‘Huge concern’ - Why MMR figures are declining and what's being done to fix problem

The decline in children getting their full measles, mumps and rubella (MMR) jabs across Liverpool is a “huge concern” but the city council has been urged to steer away from “scare tactics.” The number of youngsters being inoculated against MMR is among the lowest in England’s core cities, despite previous excellent results.

According to documents made available by the Liverpool Council adult social care and health scrutiny committee, less than three quarters of children in 2023/24 had the two doses of the MMR vaccine for full protection by their fifth birthday. Community leaders now want to do more to encourage families to ensure they are getting the vital dosage.

A report on uptake outlined how the rates had fallen steeply during and since the pandemic. It said only 80% of children aged two have had a 1st dose of MMR (2022/23 full year). In some communities the uptake is lower and will take time to recover rates.

The most recent Liverpool data available is for quarter 4 of 23/24 which shows that 81.2% of children had their first dose of MMR by their second birthday. 74.6% had the two doses they needed for full protection by their fifth birthday.

These are provided as part of routine childhood vaccination programmes. The MMR vaccine protects against measles, mumps and rubella. It is free and usually given at the GP practice. The first dose is given to babies around their first birthday and the second dose before children start school. 95% uptake is needed to prevent measles spreading. The vaccine is safe and highly effective.

Cllr Harry Doyle, cabinet member for health, wellbeing and culture, said the data should be a “huge cause for concern for the committee and the city as well,” adding that it was “deeply worrying.” He added: “We’ve got to make sure we’re addressing this issue” and “remind people of the dire consequences of outbreaks in our city.”

Cllr Doyle said the information indicated vaccine hesitancy “has increased massively since the pandemic in particular” and there had been a “disparity of take up in more deprived areas.”

In a bid to drive up vaccination numbers, the multi agency Liverpool Childhood Immunisation Group has put in place an action plan while NHS England has commissioned an intervention to support GP practices to make best use of data to protect unvaccinated children and strengthen processes to engage with parents.

All children aged between one and 11 years have been recalled to offer them any missing MMR doses. Young people aged between 16 and 25 years are now also being recalled to offer them missing MMR doses with the message that it is never too late to get vaccinated.

A pilot programme to offer catch up MMR vaccinations across a sample of primary schools has also been delivered. A series of community vaccination catch up clinics are being offered for primary and secondary aged children through the summer holidays.

Chris McBrien, associate director of public health, said there had been a slow decline which was linked to people “questioning things” around vaccinations. She added: “What’s been really useful over the last couple of years is talking to communities and understanding what those barriers are.

“I can understand residents’ concern and confusion and we’ve got to do a lot of work in terms of how we engage with our communities in a safe way with trusted voices to get that message out there.”

Cllr Steve Munby offered a more direct approach. He said: “I’m not a fan of scare tactics, but I wonder if looking at mumps and rubella, whether there’s targeted scare tactics aimed at adolescents because of the risk of mumps in older men and if you get rubella when you’re pregnant, is there a targeted message we can aim at certain groups of people?”

Ms McBrien said the public health team was keen to “take people with us” as there was a “fine balance between fear and encouragement and suspicion,” adding: “We’ve seen that with covid, suspicion if you go too hardline with something. We need to do more with encouragement.”

Cllr Lucy Williams said: “These stats are really alarming and I’d be against any type of scare tactic. The key here is education.” She asked why rates in Liverpool were so low.

Ms McBrien said: “We have seen a general decline, and particularly in areas of deprivation, we’ve seen a decline. I haven’t got the answer as to why Liverpool but in terms of our communities there’s been a widening disconnect there and it’s important we bring that back together.”

City centre member Heather Westhead suggested the answer could be more sociological. She said: “Liverpool has always seemed to have a culture of anti-establishment and with covid people felt they were being told what to do and had no choice in it, this is kind of just a reaction to it. This is the consequence of that, as unintended as it is.”