§ Mr. McCartneyTo ask the Secretary of State for Health what will be the cost of the proposed mass measles immunisation programme; which pharmaceutical company will be awarded the contract to provide the amounts of vaccine needed; on what medical, social and public health grounds the decision to provide a mass measles immunisation programme was taken; if the proposed programme is separate from current vaccination arrangements; who will be targeted; and how the programme will be delivered.
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§ Mr. SackvilleThe cost of the measles immunisation programme has been estimated at about £20 million. The contract for measles/rubella vaccine for the campaign has been awarded to two companies: SmithKline Beecham and Merieux.
The decision to undertake a comprehensive immunisation campaign against measles was based on the advice of the Joint Committee on Vaccination and Immunisation following analysis by two independent groups of data on serosurveillance of measles antibodies by age group, measles notifications to the Office of Population Censuses and Surveys and age-related case confirmation. The results indicated that an epidemic of measles was likely involving 150,000 cases—range 100,000 to 200,000—in England and Wales, mostly affecting children aged five up to 16. Two-thirds of the cases would be in secondary school aged children. This is confirmed by experience in other European countries. Trends in measles notifications in 1994, the usual seasonality of measles and a marked increase in cases experienced in Scotland show that the epidemic is likely to occur in early 1995.
Measles can lead to pneumonia, blindness, deafness, brain damage and even death. Measles is likely to be more serious in older children and we would expect many to be admitted to hospital and about 50 deaths to occur. As well as the morbidity and mortality associated with an epidemic, there would be considerable disruption to children's education. An estimated 300,000 working days would also be lost through parents needing to stay at home with sick children. The cost to the health service of treating a measles epidemic would be up to £30 million.
The main childhood immunisation campaign is separate from the measles campaign, and it will be continuing as usual.
Each district has an immunisation co-ordinator who will also be responsible for organising this campaign. This will be a school-based campaign. District health authorities have been charged with offering immunisation to all children in school forms where most children are aged five up to 16. This will include four-year-olds and 16-year-olds in those school years. Parent information leaflets and consent forms have been distributed through schools and most children will be immunised in school.
As the campaign is on a greater scale than other immunisations carried out in schools, additional staff may be contracted by the health authority to work with the existing school health service during the campaign or to immunise any children missed by the main campaign in November. This may include health visitors, practice nurses or general practitioners. Staffing arrangements will be a matter for local decision according to local circumstances.