The World Marks Immunisation Week 21-28 April 2013

Posted on April 24, 2013

The World Health Assembly, which is the decision-making body of WHO, took a resolution in May 2012 that immunisation is the most cost effective intervention in public health and that it should be recognized as a core component of the human right to health.

This resolution resulted in new goals.

· To achieve 90% vaccination coverage for each country nationally and 80% in every district by 2020.

· Ending preventable child death from pneumonia and diarrhoea by 2015.

It is estimated that between 2 and 3 million deaths can be averted annually through immunisation, and diseases and disability due to disease are also preventable. From infants to senior citizens, immunisation protects against diseases such as diphtheria, measles, pertussis (whooping cough), pneumonia, polio, diarrhoea, tetanus. The benefits of immunisation are increasingly being extended to adolescents and adults, providing protection against life-threatening diseases such as influenza, meningitis, and cancers. Successful immunisation programmes have therefore achieved global health goals particularly in reducing childhood mortality and morbidity, and for reducing mortality and morbidity across the life-course.

Vaccines are safe but they might also result in some side effects, as any medicine can cause adverse reactions in some people. Many children do not develop side effects to vaccines except for minor illness. The most common side effects are swelling around the area of vaccination and fever, but serious reactions are very rare. However, it is in the best interest of the child to get immunised, because failure to do so could result in severe cases of disability or even death.

In South Africa, the targets of the Department of Health are in line with the global targets set at 90% by 2013, and 95% by 2016. South Africa is the first country to introduce Rotavirus and pneumococcus vaccination in the routine immunisation schedule from the year 2009 at no extra cost to the patient. The district health barometer released a report that children under one year nationally meet a target of 90% vaccination coverage, although there are inequalities as districts and some provinces have not reach the target.

South Africa has been declared polio free since 2006 and neonatal tetanus has been eliminated. However, we had a measles outbreak in 2009 that lasted until January 2011, where 18 000 cases were reported. This highlights the fact that we cannot be complacent and must maintain high immunisation coverage in our society.

The Department of Health is on the right track with its policy with regard to routine immunisation of children but there are gaps in implementation as evidenced by the measles outbreaks, reports of vaccine stock shortage as well as a shortage of health care workers to provide the services.

Immunisation is effective in preventing illnesses and death due to vaccine-preventable diseases, and the world bears witness to the effective eradication of smallpox due to immunisations. In South Africa, polio has also been eradicated since 2006 (although there are no new cases reported there are still adults who are disabled due to polio). Fewer children die as a result of suffering from pneumonia, measles and diarrhoea, and this has also been attributed to robust vaccination programmes.

In honouring the WIW in South Africa and to strive to maintain polio-free status and also to eliminate measles, the Department of Health has planned a national polio and measles vaccination campaign from 29 April to 17 May and 17 to 28 June 2013. Two doses of polio oral drops and one measles injection will be freely administered to children at national health care centres throughout the country. Although the focus is on the routine immunisation of children, there are also other vaccines which benefit adults, for example flu vaccine and travel vaccines (the latter will involve some cost).

Despite all its achievements in Immunisation, the Department of Health has to resolve problems that prevent districts from reaching their immunisation coverage and it should start assessing the possibility of adding other vaccines like human papilloma virus, which prevent cervical cancer. Vaccination at schools should also be intensified as it benefits older children: they can receive their vaccines without missing school.

  • Dr Mphelekedzeni Mulaudzi is a specialist paediatrician from the University of Pretoria, based at Kalafong Hospital.

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