Health Visiting and the MMR: a matter of mutual decline

By | 28th August 2019

The Prime Minister, Boris Johnson, is reported to be concerned about the falling level of Measles, Mumps and Rubella (MMR) vaccination in the United Kingdom. The country has now lost its measles-free status… He has asked social media companies to block the spread of information from groups opposing vaccination (see previous post on this topic) and called a summit to discuss how they can promote positive information. The NHS website will also be used to address misleading claims and GPs asked to offer catch-up vaccinations.

These are all worthy efforts, but a little-known episode in the history of UK public health shows how wide of the mark they are likely to be…..

Diphtheria immunization was a well-established intervention… In December 1940, the Ministry decided to fund all local authorities to deliver vaccinations, supported by national publicity. The propaganda campaign involved advertisements and editorials in print media, despite the strict rationing of paper, radio broadcasts, information films shown in cinemas and by mobile units, leaflets and posters. The scheme was evaluated in 1942… The national publicity campaigns were abandoned and the focus shifted back to personal engagement between health visitors and mothers.

The decline in MMR vaccination rates strongly correlates with the decline in health visitor numbers in England since 2015… Bashing social media companies may make good headlines. It is, however, a distraction from the decline in public investment in child health services. If we really want to turn around the trend in MMR vaccinations, local authorities need the resources and political will to employ a sufficient number of health visitors, supported by children’s centres, to build the personal trust that is critical to accepting the minimal risks involved. This will necessarily cost rather more than giving lunch to a few representatives of the media and generate fewer headlines. It is, however, rather more likely to work.

A Cost of Living blog

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