Immunisation in chidhood: the facts: submission to the Joint Oireachtas Committee on Immunisation.
|dc.contributor.author||Department of Health (DoH)|
|dc.description||Immunisation against infectious disease has probably saved more lives than any other public health intervention apart from the provision of clean water. • A review of 587 life-saving interventions and their cost-effectiveness indicated that routine immunisation programmes for children were among the ones with better costeffectiveness. • . At least 162 published economic evaluations of vaccines have been carried out from 1969 to 1998. They consistently show that immunisation is an excellent investment: highly cost-effective and usually cost saving for vaccines that are currently recommended for universal use. • Past successes of the vaccination programme include the eradication of smallpox, the near eradication of polio and control of many other diseases such as those caused by Haemophilus influenzae B, diphtheria, pertussis and measles. An example of one such success in Ireland is the 10-fold decrease in the incidence of invasive Hib disease seen subsequent to the introduction of Hib vaccine in 1992. • There are few reasons for refraining from vaccinating a child. Unfortunately several false contraindications have prevented some children from being immunised. • Extraordinarily high safety standards have been imposed on vaccines as a result of several characteristics of vaccines and of vaccine use. These include the fact that most vaccines are given to otherwise healthy individuals (usually children and often repeatedly), the widely held view that vaccines are natural and the fact that many governments have made vaccination mandatory. • Vaccines are neither 100% safe nor 100% effective. In the last decade,· however, various changes in vaccine production and administration have reduced the number of adverse events and resulted in safer vaccines. • Many conditions with an onset in early childhood, such as autism, convulsions, and sudden infant death syndrome, do not have an obvious cause. As children are immunised at a time when these disorders manifest themselves for the first time it is inevitable that on occasion their onset follows immunisation. It may then be assumed that immunisation caused the problem. • The scare following publication of the mistaken theory that pertussis vaccine was a significant cause of brain damage is an example of what can happen when preliminary research is made public. Some children died unnecessarily because their parents refused to have them vaccinated. Another example is the recent controversy over the MMR vaccine and autism and bowel problems. • The possibility of disease such as diphtheria resurfacing was highlighted by the recent resurgence of diphtheria in parts of Eastern Europe during the 1990s. • A child is far more likely to be seriously injured by one of these diseases than by any vaccine. While any serious injury or death caused by vaccines is too many, it is also clear that the benefits of vaccination greatly outweigh the slight risk, and that many more injuries and deaths would occur without vaccinations. • Many parents have reservations about getting vaccinations for their children. There can be many reasons for fear of or opposition to vaccination. Some people have religious or philosophic objections. Some see mandatory vaccination as interference by the government into what they believe should be a personal choice. Others are concerned about the safety or efficacy of vaccines or may believe that vaccine preventable diseases do not pose a serious health risk. • Parents have a right to objective information prior to deciding whether to immunise their children. Consent for vaccination is truly 'informed' when the members of the public know the risks and benefits and make voluntary decisions. • Poor vaccine uptake rates continue to be a concern in Ireland. Because uptake rates have not reached set targets which would ensure herd immunity, we are still seeing outbreaks of vaccine preventable diseases. A measles outbreak occurred in Dublin in early 2000, for example, which led to at least 6 admissions to intensive care and two measles related deaths. • Regional immunisation co-ordinators should be appointed to co-ordinate services and monitor uptake in all health board areas. • All health care providers who administer vaccines are required to discuss the potential risks and benefits of immunisation. In these situations, risk communication is a necessary skill. • The issue of appropriate compensation for the small number of children who experience vaccine related adverse effects is one that should be addressed at national level. • Surveillance of vaccine associated adverse effects is important and resources should be made available at a time of increasing vaccine activity. • Immunisation has been shown to be both safe and effective and should be promoted and encouraged by all health professionals in Ireland.||en_GB|
|dc.publisher||Department of Health (DoH)||en_GB|
|dc.title||Immunisation in chidhood: the facts: submission to the Joint Oireachtas Committee on Immunisation.||en_GB|