Why is immunisation necessary for public health?

Why immunise?


 ... for protection against serious infectious diseases

by Dr Robert Arlt - Consultant Paediatrician

 

Dr Arlt provides general paediatric care, ultra-sound, health checks, developmental checks for babies and children at Richmond Practice.

There are two ways of protecting ourselves against most infectious diseases:

• vaccination 
•  by preventing disease being passed on from one person to another, ex. thorough hand washing

Immunisation is effective in eradicating disease and preventing death.

A worldwide immunisation campaign against smallpox in 1979 lead to complete eradication of
the disease, after reports of 10 to 15 million cases in 1966. As a result, vaccination against
this disease could be stopped. In the early 1960s hundreds of children in the UK died of
poliomyelitis every year. Now the disease has nearly disappeared thanks to the effective
vaccination programme in place worldwide. We need to protect others too
By vaccinating children we achieve "herd immunity." This is the level of immunity that occurs
when the vaccination of a majority of the population (or herd) provides protection to
unprotected individuals. It is more difficult to maintain a chain of infection when large numbers
of a population are immune and this prevents massive outbreaks of a disease. It is particularly
important to protect vulnerable people who cannot be immunised, especially babies in their
first two months of life.

The licensing of vaccines is closely regulated 

Vaccines go through many different phases of testing. Their safety and any potential side
effects are always carefully assessed. Organisations such as the European Medicines
Agency (EMEA) and the World Health Organisation (WHO) also continue to work actively to
monitor side-effects contributed to vaccines after they have been released.

What about the side effects? 

We must see vaccines as what they are. Some are ‘dead’ and contain no active disease cells.
Examples are tetanus, diphtheria and poliomyelitis. But they do contain additives needed to
preserve the vaccine and to increase its efficiency. These sometimes cause local reactions
like fever and flu symptoms and allergic reactions that we must be ready for when we
immunise. Some vaccines are ‘live’ or ‘attenuated’. However, they are so weak that anyone
with a fairly normal immune system will not have a problem. Our immune systems fight off full
strength bugs all the time. Of course, we should not use these ‘live’ vaccines on immune-
deficient people.

... and MMR?

The recent scare around the combined Mumps, Measles and Rubella (MMR) vaccine was
connected to the work of Dr Andrew Wakefield. He linked the vaccine with autism and bowel
disease (Lancet (1998.) This contributed to a resurgence of measles cases in Britain when
many parents declined the MMR vaccination for their children. Many large-scale studies,involving millions
of children ailed to establish a link to autism and the Wakefield hypothesis
has not gained acceptance in the medical community. Dr Wakefield has since admitted that
his claims were “not proved.”

To conclude, immunisation protects everyone and helps a great deal in eradicating many
serious infectious diseases. It saves lives and is safe when used appropriately.

---

Richmond Practice routine childhood immunisation programme

• when to immunise
• diseases protected against
• vaccine given

   Two months old

• Diphteria, tentanus, pertussis
• (whooping cough), polio and
• Haemophilus influenza typeb (Hib)
• Pneumococcal infection
• DTaP/OPV/Hib and
• Pneumococcal conjugate
• vaccine (PCV)

Three months old

• Diphtheria, tetanus, pertussis
• (whooping cough), polio and
• Haemophilus inflyenzae type b (Hib)
• Meningitis C (meningococcal group C)
• DTaP/IPV/Hib and MenC

Four months old

• Diphtheria, tetanus, pertussis
• (whooping gough), polio and
• Haemophilus influenza type b (Hib)
• Meningitis (meningococcal group C)
• Pneumococcal infection
• DTaP/IPV/Hib and MenC
• and PCV

Around 12 months

• Haemophilus influenza type b (Hib) and
• meningitis C
• Hib/MenC
• Around 13 months
• Measles, mumps and rubella (German
• measles)
• Pneumococcal infection
• MMR and PCV

Three years and four

• months or soon after
• Diphtheria, tetanus, pertussis and polio
• Measles, mumps and rubella
• DTaP/IPV or dTaP/IPV
• and MMR

Girls aged 12 to 13
years

• Cervical cancer caused by human
• papillomavirus types 16 and 18
• HPV*
• 13 to 18 years old
• Tetanus, diphtheria and polio
• Td/IPV
• *Human papillomavirus vaccine

The HPV vaccine was introduced into the routine immunisation programme in September 2008.