A deadly complacency
Five years ago, the UK was ‘measles free’. But with MMR jabs at their lowest for a decade, cases are rising. Here, mothers whose children became grievously ill warn against ...
The news that uptake of the MMR vaccine in england is now at its lowest level for nearly a decade filled Jasmine Chamberlain with rage. her son elias caught measles just before he was due for his first dose of the measles, mumps and rubella (MMR) jab triple vaccine when he was 12 months old.
‘People think measles either doesn’t exist any more or that it’s just “one of those childhood illnesses”, but it is a terrible illness and can kill,’ says the mother of three from Bedford. The MMR is offered to all children, with a first dose at 12 months and a second at the age of three or four.
Jasmine’s two older children, now aged eight and ten, had all their childhood jabs — including MMR — so it was natural elias would, too. But just a month before his MMR was due, Jasmine noticed a rash popping up on his neck, chest and arms.
She took her son to an emergency clinic where a health visitor examined elias and said she should take him straight to see a doctor. ‘The GP took one look and said, “That’s measles”.’ I was so shocked.
‘even though I knew children still needed to be vaccinated against it, I didn’t really think people got measles any more.’
Under guidelines, the GP had to alert the UK health Security Agency (UKhSA) which sent a swab to the family’s house by courier.
They were given the results a few days later and the whole family — Jasmine’s partner Lukas, 31, a chief projects engineer, and their other children Levayha and Aria — were told to isolate at home for 21 days.
When Sophie Dale’s son Levi also caught measles just before his first birthday, he had to be rushed to hospital in an ambulance after suffering seizures — and sepsis related to the infection.
Sophie, 25, a mother of one from Chesham, Buckinghamshire, had taken him to A&e ten days earlier with a red-raw rash over his body.
he was diagnosed and sent home to isolate. Levi recovered, only to collapse suddenly 12 days after first going to hospital.
‘I sat by his side, numb,’ Sophie recalls. ‘The doctors kept saying how very ill Levi was.’
Indeed so ill, he had to be transferred to the John Radcliffe hospital in Oxford for specialist care.
FInALLy, after six days his condition turned around. But even so Sophie says she had to help her son learn to walk again. even after his recovery, the family had to live with the anxiety of regular tests for two years of his motor skills and hearing.
Levi, now four, is ‘doing well’, says his mother. ‘But I am so lucky I still have him.’
Measles was once one of Britain’s biggest child killers. In the early 1940s it claimed around 1,100 lives a year. And while vaccines, introduced in the 1960s, have slashed that grim annual total to single figures, more than 2,000 caught the infection in 2018.
It may not be the deadly infection it once was. But it can lead to pneumonia and inflammation of the brain, which can cause deafness and intellectual disability.
The proportion of children vaccinated with MMR peaked in 2014, at almost 93 per cent, leading the World health Organisation to declare in 2017 the UK was ‘measles free’. yet within a couple of years that status was withdrawn as uptake fell to just 85 per cent in england.
The latest figures from Public health Scotland showed 94.4 per cent of children had the first dose of MMR vaccine by 24 months of age in the year ending September 30, 2021. This rose to 96.6 per cent for children aged five.
Uptake of the second dose of MMR vaccine by five years of age was 92.8 per cent, rising to 93.8 per cent by age six years. But rates of infection are rising. There were 308 measles cases between January to March 2022.
The majority of cases are in teenagers and young adults who missed their MMR vaccine when younger, says Dr Camilla Kingdon, president of the Royal College of Paediatrics and Child health and a consultant neonatologist at the evelina Children’s hospital in London.
In 2019, four of the five measlesrelated deaths in england and Wales were adults.
‘Measles can infect nine out of ten non-immune people and can have very serious complications,’ says Dr Kingdon. ‘This is not a benign viral infection. It needs to be taken seriously. We are really concerned about the low uptake of the MMR.
‘Figures from the UKhSA say that one in ten children aged five are not up to date with their MMR vaccine.’
now a new campaign by the UKhSA and nhS england is urging parents to ensure their children have their full MMR.
While it is a very effective vaccine (one dose is 93 per cent effective against measles, 78 per cent against mumps and 97 per cent against rubella) the two doses are needed for complete protection.
While the Covid pandemic has made it harder to ensure all children who need the vaccine get it, it’s not to blame for the decline.
‘This is not something we can simply say is a consequence of the pandemic, although there’s no doubt the pandemic has made it far more challenging,’ says Dr Kingdon. She believes complacency is a bigger factor.
‘When as a nation we’re not exposed to diseases such as measles, people forget that these are potentially very serious infections that can cause death,’ she says.
And ‘vaccine fatigue’ might be at play — people so exhausted by arranging three Covid vaccinations they forget about general jabs. Dr Kingdon explains: ‘I think a lot of parents essentially thought the MMR immunisation is not a serious emergency and decided, “I’m not going to bother my GP” so things like routine immunisations took a bit of a back seat in their minds.
‘A lot of health visitors, who are key to ongoing relationships with parents and have an important role in reminding people about immunisations, were moved to other activities during the pandemic.’
There is also greater awareness of potential side-effects.
AS Winston Morgan, a professor of toxicology, equity and inclusive practice at the University of east London, explains: ‘We are now seeing the impact of this new awareness, with fewer people allowing their children to be vaccinated and those who decide to accept a vaccine reporting roughly three times more adverse or sideeffects for the MMR vaccine in 2021 compared to 2018.
‘The MMR vaccines have not suddenly become more dangerous, we are just more aware of the sideeffects and adverse effects.’
he adds: ‘Generally the risks of the vaccine are rare but well known, and can be mitigated without long-term consequences.
‘That cannot be said about leaving your child unvaccinated.’
Sophie says: ‘I admit that I was in two minds about the vaccination before my son got measles.
So I understand mums who are on the fence. But having seen what measles can do, I know the other side of the story. I almost lost my son to measles.’
And two years after elias’s illness, Jasmine recalls: ‘The night after he was diagnosed, elias’s symptoms soon became alarming. The rash spread everywhere — over his eyes which were swollen shut, in his mouth, under his tongue — he was in agony. It was terrifying.’
It took ten days for elias, now three, to feel well enough to start smiling again and fortunately he has had no long-term effects.
Dr Kingdon urges parents to contact their GP if unsure of their child’s vaccination status, adding: ‘It is never too late to have the first dose or the second dose even as a teenager or into adulthood.’
Jasmine says: ‘People don’t realise how dangerous measles is. It can kill. even if it doesn’t, it’s a very nasty disease.
‘Why would you want to put your child through that?’