The number of measles cases in Ireland has increased more than three-fold, according to a United Nations (UN) report that warns millions of children worldwide are missing out on the measles vaccine.
More than 20 million children a year have not received the measles vaccines in the past eight years, while an estimated 169 million children missed out on the first dose of the vaccine between 2010 and 2017 – equating to 21.1 million children a year on average.
In Ireland, the number of cases have risen by 244 per cent, increasing from 25 cases in 2017 to 86 cases in 2018. There have been 48 cases of measles in Ireland so far this year.
Describing the UN figures as “stark and worrying”, Minister for Health Simon Harris said a fall in vaccination rates had allowed “diseases that were largely consigned to history to make a comeback”.
Earlier this month the minister said he "instinctively" agreed with barring unvaccinated children from attending schools or creches. "I have not definitively said that this is what we must do but that Ireland should be part of that debate," Mr Harris told The Irish Times, adding that he planned to examine steps taken by other nations in addressing the problem.
The minister also revealed plans to form an alliance of healthcare professionals, policy makers, parents and patients advocates to discuss how to reduce vaccine hesitancy, promote the benefits of vaccinations and “reduce the spread of myths that ultimately cost lives”.
“Sending a child to school unvaccinated is extraordinarily irresponsible and dangerous,” he said. “We have responsibilities as parents to our children and the children of others, to our community. We have to ensure people are properly informed and armed with the best medical advice.”
In 2017 the Irish vaccination rate was estimated to be 92 per cent, up from 86 per cent in 2009. However, vaccination rates have fallen slightly since 2015.
Unicef Ireland chief executive Peter Power warned that measles would "always find unvaccinated children" and that the foundations for the ongoing global measles outbreak were laid years ago. "If we are serious about averting the spread of this dangerous but preventable disease, we need to vaccinate every child, in rich and poor countries alike."
Dr Lucy Jessop, head of the HSE national immunisation office, warned that one case of measles could infect up to 18 people and that the only protection was the MMR vaccine.
A higher uptake in vaccinations is important for everyone, but particularly vital in protecting young babies who cannot receive the MMR until they are 12 months old, she said.
Measles infections worldwide nearly quadrupled in the first quarter of 2019 when compared to the same period in 2018, according to World Health Organization (WHO) data. Measles is a highly contagious disease that can kill or cause blindness, deafness or brain damage. Two doses of the measles vaccine are essential to protect children and the WHO says 95 per cent vaccine coverage is needed for "herd immunity" against measles.
Lack of access, poor health systems, complacency, and in some cases fear or scepticism about vaccines, means the global coverage of the first dose of the measles vaccine was 85 per cent in 2017 – a level that has remained similar for the past decade. Global coverage for the second dose is just 67 per cent.
The United States – which is fighting its biggest measles outbreak in almost 20 years – topped Unicef's list of high income nations with the most children missing the first dose of the vaccine between 2010 and 2017, at more than 2.5 million. Next came France and Britain, with more than 600,000 and 500,000 unvaccinated children, respectively, during the same period.
In poorer countries, the situation is "critical", Unicef's report found. In 2017, Nigeria had the highest number of children under one-year-old who missed out on the first dose, at nearly four million. It was followed by India, with 2.9 million, Pakistan and Indonesia, with 1.2 million each, and Ethiopia, with 1.1 million.
Additional reporting from Reuters