Agenda item

To consider a report presented by Dr Charlotte Stevenson and Dr Sepeedeh Saleh.

The Board receive a report submitted by Dr Charlotte Stevenson, Consultant in Public Health, which providedan update on measles risk and prevention in Oldham.

The Board was given the following background –

•      Uptake of routine childhood immunisations fell globally during the COVID-19 pandemic.

•      Coverage for the Measles, Mumps and Rubella (MMR) vaccination programme in the UK - a two dose vaccine given at 1 and approximately 3 years of age – fell to the lowest level in a decade.

•      Of particular concern here is measles, which poses a high risk and is easily transmitted across unvaccinated populations. 

•      Around 20-40% of those with measles will be hospitalised with higher rates in babies, and adults over 25 years of age.

•       

The July 2023 the national “Risk Assessment for Measles Resurgence in the UK” was published by UKHSA.  This concluded that “there is a high risk of imported cases leading to outbreaks in specific population groups … and geographies … with some risk of limited spread to the wider community”.

Vaccine Uptake –

•      Uptake for the first dose of MMR vaccine in children aged 2 years in England is 85.6%. This is well below the 95% target set by the World Health Organisation (WHO), needed to eliminate the disease.

•      Earlier this year the WHO and UK Health Security Agency (UKHSA) issued warning about the low levels of vaccine coverage and risks of measles resurgence, including recommendations for actions to prevent this.  The UK has never met the WHO target of 95% coverage and so under-vaccination is an issue across the age groups. Of key concern are teenagers and young people where national data indicates rates are low.

•      Recent vaccination data for Oldham indicate that by their 5th birthday, 94% of children in Oldham had had the first dose of the MMR vaccine: 80% had had both doses.

With regard to National actions and recommendations –

•      The UK strategy for eliminating measles and rubella includes 4 key parts:

                                  i.    Achieve and sustain MMR coverage at > 95% for 2 doses of the vaccine in the routine childhood programme (by 5 years of age)

                                ii.    Achieve coverage of > 95% for 2 doses in older age groups through opportunistic and targeted catch up programmes

                               iii.    Strengthen surveillance through rigorous case investigation and testing

                               iv.    Ensure easy access to high quality, evidence based information for health professionals and the public

In Oldham -

Leadership changes have recently taken place in relation to this work:

                                  i.    The childhood immunisations and vaccinations group was disbanded earlier this year. A new group will take its place and continue work on key areas including improving access to childhood vaccinations, community insights and engagement, and systems working with primary care.

                                ii.    This group will report to the Pan-GM Measles group, who provide strategic input to reverse the overall falling vaccine uptake rates in the childhood immunisations programme and increase the coverage for the MMR vaccination programme in the region.

•      Primary care have been actively engaged in improving vaccination uptake and on outbreak preparedness

                                  i.    Work is ongoing to increase the number of children invited to clinics and increase the number and duration of clinics.

                                ii.    Issues around reliability and consistency of primary care data on clinical systems have created challenges in understanding details of coverage rates.

                               iii.    An automated electronic data transfer solution is required to achieve high quality data and enable effective targeted action to improve coverage rates across the borough.

•      Community insights and communications, building on community engagement work during the COVID pandemic, form a critical part of vaccination uptake work in Oldham.

                                  i.    In the past this has involved Oldham Council’s neighbourhood teams, Oldham youth council, and work with school communities through school nurses and the Oldham Council communications team.

                                ii.    Further work is underway to develop links with Action Together in Oldham, bringing in key community and voluntary sector organisations to collaborate in this work. This will allow two-way communications with residents about vaccinations in a way that meets their needs: sharing valuable community insights and responding to felt needs existing within different groups.

Additional areas of work beyond vaccination uptake include measles testing, infection prevention and control measures, and system outbreak response. Steps relating to these areas are outlined in the action plan for Oldham.

Rebecca Fletcher emphasised the need to get MMR rates up with a view to protecting the community.

Jayne Ratcliffe drew attention to the effect that measles has on adults as well as children. Getting the message to adults in their own homes as well as adults in care homes.

Resolved - that the Board commits to continued support of plans to improve uptake of the MMR vaccine in children ages under 5 years and in older at-risk groups, namely unvaccinated individuals in older age groups. These plans include:

(i) Establishment of a new group, involving NHS and local authority colleagues, responsible for improving childhood vaccine uptake rates in the borough;

(ii) Improving data systems to deliver high quality vaccine coverage data to inform and support efforts to improve vaccine uptake; and

(iii) Work with communities to optimise access to vaccines and engagement in the programmes for under 5s and catchup vaccinations in older age groups