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Essay: Protect Health and Future Generations: Immunisation Explained

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  • Published: 1 April 2019*
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What is Immunisation

Immunisation is a way of preventing infectious diseases which is a process where a person is made immune or resistant to an infectious disease, typically by the administration of a vaccine. Vaccines stimulate the body’s own immune system to protect the person against subsequent infection or disease. It is a product that produces immunity from a disease and can be administered through needle injections (most common), by mouth, or by aerosol. Through this injection of a killed or weakened organism, it produces immunity in the body against that organism.

Vaccinations are offered to babies, children and adults to protect against serious and preventable diseases.

Immunisation uses your body’s natural defense mechanism, the immune response, to build resistance to specific infections. If you have been immunized and you come into contact with that disease, your immune system will respond to prevent you developing the disease. 

Very young children in particular are at risk of becoming sick, because their immune system lacks experience and strength and so is unable respond quickly. Many of the diseases that vaccines protect us from are very serious in young children. For example- measles which are highly contagious and usually fairly mild, but pose a risk of complications even in healthy people.

Immunization is the safest and most effective way to provide protection for a child’s health.

Process

A vaccine is a product that produces immunity from a disease and can be administered through needle injections, by mouth, or by aerosol. A vaccination is the injection of a killed or weakened organism that produces immunity in the body against that organism.

Vaccines contain parts of or weakened versions (inactivated or attenuated) of a particular germ. Vaccination exposes the body to parts of the germ for the first time without causing disease and eventually, the real germ can be quickly destroyed if it enters the body to prevent illness.

Diagram: http://www.mlive.com/news/index.ssf/2014/12/how_do_vaccinations_work_the_s.html

The first time we are exposed to a germ, for example a bacterium or virus, it takes time for the immune system to respond and we become unwell. However, once the immune system has memory of the infection, it is able to respond rapidly to destroy the germ the next time we are exposed.

Efficacy and effectiveness

Vaccine efficacy and effectiveness are measures that compare the rates of disease between vaccinated and unvaccinated people. Efficacy is measured in controlled clinical trials, whereas effectiveness is measured once the vaccine is approved for use in the general population. From these we can identify the proportion of vaccinated people we would expect to be protected by the vaccine.

Concept

Ideas and facts related to issue:

The National Immunisation Schedule in New Zealand is a series of vaccinations that are offered free to babies, children, adolescents and adults.

Immunisation uses the body’s natural defence, the immune response, to build resistance to specific infections. When an immunised person comes in contact with that disease in the future, their immune system will respond to prevent them developing the disease. In New Zealand, parents choose whether or not to vaccinate their children.

Influenza

Immunization is the most effective way available to prevent influenza, and should be offered as widely as practical, along with advice on hand washing and staying home when sick.  The vaccine remains funded for eligible people until 31 December.  New Zealand’s influenza illness rates this year are higher than last year’s, but still below average.  However, the dominant strain of influenza is H3N2, which results in more hospitalisations.  Meanwhile, Australia is experiencing very high influenza levels, with a similar predominance of H3N2.

In New Zealand, immunisation of children is not compulsory but is encouraged. There is a target of having 95 per cent of children fully immunised at eight months, two years and five years.

Ministry of Health figures show 92 per cent of eight-month-olds were immunised over the 12 months to June. For two-year-olds the figure was 93 per cent, and for five-year-olds it was 88 per cent.

Under a "No Jab No Play" policy in Australia, some states do not allow unvaccinated children to attend childcare of pre-school services, unless there is a medical reason. Some national benefits are not paid if a child is not immunised, on a catch up schedule, or has an approved medical exemption.

Earlier this year, then-Health Minister Jonathan Coleman said the Government in this country had no plans to change its policy. Banning children from childcare and pre-schools would harm their long-term prospects, he said.

Biological Implications

There are biological implications relating to immunisation, the main being the fact that if no one in a population gets immunised then the disease can spread, causing an increase in the chance in humans getting that particular infection. Immunisation is the most effective way to be actively protected from preventable diseases, such as whooping cough, tetanus, hepatitis B and measles therefore if one person decided not to be immunised then the rest of the population is put at risk and other who are not immune can catch it. Although some people cannot get immunised, this still creates an increase of diseases and viruses spreading in a society which can be reduced and contained through the use of vaccines and could one day be wiped out. This can only occur if a large amount of the population gets immunised as opposed to only some of the population getting the vaccine which would result in less opportunities the disease has to spread.

Image: https://www.cdc.gov/vaccines/vac-gen/whatifstop.htm

For example, Polio (Poliomyelitis)- a highly contagious viral disease, has now over time been eradicated from the New Zealand population through immuinsation. The Global Polio Eradication Initiative aims to eradicate the disease by providing polio vaccines to every child globally ensuring a polio-free world for future generations. Since 1988, polio case numbers have reduced by over 99.9%. The only countries with endemic wild-type poliovirus in 2016 were Nigeria, Afghanistan and Pakistan. Wild type-2 polio has been eradicated globally since 1999 and no cases of type-3 have been reported worldwide since 2012. Before the development of Polio vaccines, nearly every person became infected with the disease, with the highest rate being in babies and young children. New Zealand began immunising with the oral polio vaccine (OPV) in 1961 and in 2002, introduced an inactivated polio vaccine (IPV) to stop the risk of polio caused by vaccine-derived poliovirus. Although diseases can be eradicated from populations they can still be there so it doesn’t mean that just because a disease is under control we can let ourselves become vulnerable by not vaccinating. This can result in a case of an outbreak. The most recent outbreak currently in New Zealand is the Mumps outbreak in Auckland 2017. Mumps is a contagious disease caused by a virus which affects the parotid glands, salivary glands below and in front of the ear.

The last similar outbreak of mumps was in 1994 when there were between 200-300 cases reported. Since then only handfuls of cases were reported each year, many from overseas. But this year, more than 311 cases of mumps have spread across the city with Auckland Regional Public Health Service medical officer of health Josephine Herman saying she had seen mumps-related meningitis, testes inflammation and cases of hospitalization.  In addition to the cases across the Auckland region, over the last couple of months there have also been cases reported in Northland, Waikato, Taranaki, Wellington, Nelson-Marlborough, Canterbury and Otago.

Low immunisation rates in parts of Auckland are to blame, meaning a "lost generation" is facing a triple threat of disease, according to health authorities.

ARPHS is warning that a large number of 10 to 29 year olds are not only at risk of mumps but also of measles and rubella due to some parents rejecting the MMR (measles, mumps and rubella) vaccine. This is big part of the social, economical implications of immunisation.

In addition to the main biological implication of immunisation, another is also pain an and side affects. Like any medicine, vaccines have the potential to cause reactions and have side effects with some people. Most adverse reactions following vaccination are mild and short lived, however some vaccines may rarely cause more serious reactions. With any vaccine the following types of suspected adverse reactions are expected to be reported:

– Injection site reactions (eg, pain, swelling).

– 'Well- recognised' events such as headaches, dizziness, muscle aches, mild fever and tiredness

– Mild allergic reactions such as mild rashes and itching.

– A few serious allergic reactions. Healthcare professionals giving vaccines are trained to spot the symptoms of serious allergic reactions and treat them.

– Events due to fear or anticipation of the needle injection, such as fainting.

– Coincidental medical conditions (eg, neurological disorders).

– New adverse reactions (i.e. those not already listed in the datasheet)

In New Zealand it is unlikely that rare side effects to vaccines will be detected as the population immunised is usually too small. Therefore Medsafe uses international data to help determine if these rare events may be due to immunisation.

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