In January 2019 Public Health England, Public Health Wales, The Public Health Agency in Northern Ireland and Health Protection Scotland published the United Kingdom Measles and Rubella elimination strategy at the following link:

https://www.gov.uk/government/publications/measles-and-rubella-elimination-uk-strategy

NHS England and NHS Improvement, the Department and Public Health England are implementing the actions of the strategy, working with key national and local stakeholders, for example, local screening and immunisation teams. Recent examples of actions include a new catch-up vaccination programme for 10 and 11 year olds through general practitioner practices, communications campaigns targeting festival goers and students, and local initiatives led by local teams to address inequalities in vaccine uptake.

While post vaccine rash and fever is generally mild, distinguishing from wild-type measles is not based on clinical examination, rather it is based on a combination of laboratory analysis, information on the timing of vaccine and epidemiological information. The national measles guidelines describe the management and investigation of suspected cases of measles, and is available to view at the following link:

https://www.gov.uk/government/publications/national-measles-guidelines

Statistics on confirmed measles cases are reported by vaccination status and are available at the following link:

https://www.gov.uk/government/publications/measles-mumps-and-rubella-lab-confirmed-cases-in-england-2019

While post vaccine rash and fever is generally mild, distinguishing from wild-type measles is not based on clinical examination, rather it is based on a combination of laboratory analysis, information on the timing of vaccine and epidemiological information. The national measles guidelines describe the management and investigation of suspected cases of measles, and is available to view at the following link:

https://www.gov.uk/government/publications/national-measles-guidelines

Statistics on confirmed measles cases are reported by vaccination status and are available at the following link:

https://www.gov.uk/government/publications/measles-mumps-and-rubella-lab-confirmed-cases-in-england-2019

In January 2019 Public Health England, Public Health Wales, the Public Health Agency in Northern Ireland and Health Protection Scotland published the United Kingdom Measles and rubella elimination strategy, which is available at the following link:

https://www.gov.uk/government/publications/measles-and-rubella-elimination-uk-strategy

This strategy sets out four core components required to maintain elimination of measles and rubella:

- achieving and sustaining very high coverage of greater than or equal to 95% with two doses of measles, mumps and rubella (MMR) through the routine childhood immunisation programme for those children less than five years old;

- providing opportunities for MMR catch-up to all population groups at risk for and susceptible to measles and/or rubella for those over five years old;

- strengthening surveillance systems by rigorous case investigation and laboratory confirmation of suspected sporadic cases and outbreaks; and

- improving the availability and use of high-quality, evidence-based information for health professionals and the public on the measles and MMR.

A multi-agency implementation board is working with national and local stakeholders to take forward the actions of the strategy.

Vaccinations in the United Kingdom are undertaken through informed consent. Although there has been a small decline in coverage in England since 2013, measles, mumps and rubella (MMR) vaccine coverage through the routine programme (first dose given at one year and the second at three years and four months) remains high. Public Health England has said that the majority of recent measles cases are in those not eligible through this routine programme. A new MMR vaccine catch-up programme for 10- and 11-year olds that previously missed the MMR vaccine was introduced in April this year. In addition, the MMR vaccine can also be given on the National Health Service to children who missed routine vaccination and adults who may need it.

In January 2019, the UK Measles and Rubella elimination strategy was published. A multi-agency group has been established to take forward the actions in the strategy in England. Local teams are expected to work with local stakeholders to develop measles and rubella elimination action plans.

Public Health England monitors vaccine uptake and works with NHS England to increase uptake. This year, NHS England is undertaking a fundamental review of general practitioner vaccinations and immunisation standards, funding, and procurement. This will support the goal of improving immunisation coverage, using local coordinators to target variation and improve groups and areas with low vaccine uptake.

There have been no discussions between the Department of Health and Social Care and the Department for Education, on making the measles vaccination compulsory before children start school.

Official figures show that the incidences of measles, diphtheria and malaria in Venezuela have all risen over the past few years. They report that a diphtheria outbreak began in Venezuela in July 2016 and from then until February 2019, a total of 2,726 suspected cases were reported (324 in 2016; 1,040 in 2017; 1,198 in 2018; and 164 in 2019) with 1,612 confirmed cases and 270 deaths (17 in 2016; 103 in 2017; and 150 in 2018).

Regarding measles, World Health Organisation assesses that the 2018 epidemic seems to have been largely brought under control thanks to vaccination campaigns supported by Pan American Health Organisation, but the risk remains. They report that, from mid-2017 to February 2019, a total of 9,399 suspected cases were reported (1,307 in 2017; 7,809 in 2018; and 283 in 2019) with 6,242 confirmed cases and 76 deaths (2 in 2017 and 74 in 2018).

According to the World Malaria Report 2018, the Americas accounted for 0.44% of malaria cases (975,700 cases) in the world; 42% (519,109 cases) were reported by WHO in Venezuela. It is now part of the group of countries with the highest burden of malaria at the global level with 0.22% of global cases.

The UK Government remains extremely concerned about the situation in Venezuela and has announced an emergency aid package of £6.5 million to respond to the most severe needs, in particular health, by providing immunisations against deadly diseases, supporting emergency rooms and ensuring that people who are fleeing their homes have access to crucial support, including through the provision of mobile health clinics.

The UK is concerned about the rising number of measles cases globally and is supporting efforts to reduce these in low income countries through investment in Gavi, the Vaccine Alliance. The UK is the largest donor to Gavi, which has helped immunise over 700 million children since 2000 and prevented more than 10 million deaths from vaccine preventable diseases.

Gavi is helping to reduce the number of measles cases by supporting routine immunisation. This is supplemented by rapid vaccination campaigns to stem outbreaks when they occur and limit the spread. Over 67 million people have been vaccinated through Gavi against measles through routine immunisation and over 370 million people have been vaccinated through campaigns.

The UK will host Gavi’s replenishment in 2020, demonstrating the UK's continued strong commitment to support Gavi's efforts to save children’s lives from measles as well as other vaccine preventable diseases.

Public Health England publishes quarterly data on the number of measles cases in England. The latest data show that from July to September 2018 there were 143 cases of measles in England.

Data are available to view at the following link:

https://www.gov.uk/government/publications/measles-mumps-and-rubella-laboratory-confirmed-cases-in-england-2018

The next quarterly report, with data up to end December 2018, will be published at the end of February.

Officals at our Embassy in Jakarta, including the Ambassador, visit Papua and West Papua regularly. During these visits they press the Indonesian authorities to address legitimate concerns and ensure the sustainable and equitable development of the province. This includes access to healthcare. We have not to date raised the specific issue of measles immunisations, but I am happy to confirm to the honourable member that we shall do so.

Measles vaccination is offered to all children within a month of their first birthday (at ages 12 – 13 months) with a second dose before starting school, usually at three years four months (or soon after), as part of the routine measles, mumps and rubella (MMR) vaccination programme. Children up to the age of 18 who missed, or only partially completed, their earlier MMR vaccination are eligible for a catch-up MMR vaccination.

Officials at our Embassy in Jakarta, including the Ambassador, visit Papua regularly. During these visits, they consistently press the Indonesian authorities to address legitimate concerns and ensure the sustainable and equitable development of the province. This includes access to healthcare.

Officials at the Embassy in Jakarta, including the Ambassador, visit Papua regularly. During these visits they press the Indonesian authorities to address legitimate concerns and ensure the sustainable and equitable development of the province. This includes access to healthcare.

Data on the number of measles cases in England and Wales can be found at the following link:

https://www.gov.uk/government/publications/measles-confirmed-cases/confirmed-cases-of-measles-mumps-and-rubella-in-england-and-wales-2012-to-2013

In addition, between 1 January 2018 and 6 July 2018 there have been 757 laboratory confirmed measles cases in England; further information can be found at the following link:

https://www.gov.uk/government/news/measles-outbreaks-across-england

Public Health England (PHE) routinely monitors coverage for the national immunisation programme, including the Measles Mumps Rubella (MMR) vaccine on a quarterly and annual basis. PHE also conducts routine measles surveillance publishing data on laboratory confirmed cases on a quarterly and annual basis.

In 2017, the total number of laboratory confirmed measles cases in England was 274. From 1 January to 18 June 2018, there have been 643 lab confirmed cases, with London (225), the South East (137), West Midlands (82), South West (79), and Yorkshire and Humberside (74) reporting the most cases. The increase in cases is associated with importations from outbreaks in Europe that have led to some limited spread in the population, particularly in young people and adults who missed out on MMR vaccine when they were younger.

Annual national statistics from 2016/17 show that coverage for the first dose of MMR vaccine in five year olds reached the World Health Organization target of 95% for the first time. This continues an improving coverage trend which has seen figures improve year on year since 2006-07.

Coverage for MMR vaccine in England for children reaching their second birthday fell to 91.6% in 2016-17 compared to 91.9% in 2015-16. This is the third consecutive year that MMR coverage has been decreasing. PHE is working closely with the National Health Service and with staff in general practice where most vaccinations are delivered, to improve uptake for the routine childhood immunisation programme.

Public Health England (PHE) routinely monitors coverage for the national immunisation programme, including the Measles Mumps Rubella (MMR) vaccine on a quarterly and annual basis. PHE also conducts routine measles surveillance publishing data on laboratory confirmed cases on a quarterly and annual basis.

In 2017, the total number of laboratory confirmed measles cases in England was 274. From 1 January to 18 June 2018, there have been 643 lab confirmed cases, with London (225), the South East (137), West Midlands (82), South West (79), and Yorkshire and Humberside (74) reporting the most cases. The increase in cases is associated with importations from outbreaks in Europe that have led to some limited spread in the population, particularly in young people and adults who missed out on MMR vaccine when they were younger.

Annual national statistics from 2016/17 show that coverage for the first dose of MMR vaccine in five year olds reached the World Health Organization target of 95% for the first time. This continues an improving coverage trend which has seen figures improve year on year since 2006-07.

Coverage for MMR vaccine in England for children reaching their second birthday fell to 91.6% in 2016-17 compared to 91.9% in 2015-16. This is the third consecutive year that MMR coverage has been decreasing. PHE is working closely with the National Health Service and with staff in general practice where most vaccinations are delivered, to improve uptake for the routine childhood immunisation programme.

The data for cases of tuberculosis (TB) for the last 12 months are not available in the format requested.

The most recent provisional data for the number and rate of TB cases notified in England in 2017 are available here:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/693328/TB_ad_hoc_statistics_March_2018.pdf

Data on the number of cases of rickets recorded in England for each of the last 12 months are not available in the format requested.

The latest data available on the number of confirmed cases of rickets in England can be found here:

https://digital.nhs.uk/data-and-information/find-data-and-publications/supplementary-information/2018-supplementary-information-files/count-of-finished-admission-episodes-faes-with-a-primary-or-secondary-diagnosis-of-scurvy-rickets-and-malnutrition-supplementary-information

Data on the number of cases of measles recorded in England for each of the last 12 months are not available in the format requested.

The latest data available on the number of confirmed measles cases in England can be found here:

https://www.gov.uk/government/publications/measles-mumps-and-rubella-laboratory-confirmed-cases-in-england-2017.

The total number of measles cases in England was 531 in 2016 and figures for 2017 will be published in April 2018.

Annual vaccine coverage statistics for England for 2016/17 indicate uptake of the first dose measles, mumps and rubella (MMR) vaccine at two years of age was 91.6%, a 0.3% decrease from 2015/16; the first dose MMR at five years of age reached the 95% World Health Organization (WHO) target, a 0.2% increase from 2015/16; and the second dose MMR at five years was 87.6%, a 0.6% decrease from 2015/16.

In adopting the European Vaccine Action Plan 2015–2020, the United Kingdom, along with all 53 Member States of the WHO European Region, has committed to eliminating measles and rubella as one of the Region’s priority immunisation goals. In 2017, Public Health England convened a multi-stakeholder measles and rubella elimination group, to develop a UK-wide strategy with key recommendations for action, to ensure elimination will be sustained.