Childhood vaccination – Should be it be compulsory?
Introduction
Vaccination is a process that prepares the body to develop immunity to help prevent major disease out breaks from occurring in New Zealand. Making vaccination compulsory for every child in New Zealand has many positive and negative biological implication, as well as social implications, such as ethical and economic impacts. Giving children vaccinations has been debated by many different organisations, for example the New Zealand HPV who want to children to get vaccinated unlike Organic NZ magazine who are against vaccinations.
Biological Concept
The process of vaccination stimulates your immune response to fight against diseases by injecting or taking orally a small component of a disease-causing pathogen. Immunity that comes naturally from infection is usually good at providing protection because the immune system has met living organisms which persist inside the body for some time, so that the immune system has time to develop an effective response. When possible, vaccination tries to mimic this. Sometimes this works very well, when vaccines contain live microorganisms. The microorganisms reproduce, albeit rather slowly, so that the immune system is continually presented with a large dose of antigens. Less effective are those vaccines that are made from dead bacteria or viruses. Some vaccines are highly effective and one injection may well give a lifetime’s protection. Less effective ones need booster injections to stimulate secondary responses that give enhanced protection. It is often a good idea to receive booster injections if you are likely to be exposed to a disease, even though you may have been vaccinated as a child.
Biological implications
At the moment vaccinations are not compulsory, it can only be taken if a parent/guardian gives consent. There are both positive and negative biological implications due to giving children vaccinations. A problem with vaccines is that some people do not respond at all, or not very well, to vaccinations. This may be because they have a defective immune system and as a result do not develop the necessary B and T cell clones. It may also be because they suffer from malnutrition; particularly protein energy malnutrition and so not have enough protein to make antibodies or clones of lymphocytes. These people are at high risk of developing infectious diseases and transmitting them to people who have no immunity. People vaccinated with a live virus may pass it out in their faeces during the primary response and may infect others. This is why it is better to vaccinate a large number of people at the same time to give herd immunity, or to ensure that all children are vaccinated within a few months of birth. Herd immunity interrupts transmission in a population, so that those who are susceptible never encounter the infectious agents concerned.
There is an enormous volume of scientific literature to support major role of vaccination in disease control and eradication. “The impact of vaccination on the health of the world’s peoples is hard to exaggerate. With the expectation of safe water, no other modality, not even antibiotics, has had such a major effect on mortality reduction and population growth”. It is undisputed that better living conditions and improved sanitation have has an immense impact on reducing the spread of infectious diseases, but vaccinations have played a significant role in keeping those disease out of sight especially in New Zealand. In some cases, developed nations have experienced reductions in vaccine coverage following fears of vaccine safety declared by the media, or perception that vaccines were no longer required. In 1974, vaccine coverage for whooping cough dropped in Great Britain and subsequently resulted in 3 epidemics of more than 100,00 cases and 36 deaths over a 5 year period. Polio, a disease not seen in the European region since 002 has recently re-emerged in the country of Tajikistan. In 2007 Tajikistan’s oral polio vaccine coverage rate began to dip below the recommended 90% which has contributed to an outbreak of more than 400 cases and 20 deaths in 2010 thus far. While much of the developed world has not experienced the burden of vaccine preventable diseases such as polio and diphtheria in recent decades due to successful immunisation strategies, there is potential for diseases to re-emerge if vaccination programs and coverage rates are not maintained.
Social implications
There are both positive and negative social implications (ethical, economic etc.) like the business benefits: vaccine development is a highly regulated and specialized industry with only a small number of pharmaceutical companies equipped with the capacity for developing and producing safe and effective vaccines. The vaccine industry requires a commitment of 11-15 years on average and estimated $800 million to introduce a new vaccine to the market. At the end of the day, vaccines contribute to only 1.5% of annual pharmaceutical profits. Many pharmaceutical companies are choosing no to continue making vaccines due to the financial risks involved and potential for considerable loss. The increasing cost of vaccine development and production, mergers of manufacturers and relatively low revenues from vaccine sales compared with other pharmaceutical products such as lipid lowering drugs, may have contributed to the reduction in vaccine manufacturers in the past 25 years. Health professionals opposed to immunization because they will loose their funding. Many scientists are employed in academic positions, and an important part of their responsibilities is to examine and critique the validity and accuracy of research findings. However, one observation does not make a fact, one study does not prove anything, it only adds to the body of evidence – much as one building block adds to a wall. It is not only time consuming but it cost heaps of money to research. Positive implication is that vaccines are always ensured they are safe before releasing them. There are many methods in which vaccine safety is assessed monitored. Today, a new vaccine must undergo clinical trials involving tens of thousands of people where both efficacy and safety are closely monitored. Once a vaccine is licensed, ongoing monitoring of safety is conducted. Active monitoring actively seeks information about the effects of a vaccine. There is a range of ways this is done. There are a range of methods used around the world that compare disease incidence between vaccinated and unvaccinated children. For example, comparing a population for a disease incidence prior to and after the introduction of a vaccine; linked databases comparing a child’s immunization statues with their primary health care contacts and hospital admissions; and looking for time-related associations with diseases and vaccines to see if there is biological plausibility. Vaccines are one of the most closely monitored medicines in use (far more than food products or most other pharmaceutical products) with safety reports that are well established through research. Currently, New Zealand is only reliant on data from other western countries for rates of rare reactions. This is mostly because our population size is small and rare events are difficult to pick up.
Different opinions on one type of vaccine
Human papilloma virus (HPV) is the name of a group of viruses that cause infection on the skin surface. Certain types of HPV cause warts on the hands or feet while others can cause visible genital warts. However, sometimes HPV infection causes no warts, and many people with genital HPV do not know they have it. HPVs are called papilloma viruses because some of the HPV types cause warts or papilloma’s, which are non-cancerous tumors. HPV vaccines are highly effective at preventing some of the most common genital HPV infections and therefore preventing HPV related cellular changes or cancer developing. Most external visible warts are caused by HPV types 6 and 11, and these types do not cause cervical cancer.
This article was written by The New Zealand HPV.
Many people have different opinions about vaccinations and for example The New Zealand HPV pamphlet. This pamphlet would give accurate information to make the correct judgement. The intended audience is parents who have daughters or women who thinking of getting the vaccine.
One biological feature is that “Gardasil immunised against HPV types 16 and 18 which cause 70% of cervical cancers, and HPV types 6 and 11 which cause 90% of visible genital warts.” This is accurate, because it's true that HPV immunises against HPV types 16,18, and 11 and that they only cause approximately 70% of cervical cancers and 90% of visible genital warts. It also offers some cross-protection against other cancer-causing types. Studies show that both vaccines are highly effective (close to 100%) in preventing persistent infection caused by these types of HPV. This is not biased as it is a scientifically proven statement.
Another biological feature is that “both vaccines have been observed to have an excellent safety profile; the most common side effect is soreness at the injection site.” This is accurate, because it true but there are other side effects like fainting, aches fever and fatigue. Much rarer are serious adverse effects such as allergic reactions, convulsion and shock. Another is that no vaccine is 100% effective – it is impossible to tell how an individual's immune system will respond to a vaccine; however even if vaccination does not provide complete protection from the disease, it has been shown that the severity of the disease is greatly reduced. This is bias as they did not tell the whole truth. They only told side effect that you’re more likely than the much rarer side effects that could also can happen. They selected the information that they wanted.
Another biological feature is that “Will cervical screening still be need? Yes. Having the HPV vaccine will not stop the need for cervical cancer screening.” This accurate because even if you have taken the HPV vaccine as this won’t completely stop HPV but will significantly reduce the likelihood of having an abnormal cervical smear and requiring treatment. Although the vaccine prevents common HPV type problems but there are other types of HPV that is not covered and could cause disease. If sexual intercourse happened before the vaccine the virus may have already be infected which could develop into a disease. This is not biased as it is a scientifically proven statement.
The overall statement of this article is that it has bias representation of all the problems of the vaccine, showing only one side of the vaccine. The public may take this information in here as accurate as it has medical professionals interviews on it. Also some of the information in this article has no evidence to back it up. In the end most of the information in the article irrelevant as this article is outdated.
This article was written by Sue Claridge and produced by the Organic NZ magazine.
Another opinion that is opposite from the first article is by Organic NZ magazine written by Sue Claridge gives bias information about the HPV virus to parents and to stop people from taking the HPV vaccine as it is not an organic thing to do. The information is mainly about the HPV virus and how it’s not a very good thing to take. This article explains how the HPV vaccine is not needed and how there are alternative ways. At the beginning they say that women are not likely to get cervical cancer, persuading them not to get the vaccine.
One biological feature is “A study published in June 2006 found that the consistent use of condoms offered considerable protection against HPV.4 Dr Rachel Winer and colleagues found that women whose partners always wore a condom during sex were 70% less likely to become infected with HPV than those whose partners used protection less than 5% of the time.” This is accurate, because it’s true that condoms protect them from transferring HPV but how many people will carry condoms with them. Most people in New Zealand have sex while they are drunk, how are they going to know that they used a condom or not. ONly if condoms are used properly, it can stop HPV. Although condoms are effective but they don’t protect 100% against HPV. This is biased as this information favours one perspective over alternatives, which is still valid. This information only presents one view and lacks a neutral ground.
Another biological feature is “There have been numerous reports in Australia, the UK and the US of serious adverse reactions, including paralysis, Bell’s palsy, Guillain-Barré syndrome, and several deaths.” This is inaccurate as they have no evidence where they got this information or when this reaction occurred. When people see information like “paralysis, Bell’s palsy and Guillain- Barré syndrome” people drawback. When scientific language is used people struggle to comprehend the meaning in the information. People who have no experience in an area of science can claim to be experts, and their personal point of view can be picked up as fact rather than opinion. Adverse reaction or death is generally reported through social media etc. Some individuals receiving the vaccine have reported side-effects from the vaccine, however without a full analysis of other factors involved, it is difficult to be certain on the surface what was an underlying or unrelated health problem. This information is biased as there is no scientific information backing it up.
Another biological idea is “the vaccine was not well studied in children and adolescents saying that “there is absolutely no evidence that the vaccine prevents anything when administered at this young age.”” This is inaccurate because this information has been outdated. It’s been over a decade since this article was produced. There are two vaccines for preventing the most significant HPV types associated with cervical cancer. Both vaccines have been tested in tens of thousands of people in many countries, including New Zealand. This information was biased as they selected information for their liking from older time periods.
The overall statement of this article is that it has bias representation of all the problems of the vaccine, showing only one side of the vaccine. This article was written nearly a decade ago and some of the information presented is outdated. The public may take this information in here as accurate as it has medical professionals interviews on it. Also some of the information in this article has no evidence to back it up. In the end most of the information in the article irrelevant as this article is outdated.
My opinion and reasoning
Parents need to be well informed regarding all aspects of their child’s health and safety. General Practitioners are an excellent source of evidence based information regarding disease information, prevention, and treatment. While the national immunisation schedule is recommended for all children, there may be certain specific circumstances in which a child should not receive specific vaccines, known as contraindications. There are a number of conditions that are contraindications to vaccination. If one of these is present the person should not be vaccinated. Contraindications vary for different vaccines, for example of contraindications are anaphylactic or certain immunes deficiencies such as leukaemia etc.
The vaccines licensed in NZ are effective at preventing disease. Each vaccine licensed in New Zealand and used in the Immunisation Schedule has been implemented because of extensively researched and peer reviewed evidence of efficacy. For example, the efficacy of measles vaccine is about 98% after 2 doses, and the current whooping cough vaccine used in New Zealand has an efficacy of 86% after 3 doses. Vaccinated children can still get disease because no vaccine is 100% protective. If 95% of children are immunised with a vaccine that protects 95% of vaccines then half the cases of disease will be among immunised children. For example, if there is a measles outbreak in classroom of 30 children, 27 whom are vaccinated, the 3 unvaccinated children will be protected. To maximise vaccine efficacy from some diseases, at least 95% of the population must be vaccinated on time, according to the national schedule. A recent New Zealand study found that low vaccine coverage rates along with delayed immunisation were significant factors contributing to infant hospitalisation with whooping cough. In similar study, infants who were behind with their immunisations, or who are unimmunised, were 4-6 times more likely to be admitted to hospital with whooping cough. These studies further emphasise the need got high immunisation coverage rate with timely administration according to the childhood schedule.
Commenting on my gathered sources
The vast amount of information available about immunisation. Parents need to seek out the most scientifically accurate and credible information when looking for answers to immunisation concerns. Studies have shown that many anti-vaccination websites are not supported by scientific evidence that they rely on emotional appeal to convert their message. It is important that when evaluating information parents are critical and retain an open minded approach. Science is not always perfect but provides the best tools for evaluating available data.