§ Mr. Carter-Jones
asked the Secretary of State for Social Services (1) what advice he has received from the Children's Committee concerning the number of children who are likely to be born with congenital rubella as a result of the current epidemic; and if he will make a statement;
(2) what recommendations he has received from the Children's Committee concerning the action which needs to be taken to protect babiees from congenital rubella; what action he proposes to take; and if he will make a statement.
§ Mr. Ennals
I am glad to have the opportunity to remove any misapprehensions which may have arisen on this matter.
The report which I received from the Children's Committee in September suggested that the number of infants born this coming winter with congenital rubeila could, as a result of the recent steep increase in the incidence of the disease, possibly rise to 1,500 to 2,000. This figure was based on the assumption that the average annual number of children affected by congenital rubella was 400. While there is no firm evidence on which to base statistics, a surveillance scheme which has been in progress since 1971 suggests that that figure is probably twice as high as the true figure even without allowing for the effect of pregnancy terminations.111W
The Children's Committee has suggested that my Department should launch in 1979 an extensive campaign to promote the take-up of rubella vaccination by all women between the ages of 20 and 45 and by all girls between the ages of 11 and 20 who have not so far been immunised. This recommendation was considered at a meeting of the Central Health Services Council last month and will be before the Joint Committee on Vaccination and Immunisation, the medical body to which I principally look for expert advice in the field, later this month.
Rubella vaccination was first introduced for girls between their eleventh and fourteenth birthdays in 1970, and its availability was extended, as soon as the necessary facilities for serological testing were available in 1972, to women of child-bearing age at special risk—for example teachers and nurses. The extension of availability to all susceptible women of child-bearing age took place in 1976. Letters were sent to all doctors in 1972, 1974 and 1976 emphasising the need for vaccination. On 15th August 1978, the chief medical and nursing officers issued a letter setting out a revised schedule on vaccination and immunisation procedures, including rubella vaccination both for girls aged 11 to 13 and for adult women of child-bearing age who are seronegative and therefore susceptible. In all this we have had the advice of the joint committee. A seminar on measles and rubella vaccination involving the Department and practising doctors and nurses was held in Harrogate last month.
There is evidence that the number of women of child-bearing age susceptible to rubella has already fallen. But I have decided that further action is needed, and that, subject to the expert advice I shall receive from the joint committee, we should in 1979 mount a considered campaign designed to eliminate congenital rubella—though we should be fortunate indeed to achieve complete elimination.
It is by no means clear that the enhanced effort needed should all be directed at the vaccination of adult women, as distinct from children. Moreover, in working out the details of a campaign, it will be important to ensure that all branches of the medical and nursing professions are able to play their 112W full part; that the resources for serological testing in the public health laboratory service are available to meet the additional need; and that any publicity campaign is carefully planned and executed. It is by no means self-evident that a national advertising campaign would necessarily be the best way of increasing the take-up of rubella vaccination by all sections of society. We are now working urgently on all these matters.
Finally, I am glad to be able to tell my hon. Friend that we appear now to have reached substantially the end of this year's rubella epidemic.