Measles vaccine must be compulsory for children before they start school, experts warn

Alessio Perrone

The UK should consider introducing compulsory measles vaccinations before children can start school to prevent the disease from spreading, experts have warned.

A group of researchers from the Bruno Kessler Foundation and Bocconi University in Italy said that far more people to be vaccinated or a schools policy should be introduced to keep the disease from becoming endemic.

However, British experts cast doubt on the idea, saying enforcing vaccines could reduce parents’ trust in the NHS.

The study found that about 3.7 per cent of the UK population was susceptible to measles in 2018 – well below the threshold at which the disease is at “elimination level” – 7.5 per cent.

But the number of people susceptible is expected to rise by more than 50 per cent by 2050 if current vaccination policies remain the same.

Proportion of young children in England who have received the MMR vaccine (Statista)

“Most of the countries would strongly benefit from the introduction of compulsory vaccination at school entry in addition to current routine immunisation programmes,” said the researchers.

Co-author Dr Stefano Merler said that introducing compulsory vaccination before children start school would be particularly useful in the UK, Ireland and the US to prevent future outbreaks.

The study analysed current vaccination trends in several countries, including the UK, Italy, Ireland, Australia, and the US, and was published in the BMC Medicine journal.

Children need two doses of the MMR vaccine for protection, and the World Health Organisation (WHO) recommends 95 per cent coverage to achieve herd immunity to stop the disease spreading.

Uptake of the first dose in five-year-olds in the UK exceeded 95 per cent, but uptake of the second dose is 88 per cent.

There were 259 measles cases in England in 2017, rising to 966 in 2018. Most were linked to people who brought back the disease after becoming infected travelling to other countries, including Israel, Ukraine, Southern Europe and the Philippines.

But British experts expressed doubts that compulsory vaccination was the right way to tackle the rise in cases in the UK.

“Before we even consider going down this route, we should ensure that we have efficient appointments systems and reminders and adequate numbers of well-trained staff, with time to talk to parents in family-friendly clinics,” said Dr David Elliman, Consultant in Community Child Health, Great Ormond Street Hospital, and RCPCH (Royal College of Paediatrics and Child Health).

“Compulsion may work in some countries, but it is not for us.”

European countries and the US are experiencing record numbers of measles cases, as immunisation levels have declined because of a scare of the jab.

Since 2018, 47 European countries have reported a record 100,000 measles cases and over 90 measles-related deaths, according to the WHO.

In the US, measles cases have also set a new record since the disease was declared eliminated nationwide in 2000, with over 60 cases in one week in New York City alone.

Additional reporting by PA