Seven years ago the World Health Organisation declared that measles was “eliminated” from Britain. This was an approximation, of course — it meant jumpy public health authorities were able to catch the disease in time when it snuck in at airports or harbours. This seems like a tricky thing to do — measles is highly contagious — but it is just about possible when 95 per cent of the population is vaccinated.
But the virus is back — and specifically, back in London. Our vaccination rates have dropped. Last summer we were warned that tens of thousands of cases could break out in the capital — we’re not there yet, but pockets of the disease have been erupting all winter, and it could get worse.
It’s strange to be battling a disease for which we’ve had a vaccine — cheap and widely available — for more than 60 years. And it’s not like the tools for running an effective vaccine programme lie hidden out of reach. Rwanda, Eritrea and Sri Lanka have managed to get a grip on the illness — they’ve vaccinated almost everyone. So why in a rich country like Britain is this old-fashioned illness running amok in the capital?
Measles is dangerous, by the way: it’s usually mild but about one in five of its victims ends up in hospital, and when really serious it leads to pneumonia, blindness and brain damage. It also kills. When someone with measles does turn up in an A&E waiting room there’s a frantic scramble to find and quarantine anyone who came near them in the past four days. This often means quarantining the waiting room for a start, and for children perhaps their entire school. Emergency vaccines work to an extent — if taken within 72 hours of contact with the virus, you can prevent the disease appearing.
Rwanda and Sri Lanka have got a grip on it. Why in a rich country like Britain is this illness running amok?
Still, you have a hard time trying to make people frightened of measles — it’s the familiarity perhaps. London, a young population, probably won’t remember waves of childhood measles before the vaccine. It left lasting immunity in its wake, but it also killed: in 1941 for example, 1,145 people died of it.
Just why isn’t London vaccinating its children? One problem is that they are a footloose lot, constantly moving house, which makes it hard to track children due for vaccination. Another is that London has a higher population of recent immigrants, some of whom are yet to register with a doctor in Britain. A third is that anti-vaccine sentiment, prevalent in some places in London, has grown over the pandemic — and spread beyond Covid into vaccines such as measles.
But there’s also an underrated danger in the capital: London’s high population of young adults. Strangely, this is one of the groups now most susceptible to developing — and then spreading — measles. Boomers tend to be fine: most will have had measles when young. Generation X and Millennials also tend to be fine: they were the lucky lot born after the vaccine programme started. It’s Generation Y we have to worry about — many of them were not vaccinated. And when 19 to 25-year-olds interact with under-vaccinated children, there’s a real problem.
Why? It all comes down to a small, speculative study published in the Lancet in 1998 by a doctor at the Royal Free Hospital in London. Dr Andrew Wakefield drew a link between children who had been vaccinated against measles, mumps and rubella — the MMR jab — and childhood autism. The study didn’t attract much notice at first, but newspapers like scare stories, and the little study soon caught national attention. Politicians failed to reassure. When then prime minister Tony Blair refused to tell the media whether his newborn son Leo would have the vaccine, the story caught fire. Perfectly rational people who vaccinated their kids for everything else refused to give them the MMR jab. Herd immunity meant most of these children didn’t get measles.
But now the problem is catching up to us. These jumpy Nineties parents are now indirectly putting a new generation at risk. There’s a perfect storm: circulating unvaccinated young adults, and many children who have missed their first MMR dose — due at two years of age — during the Covid pandemic, when parents didn’t want to risk taking them to a virus-filled hospital. A scare story from Antwerp, in Belgium: in 2014, a childcare worker caught measles on a trip and infected 28 infants — 12 ended up in hospital. This could be us.
The solution probably lies in public information campaigns — politicians could do a lot more to encourage young adults to finally get their jabs, and counter the anti-vaxxer sentiment online which has spread during the pandemic. We can’t afford a repeat of the Nineties — miss a round of vaccines, and it echoes down the generations.
