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Blog: Is a measles epidemic inevitable?

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I struggled to choose a topic for my first blog. Should I consider the battle against healthcare associated infections (HCAI), the government’s controversial 'bare below the elbow' or 'deep cleaning' initiatives, or the HPV immunisation programme due to start in September 2008?

But what's really taxing me and other communicable disease specialists is pandemic flu, deaths from Clostridium difficile and measles.

Yes, measles is back, and should be a cause for concern. The high number and origin of measles cases means the UK now has enough cases for continued indigenous transmission. So why is the UK seeing a resurgence of measles when world-wide (mainly in the developing countries) measles deaths have fallen by over 60% since 1999?

Since 2006 two young men have died from measles; the first fatal UK cases since 1992. Unfortunately these deaths did not set the alarm bells ringing. These young men were not babies, they weren’t your ‘average’ child; both had underlying medical conditions which placed them at risk.

They should have both been protected by those around them; by the herd immunity. However, herd immunity relies on 95% of the population being immune, and with only 76% of 5-year-olds in UK having had two MMR vaccines, it’s not enough.

Measles is once again a very real risk for the unprotected child in UK. Every child and indeed adult who has not had measles or two doses of measles-containing vaccine is at risk of catching the disease.

There will be those too young to have the immunisation – babies below 13 months, those who have only had one dose of vaccine, including toddlers under three and those who have refused the MMR vaccination.

Confidence in the MMR vaccine is rightly growing among parents. It is arguably the most researched vaccine in the world. Multiple studies with huge numbers of children have failed to find any link between the vaccine and autism; an erroneous link proposed by one study published in 1998; based on only 12 sick children.

Eighteen months ago I wrote about the MMR controversy. I proposed that ‘it may take the deaths of many more babies and young children from measles to prompt resurgence in uptake of MMR vaccine’.

With all my heart I hope this prediction doesn’t come true; there’s still time to prevent it.

A single vaccine for measles is, in my opinion, rightly not available on the NHS, because it is not as good as the combined vaccine, which produces a better immune response.

If vaccine safety is the issue, I challenge anyone to find the equivalent body of evidence pertaining to single measles vaccines as there is for the MMR vaccine.

If you have your doubts about the safety of MMR, read the evidence and educate yourself. Parents and guardians trust you and rely on your opinion, so ensure it’s an educated one.

My plea to you all is – please check if the children in your care are fully protected against measles, and champion the MMR vaccine with their parents and guardians. You could quite literally save a life.


MacDonald PF (2007). The MMR vaccine controversy – winners, losers, impact and challenges. British Journal of Infection Control. 8. (1). 18-22.

Pauline MacDonald is Nurse Consultant Communicable Disease for Dudley Primary Care Trust and also runs her own business, Infection Matters Limited. As an Independent Consultant Nurse she provides, consultancy, service development expertise, advice, education, and audit in all areas of Infection prevention and Immunisation service delivery. Additionally she can provide clinical supervision and mentorship for staff in the fields of Infection Prevention and Control and Immunisation. Pauline is a member of the Joint Committee for Immunisation and Vaccination and is deputy editor for the British Journal of Infection Control. She has published and presented nationally and internationally. Pauline can be contacted at

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Readers' comments (1)

  • I place the blame for the measles epidemic, the possible mumps epidemic and most potentially tragic of all the revived possibility of 'rubella babies' firmly and squarely on the media particularly the Daily Mail who saw a wonderful opportunity to knock all its favourite targets, the public services, the labour government and modern life in general. It is particularly to blame for its continuing efforts to revive the story and refusal to give equal time to the evidence for the safety of MMR.

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