The dangers of missing vaccinations

Immunisation is a key component of primary health care and an indisputable human right. It is also one of the best health investments money can buy. Vaccines are also critical to the prevention and control of infectious disease outbreaks. They underpin global health security and will be a vital tool in the battle against antimicrobial resistance.

World Immunisation Week, celebrated in the last week of April, aims at highlighting the collective action needed and promoting the use of vaccines to protect people of all ages against preventable diseases.

According to the World Health Organisation (WHO) immunisation is a global health and development success story, saving millions of lives every year. 

“Vaccines reduce the risk of getting a disease by working with your body’s natural defences to build protection. When you receive a vaccine, your immune system responds. There are now vaccines that prevent more than 20 life-threatening diseases, helping people of all ages live longer, healthier lives,” the WHO website states.

Immunisation currently prevents three and a half to five million deaths every year from diseases such as diphtheria, tetanus, pertussis, influenza and measles.

The Covid-19 pandemic, associated disruptions and Covid-19 vaccination efforts strained health systems in 2020 and 2021, resulting in dramatic setbacks. However, from a global perspective, recovery is on the horizon. For example, the 2022 diphtheria-pertussis-tetanus (DTP) immunisation coverage, albeit unevenly distributed between countries, has almost recovered to 2019 levels.

Measles, because of its high transmissibility, quickly exposes any immunity gaps in the population. Still, 22 million children missed their routine first dose of measles vaccine in 2022, compared to 19 million in 2019.

The deadly and highly contagious disease is still common in many countries. Recently, vaccine hesitancy among parents in Uganda and many other countries has led to a growing number of children and teens who are under-vaccinated and thus, unprotected from measles.

Importance of vaccines

Dr Sabrina Kitaka, a senior lecturer of paediatrics and adolescent health at the College of Health Sciences, Makerere University, says your vaccination decision as a parent affects not only the health of your child, but also the health of your family, your child’s friends and their families, and your community at large. 

“Different vaccines work in different ways, but every vaccine helps the body’s immune system learn to fight germs. It typically takes a few weeks for protection to develop after vaccination, but that protection can last a lifetime. A few vaccines, such as those for tetanus or seasonal flu, require occasional booster doses to maintain the body’s defences,” Dr Kitaka says.

Immunity is the body’s way of preventing disease. Since a baby’s immune system is not fully developed at birth, babies face a greater risk of becoming infected and getting seriously ill. 

“Children are exposed to thousands of germs every day. This happens through the food they eat, the air they breathe and the many items they put in their mouth. Vaccines help teach the immune system how to defend against germs and vaccination protects your baby by building their immune system,” Dr Kitaka adds.

In babies

Babies are born with an immune system that can fight most germs, but some germs cause serious or even deadly diseases a baby cannot handle. For those, babies need the help of vaccines. Vaccines use very small amounts of antigens to help your child’s immune system recognise and learn to fight serious diseases. Antigens are the parts of a germ that cause the body’s immune system to go to work.

Vaccinations teach your child’s immune system to make a readymade defence against infection called antibodies, in case they meet the infection in future-so they do not get infected and do not get ill.

The diseases

Without immunisations, your child is at risk of catching a vaccine-preventable disease. Vaccines protect your child from diseases and infections such as diphtheria, hepatitis, haemophilus influenza (hib), whooping cough, tetanus, rotavirus, meningitis, pneumococcus, measles, yellow fever, mumps, rubella and HPV.

For example, influenza, a serious respiratory disease can be deadly, especially to infants and toddlers. Tragically, many children die from influenza globally.

Whooping cough or pertussis is a very dangerous disease for infants. It is not easily treated and can result in permanent brain damage or death. 

Children with chickenpox need to be kept out of daycare or school for a week or more so they do not spread the disease to others.

Safety 

Dr Kitaka says vaccines are only given to children after a long and careful review by scientists, doctors and healthcare professionals. 

“Vaccines will involve some discomfort and may cause pain, redness, or tenderness at the site of injection, but this is minimal compared to the pain, discomfort and trauma of the diseases these vaccines prevent,” she says.

Serious side effects following vaccination, such as severe allergic reaction, are very rare. The disease-prevention benefits of getting vaccines are much greater than the possible side effects for almost all children.

Asked whether it is safe for children to have several vaccines at once, Dr Kitaka says if the vaccines are spread out rather than given together, they leave the child unprotected for a longer period of time. 

“Children come into contact with many bacteria and viruses every day as they go to school or while they play. Their immune systems are very able and can respond to multiple vaccines at once,” she adds.

Worry

Many parents complained about the mass yellow fever vaccination that happened earlier this month but according to Dr Ombeva Malande, a vaccinologist at the Ministry of Health, the vaccine is safe and for a year now, it has been rolled out in the routine immunisation programme for children aged nine months. 

“It is the same vaccine manufacturer we have used for years. Even if you got it previously and got it again, it is safe. It is a one-time shot for life. Only people who are allergic to eggs, the elderly above 60 years, breastfeeding mothers and infants below nine months should not get it,” he says.

The dangers

Lower vaccination rates mean herd immunity is not as strong. If your child is not vaccinated, they can pass infection to others who are not able to get protected yet such as young babies and pregnant women, who can then get very sick.

Children who are not immunised can readily transmit vaccine-preventable diseases throughout the community including the babies who are too young to be fully immunised.

Unvaccinated children pose a threat to children and adults who cannot be immunised for medical reasons. This includes people with leukaemia and other cancers, immune system problems, and people receiving treatment or medications that suppress their immune system.

During disease outbreaks, unimmunised children may be excluded from school or child care until the outbreak is over. This is for their own protection and the protection of others. It can cause hardship for the child and parent.

Myths 

There are several myths according to Dr Kitaka that stop parents from taking their children for vaccination. Many of them are not true. 

Some parents think that if their child suffers from the disease, they will develop immunity but if your child is infected, their immune system learns how to better defend against that same infection if they are infected again. The body does this by making ‘memory immune cells’. Catching the infection however, means your child can get very ill and die, so getting vaccinated stops that risk. 

Dr Kitaka says, “Some parents wonder if getting more than one shot at a time will cause them to interfere with each other, or be too much for their baby's immune system. But, rest assured, this is how immunisations are proven to work best to safely and effectively build your child's immunity against many serious illnesses. Vaccines do not cause autism as accused by some people.”

Children who are not vaccinated are at a greater risk of getting sick and dying from infectious diseases. Protect your children by ensuring they are vaccinated.

Government policy

According to the immunisation Act of 2017, the State shall provide free vaccines and other related services to every Ugandan required to receive vaccination such as compulsory immunisation for children, HPV vaccine for girls between 10 and 12 years as well as tetanus vaccine for pregnant mothers and women.

It also requires production of immunisation cards before admission of a child to any daycare centre, pre-primary or primary education. 

A person, who without lawful excuse contravenes these commits an offence and is liable, on conviction, to a fine not exceeding twelve currency points (Shs240,000) or imprisonment not exceeding six months or to both.