Measles Cases

Lord Evans of Rainow Excerpts

Monday 22nd January 2024 Lords Chamber

[Baroness Merron]

To ask His Majesty’s Government what assessment they have made of the declaration of a national health incident by the UK Health Security Agency over a surge in measles cases across the country.

[Lord Evans of Rainow (Con)]

My Lords, the UK Health Security Agency declared a national incident on 8 January 2024. The government health system is taking control of the disease’s spread. Our aim is to protect as many individuals as possible through convenient vaccination, targeting our offer to low-uptake communities; to contain outbreaks by working with local partners to effectively contact, trace and reduce risk to the most vulnerable; and to promote vaccination through engagement and communication with GPs, teachers and trusted community leaders.

[Baroness Merron (Lab)]

My Lords, this is a grave yet preventable situation, especially as 80 countries across the world are measles-free while the UK has lost its status. I am sure that the Minister recognises that the Government should have read the warning signs and acted sooner to tackle vaccine hesitancy and low take-up. How will lessons be learned from the pandemic and used to focus on the communities, children and young people at greatest risk? Will a taskforce be established to co-ordinate relevant partners and oversee a rapid improvement to get to the WHO 95% target for take-up?

[Lord Evans of Rainow (Con)]

From 1 January 2023 to 30 November 2023 there were 209 laboratory-confirmed measles cases in England. Over three-quarters of those cases are from the West Midlands, predominantly Birmingham and Coventry. In the West Midlands, an NHS integrated care board system partnership group has been establishing and co-ordinating a regional response. Extensive local communications and engagement have been undertaken in the West Midlands alongside the immediate response to support the uptake of the measles, mumps and rubella vaccine. Nationally, the UK Health Security Agency has established an incident management team to oversee the public health response to the outbreak. The noble Baroness is exactly right: this country had a proud record on vaccination prior to Covid-19 but there has been a decline in recent years since the pandemic, and we have to do more to get back our status.

[Lord Allan of Hallam (LD)]

My Lords, a large group of adults in this country have not been vaccinated against measles for a variety of reasons. Can the Minister confirm that any adult who believes that they have not had the MMR vaccine can receive it free of charge on demand from their GP? Is he confident that there is enough capacity in the system for the routine childhood immunisations, as well as for making sure that when adults do the right thing and protect themselves with vaccination they can receive one quickly?

[Lord Evans of Rainow (Con)]

The noble Lord raises a very good point; about 25 years ago there were rumours and misinformation about the MMR vaccine, so there is a cohort of those in the younger generation—mid-20s or so—who should contact their GP today and ask for an appointment, which can be confirmed. I believe that there is capacity for all those who wish to have vaccinations at their GP surgeries.

[Baroness Verma (Con)]

My Lords, will my noble friend work with community groups that I am working with to get the message across about the importance of the measles vaccination? I have realised that, especially since Covid, there is a fear among particular groups of getting their families vaccinated. Perhaps we should have a communication plan that is accessible for everyone.

[Lord Evans of Rainow (Con)]

I am very happy to meet my noble friend’s community leaders. It is very concerning that certain segments of our communities feel uncertainty and doubt about these very safe vaccines, and the Government are working very hard with all sections of the community.

[The Lord Bishop of St Albans]

My Lords, on the relatively low take-up in minority communities, either the message is not getting through, sometimes for language reasons, or there is a lack of trust. There is quite a lot of evidence, not least in other parts of the world, that the way to address that is to clearly target the recognised community leaders so that they can act as brokers. What attempts are being made to work in our gurdwaras, temples and mosques in particular, to get those leaders to commend these vaccinations to the people with whom they are in direct contact?

[Lord Evans of Rainow (Con)]

The right reverend Prelate is right to bring up this subject. Pop-up clinics are a quick and easy way to serve hard-to-reach communities. He mentioned mosques, where the Government are using a new initiative to encourage parents to take their children for immunisation. He also mentioned distrust of the vaccine; for example, there are variations with different make-ups. For those with religious beliefs about using pig content, there are alternatives. There is no reason why anybody in this country should not take up this very safe vaccine; as he says, we have to encourage all sections of the community to take it up.

[Baroness Watkins of Tavistock (CB)]

My Lords, will the Minister comment on the fact that there is such an unequal distribution of health visitors among different communities? Often young mothers and fathers, in particular, do not have the attention of and discussion with a health visitor about the importance of vaccinations generally. Will the Government look at this in detail so that we can return to the situation we had five years ago?

[Lord Evans of Rainow (Con)]

The situation varies across the country. What is clear in the more deprived sections of certain communities is that such communications are not what they could and should be. The message to any parents of young children is that they should contact their GP today and get them vaccinated.

[Lord Hodgson of Astley Abbotts (Con)]

My Lords, for those who were involved in the vaccine reluctance programme 20 or more years ago, the major difficulty was that the simultaneous MMR vaccine had a stabiliser called thimerosal, and it was believed that thimerosal led to adverse reactions in a number of young people. Will my noble friend confirm that thimerosal as a stabiliser has been removed; I am sure that he cannot answer that now, but will he write to me and put a copy of the letter in the Library?

[Lord Evans of Rainow (Con)]

I am grateful to my noble friend for that question. He is right that I cannot answer his specific point on the make-up of the vaccine, but I will write to him and place a copy in the Library. The MMR vaccine is perfectly safe; that is not to say that some individuals—a tiny proportion—might not have an allergic reaction or whatever to it, but it is very safe and can save lives.

[Lord Harris of Haringey (Lab)]

My Lords, 11 months ago there was a gathering in the Carlton Club of those who believed that vaccines are part of some great global conspiracy. This is an international problem of people undermining trust in medical solutions such as the MMR vaccine or Covid vaccinations. Have the Government been complacent about this, perhaps because so many of their right-wing friends support this nonsense?

[Lord Evans of Rainow (Con)]

I do not accept the premise of the noble Lord’s question. The Government are committed to tackling vaccine misinformation. This includes ongoing monitoring of vaccine uptake and attitudes towards vaccines by the UK Health Security Agency. The Department of Health has always worked alongside the NHS, other government departments and social media companies to develop innovative and effective ways to tackle anti-vaccine messaging and limit misinformation. The Government also work with the UKHSA and the NHS to support parents, to ensure that patients have access to up-to-date and accurate information on all vaccines delivered by the NHS, and to identify and rebut false information.

[Lord Laming (CB)]

My Lords, have the Government been able to ascertain why the vaccination rate in the West Midlands is so low in contrast to other parts of the country?

[Lord Evans of Rainow (Con)]

My Lords, the vaccination rate in the West Midlands is below the national average but not as low as in London. In London it is 75% and in the West Midlands it is 80%, so it not just a case of the West Midlands. There are many reasons why: large concentrations of social deprivation, transient communities and misinformation bring that all to a head, and to a very low and unacceptable uptake in vaccination.

[Lord Bethell (Con)]

My Lords, it is not just the rate for MMR that has fallen behind but that for the majority of childhood vaccines recommended by the WHO. Last year, the House of Commons Health and Social Care Committee published a report with a large number of recommendations on how to catch up on those important vaccinations, including the deployment of retired clinicians and nurses to increase the capacity. Those recommendations have been largely ignored. Will my noble friend please advise me whether the Government are inclined to relook at that important report and implement some of its helpful suggestions?

[Lord Evans of Rainow (Con)]

I am grateful to my noble friend for his helpful suggestions. I do not have an answer to his question here and now but I will certainly feed it back to the department.

[Lord Turnberg (Lab)]

My Lords, it is extremely difficult to influence public opinion when people latch on to the misinformation that is floating around. One way of combating it is by using different techniques to get to the public. I wonder whether the security agency has engaged with PR companies or used IT, such as TikTok and various other things which I know nothing about but which seem to influence public opinion.

[Lord Evans of Rainow (Con)]

The noble Lord raises a very good point. There are modern communications tools, such as TikTok, which young people use. Given the collective memory of this dreadful disease that our parents or grandparents used to talk about—how debilitating measles in the first half of the 20th century could be in ruining lives, including affecting babies’ ability to see and hear—this is a success story. We almost eradicated this disease in 2015, but the collective memory means that it is perfectly safe in some people’s eyes. There is misinformation saying that not to take this vaccination is a safe thing to do. It is not and we have to do more, including through social media, to make sure that younger people realise they should get their children vaccinated.

[Baroness Bennett of Manor Castle (GP)]

My Lords, NHS England is recommending that all our staff in GP surgeries who deal with patients with suspected and confirmed cases of measles—which, given the symptoms, means a large number of patients—should wear PPE. Is the Minister confident that there are enough supplies of PPE? Do the GPs have to bear the extra cost of that PPE or will there be support from the centre to ensure that cost is covered?

--- Later in debate ---

[Lord Evans of Rainow (Con)]

The noble Baroness asked a very important question about PPE. I am not aware of any issues in GP practices when GPs are meeting patients from their communities to discuss vaccinating their children.

[Baroness Hayman (CB)]

My Lords, regarding communication with parents and community leaders, are the Government looking at and talking about the fact that vaccination is not simply a personal decision and has consequences beyond it? It has gone away from public consciousness that a decision not to vaccinate a healthy child in one’s own family can have catastrophic effects for immunocompromised children in other families and for children who cannot medically be vaccinated. It is very important, given the social impact of vaccination and immunisation programmes, that the Government take that message about responsibilities regarding other children at schools or nurseries with unvaccinated children to their communications with the public.

[Lord Evans of Rainow (Con)]

I wholeheartedly agree; the noble Baroness raises a very important point. It is a decision for parents to make about their child. However, when that child goes to school, it is also about the children within their class and wider society. As I said in a previous answer, we have lost the collective memory of what a terrible disease it is for those young people. As outlined by the noble Baroness, it is really quite simple. I say again to anybody with young children who have not been vaccinated, or who thinks they have not been vaccinated: contact your GP and arrange a vaccination visit.

[Lord Carlile of Berriew (CB)]

My Lords, in Germany children cannot attend school if they have not had a measles vaccination. In France, Italy and some other countries, such vaccinations are compulsory. Will the Government introduce such legislation here?

[Lord Evans of Rainow (Con)]

The noble Lord asks a very good question. That is how Germany and France deal with their children; this is Britain. I will take the noble Lord’s suggestion to the department and will write to him.