What the papers say – weekly digest (17/05/24)

Your weekly digest of the top healthcare stories, covering news published from 13/05/2024 – 17/05/2024.

The Guardian

 Children who are severely obese could have just half the average life expectancy if they don’t lose weight in adulthood, according to a study. Research suggests that a severely obese four-year-old boy has a life expectancy of 39, half that of a boy the same age with a healthy weight. Life expectancies give the further number of years a person can expect to live on average given the age they have attained. Statistical modelling used data from 50 clinical studies – with more than 10 million participants from across the world – on obesity-related diseases such as type 2 diabetes and cardiovascular issues.The study measured obesity based on BMI Z-scores. These indicate how strongly an individual’s BMI deviates from the norm for their age and sex. For example, a four-year-old boy with an average height of 103cm and a healthy weight of about 16.5 kg (2st 8lb) will have a BMI Z-score of 0. By contrast, a boy of the same age and height who weighs 19.5 kg would have a score of 2, while a boy at 22.7 kg would be 3.5. A four-year-old boy with a BMI Z-score of 3.5 had a life-expectancy of 39 years, compared with 80 for a boy with a score of 0, the study found. A boy with a score of 2 would see their life expectancy reduce to 65. The study, presented at the European Congress on Obesity (ECO) in Venice, looked at the age at which individuals became obese, how long they had been obese, and how obese they were. Early onset of severe obesity in childhood increased the likelihood of developing related conditions such as heart disease and type 2 diabetes. For example, a four-year-old child with severe obesity who doesn’t lose weight had a 27% chance of developing type 2 diabetes by age of 25, and a 45% by 35. Dr Urs Weidemann, who presented the study, said the impact of childhood obesity on life expectancy is ‘’profound’’ and it should be considered a ‘’life-threatening disease’’. He said: ‘’While it’s widely accepted that childhood obesity increases the risk of cardiovascular disease and related conditions such as type 2 diabetes, and that it can reduce life expectancy, evidence on the size of the impact is patchy. A better understanding of the precise magnitude of the long-term consequences and the factors that drive them could help inform prevention policies and approaches to treatment. It is clear that childhood obesity should be considered a life-threatening disease. It is vital that treatment isn’t put off until the development of type 2 diabetes, high blood pressure or other ‘warning signs’ but starts early. Early diagnosis should and can improve quality and length of life. A quarter of children aged 10 and 11 in England are living with obesity and worldwide 159 million children are obese.

Hospital surgical teams that include more female doctors improve patient outcomes, lower the risk of serious complications, and could in turn reduce healthcare costs, according to the world’s largest study of its kind. Studies show diversity is important in business, finance, tech, education and the law, for equity but also for output. However, evidence supporting the value of sex diversity in healthcare terms has been limited. Now researchers who examined more than 700,000 operations over a decade report that hospitals with more women in their surgical teams provide better outcomes for patients. The findings were published in the British Journal of Surgery. The researchers concluded: ‘’The main takeaway… is that Increasing operating room teams’ sex diversity is not a question of representation or social justice, but an Important part of optimising performance.’’ In the study, led by the University of Toronto, researchers analysed 709,899 elective operations that took place in 88 hospitals in Ontario, Canada, between 2009 and 2019. Of those, 90-day major morbidity – serious complications within three months of the operation – occurred in 14.4% of cases. The median proportion of anaesthesiologists and surgeons per hospital a year was 28%. Overall, female surgeons performed 47,874 (6.7%) of the operations, and female anaesthesiologists treated patients in 192,144 (27%). Hospitals with teams compromising more than 35%, female surgeons and anaesthesiologists had better postoperative outcomes, the study found. Operations in such hospitals were associated with a 3% reduction in the odds of 90-day postoperative major morbidity in patients. The researchers noted that the 35% threshold they observed echoed findings from research in other industries in various countries, including in the US, Italy, Australia and Japan, which also showed better outcomes once teams had 35% female members. ‘’Care by a female surgeon increased the association of higher team sex diversity with outcomes, whereas this was not observed for care by a male surgeon,’’ the researchers added. Previous studies had suggested patients operated on by women are less likely to experience complications or need follow-up care than when treated by men.

Overweight men are being paid up to £400 each by the NHS to lose weight, in a scheme which has proved more successful than traditional diet plans. The trial found that sending men a daily text message reminding them of their desire to lose weight – with cash rewards for success – was an effective way to get patients in shape. Slimmers were told they would lose money from a possible £400 prize pot if they did not slim down, while being offered advice and healthy recipes. Experts say the scheme, nicknamed ‘’Game of Stones’’, is ready to scale up for an NHS rollout. The study, presented at the European Congress on Obesity recruited 585 men from Bristol, Glasgow and Belfast. They lost an average of 4.8% of their body weight in a year with the aid of text reminders sent to their mobile. Dr Pat Hoddinott, the trial chief from the University of Stirling in Scotland, said: ‘’Losing weight can make people feel better, reduce their risk of many health problems such as diabetes, and helps the health service with their aim to keep men well. However, we know men often don’t like to go to traditional weight loss groups.’’ Cash was paid out by the NHS at the end of the year, with the final amount dependent on how much lighter they were.They won an average of £128 each and lost significantly more weight than if they received texts with no cash offer, or received neither. The NHS has no plans to roll out the scheme nationally.

‘’Soup and shake’’ diets will be rolled out across England as part of efforts to tackle obesity and reverse type 2 diabetes. The head of the NHS said the radical regime – which limits patients to about 800 calories a day – was already proving ‘’truly life-changing’’ for thousands of people. It comes as part of a wider obesity strategy, with the Prime Minister yesterday (Tuesday) backing moves to expand the rollout of weight-loss jabs on the NHS to treat conditions other than obesity. It follows a ‘’game-changing’’ trial which found the jabs can cut heart attack deaths by a fifth with Rishi Sunak saying the injections were ‘’giving people longer, healthier lives’’ while tackling chronic disease. Trials of soups and shakes found about half of those who followed the strict regime went into remission from type 2 diabetes – and many remained free of disease five years on, without having to take medication. The programme is already on offer in some parts of England, with typical weight loss of 2st achieved in three months. Health officials will today (Wednesday) announce the rollout of the weight-loss cloud plan, costing about £1,100 per head. More than 50,000 people are expected to sign up in England over the next five years, with £13 million set aside for the expansion next year. Patients referred by their GP will be given free ‘’total diet replacement products’’ for three months with support from nutrition coaches and clinicians. They will be supported for a further 12 months, in order to continue weight loss or keep the pounds off. More than 10,000 people will be offered the regime over the next 12 months as the programme expands. Anyone aged between 18 and 65 diagnosed with type 2 diabetes in the last six years with a body mass index over 27, or 25 in black, Asian and ethnic groups, will be eligible. Research on 838 participants, presented at the European Congress on Obesity in Venice showed average weight loss of 22lb after 12 months. The research led by the University of Leeds was presented alongside a study by Leeds Beckett University which found participants felt positive about being referred to the strict regime. Health officials hope the programme will reduce the spiralling costs of obesity to the taxpayer. UK cases of diabetes doubled in the past 15 years, and more than five million people are estimated to have the condition, 90% Type 2. This follows a near doubling in obesity levels since the 1990s. The NHS in England currently spends about £10 billion a year – about 10% of its budget – on detecting and treating diabetes. In addition, at least £6.5 billion a year is spent by the health service treating obesity. Nine in 10 cases of Type 2 diabetes are fuelled by excess weight. About five million people in the UK have the condition with nine in 10 cases Type 2. More than 20,000 people have already been offered the programme since it was first piloted by the NHS in 2020.

The Telegraph

Obese workers are up to twice as likely to take time off sick, a landmark study has found. The research – the first to provide a detailed breakdown of the impact of weight on productivity – shows how soaring obesity rates are driving a ‘’sick note’’ culture and stifling the economy. Experts warned that Britain’s record was amongst the worst of 28 countries examined, with six in 10 adults overweight or obese. Findings from the mass study, which examined the habits of 123,000 workers across Europe were published as the UK faces record levels of long-term sickness. Researchers found that the most severely obese were 2.5 times more likely to have been off work for a week during the past year with sickness, compared with those of a healthy weight. Even those who were overweight, but not obese, were 22% more likely than slimmer workers to have taken at least seven sick days. Last month, Rishi Sunak called for an end to ‘’sick note culture,’’ warning against ‘’over-medicalising the everyday challenges and worries of life’’ as he unveiled welfare reforms. Latest figures from the Office for National Statistics show 2.8 million people on long-term sick leave, up from 2.1 million before the pandemic, with about £50 billion spent on sickness benefits for people of working age. Critics said the Government drive cannot succeed without drastic action to combat obesity, which is linked to a host of long-term health problems. They said the UK was facing ‘’very, very profound consequences’’ from becoming the ‘’sick man of Europe’’ precisely because of a failure to tackle big public health threats, of which obesity was the greatest. The study, presented at the European Congress on Obesity in Venice, found that the more people weigh, the more sick days they take. Britain was among the worst of all countries analysed, with separate research showing it has the third highest levels of obesity across Organisation for Economic Co-operation and Development (OECD) nations. The research is the first to provide a detailed breakdown of how sick days vary according to weight, revealing how the obesity epidemic is damaging productivity and driving people out of the workforce. The authors said obesity-related health issues such as back pain, arthritis or heart disease stop people going to work and means people are ‘’increasingly excluded from contributing to society.’’ It comes as separate UK data show long-term sickness is now the main reason for women being out of the workforce, with an extra 500,000 women now economically inactive for this reason in the past five years. In total, 1.54 million women fall into this category – the highest figure since records began. Much of the growth is the result of conditions such as back pain that are driven by excess weight. The new study found that overall, women were more likely than men to be off work sick. More than one in four adults in the UK are obese, with the cost of excess weight estimated to cost the UK economy an estimated £98bn every year. The new study, led by the Health Economics and Health Policy Research Group, Institute for Advanced Studies, Vienna, Austria looked at national survey data from a representative sample of 122,598 people, representing a population of 147 million working-age people across 26 European countries. A government spokesman said: ‘’Obesity costs the NHS around £6.5 billion a year, and we are taking firm action to promote healthier options and reduce levels of obesity.’’

Dementia will cost the economy £90 billion by 2040 as the population ages, researchers have said. The largest study of the economic impact of the disease on Britain revealed the cost will more than double from £42 billion a year to £90 billion a year without action. The economic burden includes costs to the NHS and social care, as well as the loss of work and productivity of patients, their families and unpaid carers. Patients and their families are shouldering almost two thirds of the costs of the disease themselves, the analysis of 26,000 people found. The research by healthcare consultant Carnall Farrar commissioned by the Alzheimer’s Society, found the total costs for dementia care ranges from £29,000 to £81,000 per year depending on the disease’s severity. Around one million people in the UK have dementia, but this is set to rise to 1.6 million by 2040 because of an ageing population. One in three people born today will develop the condition at some point in their lives, according to latest projections.

The growth in patients also means there will be a significant and growing burden on unpaid carers. Unpaid carers already spend more than 100 hours per week providing care, while 16% have had to quit their jobs to take on full-time care of a loved one. Researchers say demand for unpaid care will increase by 43% within the next 16 years. A third of people affected have not received a diagnosis, according to the Alzheimer’s Society, with just 1.4% of the total healthcare expenditure going on diagnosis. The majority of costs come from social care, at 40%, and unpaid care, at 50%, the report said. The charity said families are ‘’left to pick up the pieces’’ and incur ‘’catastrophic costs further down the line.’’ Kate Lee, chief executive of Alzheimer’s Society, said: ‘’It is the biggest health and care issue of our time, yet it isn’t the priority It should be amongst decision-makers. We wouldn’t accept this for any other terminal disease, we shouldn’t accept it for dementia.’’ She said that without earlier diagnosis and access to treatment, there is ‘’no hope of addressing the major dementia challenges we face’’.

The whooping cough outbreak has prompted GPs to bring back masks in their surgery. At least five babies have died this year in England and Wales from the infection, dubbed the ‘’100-day cough’’, and officials are concerned about its spread, with almost 3,000 cases confirmed. Some general practices are now asking patients to wear a face covering when attending an appointment or while travelling to the surgery in a return to Covid-style measures. At least one surgery has advised its patients to wait outside before being called to appointments. The moves follow NHS England infection control guidance earlier this year in the wake of a measles outbreak and increasing whooping cough cases. It advised reinstating mask-wearing measures where appropriate. The guidance says that ‘’if possible or tolerate the patient should wear a surgical mask in communal areas’’. The decision on mask-wearing is made by local service providers depending on how bad infection rates in the area are. Whooping cough is as contagious as measles and more so than Covid-19, with young children who are not protected at the greatest risk from serious complications. The UK Health Security Agency has confirmed that five babies – all under three months of age – died after contracting the infection in the first three months of the year. It is the highest number of deaths caused by whooping cough in a decade and experts fear more will follow as case numbers could hit 40-year highs. The surge in cases has been attributed to circulation of the disease being slowed during the pandemic and lockdowns, as well as the decreasing uptake of the whooping cough vaccine, particularly among pregnant women. The latest figures show just 37 per cent of pregnant women in London had been vaccinated by the end of last year, down from 61 per cent before the pandemic. Across the country, take-up fell by 19 per cent in pregnant women, while take-up among under-fives fell by 4 per cent. The NHS recommends all pregnant women are vaccinated against whooping cough between 16 and 32 weeks to protect their baby in the first weeks of its life. However, experts claim there is confusion about whether the GP or antenatal team should be responsible for offering the jab. The NHS website says the whooping cough vaccine, first made available for pregnant women in 2012, is available from the GP and some antenatal clinics, where expectant mothers go for checkups during pregnancy and ‘’may be offered the vaccination’’.

A US laboratory that killed 10 children and gave 40,000 people polio went on to sell infected blood products to the NHS in what has been branded a ‘’failure of governance’’. Cutter Laboratories was responsible for infecting haemophiliacs with HIV and hepatitis C through contaminated doses of the drug Factor VIII in the 1970s and 1980s. The California-based company previously made a faulty polio jab that caused an epidemic of man-made cases in the US in the 1950s – a scandal that came to be known as the ‘’Cutter Incident’’. Pharmaceutical companies, including Bayer which now owns Cutter, are expected to be criticised in the Infected Blood Inquiry’s final report, which will be published on May 20. Around 1,250 people caught HIV from infected blood products supplied from US pharmaceutical firms and sold to the NHS. The notorious ‘’Cutting Incident’’ occurred when the family-run company was one of five given the task of making and stockpiling the first ever polio jab in the US as it went through clinical trials. Its faulty manufacturing system and cost-cutting measures were responsible for paralysing more than 150 people and the debacle has been credited as a major drive of anti-vax sentiment. Despite the scandal, Cutter Labs continued to operate and went on to produce the contaminated blood product Factor VIII which was sold to the NHS. The drug was made from the blood plasma of people who were paid to give blood, who were often high-risk groups such as gay men, sex workers, drug addicts and the homeless. The NHS purchased the tainted blood products because the UK was not self-sufficient in blood product supply and the US products were cheaper. Cutter’s Factor VIII, as well as that of other manufacturers, was to blame for more than 1,250 haemophiliacs in the UK contracting HIV, and around 5,000 people contracting hepatitis C. Around 3,000 people in the UK have died as a result and the death toll of the biggest treatment disaster in NHS history continues to grow. A Bayer spokesman said it was ‘’truly sorry’’ the situation occurred and that therapies developed by Bayer Group companies to save and improve lives ‘’in fact ended up causing so much suffering to too many.’’

The internet is actually good for you, a study by the University of Oxford has suggested. Experts analysed more than 2.4 million people from 168 countries in the largest study of its kind and found the effect of the internet on the world’s population was overwhelmingly positive. The researchers said the findings went against popular opinion that it had a negative force in society. While the research did not break down the type of internet use, such as social media, it found that people’s level of life satisfaction was 8.5 per cent higher among those who had regular internet access across all countries. The research used more than 33,000 statistical models to ensure that it accounted for factors such as deprivation, education and health. It utilised survey results for people aged 15 to 99 across areas such as social, physical and community wellbeing, daily positive and negative experiences, and life satisfaction. The researchers found that 85 per cent of the associations between the internet and wellbeing were positive, while 0.4 per cent were negative. The rest were neutral. The group most likely to have unfavourable experiences were women aged 15-24, particularly in relation to their sense of community wellbeing, which suggests it has a negative effect on how they felt about where they lived. The media regulator last week announced proposals to name and shame social media sites which fail to comply with new rules that are due to come into force next year under the Online Safety Act as well as ban under-18s from using them. The study was published in the journal Technology, Mind, and Behaviour.

Children allowed screen time during meals are far more likely to pile on the pounds, research has found. Experts said allowing children to scroll on phones or eat in front of the television was ‘’dangerous’’ and fuelling a growing obesity epidemic.Researchers found children who were allowed to access devices while eating were 15% more likely to carry excess pounds than those who weren’t. The ‘’distraction’’ of screens meant children were more likely to keep eating without noticing they were full, they said, warning the decline of the family meal was a ‘’really big problem’’. The study by the University of Minho, Portugal examined the impact of screentime during breakfast, lunch or dinner on children’s weight. Their study involved 735 children aged six to ten, at primary schools in more deprived neighbourhoods. Researchers interviewed each child about the foods they had eaten in the last 24 hours and gave parents a questionnaire which included the question on if they were allowed on screens at mealtimes. Measurements were then taken to calculate if a child was obese. Once factors such as their age and socioeconomic status were accounted for, scientists found those who use screens during breakfast, lunch or dinner were 15 % more likely to be overweight. Dr Ana Duarte said: ‘’When children are eating and are watching something on a TV or a mobile phone, they don’t understand when they need to stop eating or when they are full. They continue to eat and eat just because they are distracted by the screens, This is bad for society and dangerous for children because it is leading them to being overweight or obese.’’ Presenting their findings at the European Congress on Obesity in Venice, they said the data was likely to be an underestimate, with many parents potentially not admitting to letting their children use screens.

The Times

Millions of middle-aged Britons should be prescribed weight-loss injections to cut their risk of heart attacks and strokes by a fifth, according to a trial set to revolutionise medical practice.The largest study yet carried out into semaglutide, also known as Ozempic or WeGovy, has found that the drug cuts heart disease deaths by about 20% even if people don’t lose weight. The results, presented at the European Congress on Obesity in Venice, were hailed as the biggest medical breakthrough since the introduction of statins in the 1990s. The study author, Professor John Deanfield of University College London, said it was clear the drugs ‘’target the underlying biology of chronic diseases’’ independently of their effect on weight loss. This suggests they can be used to treat several conditions beyond obesity and diabetes, which is all they are now approved for. The discovery is set to transform clinical practice in the NHS, with the new class of drugs – called GLP-1 agonists – likely to be prescribed routinely by the end of the decade to reduce heart attacks and strokes in a similar way to blood pressure medication.The trial involved 17,604 adults over the age of 45 who had heart disease – a condition that affects 7.6 million people in the UK – or had previously had a heart attack or stroke. All of the participants were overweight or obese, but none had diabetes. Half were given weekly semaglutide injections, with the rest given a placebo. Over a trial period of three years and four months, the group who took semaglutide had a 20% lower risk of heart attack, stroke or death from heart disease. They also lost 9% of their body weight on average – but the heart benefits were seen regardless of how much weight people lost. This appears to demonstrate that as well as suppressing appetite, that drugs target an underlying biological mechanism such as inflammation which is linked to chronic diseases. ‘’These mechanisms may include positive impacts on blood sugar, blood pressure or inflammation, as well as direct effects on the heart muscle and blood vessels, or a combination of one or more of these,’’ Deanfield said. Semaglutide, manufactured by Novo Nordisk, is the first in a new generation of anti-obesity drugs which work by mimicking the hormone GL-1. Deanfield, who has a government position advising the health secretary on ways to prevent heart disease, said the trial showed the potential benefits of changing clinical guidelines so that semaglutide could be routinely prescribed to millions of patients with existing heart problems.’’ Deanfield added that ‘’there are other diseases that might benefit from these drugs which are going to be equally exciting’’, with research due to be published showing the benefits of semaglutide for kidney disease. Trials are also under way to see whether the drugs could slow the progression of Alzheimer’s and Parkinson’s. Deanfield said: ‘’We now have a class of drugs that could transform many chronic diseases of ageing… which currently the NHS doesn’t treat very well.’’ Deanfield, a professor of cardiology, said about half of his heart disease patients had a body mass index above 27, putting them in the overweight category, and would benefit from semaglutide. Giving the drug to half of heart disease patients across the UK would equate to almost 4 million people. Semaglutide could be ‘’added on to pre-existing therapy’’ for heart problems including statins and blood pressure medication, Deanfield said, with almost all of those in the trial also taking statins. Routine NHS prescription of the drug for heart patients will require a change in guidelines from Nice, the watchdog, which at present approves semaglutide only for the treatment of type 2 diabetes or obesity. Heart disease is one of the UK’s biggest killers, causing 68,000 deaths and more than 250,000 hospital admissions each year,  and its annual cost to the economy is about £25 billion, according to the British Heart Foundation.

Cutting screen time isn’t the only way to encourage children to be more physically active – limiting how much homework they are given may also help, a study suggests. A landmark effort to tackle sedentary behaviour among children in China has been judged a success after researchers found that it led to them spending more time playing outdoors and earlier bedtimes. The scheme in China, believed to be the first of its kind, forced online gaming companies to limit children to only three hours a week and not on school nights. It also reduced the amount of homework that school teachers were allowed to assign and restricted when tutoring businesses could provide lessons. A study led by a team from Bristol University found that the rules led to children aged nine to 18 spending an average of 45 minutes less each day being sedentary – defined as being awake and physically inactive, whether they were on their phones, computers or doing schoolwork. Fewer than half of children aged five to 16 in England meet government guidelines of taking part in sport and physical activity for an average of 60 minutes or more every day. The researchers are exploring whether similar rules could be feasible in the UK, but stressed that the Chinese template would have to be modified. China leads the way in terms of the time spent on homework by adolescents, at about 14 hours a week, according to a report from the Organisation for Economic Co-operation and Development. British children do about 5 hours. Primary school pupils could not be set more than 60 minutes of homework a day, and secondary school pupils aged up to 15 not more than 90 minutes. Tutoring companies were banned from offering sessions in school holidays or at weekends, could not set exams for pre-school, primary or middle-school children, and could not publish rankings. Students were also shown to be 20% more likely to meet the overall screen time recommendation of less than two hours daily after the regulations were introduced. The results were published in the International Journal of Behavioural Nutrition and Physical Activity.

Children’s exposure to vape marketing is at a record high, with youngsters overwhelmingly opting for fruit and dessert-flavoured vapes. An annual survey by Action on Smoking and Health (Ash) found that children were increasingly aware of vape marketing, including in shops and on sites such as TikTok and YouTube. This year’s poll, of 2,587 children aged 11 to 17, found that 7.6% vape, the same proportion as last year, but up from 2.8% in 2017 and 0.8% in 2013. It found that, for the first time, the rate of regular vape use (more than once a week) was higher than occasional use (less than once a week). Fruit flavours were preferred by 57% of child vapers and 47% of adult vapers. Vapes with sweet flavours and those that taste of vanilla or chocolate were twice as popular with children as they were with adults The proportion of children aware of vape marketing is at a record high. More than half (55%) of 11 to 17 year olds said they were aware of vape advertisements in shops, compared with 37% two years ago. Only 19% of 11 to 17 year olds said they were not aware of vape promotion at all, down from 31% two years ago. More than half (55%) of the 29% aware of online vape promotion had seen them advertised on TikTok, up slightly from 49% last year. On YouTube the figure was 32%, up from 29%. Deborah Arnott, chief executive of Ash, said: ‘’Exposure to vape marketing among teenagers is at an all-time high and it is essential that the Tobacco and Vapes Bill is passed so powers to limit promotion can be swiftly enacted.’’ The bill, which is at committee stage, would limit the flavours available and restrict packaging to reduce their appeal to children. The poll also found that half of adults think vapes are more than or equally as harmful as cigarettes, while 34% think they are less harmful.

One dose of the measles vaccine is more likely to be completely ineffective in children delivered by caesarean section, new research has found. Researchers from the University of Cambridge and Fudan University in China have said that children must have both doses of the vaccine to ensure they are fully protected. The latest figures show that there have been 1,374 measles cases in the UK since October 2023, with 80 new cases since May 2, according to the UK Health and Security Agency (UKHSA). Experts have linked the rise in measles cases to lower vaccination rates. The most recent NHS data, covering October to December, shows that 89.1% of children in the UK have had their first dose of the measles, mumps and rubella (MMR) vaccine by the age of two. About 85% of children in the UK have had both doses by age 5, below the 95% threshold needed to reach herd immunity and halt the spread of the disease. The MMR vaccine is offered to children in two doses at GP surgeries at age one and three. In the research, published in the journal Nature Microbiology, scientists looked at the data of 1,505 children in Hunan, China. They analysed samples of their blood taken every few weeks from birth until the age of 12. It showed that 12% of the children born via caesarean section had no immune response at all to their first measles vaccination, compared with 5% of children born via vaginal delivery. C-section births, according to the researchers, were linked with 2.56 times the chance of ‘’primary vaccine failure’’ compared with babies born naturally. .However, children born via caesarean section who had two doses were found to have robust immunity against the disease. The researchers suggested that the lesser immunity experienced could be linked to the development of the microbes that naturally live inside the gut, also known as the microbiome. Other studies have previously found that a vaginal birth transfers a greater variety of microbes from the mother to the baby, boosting the immune system. Latest figures for England show that 39% of all deliveries were by C-section, with 55% of deliveries in women over-40 using this method, compared with 34 percent of 20-29 year olds. In January the NHS began contacting 1 million people aged from 11-25 to urge them to catch up on missed vaccinations in the wake of the outbreak.