CHILDHOOD IMMUNISATIONS

The Isle of Man follows the same Childhood Immunisation Programme carried out within the UK.

Immunisation protects children against harmful infections before they come into contact with them in the community. Immunisation uses the body’s natural defence mechanism – the immune response - to build resistance to specific infections. Immunisation helps children stay healthy by preventing serious infections. If a child does not receive all the recommended doses he/she will remain susceptible to those diseases and may become sick if exposed to those diseases. Immunisation is not compulsory but is highly recommended for all children.

How does immunisation work?

All forms of immunisation work in the same way. When someone is injected with a vaccine, their body produces an immune response in the same way as it would following exposure to a disease. If the person comes in contact with the disease in the future, the body is able to produce a good level of antibodies fast enough to prevent the person developing the disease or developing a severe case of the disease.

What is in the vaccines?

The majority of vaccines contain a very small dose of killed/inactivated bacteria or virus or small fractions of the killed/inactivated virus or bacteria.

A small number of vaccines contain a small dose of a modified toxin produced by bacteria.

A small number of vaccines contain a very small dose of a live, but very weakened form of the virus or mycobacterium.

How long does it take for the vaccines to work?

In general, the normal immune response takes approximately 10 to 14 days to work. This means that protection from infection will not occur immediately after immunisation.

Why are vaccines given at 2 months of age?

Following birth the baby will have some antibodies that have passed from the blood of the mother – this is called passive immunity. This type of immunity doesn’t last very long. By the time the baby gets to two months of age most of these antibodies will have disappeared and the baby then needs to make its own antibodies which will last many years.

To give good protection against some diseases up to three doses of the vaccine may be necessary. This is what is called a primary course of immunisations. In some instances a reinforcing dose is needed some months or years later. This is referred to as a booster – it reminds the immune system that a good level of protection is required.

Can immunisations overload the immune system?

No. Everybody including babies and young children are in contact with bacteria and viruses (antigens) all day every day and the body has the ability to respond to millions of these antigens easily. Without a vaccine, your child can only develop antibodies and become immune by being exposed to the disease. With exposure to the disease itself is the risk of severe illness, possible disability from complications of the disease, and death in some cases. The Risks associated with vaccination are low in comparison to the risks associated with the infection, which in some diseases the risks from the disease itself are extremely high.

Why do we need to vaccinate if the diseases have disappeared?

The diseases that we vaccinate against and therefore offer protection to, haven’t disappeared across the globe. It is only through vaccination that the spread of diseases can be controlled. Each disease has a different level of infectiousness and there is a level of immunisation in the community that we need to maintain to keep this disease at bay, the diseases themselves don’t fully go away. When the immunisation rate goes down, we then see more of the disease – as happened with measles mumps and rubella. Once the number of children being immunised goes over 95% we can truly say that we have herd immunity. This means that the children who haven’t been able to have the vaccinations because of ill health are protected by those children who have antibodies to protect them. In other parts of the world, including Europe, the vaccination rates may not be high enough to control the disease and if you visit these countries, or their population visit our shores, there is a risk of disease in those who are unimmunised.

Diphtheria

Diphtheria is a serious disease that usually begins with a sore throat and can quickly cause breathing problems. It can damage the heart and nervous system, and in severe cases, it kills about 7% of people with the disease. Before the diphtheria vaccine was introduced in this country, there were more than 61,000 cases of diphtheria a year, causing over 3,000 deaths. In 1957 there were 38 cases of diphtheria and six deaths. This demonstrates how effective the vaccine is.

Tetanus

Tetanus is a disease which affects the nervous system which can lead to muscle spasms, causing breathing problems and it can kill. It used to be known as ‘lockjaw’ because early in the disease process the muscles of the jaw go in to spasm and the jaw cannot be moved. The tetanus bacteria are found in soil and manure and get into the body through open cuts and burns. Tetanus cannot be passed from person to person.

Pertussis (whooping cough)

Whooping cough is a highly contagious disease causing long bouts of coughing and choking, making it hard to breathe. The child gasps for air making a ‘whoop’ sound. Whooping cough can last for up to 10 weeks without treatment. Babies under one year of age are most at risk from whooping cough. For these babies, the disease is very serious and it can kill. It is not usually so serious in older children. Before the pertussis vaccine was introduced, the average number of cases of whooping cough reported each year in the UK was 120,000 and 92 children died in the year before the vaccine was introduced. In 2009 717 cases were reported with an estimated 9 deaths in England each year.

Polio

Polio is a virus which attacks the nervous system, the symptoms vary from no symptoms to permanent paralysis of any muscle in the body. If it affects the muscles of breathing or the brain, polio could lead to death.

Before the polio vaccine was introduced, there were as many as 8000 cases of polio in the UK in epidemic years. Because of the success of the vaccine, there have been no cases of natural polio infection in the UK since 1984.

Haemophilus influenzae type B (Hib)

Hib is an infection caused by Haemophilus influenza type b bacteria. It can lead to a number of major illnesses such as blood poisoning (septicaemia), infection of the lungs (pneumonia) and infection of the lining of the brain (meningitis). The illnesses caused by Hib can kill if they are not treated quickly. Before the Hib vaccine was introduced in 1992, there were about 800 cases of Hib in young children every year in England and Wales. The number of children under five years with Hib in 1998 was 21 – this is a very effective vaccine.

Pneumococcal disease

Pneumococcal bacteria cause infection around the lining of the brain (meningitis), blood poisoning (septicaemia) and infection of the lungs (pneumonia). Children under the age of 2 years are most at risk of these serious illnesses also known as invasive pneumococcal disease (IPD). Children are also most at risk of middle ear infections from the pneumococcal bacteria. In England and Wales during the period from July 2005 to June 2006, there were 797cases of IPD in children under 5 years old. From July 2007 and June 2008, the number had dropped by 41% to 470 reported cases.

The vaccine is called Prevenar 13 and protects against the 13 most common strains to cause infection in under 2 year olds.

Meningococcal Disease

The bacteria which causes meningococcal disease is commonly found in the back of the nose and throat in 10% to 25% of the population. It is not fully understood why some people develop the disease which presents as infection of the lining of the brain (meningitis) or blood poisoning (septicaemia) or both meningitis with septicaemia. There are different strains or types of the meningococcal bacteria which causes disease. We have a vaccine against type C - the Men C vaccine is highly effective. There were 78 deaths from meningococcal disease in the year before the introduction of the vaccine. In the last 5 years there have been 2 deaths in children and young people. Scientists are working on developing a vaccine against the meningococcal bacteria type B which causes most meningococcal disease now.

The following information has been taken from the NHS Vaccination Booklet Immunisation up to 13 months of age 404312 Feb11 issued by the Department of Health.

Immunisation Schedule: 0-13 months and Pre-School Vaccinations

Non-routine immunisations for at risk babies

Remember, it’s never too late to have your child immunised. Even if your child has missed an immunisation and is older than the recommended ages, talk to your doctor, practice nurse or health visitor to arrange for your child to be immunised.

Unfortunately, the Isle of Man Government, Department of Health can no longer supply printed copies of these UK NHS booklets. Downloadable versions can still be accessed below if required.

Click Image	Ref No.	Name
	IMM01 Feb 2012	Childhood Immunisation Guidance Booklet
	NHS 404312 Feb11	Immunisation up to 13 months of age
	NHS 404313 Jan 11	Immunisations between 12 and 13 months of age – within a month of the first birthday
	NHS 404594 Nov 10	Pre-school immunisations A guide to vaccinations at three years and four months of age
	NHS Choices Website Link	Create your own Vaccination Planner for your child NHS Choices also have useful guidance pages on vaccinations to view these pages click this link: www.nhs.uk/vaccinations
	NHS 404119 Dec 10	Routine childhood immunisations from November 2010

All health professionals that give immunisations or provide information and advice should link here to the UK - Department of Health 'Green Book' which gives a comprehensive and invaluable source of current information.

Updated October 2011 / Review October 2012