World Immunisation Week 24 – 30 April 2014; “Are you up-to-date?”

Back in 2012 I watched a BBC documentary ‘Ewan Macgregor: Cold Chain Mission’ http://www.unicef.org.uk/asp/cold-chain-ewan-mcgregor/index.asp. This filmed the actor’s mission as an ambassador of UNICEF to deliver vaccines, and immunise children in some of the world’s remotest places. This particular programme followed his journey to India and Nepal and highlighted the incredible journey he made trekking 2 days over the Himalaya whilst maintaining the ‘cold chain’ of the vaccines he was delivering to remote mountain villages. The cold chain is the essential system of transporting and storing vaccines within a safe temperature range (2°c to 8°c) from the place of manufacture to the point of administration. This ensures people receive an effective vaccine that has retained its viability by not being exposed to temperatures outside of this range. So you can only imagine how difficult this was given the circumstances of this trip!

A couple of things have stayed with me since watching this programme, namely;

• The complicated planning and effort it took the team to maintain the cold chain whilst trekking in the mountains, to preserve the efficacy of the vaccines they were delivering (without a vaccine fridge!). It really was a mission!

• The determination of these few health care workers to ensure even the remotest of children was protected against disease.

• The remoteness of where people live and their lack of basic medical care – to include limited access to vaccinations.

• The relief I saw in the parents as their children were immunised. They understood all too well the importance of immunisation, quoting that the measles vaccine being offered ‘will keep their children safe.’ I got the impression they had perhaps seen at first hand the devastating, sometimes fatal effect of measles infection in a child.

Immunisation is recognised as one of the most successful and cost effective health interventions ever introduced. It prevents 2 – 3 million deaths every year. New vaccines now protect against diseases such as pneumonia and rotavirus diarrhoea- two of the world’s biggest killers in children under 5. We also now have vaccines to protect against cervical cancer for adolescents and adults.

As highlighted in the BBC documentary, large numbers of people are not immunised, and for those who start but don’t finish immunisation schedules this is due to:

-inadequate supply of vaccines

-lack of heath care workers

-insufficient political and financial support

Here in the UK, we are extremely fortunate to have a system in place that is easy to access, evidence based, safe and funded by the NHS to ensure we are all protected against the most devastating ‘vaccine- preventable’ diseases. We now have a schedule that is started in pregnancy to protect pregnant women against influenza, and their babies, when born, from whooping cough – this continues through to the birth of their babies – the first few months of life, toddler age, pre-school age, on to teens and then later on in life above the age of 65 years.

We are very lucky indeed.

However, many people here in the UK are still not being vaccinated or are not up-to-date with the schedule. Unlike some other countries, we have robust systems in place to immunise our population, so why is this?

Lack of education about vaccination is one of the key reasons why adults consciously choose not to be vaccinated themselves, or not to vaccinate their children. Here in the UK, there have been many ‘scare’ stories and ‘controversies’ concerning immunisation that have influenced uptake of vaccinations and unfortunately we are now seeing the after effects of these, one being the recent measles outbreak.

A common misconception is that vaccines are unsafe. Remember they have been widely available for many years- some since the 19th century! They are thoroughly tested for safety before they are made routinely available, and each vaccine’s safety is then continually monitored even after it’s been made available. So in fact they are very safe and millions of children and adults are vaccinated every year without long term adverse effects.

I have at times consulted with students who at the age of 18yrs have never received a vaccine in their lifetime – as their parents did not consent to this. Fortunately, this happens infrequently and the person attending the appointment makes an informed choice, based on what they have read and what we discuss in the consultation, to complete a primary course of vaccinations, to ensure they have adequate immunity in their adult lives.

However, as more research and evidence becomes available, immunisation schedules change – so ‘lack of knowledge’ can be as a result of changes, rather than decision not to immunise. The schedule you received as a child may have changed by the time you reach adulthood. Some people also ‘miss’ receiving vaccinations due to illness on the day of vaccination.

Specific goals for this world immunisation week are:

 

  1. 1.      For you to know what vaccines are available to protect you against disease
  2. 2.      Check your vaccination status. Perhaps print off the UK schedule and check on behalf of members of your family. Make sure they are all ‘up-to-date’ – remember schedules do change…
  3. 3.      Book an appointment at SHS for any vaccines you think are missing

Young people attending Universities and Higher Education are known to be at ‘higher risk’ for certain infections, including meningitis C and mumps/measles. These infections are spread through respiratory contact- coughing and sneezing, so easily transmitted. By ensuring that you are up-to-date with your immunisations you will protect both yourself and others, via ‘herd immunity’. Herd immunity is ‘the indirect protection from infection of susceptible members of the population, and the protection of the population as a whole, which is brought about by the presence of immune individuals.’ No vaccine is 100% effective- measles vaccine is 90-95% effective, and some people are unable receive a live vaccine like MMR, e.g. the immunocompromised, so by you making sure that you’re up-to-date with your vaccinations you will be giving yourself the best protection available and also contributing to increased herd immunity in the population around you for those who most need protection.

So, are YOU ‘Up-To-Date’?

You need to ensure you have received the following vaccines:

Number of Injections

Vaccine

5

Tetanus, Diphtheria and Polio

2

combined Measles, Mumps and Rubella

1

(2 as from August 2104)

Meningitis C

3

HPV- Gardasil (females under 18 yrs only)

Annual

Influenza vaccine – ‘at risk’ groups only

 

Remember, you are able to find out if you have missed any of your immunisations by checking:

-Your GP immunisation records

-Your parent’s records

-Your school, as some immunisations are given in schools and not documented in your GP records

If you find you are not ‘up-to-date’ with your immunisations schedule, we encourage you to come in to SHS so we may help you complete your schedule.

If you are planning a trip abroad, especially to ‘high risk’ destinations, please always check you are ‘up-to-date’ with your travel immunisations at least 6-8 weeks before you travel.

We have a safe and adequate supply of vaccines in the practice and we take care of the cold chain, so all you need to do is book an appointment with one of the nurses either by phone or online, and they will then administer any free NHS vaccines you are missing.

You haven’t got to cross the Himalaya to receive a life protecting immunisation; you can have them here at SHS, but if you do intend to cross the Himalaya, please ensure you are also up-to-date with your travel immunisations as well!

 Useful Links:

UK Immunisation Schedule:

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/227651/8515_DoH_Complete_Imm_schedule_A4_2013_09.pdf.

 

Measles Outbreak:

http://www.nhs.uk/Conditions/vaccinations/Pages/measles-outbreak-advice.aspx.

http://www.bbc.co.uk/news/health-22277186.

 

History of vaccination, ‘From antiquity to the present day…’

http://www.hpa.org.uk/webc/hpawebfile/hpaweb_c/1279889314367.

 

Travel Immunisations:

http://www.fitfortravel.nhs.uk/home.aspx.