Sunday, 31 December 2017

MMR clarification on use of vaccine for travel

Just managed to get a blog done before the end of 2017 and apologies I haven't done many over the past few months, the Autumn has been particularly busy.

Measles remains endemic in many countries around the world and in Europe there have been big outbreaks particularly in Romania, Italy and Germany and imported cases from Romania have led to outbreaks in Leeds, Liverpool, Birmingham and Manchester.  More detail is available on TravelHealthPro  where it reminds us 'elimination can only be sustained by maintaining and improving coverage of the MMR vaccine in children and by using all opportunities to catch up older children and adults who missed out on the vaccine'.

The Vaccination of individuals with uncertain or incomplete immunisation status flowchart published by Public Health England (most recent edition November 2017) has excellent guidance regarding your course of action if doses are missed, and one of the statements is ' Two doses of MMR should be given irrespective of history of measles, mumps or rubella infection and/or age'.

Dealing with people born before 1970 has historically caused a greater quandary, but while the Green Book acknowledges this cohort are more likely to have had all three natural infections and are less likely to be susceptible, it states MMR vaccine should be offered to those who request it or if they are considered to be at risk of high exposure (see page 219).

In the December issue of Vaccine Update it clarifies that ImmForm stock can be used - the exact wording says Central MMR vaccine stock (ordered from Immform) can be used to catch-up anyone of any age – this also covers opportunistic catch-up prompted by travel.  I've been asking this question for many years so its good to have a confirmed answer in writing! Moreover, it says an item of service fee can be claimed manually via the CQRS MMR programme for each dose of MMR administered to patients aged 16 years or over. This includes patients born before 1970 who have no history of measles or MMR vaccination.  See page 5 of the Vaccine Update issue 273.