Developmental services suffer over swine flu vaccine staffing

Drop coincides with transfer of staff from immunisation clinics to mass vaccination centres for swine flu

THERE IS growing concern about falling MMR (measles, mumps and rubella) vaccination rates in schoolchildren as well as a lack of developmental screening for seven- to nine-month-old babies following the diversion of public health doctors and nurses to provide staff for swine flu vaccination clinics nationwide.

In the Sligo-Leitrim area alone, MMR uptake rates have dropped from 95 per cent to 90 per cent in the three months from October to December 2009. This drop coincides with the transfer of staff who normally run MMR immunisation clinics to mass vaccination centres set up in September to deal with the H1N1 pandemic.

Public health experts are especially worried about the implications of stopping MMR vaccination against a backdrop of recent measles outbreaks in several parts of the country.

In addition, some 2,400 children in the northwest should be screened annually for hearing, vision and growth checks. Sources have confirmed that the school nurses who normally carry out this work have been unable to do so for the past four months, because they have been redirected to work in swine flu clinics.

And the community medical doctors to whom children with hearing and other problems are referred by school nurses have been unable to assess children, as they too have been redeployed. As a result, children with heart defects and spinal problems such as scoliosis are not being picked up.

With a growing cohort of children who have not been offered MMR, BCG and other immunisations, experts have warned that “herd immunity”, the mechanism by which vaccination offers protection against infectious diseases, will be lost.

Although the operation of mass vaccination swine flu clinics are expected to be scaled down in coming months, the need to start a HPV vaccination programme against cervical cancer for 12-year-old girls means that staff are likely to be redirected to this programme, leading to continuing neglect of statutory child health surveillance programmes.

In a memo sent last week to senior HSE managers, Dr Kevin Kelleher, assistant national director of population health, outlined a requirement for 90,000 HPV vaccines to be administered over a six-month period to girls in their first year at secondary school.

Listing a number of key challenges, he said: “Redeployment of school vaccination teams to mass vaccination clinics has resulted in the postponement of routine school vaccination and screening programmes. This deficit requires to be addressed prior to the end of the school year in June 2010.”

Dr Paula Gilvarry, chairwoman of the national public health doctors committee of the IMO, said last night: “It is time for the Minister for Health to ask, is it the best use of resources to have skilled community medical doctors carrying out vaccines.”

A spokeswoman for the HSE told The Irish Times that in response to the unique threat of swine flu, staff had to be redeployed to administer the H1N1 vaccine. “Whilst this meant that some elements of routine work had to be deferred, the HSE is now working to ensure that all four- to five-year-old schoolchildren will receive their MMR and four-in-one vaccines within the school year,” she said.