Kathriona Devereux: All for one and one for all, how vaccinations can beat disease

In her weekly column Kathriona Devereux looks at Ireland's existing vaccination programmes and why they are so important
Kathriona Devereux: All for one and one for all, how vaccinations can beat disease

A SHOT IN THE ARM: Children today can get protection from 13 diseases — their parents could only be protected from six

“THE last thing we need at the moment is another outbreak,” says Yvonne Morrissey, Communications Manager at the National Immunisation Office.

Originally from Buttevant, Yvonne is responsible for the #KeepVaccinating campaign that is being promoted for European Immunisation Week, to encourage parents to continue with immunisations for their babies.

Nowadays, Irish children receive protection from 13 diseases in the first 13 months of their lives. Their parents were only protected from six.

Vaccines for diphtheria, polio, measles, tetanus and other diseases are carefully batched together and given at 2, 4, 6, 12 and 13 months to harness the natural immunity of babies that they receive in pregnancy from their mothers.

Vaccinations train the immune system to recognise a small part of a specific disease so if the body is exposed to the disease the immune system will know how to fight it.

The school immunisation programme is paused at the moment due to school closures but junior infant pupils receive a MMR shot and a 4-in- 1 booster to protect against polio, diphtheria, tetanus and whooping cough.

Since September, 2019, all first year students in secondary school are offered booster vaccines for tetanus, diphtheria and whopping cough, as well as the MenACWY vaccine, to protect teenagers from various strains of meningitis, and the HPV vaccine to protect against cervical cancer.

It’s amazing to think that for this generation of teenagers, cervical cancer might be a preventable disease when currently 90 women die in Ireland from it every year.

In recent weeks, Irish survivors of polio and tuberculosis have been recounting their experiences. There are currently 7,000 polio survivors in Ireland who contracted polio as children in the 1950s, spent their childhoods confined to hospitals for want of rehabilitation, and are still suffering the consequences of what is now a preventable disease.

Many of these survivors are now in their sixties and continue to suffer the late effects of polio. Their entire life stories were altered by a disease that is now entirely avoidable thanks to a vaccination developed in 1955 by Dr Jonas Salk.

The announcement that his vaccine was “safe, effective and potent” was triumphant front page news that saw jubilant people hugging each other in the streets. A scene we can only wish for now.

Yvonne Morrissey is keen to stress that, overall, vaccination rates in Ireland are good, with the vast majority of parents here vaccinating their children on time.

“Currently, there is a 91% uptake rate of MMR but we want to get to 95% as Ireland is still experiencing needless small outbreaks of measles and mumps,” she said “That rate also varies across the country, from 84-97%.”

We’ve heard a lot about “herd immunity” recently. I prefer the term “community immunity”, which is when the majority of us are vaccinated in order to protect those who can’t be vaccinated, either because they’re too young, or because they have a weakened immune system.

Having high rates of vaccination also protects the healthy population. This is because vaccines don’t work on 100% of people.

If 100 people get vaccinated, five of them may still get a disease like measles. However, if they are circulating in a population of mainly protected people, they won’t spread the disease.

Paradoxically, the success of vaccination has resulted in some apathy, with so-called ‘anti-vaxx’ movements undermining public health.

There is an effective vaccine for measles, but uptake has dropped significantly in some European countries recently.

In 2016, Ukraine had just a 31% uptake rate. In 2019, the EU reported an exceptionally high number of measles cases — more than 90,000 individuals, resulting in 37 avoidable deaths in just the first six months of the year. Half of those deaths were in infants.

These numbers are dwarfed by the Covid-19 death rates, but show how insufficient vaccination coverage breaks community immunity.

The last serious measles outbreak in Ireland was 20 years ago and three children died. That outbreak was caused by a drop in the vaccination rate to 79%, most likely in the wake of the publication of a since-debunked scientific paper linking autism to the MMR vaccine.

There are outbreaks of measles and mumps in Ireland currently. Thankfully, these cases haven’t required hospitalisation and there haven’t been any fatalities. But they are all avoidable.

Another message that Morrissey thinks is important is the need for pregnant mothers to get the whooping cough vaccination. It prevents small babies ending up in ICU with the distressing disease.

She would also like parents to persist with the rotavirus vaccine. Some parents don’t want to give babies the second dose of this because their babies got mild diarrhoea with the first dose.

However, every year almost 1000 children under the age of five were admitted to hospital with rotavirus infection and the average length of time they spent in hospital was five days.

Those numbers are coming down significantly since the introduction of the rotavirus vaccine.

For all the successes, Morrissey says we can’t be complacent. There are some areas of concern, with lower uptake for the school immunisation programme in parts of Donegal, Sligo, Leitrim, Cork, Kerry and Waterford, perhaps due to prominent local anti-vaxx groups in those areas.

Morrissey says: “Every parent wants to do the best for their child. Some parents genuinely believe that a vaccine may be harmful for their child, but I would urge all parents to discuss any concern with their GP.

“The fact is we are all benefactors and contributors to the success of vaccinations in preventing death and disability worldwide.”

There is lots more information available on www.immunisation.ie

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