Measles outbreak threat triggers plan for catch-up vaccinations for young adults

Plans are being made for an urgent catch-up vaccination programme for young adults against measles after the Health Service Executive warned the probability of an outbreak in Ireland was high.

Minister for Health Stephen Donnelly will brief Cabinet on Tuesday that a significant increase of measles cases notified in Europe this winter, coupled with falling rates of MMR (measles, mumps, rubella) vaccine uptake in Ireland, has raised concerns about wide transmission of the disease in Ireland in 2024.

One-fifth of the population in some counties have no protection against measles, due to low vaccination rates.

Mr Donnelly will tell colleagues that, following the rapid risk assessment carried out by the HSE “the probability of the introduction and transmission of measles in Ireland is high”.

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[ Measles in Europe: Officials keeping ‘close watch’ for possible cases in Ireland, says Donnelly ]

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Health officials have begun testing their response systems in the event of cases occurring, he will say.

Sources say concern about the highly contagious virus is focused on regions and population cohorts with particularly low vaccine uptake, as well as congregated settings.

Measles cases have soared in Europe since the beginning of 2023. In England, 170 cases of measles were notified in an outbreak in the west midlands between December 2023 and mid-January 2024.

Ireland recorded only four cases of the disease last year, imported from outside the EU in a single family outbreak. No cases were reported this year up to January 27th last.

The only protection against measles is vaccination. MMR vaccine uptake in Ireland is currently below the World Health Organisation recommended target uptake of 95 per cent. Nationally, uptake has been below 90 per cent for seven consecutive quarters.

There are also significant geographic variations with uptake rates below 80 per cent in Co Louth and Co Meath, but as high as 94 per cent in Dublin Southwest.

Younger men tend to be the cohort at greatest risk. A recent study estimated that almost one-in-five males between 18 and 19 are non-immune to measles. The figure is also high among young adults in general, with just over 10 per cent of people between 18 and 35 having no immunity.

The likely reason for this high level of non-immunity stems from misinformation in the past about the MMR vaccine that falsely linked it to a risk of autism, according to a briefing note for Cabinet.

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[ Ireland has lowest immunisation rate for measles in western Europe, according to ECDC ]

As autism is more often diagnosed in young male children, it is likely that a cohort of now young men were not vaccinated due to parental decisions informed by this erroneous science, which has since been discredited, the note states.

Mr Donnelly will outline measures being taken to address the threat, in addition to communication campaigns. Measles has been added to the list of notifiable infectious diseases, requiring immediate preliminary notification by telephone to a medical officer, since May 2023.

The timing of the MMR vaccination offered in junior infants has moved from the second school term to the first to provide protection as early as possible.

An MMR catch-up programme was launched through GPs in November 2023, aimed at children who did not receive the MMR vaccine when they were 12 months old and/or did not receive the second vaccination when four or five years of age when in junior infants.

The HSE is also examining a proposal for an MMR catch-up programme in Leaving Cert students to target unvaccinated teenagers, Mr Donnelly will tell colleagues. It is looking at a possibility of a similar campaign in colleges and higher educational institutions aimed at those in their late teens and 20s.

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