Australian Measles Control Campaign
Encyclopedia
The Australian Measles Control Campaign was initiated in August 1998 as part of the World Health Organisation's global Measles
eradication program, and in response to major epidemics in Australia
throughout 1994/95, together with a report predicting another impending measles epidemic in Australia. The campaign vaccinated 1.78 million children, making it the largest national vaccination campaign conducted in Australia since the introduction of poliomyelitis
vaccination in 1956.
The campaign was promoted using the slogan Let's Work Together to Beat Measles
were conducted in South Australia
and New South Wales
to assess the current levels of measles immunity. Results indicated that there were "probably enough susceptible children in the South Australian population to support a measles epidemic". In November 1997, a workshop of experts was formed to discuss the logistical, funding and surveillance issues of a potential measles elimination campaign. The group concluded that the 2nd dose of MMR
should be brought forward from 12 years to 4 years (in line with WHO recommendations), and that a school-based campaign be implemented. Three groups would be targeted for vaccination:
attacked the program both prior to commencement and as it progressed, asking their members to "Do anything and everything you can to ensure that this vaccination campaign does not take place". Their reasons for opposing the program included claims that the vaccine was not effective and that the Government was severely understating the risks and possible adverse reactions which would result from the program. The AVN claimed to have filed a Federal Court injunction and other legal action against both the campaign and the Federal Health Minister, however no such action eventuated. In a July 1998 article entitled "Bully Boy Tactics", the AVN made dire predictions of adverse reactions that would result from the program, which are compared in the table below to the actual results:
In response to the AVN's campaign, the then Federal Health Minister Dr Michael Wooldridge issued a media release which was critical of the group, writing:
Measles
Measles, also known as rubeola or morbilli, is an infection of the respiratory system caused by a virus, specifically a paramyxovirus of the genus Morbillivirus. Morbilliviruses, like other paramyxoviruses, are enveloped, single-stranded, negative-sense RNA viruses...
eradication program, and in response to major epidemics in Australia
Australia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...
throughout 1994/95, together with a report predicting another impending measles epidemic in Australia. The campaign vaccinated 1.78 million children, making it the largest national vaccination campaign conducted in Australia since the introduction of poliomyelitis
Poliomyelitis
Poliomyelitis, often called polio or infantile paralysis, is an acute viral infectious disease spread from person to person, primarily via the fecal-oral route...
vaccination in 1956.
The campaign was promoted using the slogan Let's Work Together to Beat Measles
The Campaign
Following the World Health Organization's adoption of a 2010 target date for Global Measles eradication and the notation that a single dose vaccination strategy was ineffective, the Federal Health Department began investigating the options for a measles eradication campaign in Australia. In 1996 and 1997, seroserveysSerology
Serology is the scientific study of blood serum and other bodily fluids. In practice, the term usually refers to the diagnostic identification of antibodies in the serum...
were conducted in South Australia
South Australia
South Australia is a state of Australia in the southern central part of the country. It covers some of the most arid parts of the continent; with a total land area of , it is the fourth largest of Australia's six states and two territories.South Australia shares borders with all of the mainland...
and New South Wales
New South Wales
New South Wales is a state of :Australia, located in the east of the country. It is bordered by Queensland, Victoria and South Australia to the north, south and west respectively. To the east, the state is bordered by the Tasman Sea, which forms part of the Pacific Ocean. New South Wales...
to assess the current levels of measles immunity. Results indicated that there were "probably enough susceptible children in the South Australian population to support a measles epidemic". In November 1997, a workshop of experts was formed to discuss the logistical, funding and surveillance issues of a potential measles elimination campaign. The group concluded that the 2nd dose of MMR
MMR vaccine
The MMR vaccine is an immunization shot against measles, mumps, and rubella . It was first developed by Maurice Hilleman while at Merck in the late 1960s....
should be brought forward from 12 years to 4 years (in line with WHO recommendations), and that a school-based campaign be implemented. Three groups would be targeted for vaccination:
- Primary School children(5-12yrs): This group would be offered vaccination at school-based clinics, to be provided by two Registered NurseRegistered nurseA registered nurse is a nurse who has graduated from a nursing program at a university or college and has passed a national licensing exam. A registered nurse helps individuals, families, and groups to achieve health and prevent disease...
s per school. - Pre-school children (1-4yrs): Letters would be sent to the parents of all children who were overdue for their 1st dose of MMR, encouraging them to attend their GP for vaccination.
- High-School children (12-18yrs): A letter would be sent to all parents encouraging them to ensure their children had received two doses of MMR.
Objectives
- Cease measles-related morbidity and mortality, by interrupting indigenous transmission of measles
- Prevent reintroduction of measles until global eradication is achieved, by maintaining uniformly low levels of population susceptibility
Statistics
- 1.7 million primary-school aged children vaccinated, representing 96% of children in this age group.
- 800,000 pre-school children vaccinated.
- 89 total adverse events (33% of which were faintingSyncope (medicine)Syncope , the medical term for fainting, is precisely defined as a transient loss of consciousness and postural tone characterized by rapid onset, short duration, and spontaneous recovery due to global cerebral hypoperfusion that most often results from hypotension.Many forms of syncope are...
) representing 5.24 total adverse events per 100,000 doses. - Prevented an estimated 17,500 cases of measles.
- Prevented an estimated 8 measles-related fatalities.
- Total cost of the campaign was A$30,841,356.
Results
- Increase in measles immunity for 1-18 year-olds from 85% to 90%, and 6-12 year-olds (the target age group) from 84% to 96% (Assessed by seroserveySerologySerology is the scientific study of blood serum and other bodily fluids. In practice, the term usually refers to the diagnostic identification of antibodies in the serum...
). - Increase in RubellaRubellaRubella, commonly known as German measles, is a disease caused by the rubella virus. The name "rubella" is derived from the Latin, meaning little red. Rubella is also known as German measles because the disease was first described by German physicians in the mid-eighteenth century. This disease is...
immunity in 1-18 year-olds from 83% to 91% (Assessed by seroserveySerologySerology is the scientific study of blood serum and other bodily fluids. In practice, the term usually refers to the diagnostic identification of antibodies in the serum...
). - 96% fall in reported measles cases after five years, from 836 in 1997 to 32 in 2001.
- EndemicEndemic (epidemiology)In epidemiology, an infection is said to be endemic in a population when that infection is maintained in the population without the need for external inputs. For example, chickenpox is endemic in the UK, but malaria is not...
Measles declared eradicated from Australia in February 2009.
Criticisms of the Campaign
Anti-vaccination lobby group, the Australian Vaccination NetworkAustralian Vaccination Network
The Australian Vaccination Network , formerly known as the Vaccination Awareness Network, is an Australian anti-vaccination lobby group registered in New South Wales. It is dedicated to the idea that one's health can be maintained without the use of pharmaceutical drugs and vaccines...
attacked the program both prior to commencement and as it progressed, asking their members to "Do anything and everything you can to ensure that this vaccination campaign does not take place". Their reasons for opposing the program included claims that the vaccine was not effective and that the Government was severely understating the risks and possible adverse reactions which would result from the program. The AVN claimed to have filed a Federal Court injunction and other legal action against both the campaign and the Federal Health Minister, however no such action eventuated. In a July 1998 article entitled "Bully Boy Tactics", the AVN made dire predictions of adverse reactions that would result from the program, which are compared in the table below to the actual results:
| Event | AVN Prediction | Actual Observed |
|---|---|---|
| Rash/Fever | 270,000 | 8 |
| Parotitis Parotitis Parotitis is an inflammation of one or both parotid glands, the major salivary glands located on either side of the face, in humans. The parotid gland is the salivary gland most commonly affected by inflammation.-Infectious parotitis:... |
16,700 | 4 |
| Arthritis Arthritis Arthritis is a form of joint disorder that involves inflammation of one or more joints.... |
46,260 | 1 |
| Febrile seizure Febrile seizure A febrile seizure, also known as a fever fit or febrile convulsion, is a convulsion associated with a significant rise in body temperature... |
648 | 1 |
| Thrombocytopaenia | 60 | 0 |
| Aseptic meningitis Aseptic meningitis Aseptic meningitis, or sterile meningitis, is a condition in which the layers lining the brain, meninges, become inflamed and a pyogenic bacterial source is not to blame. Meningitis is diagnosed on a history of characteristic symptoms and certain examination findings... |
15 | 0 |
| Death | 3 | 0 |
In response to the AVN's campaign, the then Federal Health Minister Dr Michael Wooldridge issued a media release which was critical of the group, writing:
- "I am deeply concerned that media organisations risk giving credibility to the crackpot views of the AVN by publishing, without question, their untrue and deceitful claims. Ultimately, young children who are particularly vulnerable to measles could suffer if their parents were influenced by the anti-science, irrational views of the AVN."