Childhood Vaccination Update for Healthcare workers
As a front line healthcare worker delivering or advising on childhood vaccination, you’re unlikely to be asked the vaccination schedule in its entirety. However you may be grilled with several questions relating to the evidence for, efficacy and safety of vaccinations. As a subject which frequently causes controversy it’s important to have a working knowledge of vaccinations and to be able to address parents’ questions and concerns confidently yet accurately so they can make informed decisions. In this article, I discuss a selection of the most frequently asked questions.
Should I have my child vaccinated?
Such is the evidence behind vaccination that many countries will not allow children into education without an up to date vaccination schedule. The success of vaccination relies on a high uptake and the resulting “herd immunity”, whereby so many individuals are vaccinated that those who definitely cannot be immunised are unlikely to be exposed to the disease causing organism.
Does the MMR vaccination cause Autism?
A poorly designed 1998 study, with only a small amount of patients claimed a link between MMR and autism. Despite its multiple failings it somehow caught the public imagination and also fear. However, in the intervening twenty years several robust trials have demonstrated that the MMR vaccination does not cause autism.
How do Vaccines work?
Vaccines contain a dead or weakened version of the germ causing the disease. When the child’s immune system encounters this, it forms antibodies to the disease. If that person then encounters the disease again, these antibodies are rapidly activated, so that the disease is dealt with swiftly, without the individual becoming ill. The vaccine will not cause the disease itself, though minor side effects are common, short-lived and usually resolve of their own.
What do I do if my child has missed vaccines?
Vaccines may be missed for several reasons. One of the most common is an acute illness at the time the immunisation was scheduled, however families that frequently move, or have emigrated from a country with a less robust healthcare system, often have children with an incomplete schedule, or who may not have not been vaccinated at all. Vaccines can be “caught up” without the need for repeating the entire course. It is better to err on the side of caution and give an extra dose rather than assume it has been given, especially if there is no documentation to back this up. An extra dose will not harm a child.
What is the proof that vaccines work?
Much of the evidence behind vaccines is that diseases have been eradicated (small pox) or reduced to such an extent that most people do not have first-hand experience of the diseases that vaccination targets. Unfortunately this is also how complacency sets in, and if you’ve never seen the after effects of an illness, you may be less fearful of it, or indeed question its existence. However, recent outbreaks of measles can be directly correlated with drops in vaccine uptake in the affected areas. Measles can kill, and for those who survive, there can often be long lasting effects and indeed severe disability as a result.
Who should not have vaccinations?
There probably aren’t many reasons for a child not being vaccinated. If the child had an active chronic disease it would be wise to seek the advice of their specialist. If they had had a severe allergic reaction to that vaccine previously, this would be a contraindication. For children with severe egg allergy it is generally assumed acceptable to give MMR in a normal primary care service, whereas the Flu vaccine may have to be administered in a hospital setting.
Dr. Zak Uddin
Consulting General Practitioner
MB ChB, MRCS, DRCOG, MRCGP
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