013, there have been 1,105 cases notified in the outbreak area with 1,292 cases notified across Wales. There have been 87 hospitalisations.
There are indications that the number of notifications from the Swansea area is slowing down and there may be grounds for cautious optimism in respect of numbers of cases from this area over the coming weeks. However, it would be premature to say that the outbreak is over, as there remain significant proportions of susceptible people in all areas of Wales. There is particular concern for the Gwent area, where there have been over 100 reported cases since November and MMR uptake in the hardest hit age group, 10 to 18 years, is still too low to prevent future outbreaks.
Local Health Boards and Public Health Wales are therefore continuing to work together to maintain public awareness of the importance of the MMR vaccination and to offer opportunities to access the vaccine. The response to date has been very encouraging with more than 52,000 non-routine MMR vaccinations being given across Wales since March 2013. These vaccinations have been delivered through a range of settings including GP surgeries, community based drop-in clinics and schools. The school based programme has been implemented throughout Wales and is due to be completed this month. In addition over 1,600 prisoners and over 4,500 healthcare staff have received MMR vaccinations since March. This is a remarkable achievement and my appreciation goes to parents and children, everyone in the NHS, schools and elsewhere who has enabled this to happen.
These efforts across Wales will, in all probability, reduce the length and severity of the outbreak. This is supported by recent modelling work carried out by Public Health Wales. However, the number of unvaccinated people, particularly in the hardest hit 10 – 18 age group remains a cause for concern
The current outbreak reinforces the Programme for Government’s commitment to increase MMR uptake. The only way to prevent future outbreaks is to ensure that at least 95% of children in Wales have received two doses of the MMR vaccine. Figures from Public Health Wales (COVER report Quarter 4, 2012) show that for Wales as a whole, uptake of the first dose of MMR was 94.3% at two years of age and uptake of the second dose at five years of age was 89.9%. Data for Quarter 1, 2013 is currently being collated and it is anticipated that Wales may achieve its highest levels of uptake of MMR in recent years; it will hopefully mean that the 95% uptake target at two years of age will be reached very soon across Wales. This will bring great protective benefit to the future health of the population.
Two useful studies have been undertaken by Public Health Wales into aspects of the outbreak which will help to inform on improving future uptake. In one, emerging data from the Swansea outbreak area shows that two doses of the MMR vaccination has been more than 99% effective in preventing infection, with fewer than 10 confirmed cases in people who have previously been vaccinated. The data also suggest that one dose of MMR vaccine has shown to protect against measles in more than 95% of cases vaccinated – higher than previous experience.
In the second study, a telephone survey has been carried out of parents in the Swansea area who have not provided consent for their children to receive the MMR vaccination to establish why those who have been invited to clinics have not attended. Analysis of the feedback from this study will assist in understanding and addressing any barriers that parents may have to their children having the MMR vaccine.
The Welsh Government, Public Health Wales and the Health Boards will continue to take all appropriate actions to reduce further the impact from measles across all age groups until the numbers of susceptible individuals are minimised. It is important that we all take every opportunity to reinforce the importance (and safety) of MMR vaccination and that it protects against mumps and rubella as well as measles. I would appeal to young people and parents of children who are still not fully vaccinated to contact health professionals to get their child vaccinated. Measles is not a trivial illness and in a minority of cases, it can lead to serious complications and it can be fatal. The longer the relatively low levels of protection against measles continue, the more cases will result and the more likely these outcomes become. It is vital we build on the solid progress made so far to bring the outbreak under control.