It is almost 30 years since one of the most significant public health scandals of the 20th century, when a now-disgraced researcher suggested there was a possible link between the MMR vaccine and autism.
Despite almost three decades having since passed, and Dr Andrew Wakefield’s retracted research being discredited as “an elaborate fraud”, its impact is still being seen across Nottingham.
New figures show around 82 per cent of children at the age of five had their first dose of the measles, mumps and rubella (MMR) vaccine last year, but only 71.7 per cent had their second dose.
For the diphtheria, tetanus, and pertussis (whooping cough) vaccine – known as DTaP – and the inactivated polio vaccine (IPV) booster, this figure was just 68.2 per cent.
An immunisation team has now been expanded in the city to address the problem, with the uptake percentages well below the 95 per cent World Health Organisation target required to eliminate diseases such as measles and rubella.
The city’s public health director, Lucy Hubber, said they are looking at two main areas, one being ease of access to vaccines, and the other being access to someone who can listen and discuss concerns – some of which stem back to the 1990s.
“We know that right back from the late 1990s, early 2000s, there were completely wrong concerns around the MMR vaccine,” she said.
“But actually, people now don’t listen to expert guidance in quite the same way. The damage there has been in the last 30 years from those messages that went out is really critical.
“So how do we work with people to make sure they have information they can understand, they can ask questions about, and can make informed choices?”
Before vaccination, measles was a serious public health threat.
In 1967, the year before a vaccine was first introduced, there were 460,407 suspected cases of measles in the UK, and 99 people died from the disease.
The measles vaccine was introduced in 1968 and changed to the MMR vaccine in 1988, after which it proved hugely successful.
However, a crisis of trust snowballed following the publication of Wakefield’s paper in the medical journal The Lancet in February 1998.
In the years following, attempts from other researchers to replicate his findings failed, and investigations revealed commercial links and conflicts of interest, leading to Wakefield being struck off the medical register.
In January this year, the UK lost its status as being measles-free once again amid a rise in cases.
Ms Hubber said the city is facing other difficulties, including having to play catch-up after the COVID-19 pandemic, when vaccinations for these infections were not offered for around 18 months.
She said there are greater concerns about access to vaccinations, adding: “What we are really concerned about are the people who don’t get the vaccine, or the people for whom it could either make a really big difference, or who are generally affected and less likely to come forward for a range of other things.
“Actually, that contact with the health service is really important, particularly while we are talking about childhood vaccines. We know from talking to people we haven’t necessarily got that right.
“A GP practice might make six, seven, or eight contacts with a family and the family doesn’t take up the offer. We’ve then got this team who will have as many conversations with that family, in that family’s home, as they need to make a decision.
“Actually, when they have somebody they can really ask questions of, and have all of their concerns addressed, they may then choose to get their children vaccinated.”
An extra £100,000 is being invested to encourage uptake in the city, with a particular focus on primary schools with low uptake.
Last year, the support team had 695 referrals for families who may not be engaging, and they ended up helping to administer 1,200 vaccinations, as well as fully immunising an extra 611 children.
“For some people, it is really personal,” Ms Hubber said.
“It might be family members giving them information, or it might be that they’ve had previous experience, or they’ve heard things. Misinformation and disinformation are really difficult to address, because almost the more you deny it, the more you add to it.
“Because we’ve been vaccinating against these diseases for so long in this country, we now don’t see a lot of things like measles, but they are still really serious infections and can affect children’s development, and very sadly, sometimes children still die.
“The more you understand and listen to people’s concerns, the better you are able to address them.”
