Long delay in decision to begin more mumps jabs


THE CATCH-UP vaccination campaign in response to the growing epidemic of mumps in 18 - 21 year olds was first suggested last September but was not undertaken for budgetary reasons.

And as a result of the “blitz” approach which started this week, clinical staff have been withdrawn from essential services such as nursing home inspections and child health surveillance, internal health service documents reveal.

Earlier this week, the Health Service Executive (HSE) initiated a nationwide MMR vaccine blitz for older second-level students in response to a surge in mumps cases to almost 2,000 this year. This compares with 110 cases in the same period last year. The school-based programme is an effort to slow the outbreak by offering a second MMR vaccine to students.

It is hoped the initiative will also prevent further measles outbreaks and push the Republic towards meeting its World Health Organisation (WHO) obligation to eradicate measles here by 2010.

However, the HSE is concerned about what it terms “risk factors” in implementing a sudden four-week campaign. An internal memo says that, because community health and public health doctors, nurses and clerical staff will work full time on the vaccine campaign, “there will be disruption to routine work . . . and this will have a consequential impact on performance indicators and service plan targets.This work includes medical processing of grants and allowances, nursing home inspections, child health surveillance programmes, school health screening, medical requirements of disabilities act assessments and other child health activity.”

The memo also refers to the potential compromise of BCG vaccination of infants in the former southern and western health boards. It concludes that these are “acceptable levels of risk”.

Informed sources have said the potential for measles and mumps outbreaks was recognised as far back as 2002. This followed a decision to change the timing of the second vaccine dose from 12 years to four - five years without putting a comprehensive “catch-up” programme in place.

Proposals for local catch-up immunisation programmes since the change-over were turned down, sources claim.

A spokeswoman for the HSE said it was utilising “existing staff and resources” to respond to the outbreak and acknowledged other work may be delayed as a result. The cost of the blitz campaign will be absorbed within the population health directorate vaccine budget for 2009, she added.

The WHO Europe strategic plan outlines its determination to eliminate measles by 2010. To be successful, 95 per cent of the target population needs to receive MMR vaccines. The latest figures for uptake of the first MMR jab in infants show an uptake rate of 89 per cent. However, it is thought that immunisation levels for the second MMR vaccine are much lower and threaten the State’s WHO obligations.