Enfield’s low vaccination rate means there was always a risk of a mass measles outbreak in the borough, the London Assembly has been told.
The North London authority only has a 64.3 per cent vaccination rate for measles, far below the 83.7 per cent national average. This has meant that the borough has born the brunt of London’s outbreak, with officials confirming today (Monday, March 9) that 71 of the 127 confirmed cases in the capital are in Enfield.
It is estimated that unvaccinated children are being primarily affected by the diseases, with around one in five infected needing hospital treatment.
During an extraordinary session of the London Assembly Health Committee, senior health practitioners and experts said the vaccination rate in Enfield was a warning to other parts of London and claimed that solving health inequalities was key to boosting take-up.
Dudu Sher Arami, Director of Public Health for Enfield, told Assembly Members: “We are the ninth largest London borough, and a highly deprived borough. We have a higher concentration of children and young people in the areas that are more deprived.
“The east of the borough has more cases and a lower vaccination rate than the west. Enfield is not unique – we have seen outbreaks in other boroughs.
“Any place where we have low vaccination uptake is at risk of an outbreak – it just happens that this time it’s Enfield. This is an opportunity to think nationally, especially around health inequality. Localised community engagement is a very effective way of opening up communication around vaccines and building trust.”
Susan Elden, a Public Health Consultant at NHS England, said the health service was not confident in bringing numbers down in the long-term unless vaccination rates significantly increased across London and the UK.
“We will only be confident once we have 95 per cent [vaccination] coverage and measles-free status,” she said.
“We can’t do this alone as the NHS – it needs to be done through local authorities and the Greater London Authority. It’s a global thing – people have vaccine fatigue. There’s something about our vaccination systems coming up to speed with our modern world – they were set up in the 1940s.
“Pre-pandemic, if there was a vaccination message, people would go – but now people are thinking differently. It’s about making sure that we are making that compelling case and using all the trusted sources. People need that confidence at an individual level.”
Officials also suggested the situation appeared to be “stabilising” but could not give any guarantees that either Enfield or the capital were on a downward trend.
Nalini Iyanger, a consultant in Health Protection at the UK Health Security Agency (UKHSA), told Assembly Members: “This is 4-5 times as infectious as Covid.
“It is a situation under close monitoring, it is stabilising but we are keeping a very close eye on it. We’re doing everything we can to control it, but I can’t say numbers won’t go up.”
However, Katherine Richardson, Director of Resilience at the Greater London Authority (GLA), noted that it was “impossible for measles to get to the pandemic stage because of the levels of vaccination that we do have”.
In a social media post, the Mayor of London said today: “Measles is highly infectious and cases are on the rise in London. Make sure you and your children are up to date with your MMRV jabs.”
Emma Best, Chairman of the London Assembly Health Committee, told the Local Democracy Reporting Service (LDRS) after the meeting: “We’ve heard clearly from experts today, that the measles outbreak in North London is not yet fully contained. As long as there are pockets of people who remain unvaccinated, the risk of further spread remains very real.
“Measles is highly contagious and around one in five people who catch it require hospital care, with emergency departments already seeing an increase in suspected cases. Because of necessary strict isolation measures required, this is placing additional pressure on NHS services.
“The vaccine is safe, tried and tested, and even a single dose provides around 90% protection. The priority now must be targeted community outreach to boost vaccination uptake – across all boroughs and across the UK.
“Without decisive action, this risks becoming a slow-burning public health problem that not only fuels further outbreaks but also diverts vital NHS resources away from other routine programmes.”
Kumail Jaffer is a Local Democracy Reporter covering City Hall and London-wide political news, with a focus on housing, transport, policing, regeneration and issues affecting communities across the capital. Before joining the Local Democracy Reporting Service, he worked as a political and foreign correspondent for national newspapers including the Daily Mail.
