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This is the Guardian. Today, the alarming spread of measles across the UK. It might start like any cold. You’ve got a temperature, your nose is running and you’re a bit achy. But a few days later, a rash starts to develop on your skin. Red brown spots that might blur into bigger blotches, usually spreading from your face, down your body. And it can get much worse. Her eyes started to swell up and the rash started to develop. And then it was really, really visible that she was. She was very sick. I thought we wouldn’t get through it. That’s the truth. She was delirious. Her body was covered in the rash, which you couldn’t touch her skin. I was very unwell when I was taken into heartlands. I don’t remember the journey to hospital. The rash was horrendous. The temperature was awful and it went into my lungs and my liver was affected by it. Measles is a virus that’s incredibly infectious, that can cause lasting harm and is potentially life threatening. But we can vaccinate against it. Take an hour out of your day, take your child to the doctor, because otherwise you’re going to have to take a month off work to look after your sick baby. Or worse, you’re going to lose them. The strange thing is that at one point in 2017, we’d eliminated it. The World Health Organization announced it was no longer endemic in the UK, thanks to so many of us getting vaccinated. But now, cases are rising and they’re rising quickly across Europe, the number of people infected with measles was 30 times higher last year than the year before. And in the UK, there are now major outbreaks in London and the West Midlands. At walk in centers across the midlands, worried parents today brought their children to be jabbed. This health hub in Wolverhampton was opened as part of a push to vaccinate against measles after a significant rise in infections. From the Guardian, I’m Hannah Moore. Today in focus, the national campaign to get measles back under control. Nicola Davis, you’re science correspondent for the Guardian and you’ve been writing about why the number of people with measles is rising in the UK. How bad’s the situation at the moment? Well, it’s certainly worrying. A lot of public health officials are clearly quite concerned about this. I mean, if you look at what’s happening, we’re seeing outbreaks in the West Midlands and in London West Midlands experiencing their highest level of measles cases since the mid 1990s. If we look at numbers from the UK, Health Security Agency. They’ve said that as of the 18 January. So just a few days ago, there have been 216 confirmed cases and 103 probable cases in the West Midlands since the 1 October last year. So that’s quite a high figure. And around 80% of those cases have been seen in Birmingham. So it’s kind of quite localized hotspots that we’re seeing, and most cases have been in children aged under ten, although not all of them. And we’ll come back to that later, a national incident has now been declared. There are concerns that outbreaks could crop up elsewhere as well. So this is clearly something that public health officials want to get on top of and do it quickly. How does measles affect people when they get it? So this is an important point, because I think it’s something that experts have said really needs to be appreciated. Measles is a nasty virus and it can cause some very serious complications. If you think about before vaccines came along, and we’ll talk a bit more about this later, that killed around 100 people a year in England and Wales. So this is a potential killer. It can have complications such as blindness, pneumonia, fits, inflammation of the brain in pregnant women, it can cause miscarriages and stillbirths. I think in most people’s mind, there is that kind of idea of a rash. But perhaps, and this is something experts have said, perhaps the severity of measles isn’t really appreciated right now, and that might well be because it’s not as widespread as it once was. People maybe never have seen a case of measles, and that’s a good thing. We don’t want measles. But it does also mean that perhaps people are not as aware as they would have been in previous decades of just how nasty measles can be. Who is most at risk then, if they catch measles? Is it children? Well, this is an interesting one. So anyone can catch measles? Anyone unvaccinated, I should say, can catch measles. This isn’t a disease only of one particular age group. It’s often thought of as a childhood disease because it’s highly contagious. And so before vaccines came along, most people had measles whilst they were in childhood. But anyone who isn’t protected can get measles. And in fact, those who are at highest risk for severe illness and complications from the virus are not only infants and children under the age of five years, but also adults, sort of from 20 years upwards. And how infectious is it, say, if a child turns up at school or an adult turns up at work and has measles, how would it then spread through the school or through the workplace to other people? It is incredibly infectious. It’s really easy to pass on. So one way of looking at this is to look at the r zero figure. We all remember r from the COVID pandemic. But just to recap, r zero is about what would happen if you had a population where there’s no vaccination. So if you imagine a room full of people who, none of whom had any protection against measles, what happens if you plop someone with measles into that situation? And estimates for what would happen kind of vary. But if you look at the UkhsA national measles guidelines, they say that this figure is often put somewhere between 15 and 20. Now, what that means is that if you have a single case of measles, if you have a single person with measles and you plop them into a room, they can pass it on to 15 to 20 other people. Wow. So it really is a case that this will spread very quickly in an unvaccinated population. And that’s the concern. It’s spread through coughing, sneezing, breathing. How long can it hang around in the air for? So, yes, you’re right, it can be spread by things like coughing and sneezing, breathing in the air somebody else has just breathed in. If they’ve got measles. The WHO, that’s the World Health Organization has said that the measles virus remains active and contagious in the air or on infected surfaces for up to 2 hours. So it’s very infectious and it can be transmitted by an infected person from four days prior to the onset of the rash and four days after the rash is seen on the body. So even before you get the measles rash, you can be contagious and spreading it to other people. Nicola scientists developed an effective measles vaccine back in the 1960s. Before that, how bad an effect was the virus having? Yes. Measles was a well known nasty disease, as said, because it’s so contagious, most people had it probably by the time they were about 15. It was something that you had as a kid with huge numbers of infections and indeed deaths. If you look at the data from the Centers for Disease Control and Prevention in the US, there was sort of an average of about 550,000 measles cases and maybe about 500 measles deaths annually in the US. You had lots of hospitalizations and of course, people developing chronic disabilities because of measles. Infections. So it’s not just that people would get it, get sick at that moment, recover. Toddle on it was that people were left with quite serious disabilities as a result of these infections. So that’s why there was this big push to To get rid of this virus. That’s why it matters. People don’t suggest people have vaccinations just for fun. There’s a really good reason for it, and that’s because this is a nasty disease. And it did have a big public health impact. And after the vaccine started to come into use around the world, how did it change things? So if you look at notifications of measles in England, Wales, you can see a really steep decline following the introduction of vaccination against the disease. So in 1968, a measles vaccine was introduced to the UK. And in 1988, I believe, the MMR vaccine was introduced. And that’s a single jab, but it protects against three nasty diseases measles, mumps and rubella. So it was all combined sort of into the one vaccine. So you can see, if you look at the data, you can see a sharp decline. And then there was a further reduction following a very influential 1994 campaign here, which was very much about really, again, trying to increase uptake of this form of protection amongst the population. So you can see quite clearly in the data the impact of these vaccinations. Since then, there have been fluctuations, but not on the scale of the pre vaccine situation. So the UK was doing really well at getting the rates of measles down. Uptake of the MMR vaccine was high in the talked about that health campaign. But then in 1998, the Lancet medical journal published findings that got worldwide attention, but that have since been completely discredited, linking the vaccine to autism. How did that conspiracy theory affect how many people got their children vaccinated? So, as you say, this 1998 study has been discredited and debunked. A number of robust studies now have shown that there is not a link between the MMR vaccine and autism. But nonetheless, obviously it worried parents at the time, and some parents continue to be worried about this. They might have come across this somewhere online or whatever. And so despite the fact that it’s been debunked, it had a big effect at the time. And for some people, it’s something they are still worried about. The paper was written by a discredited doctor called Andrew Wakefield and it gave rise to kind of what’s been dubbed the Wakefield generation. So this is kind of whole cohort of sort of youngish adults, post university now, mainly, but who missed out on their jabs when they were kids. And in fact, if you looked at sort of before the COVID pandemic, there were a lot of concerns about outbreaks of measles in young adults. At music festivals, at university and so on. And that was because they didn’t have their jabs when they were kids. So that has had a big effect. And if you’re an adult, as I said earlier, and you haven’t had your MMR jabs, you can get measles and it can be very severe. How did health bodies, the government scientists, try to get the message out to people that this vaccine is safe? And did that messaging work through the think there was a big effort in scientific circles to kind of really study this? And like I said, it wasn’t just one study. There have been numerous studies now showing that there isn’t a link between MMR and autism. If you go to the NHS web pages now about the MMR vaccine, they have a specific sort of paragraph in there sort of addressing this concern that was raised at one point, and I said, now debunked. So there has been a kind of concerted effort to really set the record straight. And did that help to actually increase the number of people who were getting the vaccine? There was a bounce back in the uptake of MMR vaccinations. And in fact, in 2017, as the UK HSA notes, the World Health Organization declared that the U. K. Had eliminated measles. So we did kind of get back to a really good point with measles vaccination. But in recent years, there’s been a decline once more. And it’s not sort of a sharp drop, it’s kind of a gradual decrease in the levels. The key thing here is that you need two doses of the MMR jab. So that’s why everyone talks about coverage of two doses. If we look at coverage of that second dose in 2022, stroke 23, say that year, 84 and a half percent of children had their second dose by their fifth birthday. But we need 95% coverage to get what we call herd immunity. Now, herd immunity had a lot of time in the press, bad press. Yeah. But just to sort of talk about what this means in terms of something like measles, basically what that means if you’ve got 95% of a population has two doses of the MMR vaccine, what it means is that if you are somebody who hasn’t been vaccinated because, say, might be a baby who’s too young to have their vaccinations or they might have some health problem or whatever, that means they can’t be vaccinated. It means that they’re still protected because there’s sort of a firewall around them. People around them can’t catch measles and spread it. So they’re kind of indirectly protected because so many people around them have been vaccinated. And for measles, like I said, that figures around 95% coverage of the second dose of the MMR vaccine that you need to get that kind of protection. So 84.5% of children receiving two doses by the age of five is just not enough. Why has this happened then, Nicola? Why have we got from being in 2017, measles free? Meaning that enough people were getting the vaccine to stop there being a large scale spread to here seven years later? And this low uptake, it’s going to be a combination of factors. There’s no easy explanation and there is no one solution. I think that’s important to say. So, obviously, vaccine misinformation is nothing new. People have also, in the wake of COVID there has been a rise in a certain amount of vaccine misinformation as well. But that alone also is not everything. So if you look at surveys of parents, a lot of parents do want to vaccinate their children. There is still a lot of trust in vaccines, which is very good, but there can be difficulties in accessing appointments, there can also be problems, kind of a legacy from the COVID pandemic. So experts say that one problem might well have been that some parents didn’t realize that childhood immunizations were still going on during that period, particularly during sort of the height of the pandemic. Also, as I said earlier, not realizing how serious measles can be, if you don’t think it’s a big priority, maybe people put off getting this done or don’t prioritize going and getting it done. As I said, 84 and a half percent still sounds like quite a high figure. But when you think about how high coverage needs to be, 95%, two doses, and that has to be sustained. You can’t just hit that once and then you’re done. You have to maintain that. Then you start to realize, well, hang on, 84 and a half, it’s just not going to cut the mustard. Coming up, there’s a new NHS campaign to get people vaccinated. How effective will it be? Hello, I’m John Harris, the host of Politics Weekly UK for the Guardian. Every week we bring you insights straight from Westminster. He essentially tries to manipulate the mob against the elite and voices from around the country. I wonder how you feel about the state. Worse now than it’s ever been. Join me every Thursday to try and make sense of the current political mess and what might come next. Listen, wherever you get your podcasts. Nicola, how straightforward is it at the moment to get a measles vaccine? So if you are an adult and you don’t know if you’ve had your jabs, you can check with your GP. If you’ve got kids and you don’t know if they’ve had it, you can look in their red book or you can go and talk to your GP as well. So anyone can have a catch up dose, anyone who has missed one can go and have one or go and have two. Needs to be. So it is something that can be tackled. What’s the NHS doing to try and encourage people to get vaccinated? So a new campaign has been launched to try to boost uptake of the MMR vaccine. So this is encouraging kind of parents or those looking after children aged from about six to eleven to make an appointment with their child’s GP so they can get any missed vaccinations. So there’s a kind of focus on that age group because a lot of cases in the current outbreaks are in those under ten s really But also around a million people, just over, I think, a million people aged of eleven to 25 in London and the West Midlands, where there have been these outbreaks, they’re also being encouraged to come forward and getting their catch up jabs. So there are things like pop up vaccination clinics and so on around, particularly in the areas where there have been outbreaks, trying to improve access, trying to encourage people to come forward and have those jabs get that protect action. You don’t want to be the next person to catch measles. There are multiple ways to access this. There is a kind of proactive campaign out. You know, some experts have said to me, part of the reason why we have these outbreaks now is because of underinvestment in the NHS, these kind of pushes to encourage people to come forward and have these jabs to remind people how important it is to make it easier for people to get them. That sort of thing should be happening in general, we shouldn’t sort of wait for an outbreak to do that. We should be being proactive and doing this regularly. Of course, that takes money. I was quite encouraged when I searched on social media for MMR and measles that all the results that I saw come up just in a quick search. But were those health messages encouraging people to go and get vaccinated where I expected, as in previous years, as we experienced at the start of the COVID pandemic, you’d have a load of conspiracy theories coming up. Hopefully. Whilst social media can also sort of fuel misinformation, it can also be a tool by which people can find the right information, can find accurate, trusted information from people who really know what they’re talking about. So I think there is a great possibility there for increasing communication of the importance of these kind of interventions and making sure public health messages are heard and that public health improves. So we can get on top of this. We have got on top of measles in the past. We have the technology, we have vaccines that are safe and effective. So the potential is there. They just need to get into people’s arms now. Nicola, thank you very much. No problem. Thank you for having me. That was Nicola Davis, our science correspondent. It’s worth checking out her page@theguardian.com, because she writes about all sorts of interesting things, like whether biological changes in the brain can help people get over their ex and how many people who bought puppies in the pandemic are still struggling to train them. If you want more science stories, you can subscribe to our sister podcast, Science Weekly. They’re doing a series about the microbiome at the moment. And today’s episode is on the vagina. On Tuesday they looked inside the gut, and next week they’ll be touching upon skin. Just search Science Weekly wherever you found this episode. That’s it for today. I’m Hannah Moore. The producer was Lucy Hoff, and sound design was by Rudy Zagadlo. The executive producer was Elizabeth Cassin. We’ll be back tomorrow. This is the Guardian.
