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Latest fall in English MMR coverage by age two 'of concern'

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Coverage of the measles, mumps and rubella vaccine by children’s second birthday has decreased in 2016-17 for the third year in a row in England.

According latest figures from NHS Digital, MMR coverage among two-year-olds fell to 91.6%, compared to 91.9% in 2015-16.

“Of particular concern is coverage of the MMR vaccine that prevents measles, mumps and rubella”

Peter Openshaw

The MMR coverage figure of 92.7% reported in 2013-14 was the highest since the vaccine was introduced in 1988, noted the body in a report published today.

All regions except London achieved coverage above 90%, but none reached 95% – the target set by the World Health Organization. Coverage was highest in the North East and lowest in London.

However, more positively, NHS Digital highlighted that the proportion of eligible children receiving a first dose of MMR by the age of five had met the WHO’s 95% target for the first time in England.

Its figures showed the proportion of children receiving MMR by their fifth birthday had increased year on year since 2006-07. It was 95% in 2016-17, up from 94.8% in 2015-16.

But this performance was not maintained for achieving both doses of MMR by the age of five. In 2016-17, 87.6% of children in England had received their first and second dose of MMR vaccine by their fifth birthday, representing a 0.6% decrease from 2015-16.

The body’s report cited a number of reasons for the continuing failure to reach the target coverage among children by the age of two years, as well as for the spike in 2013-14.

“It is crucial that the government, NHS and local authorities work together to learn lessons”

Peter Openshaw

For example, it noted the “controversy and associated publicity” around the now discredited potential link between MMR and autism and Crohn’s disease, which started in the late 1990s and continued through the early 2000s.

Meanwhile, it mooted a number of different factors that may have contributed to increased coverage up to 2013-14.

These included national MMR catch-up campaigns in 2008-09 and in 2013 and a recommendation by the Joint Committee on Vaccination and Immunisation in 2010 to offer the Hib/MenC and PCV booster vaccines and the first dose of MMR vaccine at the same visit – along with local initiatives to improve coverage and data collection, reporting and quality.

The report – titled Childhood Vaccination Coverage Statistics 2016-17 – also set out national coverage figures for other routine childhood vaccinations offered to all children up to the age of five.

Other routine vaccinations included in the report are DTaP/IPV/Hib (also referred to as the 5-in-1 vaccine), pneumococcal conjugate vaccine (PCV), and the children’s flu vaccine.

According to the report, 93.4% of children received the 5-in-1 vaccine before their first birthday in 2016-17, which is a decrease from 93.6% last year and 94.2% in 2014-15.

Meanwhile, this is the first year that national coverage figures for the rotavirus vaccine have been included in the report.

Figures show that 89.6% of children in England received the rotavirus vaccine before their first birthday during 2016-17.

Experimental statistics for the meningococcal B (MenB) vaccine, introduced in September 2015, have also been included for the first time.

Overall, levels of immunisation for 10 out of the 12 routine childhood vaccinations covered by the report were highest in the North East. London had the lowest immunisation coverage for all 12 routine childhood vaccinations included in the report.

The 2016-17 report is accompanied by a new interactive data dashboard, which has been developed in collaboration with Public Health England.

This dashboard enables users to “drill down” to local authority level and examine both local and national trends in greater detail, noted NHS Digital.

British Society for Immunology

Fall in uptake for most routine vaccination

Peter Openshaw

Professor Peter Openshaw, President of the British Society for Immunology, said: “Today’s publication of annual vaccination statistics for England paints a complex picture.  

“Although there seems to be little significant change from last year, overall vaccination rates are still below the World Health Organization’s recommended level of 95% coverage, with small decreases on some vaccine types,” he said.  

Professor Openshaw highlighted that the continuing decrease in MMR coverage was “of particular concern”.

“England’s coverage currently stands at 92% of children receiving the first MMR vaccine by their second birthday, with 88% receiving the second vaccine by their fifth birthday,” he said.  

“This is substantially lower than the WHO recommended levels of 95% coverage at these time points,” he noted.  

Professor Openshaw also highlighted that, as the UK was a world leader in vaccine research, the country needed to ensure that “this excellence is reflected in the provision of vaccines to our children to prevent disease”.  

He added: “The statistics indicate there is also significant regional variation in coverage levels, which has a substantial impact on our ability to stop the spread of these diseases within individual communities.

“It is crucial that the government, NHS and local authorities work together to learn lessons from those areas that are performing well to ensure that vaccination rates increase and prevent the spread these harmful but preventable diseases,” he said. 

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