Record measles outbreak triggers national jab campaign

A national catch-up programme to increase MMR vaccination has been launched in England after measles cases hit record levels.

Measles: national MMR campaign launched (photo: SPL)
Measles: national MMR campaign launched (photo: SPL)

Public Health England (PHE) and NHS England, working with GPs and local authorities, are targeting a million children for vaccination by September.

GPC leaders are negotiating with NHS England to determine GPs’ exact role, and funding arrangements.

Latest figures from PHE show confirmed cases reached 587 in the first quarter of 2013, following a record annual high of almost 2,000 in 2012.

GPs have been responding to the biggest measles outbreak for 18 years with over 900 cases of reported in south Wales and the north east of England.

The new PHE figures confirm the north east and north west of England as hotspots for the illness.

Officials linked the outbreak to poor uptake of the MMR vaccine in the early 2000s, following the now discredited claims linking MMR and autism.

Dr Paul Cosford, director for health protection at PHE, said the plan was to increase MMR coverage in older children to reach the levels in younger children by September.

The catch-up programme will will have three components:

  • An urgent, targeted communications strategy pushing young people towards primary care.
  • A rapid, active programme to identify and vaccinate un-vaccinated and partially-vaccinated 10- to 16-year-olds including through GP registers.
  • A sustained longer-term intervention to strengthen routine approaches, specifically targeting vulnerable and under-served populations.

PHE estimated there were a 'third of a million' unvaccinated 10- to 16-year-olds, the same number who had only had one vaccination, and another third of a million outside that age group requiring vaccination.

NHS England’s head of primary care, Dr David Geddes, told GP that while primary care would be the bedrock of the immunisation programme, GPs should not see a significant increase in workload because of the centrally co-ordinated, multi-agency approach planned for the campaign.

He said the significant work would be done through a communications campaign: ‘Injecting somebody, in reality, isn’t the issue. It’s the consent bit, the information bit. I think it's about ensuring this is a health community response, not all down to primary care.’

Rather than practices having to chase unvaccinated children, Dr Geddes said, the workload would be nationally co-ordinated.

Professor David Salisbury, director of immunisation at DH said the overall cost of the programme would be around £20m, but because GPs would be paid to vaccinate children who had not been previously vaccinated the funds were already in the budget. And the same was true for the cost of vaccines.

NHS England’s immunisation budget, which normally pays GPs for MMR vaccinations, will be used to pay for increased demand, and contingency funds are to be made available for demand not covered by contracts.

Dr Geddes said NHS England was discussing with GPC arrangements to fund GPs for work not covered by contracts.

GPC chairman Dr Laurence Buckman said negotiations over funding, workload and GPs’ precise role were ongoing, but that there was ‘plenty to be clarified’.

Dr Cosford said: ‘It’s fair to say we already have these services in place. GPs are vaccinating teenagers who come forward,' he said. Dr Cosford added that GPs were already doing a ‘huge amount’ and the catch-up programme aimed to build on that work.

He said NHS England was discussing how to use GP registers to identify unvaccinated children. Other than routine GP appointments, he said, services would be determined by local circumstances and coordinated by NHS England's area teams.

Professor Salisbury said the the situation in Swansea should be a ‘wake-up call for parents who a few years ago chose not to vaccinate their children’.

He said the catch-up programme should stimulate demand for vaccination from young people and parents.

‘The message is very simple,' he added. ‘If you don’t believe you have had two doses of MMR, or that your children have had two doses of MMR, make an appointment with your GP.’

Dr Buckman said he was pleased the programme had been launched: 'For it to be successful Public Health England, local authorities, NHS England and GPs need to work together. This is the first big test for integrated working between these organisations since the NHS was restructured and it is important that we make it a success.'

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