Government must recognise immunisation as a public health priority
Boosting the uptake of vaccinations here at home could provide a much-needed shot in the arm for our struggling health service, writes Dr Philippa Whitford
With the impact of this winter’s influenza outbreak on all four UK NHS systems, attention has turned to the falling uptake of the flu vaccine and gives us the opportunity to consider vaccination in general.
Immunisation is one of the most cost-effective ways to prevent illness and is up there with clean water and antibiotics in contributing to the reduction in infectious diseases and death, particularly among children, across the world. Improving health is a benefit in itself but it has also been shown to improve economic development in poorer countries.
Vaccination has led to a dramatic reduction in the threat from serious infectious diseases that were once commonplace. Smallpox was completely eradicated in 1977 through a global vaccination programme and, through a similar approach, the world is now close to eradicating polio. There have been no naturally occurring cases in the UK since 1984 but, before the vaccine was introduced in 1956, epidemics caused up to 7,000 cases of paralytic polio in the UK each year, with up to 750 deaths. The eradication of polio will be a cause for celebration but it is important that the intensive polio campaign is then replaced by a more systematic approach to achieving comprehensive vaccination with the 11 key childhood vaccines that are recommended by the World Health Organisation (WHO).
While there is a strong drive to improve vaccination for children in developing countries, uptake in the UK has dwindled, even falling below the WHO safe level for some vaccines. The reduction in life-threatening or disabling illnesses, due to immunisation, has led to complacency about the need for their ongoing use. Measles has come to be seen as a trivial condition in the UK while it is actually a killer and cause of blindness in developing countries. The totally spurious campaign against the measles, mumps and rubella vaccine has left many young adults in the UK and Europe unvaccinated and has led to significant, and indeed fatal, outbreaks in recent years.
These two key challenges are the reasons why I established the All-Party Parliamentary Group on Vaccination. We are in the process of establishing our first inquiry into how more comprehensive and systematic vaccination programmes could be established in the developing world as the polio campaign nears its end. Our remit is also to raise awareness of the benefits of vaccination within the UK and try to counter the anti-vaccine sentiment which is growing and has, unfortunately, been espoused by the US president in one of his tweets.
Despite a common perception that immunisation is mainly for children, the elderly are offered vaccination against pneumococcal pneumonia, shingles and influenza, while meningococcal and HPV programmes specifically target adolescents. The latter vaccine also has the potential to virtually eliminate cervical cancer if high uptake is maintained and the vaccine is also offered to boys. Research is also ongoing to develop specific anti-cancer vaccines.
Vaccination can also help the global fight against the biggest threat to modern medical practice – antimicrobial resistance (AMR). The development of antibiotics was the greatest medical breakthrough of the 20th century but resistance to all antimicrobials is rising. Unless a solution is found, it will become increasingly difficult to control infection in a range of routine medical settings which, in turn, would limit our ability to safely carry out invasive procedures or surgery. By helping to prevent infectious diseases in the first place, vaccines could reduce the widespread use of antimicrobials and research is also underway to develop vaccines against the multi-drug resistant organisms that already impact healthcare settings, such as MRSA and clostridium difficile.
There are inequalities associated with the coverage and uptake of vaccines among different social and cultural groups across the UK. All governments must recognise immunisation as a public health priority and take action to ensure easy accessibility and high uptake across all groups.
Dr Philippa Whitford is SNP MP for Central Ayrshire and chair of the Vaccinations for All APPG
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