The risk of a measles epidemic, which could pose a threat to vulnerable, non-immunised children, is now very real, the National Disease Surveillance Centre has conceded.
The NDSC advises the Government on communicable diseases.
The risk is particularly grave in the Eastern Region Health Authority, where the uptake of the MMR (measles, mumps and rubella) vaccine among children has fallen to less than 60 per cent, Dr Darina O'Flanagan, the NDSC's director, said yesterday.
The ERHA has responsibility for the densely populated Dublin conurbation, where the MMR uptake has reached record low levels. But the average uptake of the vaccine around the State is now as low as 70 per cent, said Dr O'Flanagan. It is a major cause of concern for the centre. Ideally, vaccination levels should be in excess of 95 per cent.
The situation was worse than that reported in the media at the weekend, Dr O'Flanagan added. But she insisted that public fears of a connection between the MMR vaccine and autism were groundless. Studies in countries such as the US, Britain, Sweden and Finland had shown there was no association with autism, she said.
"The USA's Centre for Disease Control and Prevention, the World Health Organisation and the Medical Research Council in Britain have all reviewed the situation and found no evidence," she said. Such bodies would not suppress the evidence if there was any hint of a connection, she insisted. Despite these reassurances, the evidence of growing public concern as a main factor for the declining MMR uptake figures is baffling medical experts.
"I don't know whether it does more harm than good pronouncing on the worsening situation and warning the public," she said.
A continuing "build-up" in the "critical mass" of susceptible children could mean an epidemic was inevitable if measles was introduced. There were 1,595 cases of measles last year, most in north Co Dublin. Two children died.
Other logistical problems affecting the MMR programme involved the system of payments for general practitioners administering the programme. Some GPs claimed that the system was inadequate, but a major overhaul in the computing area would ensure "proper payments" for the family doctor. The GP is seen as pivotal to the immunisation programme.
An NDSC sub-committee recommended in a draft report recently that all children aged over 15 months in daycare centres, nurseries and schools should have certificates to show they had received the MMR vaccination.
While the sub-committee did not recommend children should not be allowed to attend schools without immunisation certificates, it referred approvingly to schools in the US which required children to have two doses of the vaccine.
It also recommended that healthcare workers born after 1978 should have proof of immunity or evidence of MMR vaccination with two doses of vaccine.