Agenda item

Report of the Director of Public Health

The Board considered a briefing note, verbal report and presentation of the Director of Public Health which provided an update on the uptake of Measles, Mumps and Rubella (MMR) immunisation among children in Coventry and giving an overview of commissioning responsibilities and how partners were working together to build good immunisation rates and address areas of concern.

Measles was a preventable but highly contagious viral infection which, on rare occasions, could cause serious complications and could be fatal.  Young babies, the immunosuppressed and pregnant women were at higher risk of complications.  The MMR vaccine was the best way of protecting individuals, preventing outbreaks and protecting the most vulnerable individuals in the community.

As part of the childhood vaccination schedule, the MMR vaccination was routinely offered twice – at 1 year of age and as a pre-school booster.  Two doses of the vaccine provided the best protection.

The uptake of the MMR vaccine had declined over the years, including in Coventry and since 1^st October 2023, there had been an increase in measles cases country wide.

Responsibility for immunisation was fragmented with both NHS England (NHSE) and Coventry Warwickshire Integrated Care Board (ICB) holding lead roles on NHS immunisations delivery.

The main provider of MMR immunisations in Coventry were GP practices and the School Age Immunisation Services.  Uptake of the vaccine across all ages was lower in Coventry than the regional or national levels.  There was greatest success at achieving one dost of MMR by the age of 5 years however, the requirement for herd immunity was measured based on achieving two doses of MMR. 

Since summer 2023, an additional effort had been made to increase protection from measles and the levels of MMR vaccination.  This work began before the first cases of measles were seen in Coventry.  Work had been undertaken across all partners locally to ensure effective working to grow the rates of immunisation in all communities, including those less likely to routinely come forward.  Some key actions included:

·  Vaccinating Coventry Group – an established Coventry focused immunisation planning group whose aim was to bring all relevant parts of the system together to identify the best way of immunisations to the population of Coventry and reduce inequalities in accessibility.

·  Coventry and Warwickshire Schools Immunisation Service

·  Communications to increase public understanding

Councillor K Caan, Cabinet Member for Public Health and Wellbeing, congratulated the Public Health team for their report advising that the consequences of measles were very painful and the effects severe and he welcomed the work undertaken by the MMR immunisation teams across the city who were working proactively to roll out the vaccinations alongside schools.  The pop-up immunisation project had been very successful especially with the travelling, moving and new to the city communities.

Members of the Scrutiny Board, having considered the content of the briefing note, verbal update and presentation, asked questions and received information from the Director of Public Health on the following matters:

·  Single MMR vaccinations were not recommended.  Two vaccinations provided the best coverage for measles, mumps and rubella.

·  There was no proven link between the MMR vaccine and autism however, some individuals in the 18-25 year age group had not been given MMR vaccine as children.

·  The vaccine offered in Coventry did not contain porcine or pork products. 

·  The MMR offer in schools included vaccination of teachers, parents and close siblings.

·  Individuals born before 1970 would more than likely have had measles or taken part in the immunisation programme as children and therefore would not need a vaccine.  People who had measles would have lifelong immunity.

·  There was no evidence of whooping cough currently circulating however, there were a number of respiratory viruses circulating.  Research shows immunity would wain following whooping cough vaccination.

·  Babies were prioritised for the whooping cough vaccination and all pregnant women were offered it.

·  Whooping cough was a notifiable disease and would be picked up by public health.

·  Data captured by the NHS on MMR vaccination rates across the city could be seen by GP practice but not by ward.

·  Covid and the attitude towards covid vaccinations was one of a number of reasons why the MMR vaccine rate has fallen.

·  As of 1 October 2023, there were no cases of measles in the previous 12 months in the city.

·  Every secondary school and 22 primary schools across the city were taking part in the MMR immunisation programme.  Primary schools were being prioritised and grouped according to where the lowest MMR vaccine rates were being seen.

·  University students were being encouraged to take up the MMR vaccine via the NHS app.  If a low uptake was seen, the NHS may roll out pop up clinics.

·  Home visits to vaccinate would be possible for children who were home educated.

·  The reason the MMR vaccine was given in 2 doses was due to the fact that 1 in 10 recipients did not respond well to the first vaccination.

·  Uptake of vaccinations in young babies was good however, it had been found boosters were not always given. The system for checking and to ensure vaccinations were undertaken was with GP’s and health visitors.

·  Vaccine take up was dependent upon a number of factors including news articles and covid. 

·  Most of the immunisation work was undertaken via the NHS however, the community work was carried out by Public Health and partnership working was key.

·  The MMR vaccine was a live vaccine and could not be given to pregnant women or the immuno -suppressed.

The Board requested vaccination rates for other vaccines.

RESOLVED that the Health and Social Care Scrutiny Board (5):

1)  Note that the Coventry’s MMR childhood immunisation rates for 2022/23 are below the national and regional averages.

2)  Note the work that partners are working together to improve MMR uptake across Coventry and increase protection from the spread of measles and other vaccine preventable diseases.

3)  Agree that our ultimate goal in Coventry is to achieve high MMR immunisation uptake, building each success into the wider childhood immunisations programme to develop system resilience and outbreak prevention.