8 February 2024
Two doses of the MMR vaccination before the age of 5 protect against measles. Image sergei telegin/shutterstock.com.
Measles was declared to be eradicated from Britain in 2017, but it has come back. That’s an avoidable decline in Britain’s health, primarily due to a cut in health visitors.
A drop in vaccination rates has allowed measles to return as a significant threat to child health. The disease itself is a direct danger, and there’s an indirect impact from the extra strain on limited paediatric hospital beds, needed for all conditions.
Excuses
The government has been quick to offer excuses about the return of measles. Chief amongst them is the catch-all “aftermath of the pandemic”. They also blame anti-vaccination sentiments or say it’s a wider European problem.
Certainly the World Health Organisation has pointed to a 40 fold rise in measles cases across Europe. But in the past when numbers rose across the continent, immunisation rates in Britain were high enough to prevent an outbreak.
'Health visitors ensure vaccination uptake for children under 5 years old.’
The factors cited by government may contribute, but they pale into insignificance compared to the decline in the number of health visitors. These workers are the key health professionals involved in ensuring vaccination uptake for children under five years old.
In 2015, health visiting was brought back under local government control for the first time since 1974. At the time trade unions highlighted how local authority budgets were already being squeezed under the coalition government’s austerity measures.
High risk
Unions said that the administrative change could be high risk: those concerns have been borne out. There has been a 40 per cent reduction in health visitor numbers in England since 2015.
The causes of this collapse in health visitor numbers were predictable and avoidable. There was no robust plan for replacing workers reaching retirement, no coherent plan to attract new trainees and no funding to address the shortfall.
Expertise
Finally, NHS England has a workforce plan but this is not due to begin until 2025! The response to the current measles epidemic needs to be much swifter. And as we learned with the Covid vaccine, we have the expertise as a nation to mount emergency vaccination programmes.
On January 22 the NHS in England belatedly launched a new campaign for those who have missed MMR (measles, mumps and rubella) vaccination. It can only do this because of residual skills within the health visiting workforce. But if we want to eradicate measles then we have to rebuild the health visiting service immediately.