Prevention: Experts gather this week to discuss the progress of immunisation. Elaine Edwards reports.
Ireland continues to have one of the highest rates of measles, a potentially fatal disease, among the 52 countries of the World Health Organisation's European region, a conference will hear this week.
Experts on immunisation will address the second National Immunisation Conference in Sligo on Thursday.
Measles remains the most deadly vaccine-preventable childhood disease, with complications ranging from severe breathing difficulties and ear infections to encephalitis, brain damage, or even death.
While countries such as Finland and the US have effectively eliminated measles, Ireland still has insufficient uptake of MMR vaccine to eradicate the disease, according to Dr John Spika, medical officer of WHO Europe's Vaccine Preventable Diseases and Immunisation Programme.
Dr Spika, who will address the conference, says elimination of measles means a rate of less than one case per million of population per year. Ireland's rate is close to 10 per 100,000, or 100 per million.
"We have a target rate of less than 1 case per million of the population. Half of our 52 countries in the region have achieved that level. We are making a lot of progress, so now the focus is more on those countries that haven't been doing as well, particularly those countries like Ireland where the rates are quite high."
Measles immunisation was introduced here in 1985 and continued as MMR (measles, mumps, rubella) from 1988 onwards. Children require two doses of the vaccine in order to maximise immunity levels.
However, scare stories following some research papers have been responsible for a drop in the uptake of the vaccine.
While the WHO aims to have 95 per cent or more of all children immunised, Ireland's current rate of uptake for MMR is just 83 per cent, but dropped below that after such stories in the 1990s.
Dr Spika insists the vaccination is "safe and very effective".
"The claims that were being made about autism associated with the MMR vaccination were unsubstantiated and they've been pretty much withdrawn now by a number of the authors that were associated with the initial reports.
"The biggest issue is now, from a public health standpoint, to ensure that the public and public healthcare professionals are fully informed about the benefits of immunisation and the risks associated with not being immunised and encouraging children to be immunised."
Helen Bedford, lecturer in children's health at the Institute of Child Health in London will address the conference on the issue of how health professionals deal with parents and their questions about MMR.
"It's very difficult to unpick some of the scare stories which, I'm afraid, have come from the media. They go back a long way. Smallpox vaccine was introduced 200 years ago and at that time there were scare stories about people growing 'bits of cow', because the vaccine was originally derived from cowpox.
"Then in the 1970s in the UK there was a big controversy over whooping cough vaccine. A lot of people didn't have their children immunised and there were a couple of large epidemics of whooping cough."
More recently, the controversial and later retracted 1998 study on links between MMR and autism by Andrew Wakefield contributed to a dip in MMR uptake.
"We know that immunisation uptake is dependent on many different things that are interrelated, such as how well services are organised and whether they're accessible because we know that families who are disadvantaged are less likely to get their children fully immunised because it's basically difficult for them to access it. So it's up to health professionals to make it easier," says Bedford.
"Interestingly, for MMR it's the advantaged, educated people that are rejecting it. I think it's because people are searching the internet, finding loads of information and getting scared.
"Everyone has a different level of understanding, but also different levels of anxieties.
"So if there's a child in the family with autism, they are going to want very different information. For some reason because information is on a computer and comes from the internet it seems to be taken as the truth. But the truth is that anybody can put anything on the internet with no issue about questioning its validity."
Thursday's conference is organised by the Health Service Executive North Western Area and the Programme of Action for Children, originally established by the Health Boards Executive to manage child-related projects.
Other speakers will include Dr Suzanne Cotter of the Health Protection Surveillance Centre, who will discuss the recent mumps outbreak and the impact of MMR.
Dr Brenda Corcoran, assistant director of the Programme of Action for Children, is a member of a committee established by the Department of Health and Children to examine Ireland's strategy for the elimination of measles and rubella.