Measles Outbreaks in the UK: Why Are Cases Increasing While Vaccination Rates Fall?


Measles is a viral infection that can cause severe sickness, including brain inflammation.

“Even in high-income countries like the UK, about 1 in 5,000 die from the infection,” said Prof Helen Bedford of the UCL Great Ormond Street Institute of Child Health, noting that measles is typically more severe in adults.

Measles is characterized by cold-like symptoms and a high fever, followed by a rash that often appears on the face but can spread throughout the body.

“Apart from managing the symptoms of measles, there is no treatment,” Bedford went on to say.

What is the Present Situation?

Cases of measles are increasing. The UK Health Security Agency reported 1,603 suspected instances in England and Wales in 2023, compared to 735 in 2022, 360 in 2021, and 695 in 2020. Before the Covid pandemic, the number of suspected cases was much greater, with 2,422 in 2019 and 2,608 in 2018, raising concerns.

Outbreaks have occurred throughout England in recent months, notably in London, with instances in the West Midlands reaching their highest level since the mid-1990s. Birmingham Youngsters’ Hospital reported seeing more than 50 youngsters in need of care in the previous month.

Don’t we Have a Vaccine?

Yes, it is extremely effective (about 99% after two doses) and free. It is administered as part of the MMR vaccine, with the first dose being given at age one and the second at three years and four months. Teenagers and adults who missed out can still be vaccinated.

Vaccination rates of about 95% would provide the whole community with herd immunity, which means that the few who are unvaccinated, such as tiny babies, are safe because people around them are immune to measles.

So, What’s Going on?

The concern is that vaccination rates in some areas of the country are insufficient to keep the virus from spreading. According to data from 2022-23, just 84.5% of children in England obtain their second MMR vaccination dosage by the age of five, while a quarter of five-year-olds in London and Birmingham had not received two doses of MMR.

Experts attribute this to a variety of factors, including some parents not realizing the NHS was still providing MMR vaccines throughout the epidemic, not understanding how deadly measles may be, difficulty getting appointments, or being misled by anti-vaccine conspiracy theories.

Among the most significant pieces of disinformation was Andrew Wakefield’s 1998 assertion that the MMR vaccine may be connected to autism, which has subsequently been thoroughly disproved.

Paul Hunter, a professor of medicine at the University of East Anglia, cited a 2019 UK research that indicated that people born between 1998 and 2004 – the era after the Wakefield publication – were not only the most susceptible to measles but also had the greatest incidence.

However, the most recent data for England show that the bulk of the 209 laboratory-confirmed cases of measles between January 1, 2023, and November 30, 2023, were in children under the age of ten, indicating a fall in vaccination rates.

Are There Other Elements at Play?

Adam Finn, a pediatrics professor at the University of Bristol, believes that closing schools, shops, and other public places during the COVID-19 epidemic might have lowered measles transmission rates. Combined with lower vaccination rates, this meant that once Covid restrictions were lifted, there was a bigger pool of vulnerable persons.

“That of course creates a situation where you will then get more cases when the virus is around,” Finn went on to say.

Where Does This Leave Us?

In short, the UK has returned to a pre-pandemic state of devastation.

“We’ve been seeing hundreds of cases now which has been ramping up over years,” Finn added. “I think it’s right that we should be worried because it’s completely preventable.”

Indeed, in 2016, the United Kingdom was certified measles-free. However, such status has not been maintained.

Hunter predicted that measles will become an increasing concern in the coming years, as vaccination uptake in young children continues to decline.

Bedford also expressed worries. “Measles is nasty: if we do have large outbreaks it is inevitable we will have deaths,” she went on to say. “But aside from the risk to children, it will also put additional pressure on the NHS at its most pressured time.”

What Has to Be Done?

Experts believe it is critical to persuade parents to have their children vaccinated against measles.

Finn did, however, emphasize the need for financing for proactive initiatives, such as reminding individuals to attend appointments.

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