Vaccination protects hundreds of millions of people worldwide from disease and possible death.

• 2000 Routine vaccination against meningococcal Group C disease (meningitis C) was introduced in the UK in November 1999. By January 2001, there had been a drop of 90% in the number of cases of meningitis C in both the under one year old and the 15-17 year old age groups. It is estimated that 500 cases of Group C meningococcal meningitis and septicaemia have been prevented since the start of the programme, and 50 deaths have been avoided. Overall, across all age groups the reduction in meningitis C cases is 75% and this figure is expected to rise substantially when the programme is completed.³ Before the introduction of the vaccine, meningococcal Group C caused an estimated 1,530 cases of meningitis and/or septicaemia with 150 deaths in 1998, mainly in young children and teenagers. In the last six months of 2000 the vaccine reduced meningococcal C disease across all under 18's by 71% (this will have included many children still to be immunised as the programme rolled out), compared with the same period of 1999. In the first groups to be immunised, disease has been reduced by 90% (in 15-17 year olds) and 82% (in under 1s)⁴
• 1992 Routine vaccination of infants against Haemophilus influenzae type b (Hib) was introduced in the UK. Incidence of this disease in infants under one year (those at greatest risk) has since fallen by 96%.¹ Hib meningitis, epiglottitis and other serious infections from this organism have now virtually disappeared from paediatric wards in the UK
• 1988 The Measles, Mumps, Rubella (MMR) combination vaccine was introduced in the UK. In the year before its introduction, 90,000 cases of measles had been reported, with 16 deaths.⁵ There are now around 3,700 cases notified every year and no deaths other than those due to the late effects of measles infection. No child in England and Wales has died from acute measles-related infection since 1992.⁶ As a result of the MMR vaccination campaign the UK is able to consider the future eradication of measles, and Congenital Rubella Syndrome, a condition where foetal defects can occur if the mother is infected with rubella during early pregnancy
• 1950s Routine vaccination against pertussis (whooping cough) was introduced in the UK. Incidence of this disease has fallen from 100,000 notifications per year to less than 2,000 now. Complications of pertussis disease include bronchopneumonia, weight loss and brain damage due to the brain being deprived of oxygen¹
• 1950s Routine vaccination against poliomyelitis was introduced in the UK. As a result, the WHO has included the UK among the countries which are likely to have eliminated indigenous poliomyelitis due to the wild virus¹
• 1940 Routine diphtheria vaccination was introduced in the UK. Prior to this, the annual number of deaths due to diphtheria was about 2,000. Since 1994, only one death has been reported as a result of importation of the disease from abroad in an unprotected individual¹
• Smallpox has been eradicated through worldwide vaccination campaigns.¹

Industry continues to discover, research and develop new vaccines to combat disease. These include vaccines against childhood diarrhoeas, traveller's diarrhoea, stomach ulcers, chicken pox, shingles and many more.

 

 

A vaccine is a preparation of dead or modified micro-organisms, or representative components of such micro-organisms, designed to stimulate a specific immune reaction in the body. Vaccines are inoculated through the skin, or given through the mouth or nose. Such immunisation induces protection against subsequent infection by the corresponding micro-organisms, protecting both the individual and society from the disease.⁷

There are two types of vaccines in common use, inactivated or killed vaccines, and vaccines made from live organisms:

INACTIVATED OR KILLED VACCINES

These are sub-divided into three categories:¹

• Inactivated whole bacterial vaccines
  e.g. pertussis (whooping cough) vaccine
• Inactivated whole virus vaccines
  e.g. injected poliomyelitis vaccine (Salk) and hepatitis A vaccine
• Sub-component vaccines
  may be based on bacterial toxins that have been rendered harmless (toxoids) as in the case of diphtheria, some forms of pertussis (whooping cough), and tetanus vaccines, or consist of polysaccharide complex (sugar) molecules which are attached to protein molecules to improve the immune stimulatory effect. Good examples of these so-called conjugate vaccines are the Haemophilus influenzae Type b (Hib) vaccine, the meningococcal C vaccine and the pneumococcal conjugate vaccine. Sub-unit viral vaccines include influenza and hepatitis B.

VACCINES MADE FROM LIVE ORGANISMS

These have been modified or "attenuated" so that they stimulate the production of the appropriate antibodies without causing the disease. Examples of live bacterial vaccines are the BCG (Bacillus Calmette-Guérin) vaccine, which is used against tuberculosis and the more recent oral vaccine against typhoid fever. Live virus vaccines include those against yellow fever, oral poliomyelitis (Sabin), measles, mumps and rubella⁷

New multivalent vaccines may include several different sub-components, often allowing combined protection against different diseases and reducing the number of immunisations.

THE SAFETY OF VACCINES

The risks of serious disease from not vaccinating are far greater than the risks of serious reaction to the vaccination.⁷

• Vaccines have an extremely good safety record, although just as nothing we do in life is completely without risk no vaccine is completely without adverse effects⁷
• The vast majority of adverse effects following vaccination are minor, typically just local reaction at the site of injection which is expected and acceptable for the majority of vaccinees⁷
• For each death or permanent disabling injury caused by vaccination, many millions of cases of disease and death are prevented without significant harm⁷
• The success of the UK's childhood vaccination programme means that some diseases - such as diphtheria and polio - are now almost never seen in Britain. However, as such diseases become less apparent, vaccine safety or risk of possible complications assumes greater importance.⁸ This can result in a fall in the immunisation rate with potentially devastating consequences
• Inactivated vaccines cannot cause infection.

 

1. Salisbury DM & Begg NT (Eds.). 1996 Immunisation Against Infectious Disease. HMSO 1996.
   
2. Annan KA. The Children's Vaccination Initiative Strategic Plan. Managing Opportunity and Change: A Vision of Vaccination for the 21st Century. Geneva 1997.
   
3. Department of Health Press Release 3rd January 2001. Biggest vaccination drive for 40 years smashes meningitis C disease. Reference 2001/0007.
   
4. Department of Health. CMO letter. Current vaccine and immunisation issues. 9th March 2001.
   
5. Prevention is better than cure: How vaccines contribute to health. ABPI booklet.
   
6. Public Health Laboratory Service Facts and Figures. Measles deaths England and Wales, by age group, 1980-1999. http://www.phls.co.uk/facts/Immunisation/Measles/measNotDth.htm
   
7. World Health Organisation Website.  http://www.who.int/vaccines-diseases/safety/parents/geninfo.htm
   
8. Thompson J. Vaccinations - who needs them? Community Pharmacy. January 1999.