04 August 2011

Immunisation: keeping them safe

Before the advent of immunisation, outbreaks of disease were greatly feared as posing an enormous risk to people’s lives – especially children’s.


Before the advent of immunisation, outbreaks of disease were greatly feared as posing an enormous risk to people’s lives – especially children’s. It is estimated that now, immunisation prevents between two and three million deaths globally every year.

Effective immunisation has lead to the eradication of the smallpox virus in the wild – which simply means that the virus died out because it was unable to infect new hosts because they had been immunised against the disease. There’s no question that there is a great benefit to the eradication of life-threatening diseases, and yet some people are still sceptical of the immunisation schedules that infants have to undergo.

Immunisation is necessary not just to protect individuals from infection, but to create a “herd immunity” to prevent the rampant transmission of these preventable diseases. Recent outbreaks of diseases like measles around the world have shown that in some cases, the herd immunity is not sufficient to protect unvaccinated individuals from infection.

The World Health Organization’s (WHO) Expanded Programme of Immunization (EPI) encourages vaccination against measles, polio, pertussis (whooping cough), diphtheria, tetanus and tuberculosis. South Africa’s immunisation schedule (EPI-SA) is in line with the WHO’s recommendations of how children should be vaccinated.

In recent years, increasing numbers of immunisations have been added to the schedule, protecting against a wide variety of life-threatening diseases. Improvements have also been made to certain vaccines, so that for instance, in the case of the polio vaccine which used to contain the live virus, the new inactivated polio vaccine no longer carries a risk of vaccine-associated paralytic polio.

All vaccines in South Africa are manufactured according to strict safety guidelines set by the Medicines Control Council. Despite the compelling evidence in favour of vaccination, in Africa over 40% of children are not immunised against measles, with the lowest vaccine coverage in the world in sub-Saharan Africa. This makes it even more important for those who have the option of vaccinating to do so.

One of the major areas of concern among parents who are sceptical of vaccinations was a study published in 1998 by Dr Andrew Wakefield, suggesting a link between the MMR vaccine (against measles, mumps and rubella) and autism. His research has been found to be ethically unsound, his methods flawed and he has been stripped of his medical licence, but still the concern over the MMR vaccine, which has the potential to save thousands of lives, remains.

In reality, while the possibility of an adverse reaction to some of the vaccinations does exist, when compared to the risks associated with an actual infection with any of these diseases, these risks are low. Children even die from diseases perceived as “mild”, like chicken pox.

More common, but not life-threatening, are the side effects associated with some of the vaccinations. Babies can suffer from fevers, general irritability and localised pain. These can be treated with a non-aspirin painkiller. However, if the fever is over 40°C, a doctor should be contacted. Babies should also be taken to the doctor if they display any allergic reaction, seizures or convulsions, excessive sleepiness or any change in normal behaviour.

Immunisation is a hugely emotive issue for some – even for the very simple reason that the moment of administration is unpleasant for both the mother and the baby. But careful consideration of the risks and the benefits shows that prevention really is the better option.

(Press Release, August 2011)

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