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Worried about vaccines? There’s a lot of confusion surrounding the topic, so it’s important to make informed decisions for the health of your baby. Kerryn Massyn spoke to Professor Rose Burnett, from the South African Vaccination and Immunisation Centre at the Sefako Makgatho Health Sciences University, Dr Benjamin Kagina, from the Vaccines for Africa Initiative (VACFA) and Dr Melissa Suchard, Head of the Centre for Vaccines and Immunology at the National Institute for Communicable Diseases (NICD), and here are the facts.
- How does a vaccine protect my child from disease?
“The basic principle of vaccination is to activate the body’s defences by mimicking the invasion of a specific infectious agent. This triggers the body’s defense mechanisms just as a real infection would,” explains Professor Rose Burnett, from the South African Vaccination and Immunisation Centre in the Department of Virology at the Sefako Makgatho Health Sciences University. “A vaccine contains either the whole organism that causes a certain disease (either killed or weakened so that it can’t cause disease), or only non-infectious parts of the organism. These are called antigens, and they stimulate the immune system in the same way as natural infections do. So, if you come into contact with the real disease after being vaccinated against it, your body is ready to mount a rapid and potent secondary response that will control and eliminate it before it has had time to establish itself and cause clinical disease.”
- Why does it matter to a parent of a vaccinated child whether my children are vaccinated or not?
A concept called herd immunity is key to ensuring vaccinations work to prevent infectious disease on a large scale. “At an individual level, vaccination helps to prevent a child from getting sick if there is exposure to the targeted germ-causing disease that the vaccine is administered against. At a community or population level, many people need to be vaccinated to prevent the spread of the infectious vaccine preventable diseases from one person to another. This is referred to as herd immunity,” says Dr Benjamin Kagina, from the Vaccines for Africa Initiative (VACFA) of the University of Cape Town.
As Prof Burnett explains, the more people in a community who are vaccinated against infectious diseases, the stronger the herd immunity. “When most of the people in a community are immune to a particular contagious infection, the natural spread of the infection is halted. The people who have been immunised act as a ‘shield’ that protects those who have not been vaccinated from getting sick. Herd immunity is very important for protecting babies that are too young to be vaccinated, as well as those with medical conditions that mean they cannot be vaccinated,” she says.
- Why does my child needs vaccinations? I haven’t heard of anyone getting polio recently…
Put simply, it is because of vaccinations that the occurrence of many infectious diseases has decreased. “Vaccines are routinely given to prevent diseases that are likely to occur in the future. We all know that prevention is better than cure, and because we are now living in a global village due to both emigration and immigration, it’s important to vaccinate our children fully and timely,” explains Dr Kagina. “Of all the known vaccine-preventable diseases, only smallpox has been completely eradicated because of vaccination. As such, we do not need a vaccine against smallpox. However, polio virus is still circulating in some parts of the world, such as Pakistan. As long as there is polio virus circulating in the world, there is a risk of our children getting sick from it, if not fully vaccinated.”
- Why are the government and private vaccination schedules so different – is one better than the other?
Dr Kagina explains that neither schedules are inferior to the other, as both the government and private vaccination schedules are effective. The government schedule protects your child against 11 infectious diseases that research has shown cause the highest incidence of illness and death in South Africa. The difference comes from the additional optional vaccinations offered on the private schedule, such as hepatitis A, chicken pox, mumps and rubella. “Importantly, the Government provides vaccines and immunisation services to the public for free. This is not the case with private health sector, where parents are required to pay for the immunisation services,” he says.
- Aren’t all these vaccinations just exposing our children to too many things at once, overburdening their immune systems as a result?
No, says Prof Burnett. “Babies are exposed to many different microorganisms every day through eating, touching and mouthing different objects and surfaces in their environment. It’s also quite normal for them to get a number of bacterial and viral infections every year. Yet their immune systems do not get suppressed or overstimulated through this. Additionally, unvaccinated and vaccinated children respond to other infections (those for which we don’t yet have vaccines) in exactly the same way, showing that vaccines do not alter the healthy functioning of the immune system,” she explains.
- Isn’t it better for my child to develop natural immunity by getting sick?
Dr Kagina urges parents to rely on vaccines to develop immunity against the infectious illnesses they’ve been developed for. “Some diseases are very severe when acquired naturally, and may even cause death before the body is able to build natural immunity. For example, many cases of paralysis due to polio virus have been reported in the past in some children who were not vaccinated. Also, brain damage and death due from infection with the measles virus has been reported among some unvaccinated children. It stands to reason that it is better and safer to have our children vaccinated,” he says.
Prof Burnett adds that research has shown measles causes pneumonia in 1 in 20 cases and encephalitis (a brain infection) in 1 in 2000 cases, whereas the risk of developing encephalitis or a severe allergic reaction from the measles vaccine is only 1 in 1 million – proving it’s extremely safe.
- I’ve heard that vaccines, and the MMR in particular, cause autism. Is this true?
This rumour persists despite a 2001 study, as well as ongoing scientific research, disproving the link. As Prof Burnett explains, the myth that the combination mumps, measles and rubella vaccine causes autism is untrue. The results of the study were later found to be fraudulent, and the findings have been fully refuted by many very large independent studies on (collectively) millions of children,” she says. “The first signs and symptoms of autism coincidentally appear at around the same age when children in the UK receive their MMR vaccine, which is why people thought the two were related.”
- Should I give my baby a dose of paracetamol before the vaccination, or rub anything onto the site of the injection?
Don’t do anything to prevent your child developing side effects even before getting the immunisation. “There is evidence that giving paracetamol may reduce the level of protection that your child gets from being vaccinated,” says Dr Kagina. “Following the administration of vaccines, your child may experience discomfort that includes pain, redness or inflammation at the injection site. In most cases, this is bearable. Should this not be bearable, contact your family doctor or nurse for guidance.”
Likewise, leave the injection site alone for best results. “Nothing should be rubbed onto the place where the needle went in – it is not necessary and may get into the wound and cause infection,” says Dr Melissa Suchard, Head of the Centre for Vaccines and Immunology at the National Institute for Communicable Diseases (NICD). And don’t pop or scratch at the pimple-like mark on your newborn’s arm. “This is usually due to the BCG immunisation received at birth, which vaccinates against TB. This mark actually indicates a healthy immune response. If it turns into an abscess (a warm, red, swollen lump) or there is any concern, consult your doctor or clinic nurse,” she adds.
- My child has had all his vaccinations, and got measles last year – how did that happen?
“A small proportion of children may not respond to the measles vaccine within the first year. Therefore, it is possible for some children to remain unprotected despite having been vaccinated, especially within the first year of life. To prevent this, booster doses of measles are recommended and it is critical for parents to ensure their children receive all the booster doses of measles vaccines, as well as other recommended vaccines,” says Dr Kagina. This, he says, shows why herd immunity is so important – in the case of a large enough proportion of the community vaccinate against measles, the likelihood of the infection spreading is minimal.
- What should I do if my clinic doesn’t have some of the scheduled vaccinations in stock?
Dr Suchard has some important advice if this happens to you: “Take the phone number for the clinic and write down the name of the vaccine. Phone to check when it is back in stock, and come back to get it at a later date. This is very important, as making sure your children’s vaccines are up to date is vital.