Opinion | The urgent need to immunise older age groups
The European region today faces a very worrying resurgence in measles, a disease that countries had hoped to eliminate by 2010. Yet, in 2011, Europe reported more than 37,000 cases of measles, including 10 measles-related deaths, and the elimination target date has been pushed back to 2015. Outbreaks in several western European countries, and now an outbreak in Ukraine, have led to growing concern over the possibility that upcoming international sporting events, such as the Olympics in London and the European football championship, could lead to further spread of measles. In a worst-case scenario, these events could even result in exporting measles to other parts of the world.
Against this backdrop, it is important to realise that the majority of reported measles cases in 2011 occurred in individuals age 14 and older. Understanding that comprehensive childhood immunisation is the cornerstone of any successful immunisation programme, it is clear that vaccinating individuals in older age groups against the measles virus is an equally important step in our determined march towards measles elimination.
Some of the adults we have seen infected with the measles virus never received a second dose of measles-containing vaccine (MCV), due to past single-dose policies, which have proven to provide less than optimal immunity. Others have simply missed doses or have never been immunised in the first place. These people remain at risk since they are susceptible to measles infection. In Denmark, for example, the measles immunisation programme only began in 1987, leaving many adults under-immunised due to suboptimal coverage for many years.
After more than a decade with a minimal number of measles cases, the disease has surged in Denmark, particularly among young adults. For this reason, adults under 39 years of age who have not been vaccinated previously have been offered MMR vaccination free of charge from April 1 through the end of 2012. We encourage public health authorities in other countries to develop strategies to offer additional or missed doses to these individuals. We also encourage frontline health care workers to reach out to patients in these age groups and work with them to ensure they are immunised.
To adults and to parents, particularly of older adolescents, we strongly encourage you to check your own immunisation status. If you have no verification of receiving two doses of MCV, you may be at risk of becoming infected with the measles virus. If this happens, you could potentially spread this highly contagious disease to unimmunised or under-immunised family members, friends, neighbours and colleagues. You could spread this disease to infants – even your own child – who are still too young to be vaccinated against measles, but who are at high-risk of complications if they become infected with the virus. You could spread measles to people who, due to mitigating health factors, cannot be vaccinated and therefore depend on those around them to help protect them from disease.
In addition to making sure that all children are fully immunised on time and in keeping with national immunisation schedules, we urge you to check your own status and to get any missing vaccinations, measles or otherwise. Your decision to do so will protect not only you, but also your family and your community.