Measles: UK on a ‘trajectory for everything getting much worse’

The UK is on a “trajectory for everything getting much worse” when it comes to measles spreading, the head of the UK Health Security Agency (UKHSA) has warned.

Professor Dame Jenny Harries told the PA news agency that “concerted action” is needed to tackle the virus as she visited a measles blackspot in the West Midlands.

During her visit to Birmingham’s UKHSA laboratory at Heartlands Hospital on Friday, Dame Jenny said: “That’s one of the reasons why I have come to Birmingham today, because I know there is huge effort by local partners to try and contain the spread of measles but it is highly contagious, it is one of the most contagious respiratory virus diseases that we deal with routinely.

“We need to build up vaccination coverage so each new age group coming through systematically attains that 95% coverage and that will protect all of us, both those who have had the vaccine and the very few who are perhaps immunocompromised for whatever reason, or perhaps very small children under six months who cannot have the vaccine.”

She said the majority of people are not against their child receiving the measles, mumps and rubella (MMR) jab, but that they need more information to feel confident about their decision.

She said: “We have learned a lot from Covid in that we need to make vaccines accessible to people but accessibility means different things, firstly making sure that they are physically available, but we also need to make sure people feel confident and have enough information to make a decision to step forward and have that vaccine.

“What we are seeing at the moment with measles is that people have forgotten what a serious illness it is, our vaccine programmes have been very successful and our coverage rates have dropped now, so we probably need to provide more information.

“We have had very high vaccination rates, especially for young families, but they are low at the moment.”

Vaccination rates across the country have been dropping, but there are particular concerns about some regions, including parts of London and the West Midlands.

Figures released by the UKHSA show there have been 216 confirmed measles cases and 103 probable cases in the West Midlands since October 1 last year.

Four-fifths (80%) have been found in Birmingham while 10% were identified in Coventry, with the majority being in children aged under 10.

The UKHSA has declared a national incident, which it said is an internal mechanism signalling the growing public health risk and enabling it to focus work in specific areas.

Dame Jenny said she was “not generally in favour” of making the vaccinations mandatory for children before they reach school age.

She said: “We have a number of different vaccine programmes that are highly effective and the MMR vaccine is 99% effective against clinical disease.

“This is a really well tried, well trusted and highly effective vaccine, but we have never had, in our routine childhood population programmes, a mandatory programme.

“For me personally, it is really important that families trust the information because we will have new vaccines coming on board and it is important they can see individuals in their own communities coming forward, that we have trials and studies of vaccines which are representing the population that they recognise for themselves.

“I’m not generally in favour of (mandatory vaccines for children), it is not something we have generally in the UK, but nevertheless, for healthcare professionals particularly, we have a responsibility and a duty to protect our patients, so certainly for me, I would always go forward for vaccination.”

Earlier, Dame Jenny said a “national call to action” is needed across the country to ensure children are vaccinated against potentially deadly measles.

She urged parents to check whether their children have had the MMR jab.

She told BBC Radio 4’s Today programme that people have “forgotten what measles is like”, and that children can be unwell for a week or two with symptoms including a nasty rash, high fever and ear infections. She added that the virus is highly infectious.

There can also be serious complications, hospital admissions and death.

In the West Midlands, vaccine rates are down to 81% while in the Surrey Heartlands Integrated Care Board area, they are at just over 70%, she added.

Asked which communities are most affected, she said: “This is an important point, I think for the West Midlands, for those in Muslim communities, they will be not keen to take up one of the MMR vaccines that we offer which has a pork-based derivative.

“But it’s really important that they’re aware there is a non-porcine vaccine which is available to them and very effective.

“So it’s that sort of understanding and ensuring that knowledge is available to people so they can make choices.”

She added: “This is a call right across the country for all parents to check the vaccination rates of their children and also, one of our most unvaccinated populations are young adults (born around 1998 to 2004)… and many of those now, of course, will be in frontline work, so things like young teachers, and it’s really important that they also get vaccinated with MMR.”

Official figures show uptake of the vaccine is at its lowest point in over a decade.

In 2022/23, some 84.5% of youngsters in England had received both doses of the jab by the time they were five years old – the lowest level since 2010/11. Some 92.5% had received one dose.

It comes as NHS England issued, for the first time, infection control guidance on measles to the NHS.

Most of it is standard procedure for infectious diseases, such as ensuring communication between GP surgeries and hospitals if a patient has measles and is being admitted for care.

If a person needs to see a GP, they should be isolated at the time of arrival (for example, directed to a side room) and appointments should be scheduled to reduce waiting times in reception areas to avoid spreading the disease, the guidance said.

In hospitals, patients with suspected measles should also be put in a separate area (ideally a single room away from others) as soon as possible.

Those inpatients with suspected or confirmed measles should, whenever possible, be placed in an infectious disease isolation room with en-suite facilities, it added.

The guidance also said hospitals can assign a dedicated team of care staff to care for patients in isolation or group rooms and areas.

“This can only be implemented if there are sufficient levels of staff available (so as not to have a negative impact on non-affected patients’ care),” it said.

“Only staff whose vaccination status, disease history or immune status is known should be assigned to isolation or cohort rooms and areas.”

Helen Bedford, professor of children’s health at UCL Great Ormond Street Institute of Child Health, said: “About one in 1,000 people with measles develop inflammation of the brain and even in high-income countries like the UK, about one in 5,000 die from the infection.

“Apart from managing the symptoms of measles, there is no treatment.”