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As concern grows about the spread of measles worldwide and the role of social media in sharing misinformation on immunisation, journalist Juliette Astrup looks at the scale of the problem and what can be done to combat the anti-vax movement.
BIG STORY
Vaccine hesitancy, the reluctance or refusal to vaccinate, was among the WHO's top 10 threats to global health in 2019 (WHO, 2019), and its effects are already being felt.
An estimated 169 million children worldwide missed out on the first dose of the measles vaccine between 2010 and 2017, according to the latest figures (UNICEF, 2019). Among high-income nations, the UK has the third highest number of children potentially at risk, with more than 500,000 missing out on this first dose over the past eight years, behind only the US and France, with more than 2.5 million and 600,000 respectively (UNICEF, 2019).
It is no surprise then that the numbers of measles cases are rising dramatically. In the first three months of 2019, more than 110,000 incidents were reported worldwide - up nearly 300% from the same period last year. An estimated 110,000 people - most of them children - died from measles in 2017, 22% more than the year before (UNICEF, 2019).
UK COVERAGE AND OUTBREAKS
These trends are being reflected here in the UK: while overall vaccination coverage remains high, uptake is falling across all four nations. In some cases it is below the 95% rate needed to achieve 'herd immunity' (Information Services Division Scotland, 2019; Public Health Agency, 2019a; NHS Digital, 2018; Public Health Wales, 2018).
In England, where MMR vaccination coverage among children reaching their second birthday is now 91% - with just 87% receiving the second dose by their fifth birthday (NHS Digital, 2018) - there has been a sharp rise in the number of measles cases, increasing from 259 in 2017 to 966 last year (Public Health England (PHE), 2019a).
Wales, too, has seen a couple of outbreaks since 2017, thought to be linked to the outbreaks in Europe (Public Health Wales, 2018), while Scotland saw just two cases in the last year (Health Protection Scotland, 2018) and Northern Ireland had no confirmed cases (Public Health Agency, 2019b).
The bottom line is that vaccines prevent disease...