Birmingham suffered biggest measles outbreak for decades due to vaccine mistrust

Health bosses said there were large variations in the uptake of the MMR jabs across Birmingham and Solihull with the overall number being below the national rate and was a major cause in the incident.

Members of the NHS Birmingham and Solihull Integrated Care Board were told between late 2023 and summer this year, there were 1,157 confirmed cases of measles.

But the level of low vaccine uptake left the city ‘vulnerable’ - despite services being offered across Birmingham and Solihull.

Dr Clara Day, chief medical officer, said work to understand why people refused to get jabbed found there were concerns about MMR causing autism, pork products in the vaccine and a general mistrust of vaccinations.

There has since been a steady increase in the number of people being immunised but the level across Birmingham and Solihull currently stands at 83.3 per cent – lower than the national level of 89.3 per cent.

When the outbreak happened, a multi-agency incident management team was set up with the aim of protecting people against measles, containing the disease and promotion to make people aware.

Vaccination was offered across the communities and in schools but this too saw variable uptake with one school immunising the highest number of children with 83 and another registering zero.

Dr Day said their response to the outbreak, including an effective management team and good use of data, saw them share learnings with other areas such as London which experienced a subsequent outbreak.

She said: “Part of the reason we ended up with measles is we are particularly challenged around our immunisation and vaccination levels.

“From late 2023 to summer 2024, we had 1,157 cases. To be clear, normal is none so this isn’t just a few more this is very clearly a significant outbreak.

“We had an outbreak in 2017 so there was some knowledge but for many people it was the first time they’d seen measles, didn’t know what it looked like, they might have seen pictures of it on white skin but not certainly hadn’t seen it on non-white skin.

“It wasn’t something that was easily recognised. If you combine that high level of infection with people not being quite as aware of it and very busy emergency services you can imagine how tricky that was to be able to manage.

“We were particularly vulnerable because of our uptake of the MMR vaccine which is routinely given to children at one year, our overall uptake at the moment is 83.3 per cent against the national of 89.3 per cent.”

She added: “What the data didn’t do was why people weren’t taking up the vaccine.

“Those conversations, there was a lot of worry about porcine, autism remained an enormous worry and there are quite a lot of people who just do not trust vaccination.

“Whatever you say to people, they just do not trust vaccination and that came through again and again – it is not something we should under-estimate.”

Ruth Tennant, Solihull’s director of public health, said: “Fascinating to see the impact of that and how hard it can be to get people through the door for vaccine.

“It takes a lot of convincing, a lot of persuasions, a lot of conversations with a trusted clinician or somebody they believe.

“We did have a schools-based offer, again hugely variable. What we found were some schools you would get good take up – the highest had an uptake of 83 children who got vaccinated, the lowest was zero.

“You cannot assume if you put a vaccine clinic in a school, they would come. It’s not that simple.”